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Aims Treatment of patients with heart failure (HF) relies on measurement of LVEF. However, the extent to which EF is recorded varies markedly. We sought to characterize the patient group that is missing a measure of EF, and to explore the association between missing EF and outcome. Methods and results Individual data on 30 445 patients from 28 observational studies in the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) project were used to compare the prevalence of co-morbidities and outcome across three groups of HF patients: those with missing EF (HF-mEF), reduced EF (HF-REF), and preserved EF (HF-PEF). A total of 29% had HF-mEF, 52% HF-REF, and 19% HF-PEF. Compared with patients in whom EF was known, patients with HF-mEF were older, had a greater prevalence of COPD and previous stroke, and were smokers. Patients with HF-mEF were less likely to receive evidence-based treatment than those with HF-REF. Adjusted mortality in HF-mEF was similar to that in HF-REF and greater than that in HF-PEF at 3 years [HF-REF, hazard ratio (HR) 1.03, 95% confidence interval (CI) 0.95–1.12); HF-PEF, HR 0.78, 95% CI 0.71–0.86]. Conclusion Missing EF is common. The short- and long-term outcome of patients with HF-mEF is poor and they exhibit different co-morbidity profiles and treatment patterns compared with patients with known EF. HF patients with missing EF represent a high risk group.

The condition and survival of Antarctic krill (Euphausia superba) strongly depends on sea ice conditions during winter. How krill utilize sea ice depends on several factors such as region and developmental stage. A comprehensive understanding of sea ice habitat use by krill, however, remains largely unknown. The aim of this study was to improve the understanding of the krill’s interaction with the sea ice habitat during winter/early spring by conducting large-scale sampling of the ice–water interface (0–2 m) and comparing the size and developmental stage composition of krill with the pelagic population (0–500 m). Results show that the population in the northern Weddell Sea consisted mainly of krill that were <1 year old (age class 0; AC0), and that it was comprised of multiple cohorts. Size per developmental stage differed spatially, indicating that the krill likely were advected from various origins. The size distribution of krill differed between the two depth strata sampled. Larval stages with a relatively small size (mean 7–8 mm) dominated the upper two metre layer of the water column, while larger larvae and AC0 juveniles (mean 14–15 mm) were proportionally more abundant in the 0- to 500-m stratum. Our results show that, as krill mature, their vertical distribution and utilization of the sea ice appear to change gradually. This could be the result of changes in physiology and/or behaviour, as, e.g., the krill’s energy demand and swimming capacity increase with size and age. The degree of sea ice association will have an effect on large-scale spatial distribution patterns of AC0 krill and on predictions of the consequences of sea ice decline on their survival over winter.

The adsorption and dynamical behavior of the muonated cyclohexadienyl radical (C6H6Mu) in NaY zeolite, formed by muonium (Mu) addition on adsorbed benzene, was investigated by the muon spin resonance (μSR) technique, primarily at loadings of 2−3 C6H6 molecules per supercage of NaY. The dynamics of this radical are expected to be the same as its isotopic analogue, C6H7, for which there are no similar data available. Both TF-μSR and ALC-μSR spectra were recorded, with the most detailed information provided by the positions and line widths of the avoided level crossing resonances. In concert with 2H NMR, neutron diffraction and molecular dynamics studies of the parent benzene molecule, as well as current theoretical calculations, the dominant adsorption site for the C6H6Mu radical is believed to be the SII Na cation, within a supercage, which gives rise to three observed ALC lines, corresponding to two different orientations for the muon (proton) of the CHMu methylene group: pointing toward (endo) and away ...

Limited data exist evaluating the effect of blood pressure (BP) on clinical outcomes among patients with acute ischemic stroke with large vessel occlusion treated with mechanical thrombectomy (MT). We sought to evaluate the association of BP levels on clinical outcomes among patients with acute ischemic stroke with large vessel occlusion treated with MT. Studies were identified that reported the association of systolic BP (SBP) or diastolic BP levels before, during, or after MT on the outcomes of patients with acute ischemic stroke treated with MT. Unadjusted and adjusted analyses of studies reporting odds ratios (OR adj ) per 10 mm Hg BP increment were performed. Our analysis included 25 studies comprising 6474 patients. Higher pre-MT mean SBP ( P =0.008) and post-MT maximum SBP ( P =0.009) levels were observed in patients who died within 3 months. Patients with 3-month functional independence were noted to have lower pre-MT ( P <0.001) and post-MT maximum SBP levels ( P <0.001). In adjusted analyses, increasing post-MT maximum SBP and diastolic BP levels were associated with 3-month mortality (OR adj , 1.19 [95% CI,1.00–1.43]; I 2 =78%, P value for Cochran Q test: 0.001) and symptomatic intracranial hemorrhage (OR adj , 1.65 [95% CI, 1.11–2.44]; I 2 =0%, P value for Cochran Q test: 0.80), respectively. Increasing pre- and post-MT mean SBP levels were associated with lower odds of 3-month functional independence (OR adj , 0.86 [95% CI, 0.77–0.96]; I 2 =18%, P value for Cochran Q test: 0.30) and (OR adj , 0.80 [95% CI, 0.72–0.89]; I 2 =0%, P value for Cochran Q test: 0.51), respectively. In conclusion, elevated BP levels before and after MT are associated with adverse outcomes among patients with acute ischemic stroke with large vessel occlusion.

A domain $R$ is said to have the finite factorization property if every nonzero non-unit element of $R$ has at least one and at most finitely many distinct factorizations up to multiplication of irreducible factors by central units. Let $k$ be an algebraically closed field and let $A$ be a $k$-algebra. We show that if $A$ has an associated graded ring that is a domain with the property that the dimension of each homogeneous component is finite then $A$ is a finite factorization domain. As a corollary, we show that many classes of algebras have the finite factorization property, including Weyl algebras, enveloping algebras of finite-dimensional Lie algebras, quantum affine spaces and shift algebras. This provides a termination criterion for factorization procedures over these algebras. In addition, we give explicit upper bounds on the number of distinct factorizations of an element in terms of data from the filtration.

Abstract The Ecosystem Approach to Management (EAM) has emerged over the past decades, largely to promote biodiversity conservation, and more recently sectoral tradeoffs in the management of marine ecosystems. To ascertain the state of practice of EAM operationalization, a workshop was held, which included a pre-workshop online survey. The survey gauged international participants’ perspectives regarding capacity, knowledge, and application of EAM. When asked about the subject, most survey respondents had a general understanding of EAM, and provided a clear definition. Major perceived challenges to EAM objectives by those surveyed included limited knowledge, conflicting interests, insufficient communication, and limited organizational legal frameworks or governance structures. Of those directly involved in an ecosystem approach, the majority responded that processes were in place or developed for application of integrated knowledge toward assessing key issues within their respective sectors (i.e. fisheries, conservation, energy), and that capacity was generally high. Our results show that most respondents, irrespective of sector or geography, see value in considering an integrated, broader ecosystem approach as they manage their sector. Although many participants were from the North Atlantic region, our results suggest that much of the international community is converging toward continued understanding of broad-scale, integrated approaches to marine resource management.

Geochemical micro-environments within serpentinizing systems can abiotically synthesize hydrocarbons and provide the ingredients required to support life. Observations of organic matter in microgeode-like hydrogarnets found in Mid-Atlantic Ridge serpentinites suggest these garnets possibly represent unique nests for the colonization of microbial ecosystems within the oceanic lithosphere. However, little is known about the mineralogical and geochemical processes that allow such unique environments to form. Here we present work on outcrop-scale vein networks from an ultramafic massif in Norway that contain massive amounts of spherulitic garnets (andradite), which help to constrain such processes. Vein andradite spherulites are associated with polyhedral serpentine, brucite, Ni–Fe alloy (awaruite), and magnetite indicative of low temperature (<200 °C) alteration under low fO2 and low aSiO2,aq geochemical conditions. Together with the outcrop- and micro-scale analysis geochemical reaction path modeling shows that there was limited mass transport and fluid flow over a large scale. Once opened the veins remained isolated (closed system), forming non-equilibrium microenvironments that allowed, upon a threshold supersaturation, the rapid crystallization (seconds to weeks) of spherulitic andradite. The presence of polyhedral serpentine spheres indicates that veins were initially filled with a gel-like protoserpentine phase. In addition, massive Fe oxidation associated with andradite formation could have generated as much as 600 mmol H2,aq per 100 cm3 vein. Although no carboneous matter was detected, the vein networks fulfill the reported geochemical criteria required to generate abiogenic hydrocarbons and support microbial communities. Thus, systems similar to those investigated here are of prime interest when searching for life-supporting environments within the deep subsurface.

A comprehensive quality assessment of the ozone products from 18 limb-viewing satellite instruments is provided by means of a detailed intercomparison. The ozone climatologies in form of monthly zonal mean time series covering the upper troposphere to lower mesosphere are obtained from LIMS, SAGE I/II/III, UARS-MLS, HALOE, POAM II/III, SMR, OSIRIS, MIPAS, GOMOS, SCIAMACHY, ACE-FTS, ACE-MAESTRO, Aura-MLS, HIRDLS, and SMILES within 1978–2010. The intercomparisons focus on mean biases of annual zonal mean fields, interannual variability, and seasonal cycles. Additionally, the physical consistency of the data is tested through diagnostics of the quasi-biennial oscillation and Antarctic ozone hole. The comprehensive evaluations reveal that the uncertainty in our knowledge of the atmospheric ozone mean state is smallest in the tropical and midlatitude middle stratosphere with a 1σ multi-instrument spread of less than ±5%. While the overall agreement among the climatological data sets is very good for large parts of the stratosphere, individual discrepancies have been identified, including unrealistic month-to-month fluctuations, large biases in particular atmospheric regions, or inconsistencies in the seasonal cycle. Notable differences between the data sets exist in the tropical lower stratosphere (with a spread of ±30%) and at high latitudes (±15%). In particular, large relative differences are identified in the Antarctic during the time of the ozone hole, with a spread between the monthly zonal mean fields of ±50%. The evaluations provide guidance on what data sets are the most reliable for applications such as studies of ozone variability, model-measurement comparisons, detection of long-term trends, and data-merging activities.

Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries. http://purl.org/eprint/status/PeerReviewed published version Article

Professionals and professional firms provide a range of taxation-related services, from advising clients on their tax obligations to designing and implementing tax-reduction strategies. Provided that tax professionals respect the letter of the law, are all such tax services morally permissible? We answer this question in the negative by distinguishing between institutional integrity and institutional corruption in fiscal arrangements; tax services that promote a situation of fiscal institutional corruption are impermissible, given that they severely inhibit the ability of taxation institutions to collect revenue efficiently and equitably. The professional facilitation of abusive tax avoidance — explicit tax reduction that is contrary to the spirit or intent of the law — is a particularly prominent aspect of fiscal institutional corruption. We illustrate the role of professionals in designing, promoting and implementing abusive tax avoidance strategies through several case studies, including the Wyly offshore network and the KPMG tax shelter scandal. In addition, we claim that tax professionals have specific responsibilities to help remedy institutional corruption associated with abusive tax avoidance. To argue this thesis, we present general principles for assigning remedial responsibilities to particular agents. We then apply those principles to determine what three major groups of tax professionals — accountants, lawyers, and financial experts — ought to do about abusive tax avoidance.