The impact of bath gas composition on the calibration of photoacoustic spectrometers with ozone at discrete visible wavelengths spanning the Chappuis band

This is the author accepted manuscript. The final version is available from EGU via the DOI in this record.For data related to this paper, please contact Michael I. Cotterell (or Justin M. LangridgePhotoacoustic spectroscopy is a sensitive in situ technique for measuring the absorption coefficient for gas and aerosol samples. Photoacoustic spectrometer (PAS) instruments require accurate calibration by comparing the measured photoacoustic response with a known level of absorption for a calibrant. Ozone is a common calibrant of PAS instruments, yet recent work by Bluvshtein et al. (2017) has cast uncertainty on the validity of ozone as a calibrant at a wavelength of 405 nm. Moreover, Fischer and Smith (2018) demonstrate that a low O2 mass fraction in the bath gas can bias the measured PAS calibration coefficient to lower values for wavelengths in the range 532–780 nm. In this contribution, we present PAS sensitivity measurements at wavelengths of 405, 514 and 658 nm using ozone-based calibrations with variation in the relative concentrations of O2 and N2 bath gases. We find excellent agreement with the results of Fischer and Smith at the 658 nm wavelength. However, the PAS sensitivity decreases significantly as the bath gas composition tends to pure oxygen for wavelengths of 405 and 514 nm, which cannot be rationalised using arguments presented in previous studies. To address this, we develop a model to describe the variation in PAS sensitivity with both wavelength and bath gas composition that considers Chappuis band photodynamics and recognises that the photoexcitation of O3 leads rapidly to the photodissociation products O(3P) and O2(X, v > 0). We show that the rates of two processes are required to model the PAS sensitivity correctly. The first process involves the formation of vibrationally excited O3(X˜) through the reaction of the nascent O(3P) with bath gas O2. The second process involves the quenching of vibrational energy from the nascent O2(X, v > 0) to translational modes of the bath gas. Both of these processes proceed at different rates in collisions with N2 or O2 bath gas species. Importantly, we show that the PAS sensitivity is optimised for our PAS instruments when the ozone-based calibration is performed in a bath gas with a similar composition to ambient air and conclude that our methods for measuring aerosol absorption using an ozone-calibrated PAS are accurate and without detectable bias. We emphasise that the dependence of PAS sensitivity on bath gas composition is wavelength-dependent, and we recommend strongly that researchers characterise the optimal bath gas composition for their particular instrument.Analytical Chemistry Trust FundResearch Council on Norwa

The merger that led to the formation of the Milky Way's inner stellar halo and thick disk

The assembly process of our Galaxy can be retrieved using the motions and chemistry of individual stars. Chemo-dynamical studies of the nearby halo have long hinted at the presence of multiple components such as streams, clumps, duality and correlations between the stars' chemical abundances and orbital parameters. More recently, the analysis of two large stellar surveys have revealed the presence of a well-populated chemical elemental abundance sequence, of two distinct sequences in the colour-magnitude diagram, and of a prominent slightly retrograde kinematic structure all in the nearby halo, which may trace an important accretion event experienced by the Galaxy. Here report an analysis of the kinematics, chemistry, age and spatial distribution of stars in a relatively large volume around the Sun that are mainly linked to two major Galactic components, the thick disk and the stellar halo. We demonstrate that the inner halo is dominated by debris from an object which at infall was slightly more massive than the Small Magellanic Cloud, and which we refer to as Gaia-Enceladus. The stars originating in Gaia-Enceladus cover nearly the full sky, their motions reveal the presence of streams and slightly retrograde and elongated trajectories. Hundreds of RR Lyrae stars and thirteen globular clusters following a consistent age-metallicity relation can be associated to Gaia-Enceladus on the basis of their orbits. With an estimated 4:1 mass-ratio, the merger with Gaia-Enceladus must have led to the dynamical heating of the precursor of the Galactic thick disk and therefore contributed to the formation of this component approximately 10 Gyr ago. These findings are in line with simulations of galaxy formation, which predict that the inner stellar halo should be dominated by debris from just a few massive progenitors.Comment: 19 pages, 8 figures. Published in Nature in the issue of Nov. 1st, 2018. This is the authors' version before final edit

Detecting sulphate aerosol geoengineering with different methods

Sulphate aerosol injection has been widely discussed as a possible way to engineer future climate. Monitoring it would require detecting its effects amidst internal variability and in the presence of other external forcings. We investigate how the use of different detection methods and filtering techniques affects the detectability of sulphate aerosol geoengineering in annual-mean global-mean near-surface air temperature. This is done by assuming a future scenario that injects 5 Tg yr−1 of sulphur dioxide into the stratosphere and cross-comparing simulations from 5 climate models. 64% of the studied comparisons would require 25 years or more for detection when no filter and the multi-variate method that has been extensively used for attributing climate change are used, while 66% of the same comparisons would require fewer than 10 years for detection using a trend-based filter. This highlights the high sensitivity of sulphate aerosol geoengineering detectability to the choice of filter. With the same trend-based filter but a non-stationary method, 80% of the comparisons would require fewer than 10 years for detection. This does not imply sulphate aerosol geoengineering should be deployed, but suggests that both detection methods could be used for monitoring geoengineering in global, annual mean temperature should it be needed

A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial

BACKGROUND: Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services. A secondary aim is to explore the mediating factors between falls prevention and health-related quality of life. METHODS: The study is a single-blinded randomised controlled trial. Participants are older adults, aged 67 or older, receiving home help services, who are able to walk with or without walking aids, who have experienced at least one fall during the last 12 months and who have a Mini Mental State Examination of 23 or above. The intervention group receives a programme, based on the Otago Exercise Programme, lasting 12 weeks including home visits and motivational telephone calls. The control group receives usual care. The primary outcome is health-related quality of life (SF-36). Secondary outcomes are leg strength, balance, walking speed, walking habits, activities of daily living, nutritional status and falls efficacy. All measurements are performed at baseline, following intervention at 3 months and at 6 months' follow-up. Sample size, based on the primary outcome, is set to 150 participants randomised into the two arms, including an estimated 15-20% drop out. Participants are recruited from six municipalities in Norway. DISCUSSION: This trial will generate new knowledge on the effects of an exercise falls prevention programme among older fallers receiving home help services. This knowledge will be useful for clinicians, for health managers in the primary health care service and for policy makers

Differences in health outcomes for high-need high-cost patients across high-income countries.

ObjectiveThis study explores variations in outcomes of care for two types of patient personas-an older frail person recovering from a hip fracture and a multimorbid older patient with congestive heart failure (CHF) and diabetes.Data sourcesWe used individual-level patient data from 11 health systems.Study designWe compared inpatient mortality, mortality, and readmission rates at 30, 90, and 365 days. For the hip fracture persona, we also calculated time to surgery. Outcomes were standardized by age and sex.Data collection/extraction methodsData was compiled by the International Collaborative on Costs, Outcomes and Needs in Care across 11 countries for the years 2016-2017 (or nearest): Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States.Principal findingsThe hip sample across ranged from 1859 patients in Aragon, Spain, to 42,849 in France. Mean age ranged from 81.2 in Switzerland to 84.7 in Australia, and the majority of hip patients across countries were female. The congestive heart failure (CHF) sample ranged from 742 patients in England to 21,803 in the United States. Mean age ranged from 77.2 in the United States to 80.3 in Sweden, and the majority of CHF patients were males. Average in-hospital mortality across countries was 4.1%. for the hip persona and 6.3% for the CHF persona. At the year mark, the mean mortality across all countries was 25.3% for the hip persona and 32.7% for CHF persona. Across both patient types, England reported the highest mortality at 1 year followed by the United States. Readmission rates for all periods were higher for the CHF persona than the hip persona. At 30 days, the average readmission rate for the hip persona was 13.8% and 27.6% for the CHF persona.ConclusionAcross 11 countries, there are meaningful differences in health system outcomes for two types of patients

Differences in health care spending and utilization among older frail adults in high-income countries: ICCONIC hip fracture persona.

ObjectiveThis study explores differences in spending and utilization of health care services for an older person with frailty before and after a hip fracture.Data sourcesWe used individual-level patient data from five care settings.Study designWe compared utilization and spending of an older person aged older than 65 years for 365 days before and after a hip fracture across 11 countries and five domains of care as follows: acute hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, and outpatient drugs. Utilization and spending were age and sex standardized..Data collection/extraction methodsThe data were compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries as follows: Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States.Principal findingsThe sample ranged from 1859 patients in Spain to 42,849 in France. Mean age ranged from 81.2 in Switzerland to 84.7 in Australia. The majority of patients across countries were female. Relative to other countries, the United States had the lowest inpatient length of stay (11.3), but the highest number of days were spent in post-acute care rehab (100.7) and, on average, had more visits to specialist providers (6.8 per year) than primary care providers (4.0 per year). Across almost all sectors, the United States spent more per person than other countries per unit ($13,622 per hospitalization,$233 per primary care visit, $386 per MD specialist visit). Patients also had high expenditures in the year prior to the hip fracture, mostly concentrated in the inpatient setting.ConclusionAcross 11 high-income countries, there is substantial variation in health care spending and utilization for an older person with frailty, both before and after a hip fracture. The United States is the most expensive country due to high prices and above average utilization of post-acute rehab care

Cloud processing and weeklong ageing affect biomass burning aerosol properties over the south-eastern Atlantic

This is the final version. Available on open access from Nature Research via the DOI in this recordData availability: Data from the CLARIFY aircraft campaign are available on the CEDA repository at http://catalogue.ceda.ac.uk/uuid/38ab7089781a4560b067dd6c20af3769 (last access: 2022-07-04). Data from ORACLES aircraft campaigns are available on the repository at https://espo.nasa.gov/oracles/archive/browse/oracles/id14 (last access: 2022-07-04). ERA5 reanalysis data (https://doi.org/10.24381/cds.bd0915c6) can be obtained from https://cds.climate.copernicus.eu. The SEVIRI cloud poduct are provided by NASA Langley, and are available in: https://satcorps.larc.nasa.gov/cgi-bin/site/showdoc?docid=22&lkdomain=Y&domain=ORACLES (last access: 2022-07-04). GPM precipitation data (https://doi.org/10.5067/GPM/IMERG/3B-HH/06) can be obtained from: https://disc.gsfc.nasa.gov/datasets/GPM_3IMERGHH_06/summary (last access: 2022-07-04). SEVIRI fire data in Supplements are from the geostationary satellite Meteosat-8, and can be obtained from: https://navigator.eumetsat.int/product/EO:EUM:DAT:MSG:FRP-SEVIRI (last access: 2022-07-04). MODIS wildfire data (https://doi.org/10.5067/FIRMS/MODIS/MCD14DL.NRT.0061) in supplements are from NASA FIRMS https://earthdata.nasa.gov/firms (last access: 2022-07-04).Southern Africa produces a third of global biomass burning emissions, which have a long atmospheric lifetime and influence regional radiation balance and climate. Here, we use airmass trajectories to link different aircraft observations to investigate the evolution of biomass-burning aerosols during their westward transport from Southern Africa over the south-eastern Atlantic, where a semi-permanent stratocumulus cloud deck is located. Our results show secondary organic aerosol formation during the initial 3 days of transport, followed by decreases in organic aerosol via photolysis before reaching equilibrium. Aerosol absorption wavelength dependency decreases with ageing, due to an increase in particle size and photochemical bleaching of brown carbon. Cloud processing, including aqueous-phase reaction and scavenging, contributes to the oxidation of organic aerosols, while it strongly reduces large diameter particles and single-scattering albedo of biomass burning aerosols. Together, these processes resulted in a marine boundary layer with fewer yet more oxidized and absorbing aerosols.Natural Environment Research Council (NERC)Earth Venture Suborbital-2 (EVS-2) progra

A re-randomisation design for clinical trials

Background: Recruitment to clinical trials is often problematic, with many trials failing to recruit to their target sample size. As a result, patient care may be based on suboptimal evidence from underpowered trials or non-randomised studies. Methods: For many conditions patients will require treatment on several occasions, for example, to treat symptoms of an underlying chronic condition (such as migraines, where treatment is required each time a new episode occurs), or until they achieve treatment success (such as fertility, where patients undergo treatment on multiple occasions until they become pregnant). We describe a re-randomisation design for these scenarios, which allows each patient to be independently randomised on multiple occasions. We discuss the circumstances in which this design can be used. Results: The re-randomisation design will give asymptotically unbiased estimates of treatment effect and correct type I error rates under the following conditions: (a) patients are only re-randomised after the follow-up period from their previous randomisation is complete; (b) randomisations for the same patient are performed independently; and (c) the treatment effect is constant across all randomisations. Provided the analysis accounts for correlation between observations from the same patient, this design will typically have higher power than a parallel group trial with an equivalent number of observations. Conclusions: If used appropriately, the re-randomisation design can increase the recruitment rate for clinical trials while still providing an unbiased estimate of treatment effect and correct type I error rates. In many situations, it can increase the power compared to a parallel group design with an equivalent number of observations

A methodology for identifying high-need, high-cost patient personas for international comparisons.

ObjectiveTo establish a methodological approach to compare two high-need, high-cost (HNHC) patient personas internationally.Data sourcesLinked individual-level administrative data from the inpatient and outpatient sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries: Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States.Study designWe outline a methodological approach to identify HNHC patient types for international comparisons that reflect complex, priority populations defined by the National Academy of Medicine. We define two patient profiles using accessible patient-level datasets linked across different domains of care-hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, long-term care, home-health care, and outpatient drugs. The personas include a frail older adult with a hip fracture with subsequent hip replacement and an older person with complex multimorbidity, including heart failure and diabetes. We demonstrate their comparability by examining the characteristics and clinical diagnoses captured across countries.Data collection/extraction methodsData collected by ICCONIC partners.Principal findingsAcross 11 countries, the identification of HNHC patient personas was feasible to examine variations in healthcare utilization, spending, and patient outcomes. The ability of countries to examine linked, individual-level data varied, with the Netherlands, Canada, and Germany able to comprehensively examine care across all seven domains, whereas other countries such as England, Switzerland, and New Zealand were more limited. All countries were able to identify a hip fracture persona and a heart failure persona. Patient characteristics were reassuringly similar across countries.ConclusionAlthough there are cross-country differences in the availability and structure of data sources, countries had the ability to effectively identify comparable HNHC personas for international study. This work serves as the methodological paper for six accompanying papers examining differences in spending, utilization, and outcomes for these personas across countries