Development of an international standard set of outcome measures for patients with atrial fibrillation: a report of the International Consortium for Health Outcomes Measurement (ICHOM) atrial fibrillation working group.

AIMS: As health systems around the world increasingly look to measure and improve the value of care that they provide to patients, being able to measure the outcomes that matter most to patients is vital. To support the shift towards value-based health care in atrial fibrillation (AF), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international Working Group (WG) of 30 volunteers, including health professionals and patient representatives to develop a standardized minimum set of outcomes for benchmarking care delivery in clinical settings. METHODS AND RESULTS: Using an online-modified Delphi process, outcomes important to patients and health professionals were selected and categorized into (i) long-term consequences of disease outcomes, (ii) complications of treatment outcomes, and (iii) patient-reported outcomes. The WG identified demographic and clinical variables for use as case-mix risk adjusters. These included baseline demographics, comorbidities, cognitive function, date of diagnosis, disease duration, medications prescribed and AF procedures, as well as smoking, body mass index (BMI), alcohol intake, and physical activity. Where appropriate, and for ease of implementation, standardization of outcomes and case-mix variables was achieved using ICD codes. The standard set underwent an open review process in which over 80% of patients surveyed agreed with the outcomes captured by the standard set. CONCLUSION: Implementation of these consensus recommendations could help institutions to monitor, compare and improve the quality and delivery of chronic AF care. Their consistent definition and collection, using ICD codes where applicable, could also broaden the implementation of more patient-centric clinical outcomes research in AF

Freshening by glacial meltwater enhances melting of ice shelves and reduces formation of Antarctic Bottom Water

Strong heat loss and brine release during sea ice formation in coastal polynyas act to cool and salinify waters on the Antarctic continental shelf. Polynya activity thus both limits the ocean heat flux to the Antarctic Ice Sheet and promotes formation of Dense Shelf Water (DSW), the precursor to Antarctic Bottom Water. However, despite the presence of strong polynyas, DSW is not formed on the Sabrina Coast in East Antarctica and in the Amundsen Sea in West Antarctica. Using a simple ocean model driven by observed forcing, we show that freshwater input from basal melt of ice shelves partially offsets the salt flux by sea ice formation in polynyas found in both regions, preventing full-depth convection and formation of DSW. In the absence of deep convection, warm water that reaches the continental shelf in the bottom layer does not lose much heat to the atmosphere and is thus available to drive the rapid basal melt observed at the Totten Ice Shelf on the Sabrina Coast and at the Dotson and Getz ice shelves in the Amundsen Sea. Our results suggest that increased glacial meltwater input in a warming climate will both reduce Antarctic Bottom Water formation and trigger increased mass loss from the Antarctic Ice Sheet, with consequences for the global overturning circulation and sea level rise

Solve Antarctica’s sea-ice puzzle

John Turner and Josefino Comiso call for a coordinated push to crack the baffling rise and fall of sea ice around Antarctica

Biomechanical predictors of ball velocity during punt kicking in elite rugby league kickers

Punt kicking is integral to the attacking and defensive elements of rugby league and the ability to kick the ball with high velocity is desirable. This study aimed to identify important technical aspects of kicking linked to the generation of ball velocity. Maximal punt kicks were obtained from six elite rugby league kickers using a 10-camera motion capture system. Three-dimensional kinematics of the lower extremities was obtained. Regression analysis with ball velocity as criterion was used to identify the kinematic parameters associated with the development of ball velocity. The regression model yielded an adj R2¼0.76, p�0.01. Two parameters were identified: knee extension angular velocity of the kicking limb at impact (R2¼0.50) and peak flexion angular velocity of the kicking hip (R2¼0.26, p�0.01). It is conceivable that players may benefit from exposure to coaching and strength techniques geared toward the modification of kicking mechanics specific to this stud

The Evolution of Compact Binary Star Systems

We review the formation and evolution of compact binary stars consisting of white dwarfs (WDs), neutron stars (NSs), and black holes (BHs). Binary NSs and BHs are thought to be the primary astrophysical sources of gravitational waves (GWs) within the frequency band of ground-based detectors, while compact binaries of WDs are important sources of GWs at lower frequencies to be covered by space interferometers (LISA). Major uncertainties in the current understanding of properties of NSs and BHs most relevant to the GW studies are discussed, including the treatment of the natal kicks which compact stellar remnants acquire during the core collapse of massive stars and the common envelope phase of binary evolution. We discuss the coalescence rates of binary NSs and BHs and prospects for their detections, the formation and evolution of binary WDs and their observational manifestations. Special attention is given to AM CVn-stars -- compact binaries in which the Roche lobe is filled by another WD or a low-mass partially degenerate helium-star, as these stars are thought to be the best LISA verification binary GW sources.Comment: 105 pages, 18 figure

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente