Communication and information exchange between primary healthcare employees and volunteers – challenges, needs and possibilities for technology support

publishedVersionPaid Open AccessUNIT agreemen

Digitalisation of municipal healthcare collaboration with volunteers: a case study applying normalization process theory

publishedVersio

Another Shipment of Six Short-Period Giant Planets from TESS

We present the discovery and characterization of six short-period, transiting giant planets from NASA\u27s Transiting Exoplanet Survey Satellite (TESS) -- TOI-1811 (TIC 376524552), TOI-2025 (TIC 394050135), TOI-2145 (TIC 88992642), TOI-2152 (TIC 395393265), TOI-2154 (TIC 428787891), & TOI-2497 (TIC 97568467). All six planets orbit bright host stars (8.

Characterization of K2-167 b and CALM, a new stellar activity mitigation method

We report precise radial velocity (RV) observations of HD 212657 (= K2-167), a star shown by K2 to host a transiting sub-Neptune-sized planet in a 10 day orbit. Using Transiting Exoplanet Survey Satellite (TESS) photometry, we refined the planet parameters, especially the orbital period. We collected 74 precise RVs with the HARPS-N spectrograph between August 2015 and October 2016. Although this planet was first found to transit in 2015 and validated in 2018, excess RV scatter originally limited mass measurements. Here, we measure a mass by taking advantage of reductions in scatter from updates to the HARPS-N Data Reduction System (2.3.5) and our new activity mitigation method called CCF Activity Linear Model (CALM), which uses activity-induced line shape changes in the spectra without requiring timing information. Using the CALM framework, we performed a joint fit with RVs and transits using EXOFASTv2 and find $M_p = 6.3_{-1.4}^{+1.4}$ $M_{\oplus}$ and $R_p = 2.33^{+0.17}_{-0.15}$ $R_{\oplus}$, which places K2-167 b at the upper edge of the radius valley. We also find hints of a secondary companion at a $\sim$ 22 day period, but confirmation requires additional RVs. Although characterizing lower-mass planets like K2-167 b is often impeded by stellar variability, these systems especially help probe the formation physics (i.e. photoevaporation, core-powered mass loss) of the radius valley. In the future, CALM or similar techniques could be widely applied to FGK-type stars, help characterize a population of exoplanets surrounding the radius valley, and further our understanding of their formation

Hydrocortisone as an intervention for dexamethasone-induced adverse effects in pediatric patients with acute lymphoblastic leukemia: results of a double-blind, randomized controlled trial

Purpose Dexamethasone is a key component in the treatment of pediatric acute lymphoblastic leukemia (ALL), but can induce serious adverse effects. Recent studies have led to the hypothesis that neuropsychological adverse effects may be a result of cortisol depletion of the cerebral mineralocorticoid receptors. We examined whether including a physiologic dose of hydrocortisone in dexamethasone treatment can reduce neuropsychologic and metabolic adverse effects in children with ALL. Patients and Methods We performed a multicenter, double-blind, randomized controlled trial with a crossover design. Of 116 potentially eligible patients (age 3 to 16 years), 50 were enrolled and were treated with two consecutive courses of dexamethas

The K2 & TESS Synergy II: Revisiting 26 systems in the TESS Primary Mission

The legacy of NASA's K2 mission has provided hundreds of transiting exoplanets that can be revisited by new and future facilities for further characterization, with a particular focus on studying the atmospheres of these systems. However, the majority of K2-discovered exoplanets have typical uncertainties on future times of transit within the next decade of greater than four hours, making observations less practical for many upcoming facilities. Fortunately, NASA's Transiting exoplanet Survey Satellite (TESS) mission is reobserving most of the sky, providing the opportunity to update the ephemerides for $\sim$300 K2 systems. In the second paper of this series, we reanalyze 26 single-planet, K2-discovered systems that were observed in the TESS primary mission by globally fitting their K2 and TESS lightcurves (including extended mission data where available), along with any archival radial velocity measurements. As a result of the faintness of the K2 sample, 13 systems studied here do not have transits detectable by TESS. In those cases, we re-fit the K2 lightcurve and provide updated system parameters. For the 23 systems with $M_* \gtrsim 0.6 M_\odot$, we determine the host star parameters using a combination of Gaia parallaxes, Spectral Energy Distribution (SED) fits, and MESA Isochrones and Stellar Tracks (MIST) stellar evolution models. Given the expectation of future TESS extended missions, efforts like the K2 & TESS Synergy project will ensure the accessibility of transiting planets for future characterization while leading to a self-consistent catalog of stellar and planetary parameters for future population efforts.Comment: Accepted for publication in ApJ. 29 pages, 9 figures, 12 table

Another Shipment of Six Short-Period Giant Planets from TESS

We present the discovery and characterization of six short-period, transiting giant planets from NASA's Transiting Exoplanet Survey Satellite (TESS) -- TOI-1811 (TIC 376524552), TOI-2025 (TIC 394050135), TOI-2145 (TIC 88992642), TOI-2152 (TIC 395393265), TOI-2154 (TIC 428787891), & TOI-2497 (TIC 97568467). All six planets orbit bright host stars (8.9 <G< 11.8, 7.7 <K< 10.1). Using a combination of time-series photometric and spectroscopic follow-up observations from the TESS Follow-up Observing Program (TFOP) Working Group, we have determined that the planets are Jovian-sized (R$_{P}$ = 1.00-1.45 R$_{J}$), have masses ranging from 0.92 to 5.35 M$_{J}$, and orbit F, G, and K stars (4753 $<$ T$_{eff}$ $<$ 7360 K). We detect a significant orbital eccentricity for the three longest-period systems in our sample: TOI-2025 b (P = 8.872 days, $e$ = $0.220\pm0.053$), TOI-2145 b (P = 10.261 days, $e$ = $0.182^{+0.039}_{-0.049}$), and TOI-2497 b (P = 10.656 days, $e$ = $0.196^{+0.059}_{-0.053}$). TOI-2145 b and TOI-2497 b both orbit subgiant host stars (3.8 $<$ $\log$ g $<$4.0), but these planets show no sign of inflation despite very high levels of irradiation. The lack of inflation may be explained by the high mass of the planets; $5.35^{+0.32}_{-0.35}$ M$_{\rm J}$ (TOI-2145 b) and $5.21\pm0.52$ M$_{\rm J}$ (TOI-2497 b). These six new discoveries contribute to the larger community effort to use {\it TESS} to create a magnitude-complete, self-consistent sample of giant planets with well-determined parameters for future detailed studies.Comment: 20 Pages, 6 Figures, 8 Tables, Accepted by MNRA

Left ventricular blood flow kinetic energy after myocardial infarction - insights from 4D flow cardiovascular magnetic resonance

Background: Myocardial infarction (MI) leads to complex changes in left ventricular (LV) haemodynamics that are linked to clinical outcomes. We hypothesize that LV blood flow kinetic energy (KE) is altered in MI and is associated with LV function and infarct characteristics. This study aimed to investigate the intra-cavity LV blood flow KE in controls and MI patients, using cardiovascular magnetic resonance (CMR) four-dimensional (4D) flow assessment. Methods: Forty-eight patients with MI (acute-22; chronic-26) and 20 age/gender-matched healthy controls underwent CMR which included cines and whole-heart 4D flow. Patients also received late gadolinium enhancement imaging for infarct assessment. LV blood flow KE parameters were indexed to LV end-diastolic volume and include: averaged LV, minimal, systolic, diastolic, peak E-wave and peak A-wave KEiEDV. In addition, we investigated the in-plane proportion of LV KE (%) and the time difference (TD) to peak E-wave KE propagation from base to mid-ventricle was computed. Association of LV blood flow KE parameters to LV function and infarct size were investigated in all groups. Results: LV KEiEDV was higher in controls than in MI patients (8.5 ± 3 μJ/ml versus 6.5 ± 3 μJ/ml, P = 0.02). Additionally, systolic, minimal and diastolic peak E-wave KEiEDV were lower in MI (P < 0.05). In logistic-regression analysis, systolic KEiEDV (Beta = − 0.24, P < 0.01) demonstrated the strongest association with the presence of MI. In multiple-regression analysis, infarct size was most strongly associated with in-plane KE (r = 0.5, Beta = 1.1, P < 0.01). In patients with preserved LV ejection fraction (EF), minimal and in-plane KEiEDV were reduced (P < 0.05) and time difference to peak E-wave KE propagation during diastole increased (P < 0.05) when compared to controls with normal EF. Conclusions: Reduction in LV systolic function results in reduction in systolic flow KEiEDV. Infarct size is independently associated with the proportion of in-plane LV KE. Degree of LV impairment is associated with TD of peak E-wave KE. In patient with preserved EF post MI, LV blood flow KE mapping demonstrated significant changes in the in-plane KE, the minimal KEiEDV and the TD. These three blood flow KE parameters may offer novel methods to identify and describe this patient population