Intense CIII] 1907,1909 emission from a strong Lyman continuum emitting galaxy

We have obtained the first complete ultraviolet (UV) spectrum of a strong Lyman continuum(LyC) emitter at low redshift -- the compact, low-metallicity, star-forming galaxy J1154+2443 -- with a Lyman continuum escape fraction of 46% discovered recently. The Space Telescope Imaging Spectrograph spectrum shows strong Lya and CIII] 1909 emission, as well as OIII] 1666. Our observations show that strong LyC emitters can have UV emission lines with a high equivalent width (e.g. EW(CIII])$=11.7 \pm 2.9 \AA$ rest-frame), although their equivalent widths should be reduced due to the loss of ionizing photons. The intrinsic ionizing photon production efficiency of J1154+2443 is high, $\log(\xi_{\rm ion}^0)=25.56$ erg$^{-1}$ Hz, comparable to that of other recently discovered $z \sim 0.3-0.4$ LyC emitters. Combining our measurements and earlier determinations from the literature, we find a trend of increasing $\xi_{\rm ion}^0$ with increasing CIII] 1909 equivalent width, which can be understood by a combination of decreasing stellar population age and metallicity. Simple ionization and density-bounded photoionization models can explain the main observational features including the UV spectrum of J1154+2443.Comment: 5 pages, 4 figures. Accepted for publication in A&A Letter

Accurately predicting the escape fraction of ionizing photons using restframe ultraviolet absorption lines

The fraction of ionizing photons that escape high-redshift galaxies sensitively determines whether galaxies reionized the early universe. However, this escape fraction cannot be measured from high-redshift galaxies because the opacity of the intergalactic medium is large at high redshifts. Without methods to indirectly measure the escape fraction of high-redshift galaxies, it is unlikely that we will know what reionized the universe. Here, we analyze the far-ultraviolet (UV) H I (Lyman series) and low-ionization metal absorption lines of nine low-redshift, confirmed Lyman continuum emitting galaxies. We use the H I covering fractions, column densities, and dust attenuations measured in a companion paper to predict the escape fraction of ionizing photons. We find good agreement between the predicted and observed Lyman continuum escape fractions (within $1.4\sigma$) using both the H I and ISM absorption lines. The ionizing photons escape through holes in the H I, but we show that dust attenuation reduces the fraction of photons that escape galaxies. This means that the average high-redshift galaxy likely emits more ionizing photons than low-redshift galaxies. Two other indirect methods accurately predict the escape fractions: the Ly$\alpha$ escape fraction and the optical [O III]/[O II] flux ratio. We use these indirect methods to predict the escape fraction of a sample of 21 galaxies with rest-frame UV spectra but without Lyman continuum observations. Many of these galaxies have low escape fractions ($f_{\rm esc} \le 1$\%), but 11 have escape fractions $>1$\%. The methods presented here will measure the escape fractions of high-redshift galaxies, enabling future telescopes to determine whether star-forming galaxies reionized the early universe.Comment: Accepted for publication in A&A. 12 pages, 5 figure

J1154+2443: a low-redshift compact star-forming galaxy with a 46 per cent leakage of Lyman continuum photons

We report the detection of the Lyman continuum (LyC) radiation of the compact star-forming galaxy (SFG) J1154+2443 observed with the Cosmic Origins Spectrograph (COS) onboard the Hubble Space Telescope. This galaxy, at a redshift of z=0.3690, is characterized by a high emission-line flux ratio O32=[OIII]5007/[OII]3727=11.5. The escape fraction of the LyC radiation fesc(LyC) in this galaxy is 46 per cent, the highest value found so far in low-redshift SFGs and one of the highest values found in galaxies at any redshift. The narrow double-peaked Lya emission line is detected in the spectrum of J1154+2443 with a separation between the peaks Vsep of 199 km/s, one of the lowest known for Lya-emitting galaxies, implying a high fesc(Lya). Comparing the extinction-corrected Lya/Hb flux ratio with the case B value we find fesc(Lya) = 98 per cent. Our observations, combined with previous detections in the literature, reveal an increase of O32 with increasing fesc(LyC). We also find a tight anticorrelation between fesc(LyC) and Vsep. The surface brightness profile derived from the COS acquisition image reveals a bright star-forming region in the centre and an exponential disc in the outskirts with a disc scale length alpha=1.09 kpc. J1154+2443, compared to other known low-redshift LyC leakers, is characterized by the lowest metallicity, 12+logO/H=7.65+/-0.01, the lowest stellar mass M*=10^8.20 Msun, a similar star formation rate SFR=18.9 Msun/yr and a high specific SFR of 1.2x10^-7 yr^-1.Comment: 16 pages, 8 figures, accepted for publication in MNRAS. arXiv admin note: text overlap with arXiv:1605.0516

Methods to assess COPD medications adherence in healthcare databases:a systematic review

Background: The Global Initiative for Chronic Obstructive Lung Disease 2023 report recommends medication adherence assessment in COPD as an action item. Healthcare databases provide opportunities for objective assessments; however, multiple methods exist. We aimed to systematically review the literature to describe existing methods to assess adherence in COPD in healthcare databases and to evaluate the reporting of influencing variables. Method: We searched MEDLINE, Web of Science and Embase for peer-reviewed articles evaluating adherence to COPD medication in electronic databases, written in English, published up to 11 October 2022 (PROSPERO identifier CRD42022363449). Two reviewers independently conducted screening for inclusion and performed data extraction. Methods to assess initiation (dispensing of medication after prescribing), implementation (extent of use over a specific time period) and/or persistence (time from initiation to discontinuation) were listed descriptively. Each included study was evaluated for reporting variables with an impact on adherence assessment: inpatient stays, drug substitution, dose switching and early refills. Results: 160 studies were included, of which four assessed initiation, 135 implementation and 45 persistence. Overall, one method was used to measure initiation, 43 methods for implementation and seven methods for persistence. Most of the included implementation studies reported medication possession ratio, proportion of days covered and/or an alteration of these methods. Only 11% of the included studies mentioned the potential impact of the evaluated variables. Conclusion: Variations in adherence assessment methods are common. Attention to transparency, reporting of variables with an impact on adherence assessment and rationale for choosing an adherence cut-off or treatment gap is recommended.</p

Hypertension in older patients, a retrospective cohort study

Background: It is unknown to what extent General Practitioners (GPs) manage hypertension (HT) differently in older patients, as compared to younger age groups. The purpose of our study was to compare HT management in older patients to younger age groups. Methods: We performed a retrospective cohort study of patients of 159 GP's practices in the Integrated Primary Care Information (IPCI) database. The study period lasted from September 2010 through December 2012. The study population consisted of all patients aged 60 years or older with at least one blood pressure (BP) measurement during the inclusion period, without pre-existent HT, diabetes mellitus (DM) or atherosclerotic cardiovascular disease at time of study start. Study outcomes were a diagnosis of HT within one month after cohort entry and the use of antihypertensive medication within 4 months after cohort entry in HT diagnosed patients. We compared the incidence of outcomes between the age groups, stratified by systolic blood pressure (SBP). Logistic regression analysis was used to assess the influence of age-adjusted SBP Z-scores, age and gender on the outcomes. Results: We included 19,500 patients from 159 GP's practices of whom 1,181 (6.1 %) were newly diagnosed with HT. Corrected for age-adjusted SBP, older patients were less likely to be diagnosed with HT (odds ratio per year age increase 0.98, p < 0.001). Corrected for age-adjusted SBP, no significant effect of age on the probability of treatment in newly diagnosed HT patients was observed (p = 0.82). Conclusions: This study showed that GPs are less inclined to diagnose HT with increasing patient age, but do not withhold treatment when they diagnose HT in older patients

The properties of the brightest Lyα emitters at z ∼ 5.7

We use deep Very Large Telescope (VLT) optical and near-infrared spectroscopy and deep Spitzer/IRAC imaging to examine the properties of two of the most luminous Lyα emitters at z= 5.7. The continuum redward of the Lyα line is clearly detected in both objects, thus facilitating a relatively accurate measurement (10-20 per cent uncertainties) of the observed rest-frame equivalent widths, which are around 160 Å for both objects. Through detailed modelling of the profile of the Lyα line with a 3D Monte Carlo radiative transfer code, we estimate the intrinsic rest-frame equivalent width of Lyα and find values that are around 300 Å, which is at the upper end of the range allowed for very young, moderately metal-poor star-forming galaxies. However, the uncertainties are large and values as high as 700 Å are permitted by the data. Both Lyα emitters are detected at 3.6 m in deep images taken with the Spitzer Space Telescope. We use these measurements, the measurement of the continuum redward of Lyα and other photometry to constrain the spectral energy distributions of these very luminous Lyα emitters and to compare them with three similar Lyα emitters from the literature. The contribution from nebular emission is included in our models: excluding it results in significantly higher masses. Four of the five Lyα emitters have masses of the order of ∼109 M⊙ and fairly high specific star formation rates (≳10-100 Gyr−1). While our two Lyα emitters appear similar in terms of the observed Lyα rest-frame equivalent width, they are quite distinct from each other in terms of age, mass and star formation history. Evidence for dust is found in all objects, and emission from nebular lines often makes a dominant contribution to the rest-frame 3.6 m flux. Rich in emission lines, these objects are prime targets for the next generation of extremely large telescopes, the James Webb Space Telescope (JWST) and the Atacama Large Millimeter Array (ALMA

Galaxy Counterparts of metal-rich Damped Lyman-alpha Absorbers - I: The case of the z=2.35 DLA towards Q2222-0946

We have initiated a survey using the newly commissioned X-shooter spectrograph to target candidate relatively metal-rich damped Lyman-alpha absorbers (DLAs). The spectral coverage of X-shooter allows us to search for not only Lyman-alpha emission, but also rest-frame optical emission lines. We have chosen DLAs where the strongest rest-frame optical lines ([OII], [OIII], Hbeta and Halpha) fall in the NIR atmospheric transmission bands. In this first paper resulting from the survey, we report on the discovery of the galaxy counterpart of the z_abs = 2.354 DLA towards the z=2.926 quasar Q2222$-0946. This DLA is amongst the most metal-rich z>2 DLAs studied so far at comparable redshifts and there is evidence for substantial depletion of refractory elements onto dust grains. We measure metallicities from ZnII, SiII, NiII, MnII and FeII of -0.46+/-0.07, -0.51+/-0.06, -0.85+/-0.06, -1.23+/-0.06, and -0.99+/-0.06, respectively. The galaxy is detected in the Lyman-alpha, [OIII] lambda4959,5007 Halpha emission lines at an impact parameter of about 0.8 arcsec (6 kpc at z_abs = 2.354). We infer a star-formation rate of 10 M_sun yr^-1, which is a lower limit due to the possibility of slit-loss. Compared to the recently determined Halpha luminosity function for z=2.2 galaxies the DLA-galaxy counterpart has a luminosity of L~0.1L^*_Halpha. The emission-line ratios are 4.0 (Lyalpha/Halpha) and 1.2 ([OIII]/Halpha). The Lyalpha line shows clear evidence for resonant scattering effects, namely an asymmetric, redshifted (relative to the systemic redshift) component and a much weaker blueshifted component. The fact that the blueshifted component is relatively weak indicates the presence of a galactic wind. The properties of the galaxy counterpart of this DLA is consistent with the prediction that metal-rich DLAs are associated with the most luminous of the DLA-galaxy counterparts.Comment: 9 pages, 7 figures. Accepted for publication in MNRA