Older adults' beliefs about physician-estimated life expectancy: a cross-sectional survey

BACKGROUND: Estimates of life expectancy assist physicians and patients in medical decision-making. The time-delayed benefits for many medical treatments make an older adult's life expectancy estimate particularly important for physicians. The purpose of this study is to assess older adults' beliefs about physician-estimated life expectancy. METHODS: We performed a mixed qualitative-quantitative cross-sectional study in which 116 healthy adults aged 70+ were recruited from two local retirement communities. We interviewed them regarding their beliefs about physician-estimated life expectancy in the context of a larger study on cancer screening beliefs. Semi-structured interviews of 80 minutes average duration were performed in private locations convenient to participants. Demographic characteristics as well as cancer screening beliefs and beliefs about life expectancy were measured. Two independent researchers reviewed the open-ended responses and recorded the most common themes. The research team resolved disagreements by consensus. RESULTS: This article reports the life-expectancy results portion of the larger study. The study group (n = 116) was comprised of healthy, well-educated older adults, with almost a third over 85 years old, and none meeting criteria for dementia. Sixty-four percent (n = 73) felt that their physicians could not correctly estimate their life expectancy. Sixty-six percent (n = 75) wanted their physicians to talk with them about their life expectancy. The themes that emerged from our study indicate that discussions of life expectancy could help older adults plan for the future, maintain open communication with their physicians, and provide them knowledge about their medical conditions. CONCLUSION: The majority of the healthy older adults in this study were open to discussions about life expectancy in the context of discussing cancer screening tests, despite awareness that their physicians' estimates could be inaccurate. Since about a third of participants perceived these discussions as not useful or even harmful, physicians should first ascertain patients' preferences before discussing their life expectancies

A diagnosis of the plasma waves responsible for the explosive energy release of substorm onset

During geomagnetic substorms, stored magnetic and plasma thermal energies are explosively converted into plasma kinetic energy. This rapid reconfiguration of Earth’s nightside magnetosphere is manifest in the ionosphere as an auroral display that fills the sky. Progress in understanding of how substorms are initiated is hindered by a lack of quantitative analysis of the single consistent feature of onset; the rapid brightening and structuring of the most equatorward arc in the ionosphere. Here, we exploit state-of-the-art auroral measurements to construct an observational dispersion relation of waves during substorm onset. Further, we use kinetic theory of high-beta plasma to demonstrate that the shear Alfven wave dispersion relation bears remarkable similarity to the auroral dispersion relation. In contrast to prevailing theories of substorm initiation, we demonstrate that auroral beads seen during the majority of substorm onsets are likely the signature of kinetic Alfven waves driven unstable in the high-beta magnetotail

Ultra-Fast Flash Observatory for the observation of early photons from gamma-ray bursts:Paper

One of the least documented and understood aspects of gamma-ray bursts (GRBs) is the rise phase of the optical light curve. The Ultra-Fast Flash Observatory (UFFO) is an effort to address this question through extraordinary opportunities presented by a series of space missions including a small spacecraft observatory. The UFFO is equipped with a fast-response Slewing Mirror Telescope (SMT) that uses a rapidly moving mirror or mirror array to redirect the optical beam rather than slewing the entire spacecraft to aim the optical instrument at the GRB position. The UFFO will probe the early optical rise of GRBs with sub-second response, for the first time, opening a completely new frontier in GRBs and transient studies. Its fast response measurements of the optical emission of dozens of GRBs each year will provide unique probes of the burst mechanism and test the prospect of GRBs as a new standard candle, potentially opening up the z > 10 universe. For the first time we employ a motorized slewing stage in SMT that can point to the event within 1 s after the x-ray trigger provided by the UFFO Burst Alert and Trigger Telescope. These two scientific instruments comprise the UFFO-pathfinder payload, which will be placed onboard the Lomonosov satellite and launched in 2013. The UFFO-pathfinder is the first step of our long-term program of space instruments for rapid-response GRB observations. We describe early photon science, our soon-to-be-launched UFFO-pathfinder hardware and mission, and our next planned mission, the UFFO-100. © IOP Publishing and Deutsche Physikalische Gesellschaft.This work was supported by the Creative Research Initiatives program (RCMST) of MEST/NRF. IP, EL, GS and HL are members of IEU, which is funded by the WCU program (R32-2009-000-10130-0). VL and ACT acknowledge financial support from the Spanish MINECO through project number AYA 2009-14000-C03-01/ESP and PC Taiwan's National Science Council Vanguard Program (100-2119-M-002-025) and the MP program of development of Lomonosov Moscow State University.Peer Reviewe

Evaluation of the HadGEM3-A simulations in view of detection and attribution of human influence on extreme events in Europe

A detailed analysis is carried out to assess the HadGEM3-A global atmospheric model skill in simulating extreme temperatures, precipitation and storm surges in Europe in the view of their attribution to human influence. The analysis is performed based on an ensemble of 15 atmospheric simulations forced with observed Sea Surface Temperature of the 54 year period 1960-2013. These simulations, together with dual simulations without human influence in the forcing, are intended to be used in weather and climate event attribution. The analysis investigates the main processes leading to extreme events, including atmospheric circulation patterns, their links with temperature extremes, land-atmosphere and troposphere-stratosphere interactions. It also compares observed and simulated variability, trends and generalized extreme value theory parameters for temperature and precipitation. One of the most striking findings is the ability of the model to capture North Atlantic atmospheric weather regimes as obtained from a cluster analysis of sea level pressure fields. The model also reproduces the main observed weather patterns responsible for temperature and precipitation extreme events. However, biases are found in many physical processes. Slightly excessive drying may be the cause of an overestimated summer interannual variability and too intense heat waves, especially in central/northern Europe. However, this does not seem to hinder proper simulation of summer temperature trends. Cold extremes appear well simulated, as well as the underlying blocking frequency and stratosphere-troposphere interactions. Extreme precipitation amounts are overestimated and too variable. The atmospheric conditions leading to storm surges were also examined in the Baltics region. There, simulated weather conditions appear not to be leading to strong enough storm surges, but winds were found in very good agreement with reanalyses. The performance in reproducing atmospheric weather patterns indicates that biases mainly originate from local and regional physical processes. This makes local bias adjustment meaningful for climate change attribution

Adaptations to Climate-Mediated Selective Pressures in Humans

Humans inhabit a remarkably diverse range of environments, and adaptation through natural selection has likely played a central role in the capacity to survive and thrive in extreme climates. Unlike numerous studies that used only population genetic data to search for evidence of selection, here we scan the human genome for selection signals by identifying the SNPs with the strongest correlations between allele frequencies and climate across 61 worldwide populations. We find a striking enrichment of genic and nonsynonymous SNPs relative to non-genic SNPs among those that are strongly correlated with these climate variables. Among the most extreme signals, several overlap with those from GWAS, including SNPs associated with pigmentation and autoimmune diseases. Further, we find an enrichment of strong signals in gene sets related to UV radiation, infection and immunity, and cancer. Our results imply that adaptations to climate shaped the spatial distribution of variation in humans

A Bayesian hierarchical approach for spatial analysis of climate model bias in multi-model ensembles

Coupled atmosphere–ocean general circulation models are key tools to investigate climate dynamics and the climatic response to external forcings, to predict climate evolution and to generate future climate projections. Current general circulation models are, however, undisputedly affected by substantial systematic errors in their outputs compared to observations. The assessment of these so-called biases, both individually and collectively, is crucial for the models’ evaluation prior to their predictive use. We present a Bayesian hierarchical model for a unified assessment of spatially referenced climate model biases in a multi-model framework. A key feature of our approach is that the model quantifies an overall common bias that is obtained by synthesizing bias across the different climate models in the ensemble, further determining the contribution of each model to the overall bias. Moreover, we determine model-specific individual bias components by characterizing them as non-stationary spatial fields. The approach is illustrated based on the case of near-surface air temperature bias in the tropical Atlantic and bordering regions from a multi-model ensemble of historical simulations from the fifth phase of the Coupled Model Intercomparison Project. The results demonstrate the improved quantification of the bias and interpretative advantages allowed by the posterior distributions derived from the proposed Bayesian hierarchical framework, whose generality favors its broader application within climate model assessment

Effects of sprint interval training on ectopic lipids and tissue-specific insulin sensitivity in men with non-alcoholic fatty liver disease

Purpose: This study examined the feasibility of sprint interval exercise training (SIT) for men with non-alcoholic fatty liver disease (NAFLD) and its effects on intrahepatic triglyceride (IHTG), insulin sensitivity (hepatic and peripheral), visceral (VAT) and subcutaneous adipose tissue (ScAT). Methods: Nine men with NAFLD (age 41 ± 8 years; BMI 31.7 ± 3.1 kg m−2; IHTG 15.6 ± 8.3%) were assessed at: (1) baseline (2) after a control phase of no intervention (pre-training) and (3) after 6 weeks of SIT (4–6 maximal 30 s cycling intervals, three times per week). IHTG, VAT and ScAT were measured using magnetic resonance spectroscopy or imaging and insulin sensitivity was assessed via dual-step hyperinsulinaemic-euglycaemic clamp with [6,6-D2] glucose tracer. Results: Participants adhered to SIT, completing ≥ 96.7% of prescribed intervals. SIT increased peak oxygen uptake [ V O2peak: + 13.6% (95% CI 8.8–18.2%)] and elicited a relative reduction in IHTG [− 12.4% (− 31.6 to 6.7%)] and VAT [− 16.9% (− 24.4 to − 9.4%); n = 8], with no change in body weight or ScAT. Peripheral insulin sensitivity increased throughout the study (n = 8; significant main effect of phase) but changes from pre- to post-training were highly variable (range − 18.5 to + 58.7%) and not significant (P = 0.09), despite a moderate effect size (g* = 0.63). Hepatic insulin sensitivity was not influenced by SIT. Conclusions: SIT is feasible for men with NAFLD in a controlled laboratory setting and is able to reduce IHTG and VAT in the absence of weight loss