ABSTRACT
We report the discovery of two mini-Neptunes in near 2:1 resonance orbits (P = 7.610303 d for HIP 113103 b and P = 14.245651 d for HIP 113103 c) around the adolescent K-star HIP 113103 (TIC ...121490076). The planet system was first identified from the TESS mission, and was confirmed via additional photometric and spectroscopic observations, including a ∼17.5 h observation for the transits of both planets using ESA CHEOPS. We place ≤4.5 min and ≤2.5 min limits on the absence of transit timing variations over the 3 yr photometric baseline, allowing further constraints on the orbital eccentricities of the system beyond that available from the photometric transit duration alone. With a planetary radius of Rp = $1.829_{-0.067}^{+0.096}$ R⊕, HIP 113103 b resides within the radius gap, and this might provide invaluable information on the formation disparities between super-Earths and mini-Neptunes. Given the larger radius Rp = $2.40_{-0.08}^{+0.10}$ R⊕ for HIP 113103 c, and close proximity of both planets to HIP 113103, it is likely that HIP 113103 b might have lost (or is still losing) its primordial atmosphere. We therefore present simulated atmospheric transmission spectra of both planets using JWST, HST, and Twinkle. It demonstrates a potential metallicity difference (due to differences in their evolution) would be a challenge to detect if the atmospheres are in chemical equilibrium. As one of the brightest multi sub-Neptune planet systems suitable for atmosphere follow up, HIP 113103 b and HIP 113103 c could provide insight on planetary evolution for the sub-Neptune K-star population.
First Results of the SkyMapper Transient Survey Möller, A.; Tucker, B. E.; Armstrong, P. ...
Proceedings of the International Astronomical Union,
11/2017, Letnik:
14, Številka:
S339
Journal Article
Recenzirano
The SkyMapper Transient survey (SMT) is exploring variability in the southern sky by performing (a) a rolling search to discover and study supernovæ, and (b) a Target of Opportunity programme that ...uses the robotic SkyMapper Telescope at Siding Spring Observatory. The supernova survey is obtaining a non-targeted sample of Type Ia supernovæ (SNe Ia) at low redshifts, z < 0.1, and studying other interesting transients found with the search strategy. We have a Target of Opportunity programme with an automatic response mechanism to search for optical counterparts to gravitational-wave and fast radio-burst events; it benefits from SkyMapper’s large field of view of 5.7 sq. deg. and a rapid data reduction pipeline. We present first results of the SMT survey. The SMT pipeline can process and obtain potential candidates within 12 hours of observation. It disentangles real transients from processing artefacts using a machine-learning algorithm. To date, SMT has discovered over 60 spectroscopically confirmed supernovæ, several peculiar objects, and over 40 SNe Ia including one (SNIa 2016hhd) which was found within the first few days of explosion. We have also participated in searches for optical counterparts of gravitational waves, fast radio bursts and other transients, and have published observations of the optical counterpart of the gravitational-wave event GW170817. We also participate in coordinated observations with the Deeper Wider Faster programme, and the Kepler K2 cosmology project.
Inhaled nitric oxide (NO), an endothelium-derived relaxing factor, is a selective pulmonary vasodilator. The authors investigated whether inhaled NO decreases pulmonary vascular resistance (PVR) ...while preserving hypoxic pulmonary vasoconstriction and whether it maintains or improves oxygenation in patients during one-lung ventilation.
In supine cardiac surgical patients with a normal mean pulmonary artery pressure (PAP) (< 25 mmHg, n = 10) or a moderately elevated PAP (25-35 mmHg, n = 10), one-lung ventilation was established with 80% oxygen and 20% nitrogen followed by the same gas mixture containing 20 ppm NO for 6 min.
Inhaled NO decreased (P < 0.05) PAP from 30 +/- 2 to 27 +/- 2 mmHg in the patients with moderate pulmonary hypertension. Likewise, PVR decreased (P < 0.05) from 266 +/- 10 to 205 +/- 8 dyn.s.cm-5. The PAP and PVR did not change significantly after NO inhalation in the patients without pulmonary hypertension. All other hemodynamic variables remained unchanged after inhalation of NO in both groups. In the patients with pulmonary hypertension, the PAP and PVR returned to baseline after discontinuation of inhaled NO. Inhaled NO did not significantly change the arterial oxygen tension or venous admixture in either group of patients. Ventilation, airway pressure, tidal volume, and lung compliance also were unaffected by inhaled NO.
This study demonstrates that 20 ppm inhaled NO is a selective pulmonary vasodilator in patients with moderate pulmonary hypertension secondary to cardiac disease who are undergoing one-lung ventilation. In contrast to what would be expected with intravenous vasodilators that inhibit hypoxic pulmonary vasoconstriction, inhaled NO does not increase the venous admixture or impair oxygenation.
Background
The massive transfusion protocol (MTP) is designed to quickly provide blood products at a fixed ratio for the exsanguinating patient. At our academic medical center, the frequency of MTP ...activation increased over 10‐fold between 2008 and 2015, putting inordinate stress on our transfusion service.
Study design and methods
Gathering a large number of relevant stakeholders, we performed a multidisciplinary root cause analysis (RCA) in response to the acute clinical need to reform our MTP.
Results
Through the RCA, we identified four principal opportunities for improvement (OFI) associated with our MTP: education, stewardship, process improvement, and communication. Through the deployment of new approaches to each of these OFI, we reduced MTP activations, blood product waste, and transfusion service technologist stress.
Conclusion
The MTP is amenable to improvement, and, although time intensive, the RCA process yields significant favorable effects: improving communication with colleagues, reducing stress within the transfusion service, and improving resource utilization. Activation of the MTP at our institution is now more aligned with its primary purpose: rapidly providing large quantities of blood products to exsanguinating patients.
Objectives To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). Design Interrupted time series analysis, review of case ...notes, survey, and interviews. Setting Acute and primary care trusts in England and Wales. Participants All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. Main outcome measures Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. Results 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P < 0.002) and orlistat for obesity (P < 0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer's disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. Conclusions Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context.
Purpose
To compare patient-triggered follow-up (PTFU) for curatively treated colorectal cancer against traditional outpatient follow-up (OPFU)
.
Methods
Questionnaires were mailed at four time points ...over one-year post-treatment to two prospectively-recruited cohorts: A, patients entering follow-up and receiving OPFU pre-implementation of PTFU; B, patients entering follow-up (FU) and receiving either OPFU (B1) or PTFU (B2) post-implementation of PTFU. Bi-variate tests were used to compare patient characteristics and outcomes eight months after entering follow-up (generic and cancer-specific quality of life (QoL), satisfaction). Regression analysis explored associations between follow-up model and outcomes. Resource implications and costs of models were compared.
Results
Patients in Cohort B1 were significantly more likely to have received chemotherapy (
p
< 0.001), radiotherapy (
p
< 0.05), and reported poorer QoL (
p
= 0.001). Having a longstanding co-morbid condition was the most important determinant of QoL (
p
< 0.001); model of care was not significant. Patients were satisfied with their follow-up care regardless of model. Health service costs were higher in PTFU over the first year
Conclusions
PTFU is acceptable to patients with colorectal cancer and can be considered to be a realistic alternative to OPFU for clinically suitable patients. The initial costs are higher due to provision of a self-management (SM) programme and remote surveillance. Further research is needed to establish long-term outcomes and costs.
Abstract
The Transiting Exoplanet Survey Satellite (TESS) mission has enabled discoveries of the brightest transiting planet systems around young stars. These systems are the benchmarks for testing ...theories of planetary evolution. We report the discovery of a mini-Neptune transiting a bright star in the AB Doradus moving group. HIP 94235 (TOI-4399, TIC 464646604) is a
V
mag
= 8.31 G-dwarf hosting a
3.00
−
0.28
+
0.32
R
⊕
mini-Neptune in a 7.7 day period orbit. HIP 94235 is part of the AB Doradus moving group, one of the youngest and closest associations. Due to its youth, the host star exhibits significant photometric spot modulation, lithium absorption, and X-ray emission. Three 0.06% transits were observed during Sector 27 of the TESS Extended Mission, though these transit signals are dwarfed by the 2% peak-to-peak photometric variability exhibited by the host star. Follow-up observations with the Characterising Exoplanet Satellite confirmed the transit signal and prevented the erosion of the transit ephemeris. HIP 94235 is part of a 50 au G-M binary system. We make use of diffraction limited observations spanning 11 yr, and astrometric accelerations from Hipparcos and Gaia, to constrain the orbit of HIP 94235 B. HIP 94235 is one of the tightest stellar binaries to host an inner planet. As part of a growing sample of bright, young planet systems, HIP 94235 b is ideal for follow-up transit observations, such as those that investigate the evaporative processes driven by high-energy radiation that may sculpt the valleys and deserts in the Neptune population.
Abstract
The imminent launch of space telescopes designed to probe the atmospheres of exoplanets has prompted new efforts to prioritize the thousands of transiting planet candidates for follow-up ...characterization. We report the detection and confirmation of TOI-1842b, a warm Saturn identified by TESS and confirmed with ground-based observations from M
inerva
-Australis, NRES, and the Las Cumbres Observatory Global Telescope. This planet has a radius of
1.04
−
0.05
+
0.06
R
J
, a mass of
0.214
−
0.038
+
0.040
M
J
, an orbital period of
9.5739
−
0.0001
+
0.0002
days, and an extremely low density (
ρ
= 0.252 ± 0.091 g cm
−3
). TOI-1842b has among the best known combinations of large atmospheric scale height (893 km) and host-star brightness (
J
= 8.747 mag), making it an attractive target for atmospheric characterization. As the host star is beginning to evolve off the main sequence, TOI-1842b presents an excellent opportunity to test models of gas giant reinflation. The primary transit duration of only 4.3 hr also makes TOI-1842b an easily-schedulable target for further ground-based atmospheric characterization.
ObjectivesTo assess the quality and impact of medication safety outputs issued by the National Patient Safety Agency (NPSA) to the NHS in England and Wales.MethodsA multi-method study comprising (1) ...focus groups and interviews with NHS Chief Pharmacists and (2) an electronic survey of medical, nursing and clinical governance directors.ResultsAcute sector respondents agreed that the medication outputs had a major impact on patient safety. Pharmacists welcomed national support for medication safety improvement, despite the resulting workload. Medical Directors were much less likely to be aware of alerts and Rapid Response Reports (RRRs) than their nursing and clinical governance colleagues. One key finding was the inability of around half of NHS trusts to communicate effectively and reliably with their junior doctors.ConclusionMedication alerts issued by the NPSA have stimulated significant work to improve medication safety and are believed to have had an important impact on patient safety.
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