Third molar removal and orofacial pain : a population-based survey

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Detection of Helium in the Atmosphere of the Exo-Neptune HAT-P-11b

The helium absorption triplet at a wavelength of 10,833 \AA\ has been proposed as a way to probe the escaping atmospheres of exoplanets. Recently this feature was detected for the first time using Hubble Space Telescope (HST) WFC3 observations of the hot Jupiter WASP-107b. We use similar HST/WFC3 observations to detect helium in the atmosphere of the hot Neptune HAT-P-11b at the $4\sigma$ confidence level. We compare our observations to a grid of 1D models of hydrodynamic escape to constrain the thermospheric temperatures and mass loss rate. We find that our data are best fit by models with high mass loss rates of $\dot{M} \approx 10^{9}$ - $10^{11}$ g s$^{-1}$. Although we do not detect the planetary wind directly, our data are consistent with the prediction that HAT-P-11b is experiencing hydrodynamic atmospheric escape. Nevertheless, the mass loss rate is low enough that the planet has only lost up to a few percent of its mass over its history, leaving its bulk composition largely unaffected. This matches the expectation from population statistics, which indicate that close-in planets with radii greater than 2 R$_{\oplus}$ form and retain H/He-dominated atmospheres. We also confirm the independent detection of helium in HAT-P-11b obtained with the CARMENES instrument, making this the first exoplanet with the detection of the same signature of photoevaporation from both ground- and space-based facilities.Comment: 12 pages, 9 figures, accepted for publication in ApJ

A Precise Water Abundance Measurement for the Hot Jupiter WASP-43b

The water abundance in a planetary atmosphere provides a key constraint on the planet's primordial origins because water ice is expected to play an important role in the core accretion model of planet formation. However, the water content of the Solar System giant planets is not well known because water is sequestered in clouds deep in their atmospheres. By contrast, short-period exoplanets have such high temperatures that their atmospheres have water in the gas phase, making it possible to measure the water abundance for these objects. We present a precise determination of the water abundance in the atmosphere of the 2 $M_\mathrm{Jup}$ short-period exoplanet WASP-43b based on thermal emission and transmission spectroscopy measurements obtained with the Hubble Space Telescope. We find the water content is consistent with the value expected in a solar composition gas at planetary temperatures (0.4-3.5x solar at 1 $\sigma$ confidence). The metallicity of WASP-43b's atmosphere suggested by this result extends the trend observed in the Solar System of lower metal enrichment for higher planet masses.Comment: Accepted to ApJL; this version contains three supplemental figures that are not included in the published paper. See also our companion paper "Thermal structure of an exoplanet atmosphere from phase-resolved emission spectroscopy" by Stevenson et a

Using Complex, Multi-Sectoral Data in a Needs Assessment to Inform Future Strategies in Childhood Asthma Management

The purpose of this needs assessment was to study the current state of asthma management in high-risk children in Houston, Texas to inform a theory-based approach to improving asthma management. The mixed-method assessment included multi-sectoral survey, quantitative, and geospatial data that address a range of social and community factors in family, community, home, and medical contexts. Houston Emergency Medical Services (EMS) provided ambulance-treated asthma data mapped by geographic area to identify where childhood asthma management was weakest. Texas Children’s Health Plan (TCHP) provided medication compliance rates and counts of children by zip code that TCHP considered high-risk according to claims data. Houston Independent School District (HISD) provided school nurse survey results from schools with high-rates of ambulance-treated asthma attacks regarding local barriers to asthma management. Elementary schools with children at highest risk were identified by overlaying the EMS data, TCHP data, and HISD school zone boundaries. Survey results from the high-rate schools indicate the priority challenges to childhood asthma management, including lack of resources, lack of communication, lack of knowledge of triggers, and inadequate time for quality care from providers. By weaving together EMS, TCHP, and HISD data, the needs assessment informed a socio-ecological view of gaps in high-risk childhood asthma management and control, specifically where and what to target. An assessment approach with multi-sectoral data, geospatial mapping, nurse input, current systems of care, education, and funding helped focus planning on a practical approach to asthma control solutions for high-risk children

Climate of an Ultra hot Jupiter: Spectroscopic phase curve of WASP-18b with HST/WFC3

We present the analysis of a full-orbit, spectroscopic phase curve of the ultra hot Jupiter WASP-18b, obtained with the Wide Field Camera 3 aboard the Hubble Space Telescope. We measure the planet's normalized day-night contrast as >0.96 in luminosity: the disk-integrated dayside emission from the planet is at 964+-25 ppm, corresponding to 2894+-30 K, and we place an upper limit on the nightside emission of <32ppm or 1430K at the 3-sigma level. We also find that the peak of the phase curve exhibits a small, but significant offset in brightness of 4.5+-0.5 degrees eastward. We compare the extracted phase curve and phase resolved spectra to 3D Global Circulation Models and find that broadly the data can be well reproduced by some of these models. We find from this comparison several constraints on the atmospheric properties of the planet. Firstly we find that we need efficient drag to explain the very inefficient day-night re-circulation observed. We demonstrate that this drag could be due to Lorentz-force drag by a magnetic field as weak as 10 Gauss. Secondly, we show that a high metallicity is not required to match the large day-night temperature contrast. In fact, the effect of metallicity on the phase curve is different from cooler gas-giant counterparts, due to the high-temperature chemistry in WASP-18b's atmosphere. Additionally, we compare the current UHJ spectroscopic phase curves, WASP-18b and WASP-103b, and show that these two planets provide a consistent picture with remarkable similarities in their measured and inferred properties. However, key differences in these properties, such as their brightness offsets and radius anomalies, suggest that UHJ could be used to separate between competing theories for the inflation of gas-giant planets.Comment: Accepted for publication in A&

A HST/WFC3 Thermal Emission Spectrum of the Hot Jupiter HAT-P-7b

Secondary eclipse observations of several of the hottest hot Jupiters show featureless, blackbody-like spectra or molecular emission features, which are consistent with thermal inversions being present in those atmospheres. Theory predicts a transition between warmer atmospheres with thermal inversions and cooler atmospheres without inversions, but the exact transition point is unknown. In order to further investigate this issue, we observed two secondary eclipses of the hot Jupiter HAT-P-7b with the Hubble Space Telescope (HST) WFC3 instrument and combined these data with previous Spitzer and Kepler secondary eclipse observations. The HST and Spitzer data can be well fit by a blackbody with $T=2692 \pm 14$ K, and the Kepler data point constrains the geometric albedo to $A_{g}=0.077 \pm 0.006$. We modeled these data with a 3D GCM and 1D self-consistent forward models. The 1D models indicate that the atmosphere has a thermal inversion, weak heat redistribution, and water dissociation that limits the range of pressures probed. This result suggests that WFC3 observations of HAT-P-7b and possibly some other ultra-hot Jupiters appear blackbody-like because they probe a region near the tropopause where the atmospheric temperature changes slowly with pressure. Additionally, the 1D models constrain the atmospheric metallicity ($[\text{M/H}]=-0.87^{+0.38}_{-0.34}$) and the carbon-to-oxygen ratio (C/O $<1$ at 99 % confidence). The solar composition 3D GCM matches the Spitzer data but generally underpredicts the flux in the WFC3 bandpass and cannot reproduce its featureless shape. This discrepancy could be explained by high atmospheric drag or nightside clouds, and may be better understood through further observation with the James Webb Space Telescope (JWST).Comment: 14 pages, 10 figures, submitted to AAS Journal

An Unusual Transmission Spectrum for the Sub-Saturn KELT-11b Suggestive of a Sub-Solar Water Abundance

We present an optical-to-infrared transmission spectrum of the inflated sub-Saturn KELT-11b measured with the Transiting Exoplanet Survey Satellite (TESS), the Hubble Space Telescope (HST) Wide Field Camera 3 G141 spectroscopic grism, and the Spitzer Space Telescope (Spitzer) at 3.6 $\mu$m, in addition to a Spitzer 4.5 $\mu$m secondary eclipse. The precise HST transmission spectrum notably reveals a low-amplitude water feature with an unusual shape. Based on free retrieval analyses with varying molecular abundances, we find strong evidence for water absorption. Depending on model assumptions, we also find tentative evidence for other absorbers (HCN, TiO, and AlO). The retrieved water abundance is generally $\lesssim 0.1\times$ solar (0.001--0.7$\times$ solar over a range of model assumptions), several orders of magnitude lower than expected from planet formation models based on the solar system metallicity trend. We also consider chemical equilibrium and self-consistent 1D radiative-convective equilibrium model fits and find they too prefer low metallicities ($[M/H] \lesssim -2$, consistent with the free retrieval results). However, all the retrievals should be interpreted with some caution since they either require additional absorbers that are far out of chemical equilibrium to explain the shape of the spectrum or are simply poor fits to the data. Finally, we find the Spitzer secondary eclipse is indicative of full heat redistribution from KELT-11b's dayside to nightside, assuming a clear dayside. These potentially unusual results for KELT-11b's composition are suggestive of new challenges on the horizon for atmosphere and formation models in the face of increasingly precise measurements of exoplanet spectra.Comment: Accepted to The Astronomical Journal. 31 pages, 20 figures, 7 table

Does attendance at a specialist antenatal clinic improve clinical outcomes in women with Class III obesity compared to standard care? a retrospective case-note analysis

OBJECTIVES: To determine whether attendance at a specialised multidisciplinary antenatal clinic for women with class III obesity (BMI >40 kg/m2) is associated with improved clinical outcomes compared with standard antenatal care. DESIGN: Retrospective cohort study using routinely collected data from electronic patient record. SETTING: Community and hospital based antenatal care. PARTICIPANTS: Women with a singleton pregnancy with class III obesity booked for antenatal care and delivered in one of two hospitals in NHS Lothian, Scotland, UK between 2008 and 2014. Maternal and offspring outcomes were compared in women who attended a specialised obesity clinic (n=511) compared with standard antenatal care (n=502). MAIN OUTCOME MEASURES: Included stillbirth, low birth weight, gestational diabetes, induction of labour and caesarean section. RESULTS: Compared with standard care, women receiving specialist care were less likely to have a stillbirth (OR 0.12, 95% CI 0.06 to 0.97) and a low birthweight baby (OR 0.57, 95% CI 0.33 to 0.99) and more likely to be screened for (100% vs 73.6%; p<0.001) and diagnosed with (26.0% vs 12.5%; p<0.001) gestational diabetes, to require induction of labour (38.4% vs 29.9%; p=0.009), an elective (20.3% vs 17.7%; p<0.001) and emergency (23.9% vs 20.3%; p<0.001) caesarean section and attend antenatal triage one or more times during pregnancy (77.7% vs 53.1%; p<0.001). Women attending the specialist clinic had a higher BMI (44.5 kg/m2 (4.3) vs 43.2 kg/m2 (3.1); p<0.001) and were more likely to be nulliparous (46.0% vs 24.9%; p<0.001). There were no other differences in maternal demographic or maternal and offspring outcomes between groups. CONCLUSIONS: Attendance at a specialised antenatal clinic for obesity is associated with reduced rates of stillbirth and low birth weight and improved detection of gestational diabetes. The improvement in clinical outcomes is associated with an increase in healthcare attendance to obstetric triage and clinical interventions including induction of labour and caesarean section