Antiplatelet therapy is not a safer alternative to oral anticoagulants, even in older hospital-discharged patients with atrial fibrillation

Although oral anticoagulant therapy (OAT) is recommended for patients with atrial fibrillation (AF), it is widely underused among older patients, who are frequently prescribed antiplatelet therapy (APT) instead. We assessed mortality and incidence of ischemic and hemorrhagic events according to prescription of OAT or APT in older medical in-patients with AF discharged from hospital. Stroke and bleeding risk were evaluated using the CHA2DS2-VASC (Congestive heart failure/ left ventricular dysfunction, Hypertension, Aged ≥75 years, Diabetes Mellitus, Stroke/transient ischemic attack/systemic embolism, Vascular Disease, Aged 65-74 years, Sex Category) and HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly, Drugs/alcohol concomitantly) scores. Comorbidity, cognitive status and functional autonomy were assessed using standardized scales. Association of OAT and APT with overall mortality, ischemic stroke and bleeding events was evaluated through multivariate analysis and propensity score matching. During a mean follow-up period of 11 months 384 of the 962 patients discharged (mean age 82.9±6.6 years, 59.1% female) died (39.9%), 66 had an ischemic stroke and 49 experienced a major bleeding event. Compared with APT, OAT was associated with reduced overall mortality after multivariate analysis [odds ratio (OR) 0.62, confidence interval (CI): 0.46-0.83] and after propensity score matched analysis (OR 0.65, CI: 0.52-0.82, P=0.0004), with a not significant reduced incidence of total and fatal ischemic stroke, and without increase in total, intracranial, major and fatal bleedings. In a sample of older AF patients with poor health status, OAT was associated with reduced mortality, without evidence of a significant increase in major or fatal bleedings

Variations in the amount of water ice on Ceres' surface suggest a seasonal water cycle.

The dwarf planet Ceres is known to host a considerable amount of water in its interior, and areas of water ice were detected by the Dawn spacecraft on its surface. Moreover, sporadic water and hydroxyl emissions have been observed from space telescopes. We report the detection of water ice in a mid-latitude crater and its unexpected variation with time. The Dawn spectrometer data show a change of water ice signatures over a period of 6 months, which is well modeled as ~2-km2 increase of water ice. The observed increase, coupled with Ceres' orbital parameters, points to an ongoing process that seems correlated with solar flux. The reported variation on Ceres' surface indicates that this body is chemically and physically active at the present time

Nature, formation, and distribution of carbonates on Ceres

Different carbonates have been detected on Ceres, and their abundance and spatial distribution have been mapped using a visible and infrared mapping spectrometer (VIR), the Dawn imaging spectrometer. Carbonates are abundant and ubiquitous across the surface, but variations in the strength and position of infrared spectral absorptions indicate variations in the composition and amount of these minerals. Mg-Ca carbonates are detected all over the surface, but localized areas show Na carbonates, such as natrite (Na_2CO_3) and hydrated Na carbonates (for example, Na_2CO_3·H_2O). Their geological settings and accessory NH_4-bearing phases suggest the upwelling, excavation, and exposure of salts formed from Na-CO_3-NH_4-Cl brine solutions at multiple locations across the planet. The presence of the hydrated carbonates indicates that their formation/exposure on Ceres’ surface is geologically recent and dehydration to the anhydrous form (Na_2CO_3) is ongoing, implying a still-evolving body

One Year of Observations of Dawn at Ceres: Composition as seen by VIR

NASA's Dawn spacecraft [1] arrived at Ceres on March 5, 2015, and has been studying the dwarf planet. The Dawn mission is observing Ceres' surface with its suite of instruments [1] including a Visible and InfraRed Mapping Spectrometer (VIR-MS) [2]. VIR-MS is an imaging spectrometer coupling high spectral and spatial resolution in the VIS (0.25-1-micron) and IR (0.95-5-micron) spectral ranges. Ceres' surface is very dark, but small localized areas exhibit unexpectedly bright materials. Since the first approach data, near infrared spectra revealed a dark surface, with a strong and complex absorption band in the spectral region around 3 microns [3]. Near-infrared spectroscopic analyses confirmed previous observation of bands at 3.1, 3.3-3.5, 3.9 micron but have clearly identified a band at 2.72 micron. This characteristic narrow feature is distinctive for OH-bearing minerals, while H2O-bearing phases, show a much broader absorption band that is a poor match for the Ceres spectrum. Water ice does not fit the observed spectrum. The 3.05-3.1 μm band is also visible in Ceres' ground-based spectra, and has been previously attributed to different phases including water ice, hydrated or NH4-bearing clays and brucite [4,5,6]. We find here that the best fit is obtained with ammoniated phyllosilicate added to a dark material (likely magnetite), antigorite and carbonate [7]. These different components, including ammoniated phases, occur everywhere across the surface although with different relative abundances [8]. Particularly interesting are the bright materials present in some craters like Occator, Haulani and Oxo that show different proportions of the components of the mixture [8]. However, the distribution of the band depths are not always linked to morphological structures. The retrieved mineralogy and composition indicates pervasive aqueous alteration of the surface, processes that are expected to be favored on large bodies like Ceres [9]. Furthermore, Ceres' low density and the presence of OH-bearing minerals, suggests a high content of water inside the body, consistent with extensive differentiation and hydrothermal activity, and possibly even a present-day liquid subsurface layer [10]. However, we note that large amounts of water ice are unlikely on the surface due to the instability of this phase at Ceres' surface temperatures [11]. On the other hand, the presence of ammoniated clays (ammonia ice is extremely volatile) together with the low density, may indicate that Ceres retained more volatiles than objects represented in the meteorite collection, or that it accreted from more volatile-rich material typical of the outer solar system [3]. References: 1] Russell, C.T. et al., Science, 336, 684, 2012. [2]De Sanctis M.C. et al., SSR, doi: I 10.1007/s11214-010-9668-5 , 2010. [3]De Sanctis M.C. et al., Nature, 2015, doi:10.1038/nature16172. [4] Lebofsky et al.,, Icarus 48, 453-459. 1981. [5] King, T.V.V. et al., Science 255, 1551-1553, 1992. [6] Rivkin, A.S. et al., , Icarus 185, 563-567, 2006. [7] Raponi A. et al., LPSC 2016. [8] Ammannito E. et al., LPSC2016. [9] McSween et al., LPSC 2016. [10] Neveu M., Desch S. J., Geophys. R. Lett., 2015. [11] Formisano M. et al., MNRAS, 2015

DETECTION OF WIDESPREAD HYDRATED MATERIALS ON VESTA BY THE VIR IMAGING SPECTROMETER ON BOARD THE DAWN MISSION

Water plays a key role in the evolution of terrestrial planets, and notably in the occurrence of Earth's oceans. However, the mechanism by which water has been incorporated into these bodies—including Earth—is still extensively debated. Here we report the detection of widespread 2.8 μm OH absorption bands on the surface of the asteroid Vesta by the VIR imaging spectrometer on board Dawn. These observations are surprising as Vesta is fully differentiated with a basaltic surface. The 2.8 μm OH absorption is distributed across Vesta's surface and shows areas enriched and depleted in hydrated materials. The uneven distribution of hydrated mineral phases is unexpected and indicates ancient processes that differ from those believed to be responsible for OH on other airless bodies, like the Moon. The origin of Vestan OH provides new insight into the delivery of hydrous materials in the main belt and may offer new scenarios on the delivery of hydrous minerals in the inner solar system, suggesting processes that may have played a role in the formation of terrestrial planets