Greenland during the last interglacial:the relative importance of insolation and oceanic changes

Insolation changes during the Eemian (the last interglacial period, 129 000–116 000 years before present) resulted in warmer than present conditions in the Arctic region. The NEEM ice core record suggests warming of 8 ± 4 K in northwestern Greenland based on stable water isotopes. Here we use general circulation model experiments to investigate the causes of the Eemian warming in Greenland. Simulations of the atmospheric response to combinations of Eemian insolation and preindustrial oceanic conditions and vice versa are used to disentangle the impacts of the insolation change and the related changes in sea surface temperatures and sea ice conditions. The changed oceanic conditions cause warming throughout the year, prolonging the impact of the summertime insolation increase. Consequently, the oceanic conditions cause an annual mean warming of 2 K at the NEEM site, whereas the insolation alone causes an insignificant change. Taking the precipitation changes into account, however, the insolation and oceanic changes cause more comparable increases in the precipitation-weighted temperature, implying that both contributions are important for the ice core record at the NEEM site. The simulated Eemian precipitation-weighted warming of 2.4 K at the NEEM site is low compared to the ice core reconstruction, partially due to missing feedbacks related to ice sheet changes and an extensive sea ice cover. Surface mass balance calculations with an energy balance model further indicate that the combination of temperature and precipitation anomalies leads to potential mass loss in the north and southwestern parts of the ice sheet. The oceanic conditions favor increased accumulation in the southeast, while the insolation appears to be the dominant cause of the expected ice sheet reduction. Consequently, the Eemian is not a suitable analogue for future ice sheet changes

Return to the workforce following first hospitalization for heart failure: a Danish nationwide cohort study

Background: Return to work is important financially, as a marker of functional status and for self-esteem in patients developing chronic illness. We examined return to work after first heart failure (HF) hospitalization. Methods: By individual-level linkage of nationwide Danish registries, we identified 21455 patients of working age (18-60 years) with a first HF hospitalization in the period of 1997-2012. Of these 11880 (55%) were in the workforce prior to HF hospitalization and comprised the study population. We applied logistic regression to estimate odds ratios (OR) for associations between age, sex, length of hospital stay, level of education, income, comorbidity and return to work. Results: One year after first HF hospitalization, 8040 (67.7%) returned to the workforce, 2981 (25.1%) did not, 805 (6.7%) died and 54 (0.5%) emigrated. Predictors of return to work included younger age (18-30 vs. 51-60 years, OR 3.12; 95% CI 2.42-4.03), male sex (OR 1.22 [1.18-1.34]) and level of education (long-higher vs. basic school OR 2.06 [1.63-2.60]). Conversely, hospital stay >7 days (OR 0.56 [0.51-0.62]) and comorbidity including history of stroke (OR 0.55 [0.45-0.69]), chronic kidney disease (OR 0.46 [0.36-0.59]), chronic obstructive pulmonary disease (OR 0.62 [0.52-0.75]), diabetes (OR 0.76 [0.68-0.85]) and cancer (OR 0.49 [0.40-0.61]) were all significantly associated with lower chance of return to work. Conclusions: Patients in the workforce prior to HF hospitalization had low mortality but high risk of detachment from the workforce one year later. Young age, male sex, and higher level of education were predictors of return to work

Hybrid diamond/silicon suspended integrated photonic platform using SF6 isotropic etching

A hybrid diamond/silicon air-clad ridge waveguide platform is demonstrated. The air-clad structure coupled with the wide transmission window of diamond can allow for the use of this architecture over a large wavelength range, especially for the longer infrared wavelengths. In order to provide vertical confinement, the silicon substrate was isotropically etched using S F6 plasma to create undercut diamond films. An in-depth analysis of the etch characteristics of this process was performed to highlight its potential to replace wet isotropic etching or XeF 2 isotropic vapour phase etching techniques. The performance of the waveguide at 1550 nm was measured, and yielded an average loss of 4.67 +/- 0.47 dB/mm

Initiation of domiciliary care and nursing home admission following first hospitalization of heart failure patients:A nationwide cohort study

Background: Heart failure (HF) has a major impact on a patient’s quality of life and functional status. This impact may be sufficiently profound to prevent independent living although how often this is the case is unknown. We examined the need for domiciliary assistance and admission to a nursing home following first HF hospitalization. Methods: In nationwide Danish registries, we identified a cohort of patients discharged alive after a first-time HF hospitalization in the period 2008–2014 who were matched 1:5 with comparison subjects based on age and sex and followed for 5 years. Results: We included 37,547 patients (69% men) discharged after a first-time HF-hospitalization and 187,735 comparison subjects. The 5-year incidence of initiation of domiciliary care was 24.1% [23.7%–24.6%] among HF patients and 9.2% [9.1%–9.4%] among the comparison cohort and yielded a corresponding adjusted HR of 2.02 [1.96–2.09]. Covariates associated with initiation of domiciliary support included older age (HR 1.08 [1.07–1.08] per 1 year increase in age), living alone (HR 2.09 [2.04–2.15]) and comorbidities. The 5-year incidence of nursing home admission was 3.9% [3.7%–4.0%] among HF patients and 1.7% [1.7%–1.8%] among the comparison cohort and this resulted in an adjusted HR of 1.91 [1.77–2.06]. Covariates associated with nursing home admission included older age (HR 1.10 [1.10–1.11]), living alone (HR 2.15 [2.02–2.28]) and history of stroke (HR 2.71 [2.53–2.90]). Conclusion: Hospitalization for HF is associated with increased need for domiciliary support and nursing home admissions. Older age, living alone, and comorbidities were associated with higher risk of both outcomes

Ischemic Stroke Severity and Mortality in Patients With and Without Atrial Fibrillation

Background Our objective was to investigate stroke severity and subsequent rate of mortality among patients with and without atrial fibrillation (AF). Contemporary data on stroke severity and prognosis in patients with AF are lacking. Methods and Results First‐time ischemic stroke patients from the Danish Stroke Registry (January 2005–December 2016) were included in an observational study. Patients with AF were matched 1:1 by sex, age, calendar year, and CHA2DS2‐VASc score with patients without AF. Stroke severity was determined by the Scandinavian Stroke Scale (0–58 points). The rate of death was estimated by Kaplan‐Meier plots and multivariable Cox regression. Among 86 458 identified patients with stroke, 17 205 had AF. After matching, 14 662 patients with AF and 14 662 patients without AF were included (51.8% women; median age, 79.6 years [25th–75th percentile, 71.8–86.0]). More patients with AF had very severe stroke (0–14 points) than patients without AF (13.7% versus 7.9%, P<0.01). The absolute rates of 30‐day and 1‐year mortality were significantly higher for patients with AF (12.1% and 28.4%, respectively) versus patients without AF (8.7% and 21.8%, respectively). This held true in adjusted models for 30‐day mortality (hazard ratio [HR], 1.40 [95% CI, 1.30–1.51]). However, this association became nonsignificant when additionally adjusting for stroke severity (HR, 1.10 [95% CI, 1.00–1.23]). AF was associated with a higher rate of 1‐year mortality (HR, 1.39 [95% CI, 1.32–1.46]), although it was mediated by stroke severity (HR, 1.15 [95% CI, 1.09–1.23], model including stroke severity). Conclusions In a contemporary nationwide cohort of patients with ischemic stroke, patients with AF had more severe strokes and higher mortality than patients without AF. The difference in mortality was mainly driven by stroke severity

Press notice. EC agricultural price indices. Trends in EC agricultural price indices (output and input): 1st quarter 1985. 1985.3

The high precious metal loading and high overpotential of the oxygen evolution reaction (OER) prevents the widespread utilization of polymer electrolyte membrane (PEM) water electrolyzers. Herein we explore the OER activity and stability in acidic electrolyte of a combined IrO_<i>x</i>/RuO₂ system consisting of RuO₂ thin films with submonolayer (1, 2, and 4 Å) amounts of IrO_<i>x</i> deposited on top. Operando extended X-ray absorption fine structure (EXAFS) on the Ir L-3 edge revealed a rutile type IrO₂ structure with some Ir sites occupied by Ru, IrO_<i>x</i> being at the surface of the RuO₂ thin film. We monitor corrosion on IrO_<i>x</i>/RuO₂ thin films by combining electrochemical quartz crystal microbalance (EQCM) with inductively coupled mass spectrometry (ICP-MS). We elucidate the importance of submonolayer surface IrO_<i>x</i> in minimizing Ru dissolution. Our work shows that we can tune the surface properties of active OER catalysts, such as RuO₂, aiming to achieve higher electrocatalytic stability in PEM electrolyzers