Disparities by sex in P2Y 12 inhibitor therapy duration, or differences in the balance of ischaemic-benefit and bleeding-risk clinical outcomes in older women versus comparable men following acute myocardial infarction? A P2Y 12 inhibitor new user retrospective cohort analysis of US Medicare claims data

Objectives To determine if comparable older women and men received different durations of P2Y 12 inhibitor therapy following acute myocardial infarction (AMI) and if therapy duration differences were justified by differences in ischaemic benefits and/or bleeding risks. Design Retrospective cohort. Setting 20% sample of 2007-2015 US Medicare fee-for-service administrative claims data. Participants ≥66-year-old P2Y 12 inhibitor new users following 2008-2013 AMI hospitalisation (N=30 613). Older women compared to older men with similar predicted risks of study outcomes. Primary and secondary outcome measures Primary outcome: P2Y 12 inhibitor duration (modelled as risk of therapy discontinuation). Secondary outcomes: clinical events while on P2Y 12 inhibitor therapy, including (1) death/hospice admission, (2) composite of ischaemic events (AMI/stroke/revascularisation) and (3) hospitalised bleeds. Cause-specific risks and relative risks (RRs) estimated using Aalen-Johansen cumulative incidence curves and bootstrapped 95% CIs. Results 10 486 women matched to 10 486 men with comparable predicted risks of all 4 study outcomes. No difference in treatment discontinuation was observed at 12 months (women 31.2% risk; men 30.9% risk; RR 1.01; 95% CI 0.97 to 1.05), but women were more likely than men to discontinue therapy at 24 months (54.4% and 52.9% risk, respectively; RR 1.03; 95% CI 1.00 to 1.05). Among patients who did not discontinue P2Y 12 inhibitor therapy, women had lower 24-month risks of ischaemic outcomes than men (13.1% and 14.7%, respectively; RR 0.90; 95% CI 0.84 to 0.96), potentially lower 24-month risks of death/hospice admission (5.0% and 5.5%, respectively; RR 0.91; 95% CI 0.82 to 1.02), but women and men both had 2.5% 24-month bleeding risks (RR 0.98; 95% CI 0.82 to 1.14). Conclusions Risks for death/hospice and ischaemic events were lower among women still taking a P2Y 12 inhibitor than comparable men, with no difference in bleeding risks. Shorter P2Y 12 inhibitor durations in older women than comparable men observed between 12 and 24 months post-AMI may reflect a disparity that is not justified by differences in clinical need

Thermonuclear reaction rate of O17(p,γ)F18

The O17(p,γ)F18 and O17(p,α)N14 reactions have a profound influence on hydrogen-burning nucleosynthesis in a number of stellar sites, including red giants, asymptotic giant branch (AGB) stars, massive stars, and classical novae. Previously evaluated thermonuclear rates for both reactions carry large uncertainties. We investigated the proton-capture reaction on O17 in the bombarding energy range of Eplab=180-540keV. We observed a previously undiscovered resonance at ERlab=193.2±0.9keV. The resonance strength amounts to (ωγ)pγ=(1.2±0.2)×10-6eV. With this value, the uncertainties of the O17(p,γ)F18 reaction rates are reduced by orders of magnitude in the peak temperature range of classical novae (T=0.1-0.4GK). We also report on a reevaluation of the O17(p,γ)F18 reaction rates at lower temperatures that are pertinent to red giants, AGB stars, or massive stars. The present work establishes the O17(p,γ)F18 reaction rates over a temperature range of T=0.01-1.5GK with statistical uncertainties of 10-50%. The new recommended reaction rates deviate from the previously accepted values by an order of magnitude around T0.2GK and by factors of 2-3 at T<0.1GK

Photospheric Magnetic Field: Relationship Between North-South Asymmetry and Flux Imbalance

Photospheric magnetic fields were studied using the Kitt Peak synoptic maps for 1976-2003. Only strong magnetic fields (B>100 G) of the equatorial region were taken into account. The north-south asymmetry of the magnetic fluxes was considered as well as the imbalance between positive and negative fluxes. The north-south asymmetry displays a regular alternation of the dominant hemisphere during the solar cycle: the northern hemisphere dominated in the ascending phase, the southern one in the descending phase during Solar Cycles 21-23. The sign of the imbalance did not change during the 11 years from one polar-field reversal to the next and always coincided with the sign of the Sun's polar magnetic field in the northern hemisphere. The dominant sign of leading sunspots in one of the hemispheres determines the sign of the magnetic-flux imbalance. The sign of the north-south asymmetry of the magnetic fluxes and the sign of the imbalance of the positive and the negative fluxes are related to the quarter of the 22-year magnetic cycle where the magnetic configuration of the Sun remains constant (from the minimum where the sunspot sign changes according to Hale's law to the magnetic-field reversal and from the reversal to the minimum). The sign of the north-south asymmetry for the time interval considered was determined by the phase of the 11-year cycle (before or after the reversal); the sign of the imbalance of the positive and the negative fluxes depends on both the phase of the 11-year cycle and on the parity of the solar cycle. The results obtained demonstrate the connection of the magnetic fields in active regions with the Sun's polar magnetic field in the northern hemisphere.Comment: 24 pages, 12 figures, 2 table

HI in the Outskirts of Nearby Galaxies

The HI in disk galaxies frequently extends beyond the optical image, and can trace the dark matter there. I briefly highlight the history of high spatial resolution HI imaging, the contribution it made to the dark matter problem, and the current tension between several dynamical methods to break the disk-halo degeneracy. I then turn to the flaring problem, which could in principle probe the shape of the dark halo. Instead, however, a lot of attention is now devoted to understanding the role of gas accretion via galactic fountains. The current $\rm \Lambda$ cold dark matter theory has problems on galactic scales, such as the core-cusp problem, which can be addressed with HI observations of dwarf galaxies. For a similar range in rotation velocities, galaxies of type Sd have thin disks, while those of type Im are much thicker. After a few comments on modified Newtonian dynamics and on irregular galaxies, I close with statistics on the HI extent of galaxies.Comment: 38 pages, 17 figures, invited review, book chapter in "Outskirts of Galaxies", Eds. J. H. Knapen, J. C. Lee and A. Gil de Paz, Astrophysics and Space Science Library, Springer, in pres

Evaluation of status of commercial fish stocks in European marine subareas using mean trophic levels of fish landings and spawning stock biomass

Most of the fish stocks in the world, including European fish stocks, are threatened by overfishing and/or degraded environmental conditions. Although the Common Fisheries Policy (CFP) is the main policy instrument managing fish stocks in Europe, there is continued concern as to whether commercial fish stocks will achieve Good Environmental Status (GEnS) in 2020 in accordance with the Marine Strategy Framework Directive (MSFD). In this context, the evaluation of the status of fish stocks in the subareas of FAO fishing area 27 was carried out using mean trophic levels (MTL) in fish landings and spawning stock biomass (SSB). Comparisons were made before and after 2008 to establish whether the trend is positive or negative. The main data sources for landings and SSB were the International Council for the Exploration of the Sea (ICES) advisory reports. MTLs in landing and SSB were determined for each subarea and the subareas were categorized into four groups, according to MTLs after 2008. The first group (subareas I + II, V) had higher MTL in landings and higher MTL in SSB after 2008. Therefore, fisheries in these subareas appear sustainable. The second group was subareas VIII + IX, for which the fish stocks have higher MTL in landings but low MTL in SSB, indicating that SSB was being overfished. The third was subarea (VI), where fish stocks have lower MTL in landings than those in SSB after 2008, which may indicate that fish stocks are recovering. Fish stocks in the fourth group (subareas III, IV and VII) had low MIL in landings and the MTL in SSB was lower than that of landings before 2008. This may be due to heavy fishing. In addition, we estimated the harvest rate (HR) of the fish stocks before and after 2008. The results showed that most of the fish stocks have lower HR after 2008, indicating that the status has improved, perhaps due to improvements in the implementation of CFP. However, some fish stocks showed high HR even after 2008, so that new management options are still needed. Other factors such as eutrophication, seafloor disturbances, marine pollution, invasive species etc., influence SSB ecosystem health options and should also be incorporated in the management criteria. Most of these environmental pressures are of high priority in the MSFD, and therefore the findings of this study will be useful for both CFP and MSFD. (C) 2016 The Authors. Published by Elsevier Ltd.Erasmus Mundus Joint Doctorate in Marine and Coastal Management (MACOMA); EC 7FP [308392]info:eu-repo/semantics/publishedVersio

Evaluation of marine subareas of Europe using life history parameters and trophic levels of selected fish populations

European marine waters include four regional seas that provide valuable ecosystem services to humans, including fish and other seafood. However, these marine environments are threatened by pressures from multiple anthropogenic activities and climate change. The European Marine Strategy Framework Directive (MSFD) was adopted in 2008 to achieve good environmental status (GEnS) in European Seas by year 2020, using an Ecosystem Approach. GEnS is to be assessed using 11 descriptors and up to 56 indicators. In the present analysis two descriptors namely "commercially exploited fish and shellfish populations" and "food webs" were used to evaluate the status of subareas of FAO 27 area. Data on life history parameters, trophic levels and fisheries related data of cod, haddock, saithe, herring, plaice, whiting, hake and sprat were obtained from the FishBase online database and advisory reports of International Council for the Exploration of the Sea (ICES). Subareas inhabited by r and K strategists were identified using interrelationships of life history parameters of commercially important fish stocks. Mean trophic level (MTL) of fish community each subarea was calculated and subareas with species of high and low trophic level were identified. The Fish in Balance (FiB) index was computed for each subarea and recent trends of FiB indices were analysed. The overall environmental status of each subarea was evaluated considering life history trends, MTL and FiB Index. The analysis showed that subareas I, II, V, VIII and IX were assessed as "good" whereas subareas III, IV, VI and VII were assessed as "poor". The subareas assessed as "good" were subject to lower environmental pressures, (less fishing pressure, less eutrophication and more water circulation), while the areas with "poor" environment experienced excessive fishing pressure, eutrophication and disturbed seabed. The evaluation was based on two qualitative descriptors ("commercially exploited fish and shellfish populations" and "food webs") is therefore more robust (C) 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Erasmus Mundus Joint Doctorate in Marine and Coastal Management (MACOMA); EC 7FP grant [308392]info:eu-repo/semantics/publishedVersio

Microflares and the Statistics of X-ray Flares

This review surveys the statistics of solar X-ray flares, emphasising the new views that RHESSI has given us of the weaker events (the microflares). The new data reveal that these microflares strongly resemble more energetic events in most respects; they occur solely within active regions and exhibit high-temperature/nonthermal emissions in approximately the same proportion as major events. We discuss the distributions of flare parameters (e.g., peak flux) and how these parameters correlate, for instance via the Neupert effect. We also highlight the systematic biases involved in intercomparing data representing many decades of event magnitude. The intermittency of the flare/microflare occurrence, both in space and in time, argues that these discrete events do not explain general coronal heating, either in active regions or in the quiet Sun.Comment: To be published in Space Science Reviews (2011

On the exhaust of electromagnetic drive

Recent reports about propulsion without reaction mass have been met on one hand with enthusiasm and on the other hand with some doubts. Namely, closed metal cavities, when fueled with microwaves, have delivered thrust that could eventually maintain satellites on orbits using solar power. However, the measured thrust appears to be without any apparent exhaust. Thus the Law of Action-Reaction seems to have been violated. We consider the possibility that the exhaust is in a form that has so far escaped both experimental detection and theoretical attention. In the thruster's cavity microwaves interfere with each other and invariably some photons will also end up co-propagating with opposite phases. At the destructive interference electromagnetic fields cancel. However, the photons themselves do not vanish for nothing but continue in propagation. These photon pairs without net electromagnetic field do not reflect back from the metal walls but escape from the resonator. By this action momentum is lost from the cavity which, according to the conservation of momentum, gives rise to an equal and opposite reaction. We examine theoretical corollaries and practical concerns that follow from the paired-photon conclusion. (C) 2016 Author(s).Peer reviewe