Type II radio bursts arise due to shocks typically driven by coronal mass ejections (CMEs). When these shocks propagate outward from the Sun, their associated radio emissions drift down in frequency ...as excited particles emit at the local plasma frequency, creating the usual type II patterns. In this work, we use dynamic spectra from the Wind/WAVES Thermal Noise Receiver (TNR) to identify type II radio emissions in the kilometric wavelength range (kmTIIs,
f
<
300
kHz
) between 1 January 2000 and 31 December 2012, i.e., over a solar cycle. We identified 134 kmTII events and compiled various characteristics for each of them. The finding of 45 kmTII events not reported by the official Wind/WAVES catalog (based on RAD1 and RAD2 data) is particularly important. We search for associations with interplanetary structures and analyze their main characteristics to reveal distinctive attributes that may correlate with the occurrence of kmTII emission. We find that the fraction of interplanetary coronal mass ejections (ICMEs) classified as magnetic clouds (MCs) that are associated with kmTIIs is roughly similar to that of MCs not associated with kmTIIs. Conversely, the fraction of ICMEs with bidirectional electrons is significantly larger for those ICMEs associated with kmTIIs (74% vs. 48%). Likewise, on average, ICMEs associated with kmTIIs are 23% faster. The disturbance storm time (Dst) mean value is almost twice as large for kmTII-associated ICMEs, indicating that they tend to produce intense geomagnetic storms. In addition, the proportion of ICMEs producing moderate to intense geomagnetic storms is twice as large for the kmTII-associated ICMEs. After this investigation, TNR data proved to be valuable not only as complementary data for the analysis of kmTII events but also for forecasting the arrival of shocks at Earth.
ObjectivesTo update the Assessment of SpondyloArthritis international Society (ASAS)-EULAR recommendations for the management of axial spondyloarthritis (axSpA).MethodsFollowing the EULAR ...Standardised Operating Procedures, two systematic literature reviews were conducted on non-pharmacological and pharmacological treatment of axSpA. In a task force meeting, the evidence was presented, discussed, and overarching principles and recommendations were updated, followed by voting.ResultsFive overarching principles and 15 recommendations with a focus on personalised medicine were agreed: eight remained unchanged from the previous recommendations; three with minor edits on nomenclature; two with relevant updates (#9, 12); two newly formulated (#10, 11). The first five recommendations focus on treatment target and monitoring, non-pharmacological management and non-steroidal anti-inflammatory drugs (NSAIDs) as first-choice pharmacological treatment. Recommendations 6–8 deal with analgesics and discourage long-term glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) for pure axial involvement. Recommendation 9 describes the indication of biological DMARDs (bDMARDs, that is, tumour necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i)) and targeted synthetic DMARDs (tsDMARDs, ie, Janus kinase inhibitors) for patients who have Ankylosing Spondylitis Disease Activity Score ≥2.1 and failed ≥2 NSAIDs and also have either elevated C reactive protein, MRI inflammation of sacroiliac joints or radiographic sacroiliitis. Current practice is to start a TNFi or IL-17i. Recommendation 10 addresses extramusculoskeletal manifestations with TNF monoclonal antibodies preferred for recurrent uveitis or inflammatory bowel disease, and IL-17i for significant psoriasis. Treatment failure should prompt re-evaluation of the diagnosis and consideration of the presence of comorbidities (#11). If active axSpA is confirmed, switching to another b/tsDMARD is recommended (#12). Tapering, rather than immediate discontinuation of a bDMARD, can be considered in patients in sustained remission (#13). The last recommendations (#14, 15) deal with surgery and spinal fractures.ConclusionsThe 2022 ASAS-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA.
To demonstrate the efficacy of the anti-interleukin-6 receptor monoclonal antibody tocilizumab in patients with moderate-to-severe corticosteroid-resistant Graves orbitopathy (GO).
Double-masked ...randomized clinical trial.
Setting and Participants: Thirty-two adults with moderate-to-severe corticosteroid-resistant GO from 10 medical centers in Spain were randomized (1:1). Intervention: Randomization to either 8 mg/kg body weight tocilizumab or placebo administered intravenously at weeks 0, 4, 8, and 12, and follow-up for an additional 28 weeks. Main Outcomes and Measures: The primary outcome was the proportion of patients with a change from baseline to week 16 of at least 2 in the clinical activity score (CAS).
The primary outcome was met by 93.3% (95% confidence interval CI 70.1%-98.8%) of the patients receiving tocilizumab and 58.8% (36%-78.3%) receiving placebo (P = .04; odds ratio, 9.8 CI 1.3-73.2). A significant difference was also observed in the proportion of patients achieving a CAS < 3 (86.7% CI 62.1%-96.2% vs 35.2% CI 17.3%-58.7%, P = .005; OR 11.9 CI 2.1-63.1) at week 16. Additionally, a larger proportion of patients with improvement in the European Group on GO–proposed composite ophthalmic score at week 16 (73.3% CI 48%-89.1% vs 29.4% CI 13.2%-53.1%; P = .03), and exophthalmos size change from baseline to week 16 (-1.5 -2.0 to 0.5 mm vs 0.0 -1.0 to 0.5 mm; P = .01) were seen with tocilizumab. One patient experienced a moderate increase in transaminases at week 8; another had an acute pyelonephritis at week 32 in the tocilizumab-treated group.
Tocilizumab offers a meaningful improvement in activity and severity in corticosteroid-resistant GO. This trial justifies further studies to characterize the role of tocilizumab in GO.
The low energy excitation states in frustrated magnetic structures can generate quasiparticles that behave as if they were magnetic charges. These excited states produce, in the so-called spin-ice ...materials, two different peaks of specific heat at temperatures less than 1.5 K. In this paper, we consider that the first structure is caused by the formation of fluid of magnetic dipoles configured by the dumbbell model with a boson nature in consonance with that described by Witten for mesons. The second structure, wider than the first one, corresponds to a plasma state that comes from the breaking of a great number of dipoles, which provokes the appearance of free magnetic charges, which constitute a cool magnetic plasma fluid. In this paper, we determine thermodynamic analytical functions: the thermo-potential and internal energy and their respective derivative physical magnitudes: entropy, and magnetic specific heat. We obtain results in a good concordance with the experimental data, which allow us to explain the phase transitions occurred in these spin-ice materials at very low temperatures.
We study an extreme ultraviolet (EUV) confined ejection observed on 9 May 2012 in Active Region (AR) NOAA 11476. For the analysis we use observations in multiple wavelengths (EUV, X-rays, H
α
, and ...magnetograms) from a variety of ground- and space-based instruments. The magnetic configuration showed two rotating bipoles within the following polarity of the AR. This evolution was present some tens of hours before the studied event and continued thereafter. During this period, the magnetic flux of both bipoles continuously decreased. A mini-filament with a length of
≈
30
″
lay along the photospheric inversion line of the largest bipole. The mini-filament was observed to erupt, accompanied by an M4.7 flare (SOL20120509T12:23:00). This injected dense material as well as twist along closed loops in the form of a very broad ejection whose morphology resembled that of typical H
α
surges. We conclude that the flare and eruption can be explained as due to two reconnection processes, one occurring below the erupting mini-filament, and another above it. This second process injects the mini-filament plasma within the reconnected closed loops linking the main AR polarities. By analyzing the magnetic topology using a force-free model of the coronal field, we identify the location of quasi-separatix layers, where reconnection is prone to occur, and present a detailed interpretation of the chromospheric and coronal eruption observations. In particular, this event, in contrast to what has been proposed in several models explaining surges and/or jets, is not produced by magnetic flux emergence, but by magnetic flux cancellation accompanied by the rotation of the bipoles. In fact, the conjunction of these two processes, flux cancellation and bipole rotations, is at the origin of a series of events, homologous to the event we analyze in this article, which occurred in AR 11476 from 8 to 10 May 2012.
Background
Gastric cancer (GC) with peritoneal carcinomatosis (PC) is traditionally considered a terminal stage of the disease. The use of a multimodal treatment, including cytoreductive surgery ...(CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), can benefit these patients. Our goal was to evaluate the morbidity and survival outcomes of these patients.
Methods
This is a retrospective, multicenter study from a prospective national database of patients diagnosed with PC secondary to GC treated with CRS and HIPEC from June 2006 to October 2017.
Results
Eighty-eight patients from seven specialized Spanish institutions were treated with CRS and HIPEC, with median age of 53 years; 51% were women. Median Peritoneal Cancer Index (PCI) was 6, and complete cytoreduction was achieved in 80 patients (90.9%). HIPEC was administered in 85 cases with 4 different regimens (Cisplatin + Doxorubicin, Mitomycin-C + Cisplatin, Mitomycin-C and Oxaliplatin). Twenty-seven cases (31%) had severe morbidity (grade III–IV) and 3 patients died in the postoperative period (3.4%). Median follow-up was 32 months. Median overall survival (OS) was 21.2 months, with 1-year OS of 79.9% and 3-year OS of 30.9%. Median disease-free survival (DFS) was 11.6 months, with 1-year DFS of 46.1% and 3-year DFS of 21.7%. After multivariate analysis, the extent of peritoneal disease (PCI ≥ 7) was identified as the only independent factor that influenced OS (hazard ratio HR 2.37, 95% confidence interval CI 1.26–4.46,
p
= 0.007).
Conclusions
The multimodal treatment, including CRS and HIPEC, for GC with PC can improve the survival results in selected patients (PCI < 7) and in referral centers.
There are few concordance studies on the Chlamydia trachomatis (infection among infertile couples. The objective of this research was to know the prevalence, concordance and reproductive sequelae ...that couples may develop when both partners show a C. trachomatis infection. A cross‐sectional study among 688 infertile couples using the C. trachomatis detection by real‐time PCR was performed. The infertility causes were obtained from their medical records. The prevalence of infection was 8.68%. The percentage of concordance was 22.4% (13 couples). A presence of tubal occlusion was only associated with infected‐discordant women RR = 3.46, 95% CI (1.54–7.74), p < .003. Seminal values were not associated with discordant men. The concordant couples showed association with the infection and tubal occlusion RR = 3.19, 95% CI (1.09–9.34), p < .05, and oligozoospermia RR = 12.17, 95% CI (4.29–34.54), p < .001, hypospermia RR = 14.13, 95% CI (4.78–41.84), p < .001. An alteration in semen quality was shown particularly in men whose sexual partners show a tubal pathology. This could occur due to a C. trachomatis infection in the testis, which underlines the need to carry out effective and efficient strategies to identify and treat all sexual partners exposed to C. trachomatis.
A field study was conducted to assess the long‐term effects of no‐tillage (NT) and conventional tillage (CT), and the short‐term effects following tillage conversion from CT to NT (NTn) and from NT ...to CT (CTn) on soil quality (SQ) indicators in a semi‐humid climate. First, plots of a long‐term tillage experiment on a Luvic Phaeozem initiated in 1986 were split into two subplots in 2012, yielding four treatments: NT, CT, NTn and CTn. In 2015, composite soil samples were collected from each treatment and from a natural site (Ref) at depths 0–5, 5–10, 10–20 and 0–20 cm. Several indicators were determined: soil organic carbon (SOC) and nitrogen (SON); particulate organic C (POM‐C) and N (POM‐N); potential N mineralization (PMN) and soil respiration (Rs). Moreover, bulk density was determined in long‐term tillage systems. Different ratios between indicators were calculated, with emphasis on its function in the agroecosystem, that is functional indicators. Significant differences in SOC, SON and PMN were found between CT and NT at most depths. In contrast, 3 years after tillage conversion, only a part of the SQ indicators studied were modified mainly at the 0–10 cm depth. The functional indicators showed differences between tillage systems in the long‐term and after short‐term tillage conversion depending on the depth; however, the PMN/SON ratio demonstrated differences at all depths. Under these conditions, this ratio‐related to easily mineralizable N fraction proved to be a promising indicator for assessing SQ under contrasting tillage systems regardless of the sampling depth.
We carry out an analysis of the mass that is evacuated from three coronal dimming regions observed by the
Atmospheric Imaging Assembly
(AIA) on board the
Solar Dynamics Observatory
. The three events ...are unambiguously identified with white-light coronal mass ejections (CMEs) that are associated in turn with surface activity of diverse nature: an impulsive (M-class) flare, a weak (B-class) flare, and a filament eruption without a flare. The use of three AIA coronal passbands allows applying a differential emission measure technique to define the dimming regions and identify their evacuated mass through the analysis of the electronic density depletion associated with the eruptions. The temporal evolution of the mass loss from the three dimmings can be approximated by an exponential equation followed by a linear fit. We determine the mass of the associated CMEs from COR2 data. The results show that the evacuated masses from the low corona represent a considerable amount of the CME mass. We also find that plasma is still being evacuated from the low corona at the time when the CMEs reach the COR2 field of view. The temporal evolution of the angular width of the CMEs, of the dimming regions in the low corona, and of the flux registered by GOES in soft X-rays are all in close relation with the behavior of mass evacuation from the low corona. We discuss the implications of our findings toward a better understanding of the temporal evolution of several parameters associated with the analyzed dimmings and CMEs.
•POCc was the most affected by the agricultural practices.•POCf was the most sensitive organic fraction to agricultural practices.•Agricultural management differences were better observed in early ...spring sampling.•Seasonal variations in the organic fractions were: POCc≥CHs>CHt≥POCf>SOC>MOC.•Multivariate analysis was useful for identifying variables sensitive to management.
The turnover rate of labile organic fractions varies continuously due to different soil uses and managements, weather conditions and sampling time. The aim of this study was to quantify the effect of different agricultural management, season and soil type on soil organic carbon (SOC) and its different fractions. The study was conducted on four sites located in the Argentinean Pampas. In each site, three treatments were defined: Good Agricultural Practices (GAP), Poor Agricultural Practices (PAP) and Natural Environment (NE). During two consecutive years (2010 and 2011) and at two different times (February and September) undisturbed soil samples were taken at 0–20cm depth. Variables assessed included: SOC and its organic fractions: coarse (POCc) and fine (POCf) particulate organic carbon, SOC associated with a mineral fraction (MOC), total (CHt) and soluble (CHs) carbohydrates, bulk density (BD), and large pores (P>30). Also, indices associated with soil and management variables were determined. SOC reductions caused by agricultural practices were mainly from POCc. This fraction represented 34–52% and 50–74% for PAP and GAP, respectively, of the observed in NE. The carbon pool index (CPI) shows that agricultural treatments induced greater variations in all the labile organic fractions compared with SOC and MOC. In turn, the magnitude of variability was different among fractions, where temporal fluctuations increased according to the following order MOC<SOC<POCf≤CHt<CHs≤POCc. Independently of the soil type, the CPI was a sensitive indicator of soil quality in these systems under no-tillage. The multivariate analysis has proven to be an efficient analytical methodology for the identification of soil indicators that respond to agricultural practices, in which chemical properties (POCf and CHt), physical (BD and P>30), and indices (SOC: clay, structural index and intensification sequence index) were the variables that best explained the total variance of information of the four sites. Therefore, these indicators/indices should be included in any minimum data set for evaluating the agricultural soil quality under no-tillage in the studied area.
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