Carbon enrichment of the evolved stars in the Sagittarius dwarf spheroidal

We present spectra of 1142 colour-selected stars in the direction of the Sagittarius Dwarf Spheroidal (Sgr dSph) galaxy, of which 1058 were taken with VLT/FLAMES multi-object spectrograph and 84 were taken with the SAAO Radcliffe 1.9-m telescope grating spectrograph. Spectroscopic membership is confirmed (at >99% confidence) for 592 stars on the basis of their radial velocity, and spectral types are given. Very slow rotation is marginally detected around the galaxy's major axis. We identify five S stars and 23 carbon stars, of which all but four carbon stars are newly-determined and all but one (PQ Sgr) are likely Sgr dSph members. We examine the onset of carbon-richness in this metal-poor galaxy in the context of stellar models. We compare the stellar death rate (one star per 1000-1700 years) to known planetary nebula dynamical ages and find that the bulk population produce the observed (carbon-rich) planetary nebulae. We compute average lifetimes of S and carbon stars as 60-250 and 130-500 kyr, compared to a total thermal-pulsing asymptotic giant branch lifetime of 530-1330 kyr. We conclude by discussing the return of carbon-rich material to the ISM.Comment: 14 pages, 10 figures, accepted MNRA

Gain control network conditions in early sensory coding

Gain control is essential for the proper function of any sensory system. However, the precise mechanisms for achieving effective gain control in the brain are unknown. Based on our understanding of the existence and strength of connections in the insect olfactory system, we analyze the conditions that lead to controlled gain in a randomly connected network of excitatory and inhibitory neurons. We consider two scenarios for the variation of input into the system. In the first case, the intensity of the sensory input controls the input currents to a fixed proportion of neurons of the excitatory and inhibitory populations. In the second case, increasing intensity of the sensory stimulus will both, recruit an increasing number of neurons that receive input and change the input current that they receive. Using a mean field approximation for the network activity we derive relationships between the parameters of the network that ensure that the overall level of activity of the excitatory population remains unchanged for increasing intensity of the external stimulation. We find that, first, the main parameters that regulate network gain are the probabilities of connections from the inhibitory population to the excitatory population and of the connections within the inhibitory population. Second, we show that strict gain control is not achievable in a random network in the second case, when the input recruits an increasing number of neurons. Finally, we confirm that the gain control conditions derived from the mean field approximation are valid in simulations of firing rate models and Hodgkin-Huxley conductance based models

Carriers of the mid-IR emission bands in PNe reanalysed. Evidence of a link between circumstellar and interstellar aromatic dust

It has been shown that the diversity of the aromatic emission features can be rationalized into different classes of objects, in which differences between circumstellar and interstellar matter are emphasised. We probe the links between the mid-IR emitters observed in planetary nebulae (PNe) and their counterparts in the interstellar medium in order to probe a scenario in which the latter have been formed in the circumstellar environment of evolved stars. The mid-IR (6-14 um) emission spectra of PNe and compact HII regions were analysed on the basis of previous work on photodissociation regions (PDRs). Galactic, Large Magellanic Cloud (LMC), and Small Magellanic Cloud (SMC) objects were considered in our sample.We show that the mid-IR emission of PNe can be decomposed as the sum of six components. Some components made of polycyclic aromatic hydrocarbon (PAH) and very small grain (VSG) populations are similar to those observed in PDRs. Others are fitted in an evolutionary scenario involving the destruction of the aliphatic component observed in the post-AGB stage, as well as strong processing of PAHs in the extreme conditions of PNe that leads to a population of very large ionized PAHs. This species called PAH^x are proposed as the carriers of a characteristic band at 7.90 um. This band can be used as part of diagnostics that identify PNe in nearby galaxies and is also observed in galactic compact HII regions. These results support the formation of the aromatic very small dust particles in the envelopes of evolved stars, in the Milky Way, as well as in the LMC and SMC, and their subsequent survival in the interstellar medium.Comment: Accepted for publication in A&

International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)

Background Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment. Methods and results Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines). Conclusions The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world

Is there a space–time continuum in olfaction?

The coding of olfactory stimuli across a wide range of organisms may rely on fundamentally similar mechanisms in which a complement of specific odorant receptors on olfactory sensory neurons respond differentially to airborne chemicals to initiate the process by which specific odors are perceived. The question that we address in this review is the role of specific neurons in mediating this sensory system—an identity code—relative to the role that temporally specific responses across many neurons play in producing an olfactory perception—a temporal code. While information coded in specific neurons may be converted into a temporal code, it is also possible that temporal codes exist in the absence of response specificity for any particular neuron or subset of neurons. We review the data supporting these ideas, and we discuss the research perspectives that could help to reveal the mechanisms by which odorants become perceptions

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

Scaling slowly rotating asteroids with stellar occultations

Context. As evidenced by recent survey results, the majority of asteroids are slow rotators (spin periods longer than 12 h), but lack spin and shape models because of selection bias. This bias is skewing our overall understanding of the spins, shapes, and sizes of asteroids, as well as of their other properties. Also, diameter determinations for large (>60 km) and medium-sized asteroids (between 30 and 60 km) often vary by over 30% for multiple reasons. Aims. Our long-term project is focused on a few tens of slow rotators with periods of up to 60 h. We aim to obtain their full light curves and reconstruct their spins and shapes. We also precisely scale the models, typically with an accuracy of a few percent. Methods. We used wide sets of dense light curves for spin and shape reconstructions via light-curve inversion. Precisely scaling them with thermal data was not possible here because of poor infrared datasets: large bodies tend to saturate in WISE mission detectors. Therefore, we recently also launched a special campaign among stellar occultation observers, both in order to scale these models and to verify the shape solutions, often allowing us to break the mirror pole ambiguity. Results. The presented scheme resulted in shape models for 16 slow rotators, most of them for the first time. Fitting them to chords from stellar occultation timings resolved previous inconsistencies in size determinations. For around half of the targets, this fitting also allowed us to identify a clearly preferred pole solution from the pair of two mirror pole solutions, thus removing the ambiguity inherent to light-curve inversion. We also address the influence of the uncertainty of the shape models on the derived diameters. Conclusions. Overall, our project has already provided reliable models for around 50 slow rotators. Such well-determined and scaled asteroid shapes will, for example, constitute a solid basis for precise density determinations when coupled with mass information. Spin and shape models in general continue to fill the gaps caused by various biases