‘Hearts and minds’: association, causation and implication of cognitive impairment in heart failure

The clinical syndrome of heart failure is one of the leading causes of hospitalisation and mortality in older adults. An association between cognitive impairment and heart failure is well described but our understanding of the relationship between the two conditions remains limited. In this review we provide a synthesis of available evidence, focussing on epidemiology, the potential pathogenesis, and treatment implications of cognitive decline in heart failure. Most evidence available relates to heart failure with reduced ejection fraction and the syndromes of chronic cognitive decline or dementia. These conditions are only part of a complex heart failure-cognition paradigm. Associations between cognition and heart failure with preserved ejection fraction and between acute delirium and heart failure also seem evident and where data are available we will discuss these syndromes. Many questions remain unanswered regarding heart failure and cognition. Much of the observational evidence on the association is confounded by study design, comorbidity and insensitive cognitive assessment tools. If a causal link exists, there are several potential pathophysiological explanations. Plausible underlying mechanisms relating to cerebral hypoperfusion or occult cerebrovascular disease have been described and it seems likely that these may coexist and exert synergistic effects. Despite the prevalence of the two conditions, when cognitive impairment coexists with heart failure there is no specific guidance on treatment. Institution of evidence-based heart failure therapies that reduce mortality and hospitalisations seems intuitive and there is no signal that these interventions have an adverse effect on cognition. However, cognitive impairment will present a further barrier to the often complex medication self-management that is required in contemporary heart failure treatment

Fermions out of Dipolar Bosons in the lowest Landau level

In the limit of very fast rotation atomic Bose-Einstein condensates may reside entirely in the lowest two-dimensional Landau level (LLL). For small enough filling factor of the LLL, one may have formation of fractional quantum Hall states. We investigate the case of bosons with dipolar interactions as may be realized with Chromium-52 atoms. We show that at filling factor equal to unity the ground state is a Moore-Read (a.k.a Pfaffian) paired state as is the case of bosons with purely s-wave scattering interactions. This Pfaffian state is destabilized when the interaction in the s-wave channel is small enough and the ground state is a stripe phase with unidimensional density modulation. For filling factor 1/3, we show that there is formation of a Fermi sea of ``composite fermions''. These composites are made of one boson bound with three vortices. This phase has a wide range of stability and the effective mass of the fermions depends essentially only of the scattering amplitude in momentum channels larger or equal to 2. The formation of such a Fermi sea opens up a new possible route to detection of the quantum Hall correlations.Comment: 12 pages, 5 figures, published versio

Triple cascade behaviour in QG and drift turbulence and generation of zonal jets

We study quasigeostrophic (QG) and plasma drift turbulence within the Charney-Hasegawa-Mima (CHM) model. We focus on the zonostrophy, an extra invariant in the CHM model, and on its role in the formation of zonal jets. We use a generalized Fjørtoft argument for the energy, enstrophy, and zonostrophy and show that they cascade anisotropically into nonintersecting sectors in k space with the energy cascading towards large zonal scales. Using direct numerical simulations of the CHM equation, we show that zonostrophy is well conserved, and the three invariants cascade as predicted by the Fjørtoft argument

Uncovering CDM halo substructure with tidal streams

Models for the formation and growth of structure in a cold dark matter dominated universe predict that galaxy halos should contain significant substructure. Studies of the Milky Way, however, have yet to identify the expected few hundred sub-halos with masses greater than about 10^6 Msun. Here we propose a test for the presence of sub-halos in the halos of galaxies. We show that the structure of the tidal tails of ancient globular clusters is very sensitive to heating by repeated close encounters with the massive dark sub-halos. We discuss the detection of such an effect in the context of the next generation of astrometric missions, and conclude that it should be easily detectable with the GAIA dataset. The finding of a single extended cold stellar stream from a globular cluster would support alternative theories, such as self-interacting dark matter, that give rise to smoother halos.Comment: 7 pages, 7 figures, submitted to MNRA

The Role of Cold Flows in the Assembly of Galaxy Disks

We use high resolution cosmological hydrodynamical simulations to demonstrate that cold flow gas accretion, particularly along filaments, modifies the standard picture of gas accretion and cooling onto galaxy disks. In the standard picture, all gas is initially heated to the virial temperature of the galaxy as it enters the virial radius. Low mass galaxies are instead dominated by accretion of gas that stays well below the virial temperature, and even when a hot halo is able to develop in more massive galaxies there exist dense filaments that penetrate inside of the virial radius and deliver cold gas to the central galaxy. For galaxies up to ~L*, this cold accretion gas is responsible for the star formation in the disk at all times to the present. Even for galaxies at higher masses, cold flows dominate the growth of the disk at early times. Within this modified picture, galaxies are able to accrete a large mass of cold gas, with lower initial gas temperatures leading to shorter cooling times to reach the disk. Although star formation in the disk is mitigated by supernovae feedback, the short cooling times allow for the growth of stellar disks at higher redshifts than predicted by the standard model.Comment: accepted to Ap

Derivation of Delay Equation Climate Models Using the Mori-Zwanzig Formalism

Models incorporating delay have been frequently used to understand climate variability phenomena, but often the delay is introduced through an ad-hoc physical reasoning, such as the propagation time of waves. In this paper, the Mori-Zwanzig formalism is introduced as a way to systematically derive delay models from systems of partial differential equations and hence provides a better justification for using these delay-type models. The Mori-Zwanzig technique gives a formal rewriting of the system using a projection onto a set of resolved variables, where the rewritten system contains a memory term. The computation of this memory term requires solving the orthogonal dynamics equation, which represents the unresolved dynamics. For nonlinear systems, it is often not possible to obtain an analytical solution to the orthogonal dynamics and an approximate solution needs to be found. Here, we demonstrate the Mori-Zwanzig technique for a two-strip model of the El Nino Southern Oscillation (ENSO) and explore methods to solve the orthogonal dynamics. The resulting nonlinear delay model contains an additional term compared to previously proposed ad-hoc conceptual models. This new term leads to a larger ENSO period, which is closer to that seen in observations.Comment: Submitted to Proceedings of the Royal Society A, 25 pages, 10 figure