Governmental surveillance system of healthcare-associated infection in Brazil

Objective: This study aimed to describe the structure of governmental surveillance systems for Healthcare Associated Infection (HAI) in the Brazilian Southeastern and Southern States. Method: A cross-sectional, descriptive and exploratory study, with data collection by means of two-phases: characterization of the healthcare structure and of the HAI surveillance system. Results: The governmental teams for prevention and control of HAI in each State ranged from one to six members, having at least one nurse. All States implemented their own surveillance system. The information systems were classified into chain (n=2), circle (n=4) or wheel (n=1). Conclusion: Were identified differences in the structure and information flow from governmental surveillance systems, possibly limiting a nationwide standardization. The present study points to the need for establishing minimum requirements in public policies, in order to guide the development of HAI surveillance systems

Coherent Quantum Network of Superconducting Qubits as a Highly Sensitive Detector of Microwave Photons for Searching of Galactic Axions

We propose a novel approach to detect a low power microwave signal with a frequency of the order of several GHz based on a coherent collective response of quantum states occurring in a superconducting qubits network (SQN). An SQN composes of a large number of superconducting qubits embedded in a low-dissipative superconducting resonator. Our theory predicts that an SQN interacting with the off-resonance microwave radiation, demonstrates the collective alternating current Stark effect that can be measured even in the limit of single photon counting. A design of the layout of three terminals SQN detectors containing 10 flux qubits weakly coupled to a low-dissipative R-resonator and T-transmission line was developed. The samples were fabricated by Al-based technology with Nb resonator. The SQN detector was tested in terms of microwave measurements of scattering parameters and two-tone spectroscopy. A substantial shift of the frequency position of the transmission coefficient drop induced by a second tone pump signal was observed, and this effect clearly manifests a nonlinear multiphoton interaction between the second-tone microwave pump signal and an array of qubits

Characteristics of Local Health Departments Associated with Implementation of Electronic Health Records and Other Informatics Systems

Objective: Assessing local health departments’ (LHDs’) informatics capacities is important, especially within the context of broader, systems-level health reform. We assessed a nationally representative sample of LHDs’ adoption of information systems and the factors associated with adoption and implementation by examining electronic health records, health information exchange, immunization registry, electronic disease reporting system, and electronic laboratory reporting. Methods: We used data from the National Association of County and City Health Officials’ 2013 National Profile of LHDs. We performed descriptive statistics and multinomial logistic regression for the five implementation-oriented outcome variables of interest, with three levels of implementation (implemented, plan to implement, and no activity). Independent variables included infrastructural and financial capacity and other characteristics associated with informatics capacity. Results: Of 505 LHDs that responded to the survey, 69 (13.5%) had implemented health information exchanges, 122 (22.2%) had implemented electronic health records, 245 (47.5%) had implemented electronic laboratory reporting, 368 (73.0%) had implemented an electronic disease reporting system, and 416 (83.8%) had implemented an immunization registry. LHD characteristics associated with health informatics adoption included provision of greater number of clinical services, greater per capita public health expenditures, health information systems specialists on staff, larger population size, decentralized governance system, one or more local boards of health, metropolitan jurisdiction, and top executive with more years in the job. Conclusion: Many LHDs lack health informatics capacity, particularly in smaller, rural jurisdictions. Cross-jurisdictional sharing, investment in public health informatics infrastructure, and additional training may help address these shortfalls

TOI-969: a late-K dwarf with a hot mini-Neptune in the desert and an eccentric cold Jupiter

Context. The current architecture of a given multi-planetary system is a key fingerprint of its past formation and dynamical evolution history. Long-term follow-up observations are key to complete their picture. Aims. In this paper, we focus on the confirmation and characterization of the components of the TOI-969 planetary system, where TESS detected a Neptune-size planet candidate in a very close-in orbit around a late K-dwarf star. Methods. We use a set of precise radial velocity observations from HARPS, PFS, and CORALIE instruments covering more than two years in combination with the TESS photometric light curve and other ground-based follow-up observations to confirm and characterize the components of this planetary system. Results. We find that TOI-969 b is a transiting close-in (Pb ∼ 1.82 days) mini-Neptune planet (Formula Presented), placing it on the lower boundary of the hot-Neptune desert (Teq,b = 941 \ub1 31 K). The analysis of its internal structure shows that TOI-969 b is a volatile-rich planet, suggesting it underwent an inward migration. The radial velocity model also favors the presence of a second massive body in the system, TOI-969 c, with a long period of (Formula Presented) days, a minimum mass of (Formula Presented), and a highly eccentric orbit of (Formula Presented). Conclusions. The TOI-969 planetary system is one of the few around K-dwarfs known to have this extended configuration going from a very close-in planet to a wide-separation gaseous giant. TOI-969 b has a transmission spectroscopy metric of 93 and orbits a moderately bright (G = 11.3 mag) star, making it an excellent target for atmospheric studies. The architecture of this planetary system can also provide valuable information about migration and formation of planetary systems

\u3cem\u3eTESS\u3c/em\u3e Discovery Of A Sub-Neptune Orbiting A Mid-M Dwarf TOI-2136

We present the discovery of TOI-2136 b, a sub-Neptune planet transiting a nearby M4.5V-type star every 7.85 d, identified through photometric measurements from the Transiting Exoplanet Survey Satellite (TESS) mission. The host star is located 33 pc away with a radius of R* = 0.34 ± 0.02 R⊙, a mass of 0.34 ± 0.02 M⊙, and an effective temperature of 3342 ± 100 K. We estimate its stellar rotation period to be 75 ± 5 d based on archival long-term photometry. We confirm and characterize the planet based on a series of ground-based multiwavelength photometry, high-angular-resolution imaging observations, and precise radial velocities from Canada–France–Hawaii Telescope (CFHT)/SpectroPolarimètre InfraROUge (SPIRou). Our joint analysis reveals that the planet has a radius of 2.20 ± 0.17 R⊕ and a mass of 6.4 ± 2.4 M⊕. The mass and radius of TOI-2136 b are consistent with a broad range of compositions, from water-ice to gas-dominated worlds. TOI-2136 b falls close to the radius valley for M dwarfs predicted by thermally driven atmospheric mass-loss models, making it an interesting target for future studies of its interior structure and atmospheric properties

EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis

Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional’s approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasized the importance for the health professional to adopt a patient-centered framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localized and generalized pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management, and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain management support for people with IA and OA

TOI-2266 b : a keystone super-Earth at the edge of the M dwarf radius valley

We validate the Transiting Exoplanet Survey Satellite (TESS) object of interest TOI-2266.01 (TIC 348911) as a small transiting planet (most likely a super-Earth) orbiting a faint M5 dwarf (V=16.54) on a 2.33~d orbit. The validation is based on an approach where multicolour transit light curves are used to robustly estimate the upper limit of the transiting object's radius. Our analysis uses SPOC-pipeline TESS light curves from Sectors 24, 25, 51, and 52, simultaneous multicolour transit photometry observed with MuSCAT2, MuSCAT3, and HiPERCAM, and additional transit photometry observed with the LCOGT telescopes. TOI-2266 b is found to be a planet with a radius of 1.54 ± 0.09,R⊕, which locates it at the edge of the transition zone between rocky planets, water-rich planets, and sub-Neptunes (the so-called M~dwarf radius valley). The planet is amenable to ground-based radial velocity mass measurement with red-sensitive spectrographs installed in large telescopes, such as MAROON-X and Keck Planet Finder (KPF), which makes it a valuable addition to a relatively small population of planets that can be used to probe the physics of the transition zone. Further, the planet's orbital period of 2.33 days places it inside a 'keystone planet' wedge in the period-radius plane where competing planet formation scenarios make conflicting predictions on how the radius valley depends on the orbital period. This makes the planet also a welcome addition to the small population of planets that can be used to test small-planet formation scenarios around M~dwarfs.Peer reviewe

The TESS Grand Unified Hot Jupiter Survey. I. Ten TESS Planets

Hot Jupiters—short-period giant planets—were the first extrasolar planets to be discovered, but many questions about their origin remain. NASA\u27s Transiting Exoplanet Survey Satellite (TESS), an all-sky search for transiting planets, presents an opportunity to address these questions by constructing a uniform sample of hot Jupiters for demographic study through new detections and unifying the work of previous ground-based transit surveys. As the first results of an effort to build this large sample of planets, we report here the discovery of 10 new hot Jupiters (TOI-2193A b, TOI-2207b, TOI-2236b, TOI-2421b, TOI-2567b, TOI-2570b, TOI-3331b, TOI-3540A b, TOI-3693b, TOI-4137b). All of the planets were identified as planet candidates based on periodic flux dips observed by TESS, and were subsequently confirmed using ground-based time-series photometry, high-angular-resolution imaging, and high-resolution spectroscopy coordinated with the TESS Follow-up Observing Program. The 10 newly discovered planets orbit relatively bright F and G stars (G \u3c 12.5, Teff between 4800 and 6200 K). The planets\u27 orbital periods range from 2 to 10 days, and their masses range from 0.2 to 2.2 Jupiter masses. TOI-2421b is notable for being a Saturn-mass planet and TOI-2567b for being a sub-Saturn, with masses of 0.322 ± 0.073 and 0.195 ± 0.030 Jupiter masses, respectively. We also measured a detectably eccentric orbit (e = 0.17 ± 0.05) for TOI-2207b, a planet on an 8 day orbit, while placing an upper limit of e \u3c 0.052 for TOI-3693b, which has a 9 day orbital period. The 10 planets described here represent an important step toward using TESS to create a large and statistically useful sample of hot Jupiters

A hot sub-Neptune in the desert and a temperate super-Earth around faint M dwarfs: Color validation of TOI-4479b and TOI-2081b

We report the discovery and validation of two TESS exoplanets orbiting faint M dwarfs: TOI-4479b and TOI-2081b. We have jointly analyzed space (TESS mission) and ground based (MuSCAT2, MuSCAT3 and SINISTRO instruments) lightcurves using our multi-color photometry transit analysis pipeline. This allowed us to compute contamination limits for both candidates and validate them as planet-sized companions. We found TOI-4479b to be a sub-Neptune-sized planet ($R_{p}=2.82^{+0.65}_{-0.63}~\rm R_{\oplus}$) and TOI-2081b to be a super-Earth-sized planet ($R_{p}=2.04^{+0.50}_{-0.54}~\rm R_{\oplus}$). Furthermore, we obtained that TOI-4479b, with a short orbital period of $1.15890^{+0.00002}_{-0.00001}~\rm days$, lies within the Neptune desert and is in fact the largest nearly ultra-short period planet around an M dwarf known to date. These results make TOI-4479b rare among the currently known exoplanet population around M dwarf stars, and an especially interesting target for spectroscopic follow-up and future studies of planet formation and evolution.Comment: Accepted for publication in Astronomy&Astrophysic

TESS Hunt for Young and Maturing Exoplanets (THYME) VII : Membership, rotation, and lithium in the young cluster Group-X and a new young exoplanet

The public, all-sky surveys Gaia and TESS provide the ability to identify new young associations and determine their ages. These associations enable study of planetary evolution by providing new opportunities to discover young exoplanets. A young association was recently identified by Tang et al. and F{\"u}rnkranz et al. using astrometry from Gaia (called "Group-X" by the former). In this work, we investigate the age and membership of this association; and we validate the exoplanet TOI 2048 b, which was identified to transit a young, late G dwarf in Group-X using photometry from TESS. We first identified new candidate members of Group-X using Gaia EDR3 data. To infer the age of the association, we measured rotation periods for candidate members using TESS data. The clear color--period sequence indicates that the association is the same age as the $300\pm50$ Myr-old NGC 3532. We obtained optical spectra for candidate members that show lithium absorption consistent with this young age. Further, we serendipitously identify a new, small association nearby Group-X, which we call MELANGE-2. Lastly, we statistically validate TOI 2048 b, which is $2.6\pm0.2$ \rearth\ radius planet on a 13.8-day orbit around its 300 Myr-old host star.Comment: Revised to correct error in reported planet radius (original: 2.1 Earth radii, corrected: 2.6 Earth radii) and units for planetary radius ratio entries in Table 8. All data tables available open-access with the AJ articl