Magnetic fields inferred by Solar Orbiter: A comparison between SO/PHI-HRT and SDO/HMI

Context. The High Resolution Telescope (HRT) of the Polarimetric and Helioseismic Imager on board the Solar Orbiter spacecraft (SO/PHI) and the Helioseismic and Magnetic Imager (HMI) on board the Solar Dynamics Observatory (SDO) both infer the photospheric magnetic field from polarised light images. SO/PHI is the first magnetograph to move out of the Sun–Earth line and will provide unprecedented access to the Sun’s poles. This provides excellent opportunities for new research wherein the magnetic field maps from both instruments are used simultaneously. Aims. We aim to compare the magnetic field maps from these two instruments and discuss any possible differences between them. Methods. We used data from both instruments obtained during Solar Orbiter’s inferior conjunction on 7 March 2022. The HRT data were additionally treated for geometric distortion and degraded to the same resolution as HMI. The HMI data were re-projected to correct for the 3° separation between the two observatories. Results. SO/PHI-HRT and HMI produce remarkably similar line-of-sight magnetograms, with a slope coefficient of 0.97, an offset below 1 G, and a Pearson correlation coefficient of 0.97. However, SO/PHI-HRT infers weaker line-of-sight fields for the strongest fields. As for the vector magnetic field, SO/PHI-HRT was compared to both the 720-second and 90-second HMI vector magnetic field: SO/PHI-HRT has a closer alignment with the 90-second HMI vector. In the weak signal regime (< 600 G), SO/PHI-HRT measures stronger and more horizontal fields than HMI, very likely due to the greater noise in the SO/PHI-HRT data. In the strong field regime (≳600 G), HRT infers lower field strengths but with similar inclinations (a slope of 0.92) and azimuths (a slope of 1.02). The slope values are from the comparison with the HMI 90-second vector. Possible reasons for the differences found between SO/PHI-HRT and HMI magnetic field parameters are discussed.Sección Deptal. de Óptica (Óptica)Fac. de Óptica y OptometríaTRUEBMWi - Bundesministerium für Wirtschaft und Energie (Alemania)AEI/MCIN/10.13039/501100011033Ministerio de ciencia e innovación de EspañaInstituto Astrofísico de Andalucía (España)Agencia Estatal de Investigación (España)Fondo Europeo de Desarrollo Regional (Fondos FEDER)Centre national d'études spatiales (CNES) (Francia)CSIC (Centro Superior de Investigaciones Científicas) (España)pu

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

25th annual computational neuroscience meeting: CNS-2016

The same neuron may play different functional roles in the neural circuits to which it belongs. For example, neurons in the Tritonia pedal ganglia may participate in variable phases of the swim motor rhythms [1]. While such neuronal functional variability is likely to play a major role the delivery of the functionality of neural systems, it is difficult to study it in most nervous systems. We work on the pyloric rhythm network of the crustacean stomatogastric ganglion (STG) [2]. Typically network models of the STG treat neurons of the same functional type as a single model neuron (e.g. PD neurons), assuming the same conductance parameters for these neurons and implying their synchronous firing [3, 4]. However, simultaneous recording of PD neurons shows differences between the timings of spikes of these neurons. This may indicate functional variability of these neurons. Here we modelled separately the two PD neurons of the STG in a multi-neuron model of the pyloric network. Our neuron models comply with known correlations between conductance parameters of ionic currents. Our results reproduce the experimental finding of increasing spike time distance between spikes originating from the two model PD neurons during their synchronised burst phase. The PD neuron with the larger calcium conductance generates its spikes before the other PD neuron. Larger potassium conductance values in the follower neuron imply longer delays between spikes, see Fig. 17.Neuromodulators change the conductance parameters of neurons and maintain the ratios of these parameters [5]. Our results show that such changes may shift the individual contribution of two PD neurons to the PD-phase of the pyloric rhythm altering their functionality within this rhythm. Our work paves the way towards an accessible experimental and computational framework for the analysis of the mechanisms and impact of functional variability of neurons within the neural circuits to which they belong

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

An Image is Worth a Thousand Numbers. Transesophageal Echocardiography Monitoring in Cardiac Surgery

Background: Transesophageal echocardiography (TEE), a technique with almost universal applicability, is being used withincreasing frequency in the operating room, and the use of a miniaturized device for hemodynamic monitoring based on TEEis particularly useful in critically ill patients during the postoperative period.Objectives: The aim of this study was to evaluate the use of a miniaturized device for hemodynamic monitoring based on TEEanalyzing the number of patients evaluated, the hemodynamic findings and the associated complications.Methods: Unstable patients undergoing surgery were included between October 2010 and July 2012.Results: The device was used in 252/1,435 (17.6%) patients; hypovolemia was the main finding in 165 (73.4%) patients. Mediastinalhematoma was detected in 4 patients (1.6%) and resolved with conservative management. Eight patients (3.2%)under ventricular assist devices presented events. In the 27 patients (10.7%) undergoing delayed sternal closure, the devicehelped to determine the time to sternal closure. No associated complications were reported.Conclusions: This technique modified the initial diagnosis, and hypovolemia was the main finding. Patients with mediastinalhematoma could be managed with a conservative approach. The greatest benefit was achieved by patients under ventricularassist devices and by those undergoing delayed sternal closure. Further studies are necessary to determine the value of thistechnique.Objetivos: Valorar el empleo de una nueva sonda miniaturizada para monitoreo hemodinámico basado en ecocardiograma transesofágico continuo analizando: número de pacientes evaluados, indicaciones de utilización, hallazgos hemodinámicos, y complicaciones asociadas. Material y Métodos: Fueron incluidos pacientes intervenidos entre el 1 de Octubre de 2010 y el 1 de Julio de 2012, empleándose el dispositivo ante inestabilidad hemodinámica. Resultados: Se utilizó el dispositivo en 252(17.6%) de 1435 cirugías. Los hallazgos principales resultaron: hipovolemia en 76(71.7%) de 106 pacientes hipotensos(sin aparente hipovolemia) así como en 27(59.9%) de 52 con elevación del lactato, 22(62.9%) de 35 pacientes con bajo índice cardiaco, 19(59.4%) de 32 con elevación de presiones derechas y en 21(77.8%) bajo cierre diferido del tórax. En 4 pacientes(1.6%)se detectaron hematomas mediastinales sin taponamiento que resolvieron con manejo conservador. Ocho pacientes(3.2%) bajo implante de dispositivos de asistencia ventricular presentaron eventos de succión manejados con el cambio de parámetros del dispositivo. En los 27 pacientes(10.7%) bajo cierre diferido del tórax determino el momento para el cierre definitivo.  No hubo complicaciones asociadas. Conclusiones: 1) Esta técnica modifico el diagnóstico inicial en pacientes inestables resultando la hipovolemia el principal hallazgo. 2) Pacientes con hematomas mediastinales pudieron manejarse en forma conservadora. 3) En pacientes bajo implante de dispositivos de asistencia ventricular permitió su manejo hemodinámico valorando disfunción derecha, eventos de succión y posición de la cánula de influjo. 4) En pacientes con cierre diferido del tórax determino el momento del cierre. 5) Mayor experiencia determinara el valor de esta técnica

The on-ground data reduction and calibration pipeline for SO/PHI-HRT

The ESA/NASA Solar Orbiter space mission has been successfully launched in February 2020. Onboard is the Polarimetric and Helioseismic Imager (SO/PHI), which has two telescopes, a High Resolution Telescope (HRT) and the Full Disc Telescope (FDT). The instrument is designed to infer the photospheric magnetic field and line-of-sight velocity through differential imaging of the polarised light emitted by the Sun. It calculates the full Stokes vector at 6 wavelength positions at the Fe I 617.3 nm absorption line. Due to telemetry constraints, the instrument nominally processes these Stokes profiles onboard, however when telemetry is available, the raw images are downlinked and reduced on ground. Here the architecture of the on-ground pipeline for HRT is presented, which also offers additional corrections not currently available on board the instrument. The pipeline can reduce raw images to the full Stokes vector with a polarimetric sensitivity of 10−3⋅Ic or better.Sección Deptal. de Óptica (Óptica)Fac. de Óptica y OptometríaTRUEBMWi - Bundesministerium für Wirtschaft und Energie (Alemania)MPG - Max-Planck-Gesellschaft (Alemania)Ministerio de Ciencia e Innovación de España - MCIUInstituto de Astrofísica de Andalucía - CSIC (España)CNES - Centre National d'études spatiales (Francia)Fondos FEDERAgencia Estatal de Investigación - AEI (ESpaña)pu

Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

BACKGROUNDRight hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIMTo investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODSThis is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTSThree hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P &lt; 0.01), had lower American Society of Anesthesiology score (ASA) grade (P &lt; 0.01) and less comorbidity (P &lt; 0.01), but were more likely to be current smokers (P &lt; 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P &lt; 0.01) and frequently underwent ileocecal resection (P &lt; 0.01) with higher rate of de-functioning/primary stoma construction (P &lt; 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P &lt; 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSIONPatients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complication's rate was not different between the two groups