Alcohol-specific activity in hospitals in England

Alcohol-related harm is placing increasing demands on the NHS. At a time when unprecedented efficiencies need to be made by the NHS and local authorities, preventative action must be taken seriously. This analysis explores trends in alcohol-specific activity in hospitals due to alcohol poisoning and alcohol-related inpatient admissions by looking at six years of hospital activity data in England. The analysis also explores the use of hospital services before and after a diagnosis of alcohol-related liver disease and highlights opportunities for preventative action to reduce future alcohol-related harm in England

Evaluation of complex integrated care programmes: the approach in North West London

Background: Several local attempts to introduce integrated care in the English National Health Service have been tried, with limited success. The Northwest London Integrated Care Pilot attempts to improve the quality of care of the elderly and people with diabetes by providing a novel integration process across primary, secondary and social care organisations. It involves predictive risk modelling, care planning, multidisciplinary management of complex cases and an information technology tool to support information sharing. This paper sets out the evaluation approach adopted to measure its effect. Study design: We present a mixed methods evaluation methodology. It includes a quantitative approach measuring changes in service utilization, costs, clinical outcomes and quality of care using routine primary and secondary data sources. It also contains a qualitative component, involving observations, interviews and focus groups with patients and professionals, to understand participant experiences and to understand the pilot within the national policy context. Theory and discussion: This study considers the complexity of evaluating a large, multi-organisational intervention in a changing healthcare economy. We locate the evaluation within the theory of evaluation of complex interventions. We present the specific challenges faced by evaluating an intervention of this sort, and the responses made to mitigate against them. Conclusions: We hope this broad, dynamic and responsive evaluation will allow us to clarify the contribution of the pilot, and provide a potential model for evaluation of other similar interventions. Because of the priority given to the integrated agenda by governments internationally, the need to develop and improve strong evaluation methodologies remains strikingly important

A comparative study of Corynephorus canescens (L.) P.Beauv. communities of inland sand dunes in England and Poland

Inland sand dunes supporting Grey Hair-grass Corynephorus canescens are a declining European habitat designated for conservation under the EU’s Habitats Directive. In Britain they are confined to a handful of sites in East Anglia and the West Midlands. This study investigated the relationships of the British populations to each other and to populations on five sites in Poland, where C. canescens is still widespread. It also conducted exploratory investigations into factors relevant to the conservation of this ecosystem, particularly in the West Midlands. Data were collected chiefly from 1m2 quadrat samples and direct sampling, which recorded the plants and animals present together with parameters such as vigour and fecundity in C. canescens, amounts of bare sand and litter, and measures of erosion and grazing. These data were variously analysed including by CANOCO multivariate analysis and, for the vegetation, TWINSPAN analysis. 153 taxa of plants and 251 of invertebrates were identified. Though strongly distributed on a regional basis, both flora and invertebrate fauna showed relationships particularly between Polish and West Midlands sites. Analysis of the vegetation suggested that West Midlands vegetation had some associations with C. canescens habitats in Europe and that East Anglian vegetation had links with British coastal C. canescens habitats. The invertebrate fauna showed some complex community relationships in Poland and the West Midlands but less so in East Anglia, while assemblages of invertebrates were associated with various vegetational and abiotic factors. Rabbits and hares were the only vertebrates regularly exploiting C. canescens habitats, which they grazed and, in the former case, produced sand disturbances for colonisation by C. canescens. Ants and to a lesser degree some other invertebrates also produced sand disturbances. Observations made in a preliminary cultivation study in the West Midlands suggested that C. canescens may have a biennial phenology, high fecundity, low germination rates and limited dispersal powers in that region. A trampling investigation suggested that C. canescens may be very sensitive to heavy uncontrolled trampling and to vegetational succession under protection. Stages in succession of the C. canescens community were identified, and suggestions for further study and the conservation of C. canescens were drawn up.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Droplet fragmentation: 3D imaging of a previously unidentified pore-scale process during multiphase flow in porous media

Using X-ray computed microtomography, we have visualized and quantified the in situ structure of a trapped nonwetting phase (oil) in a highly heterogeneous carbonate rock after injecting a wetting phase (brine) at low and high capillary numbers. We imaged the process of capillary desaturation in 3D and demonstrated its impacts on the trapped nonwetting phase cluster size distribution. We have identified a previously unidentified pore-scale event during capillary desaturation. This pore-scale event, described as droplet fragmentation of the nonwetting phase, occurs in larger pores. It increases volumetric production of the nonwetting phase after capillary trapping and enlarges the fluid−fluid interface, which can enhance mass transfer between the phases. Droplet fragmentation therefore has implications for a range of multiphase flow processes in natural and engineered porous media with complex heterogeneous pore spaces

Updated Parameters and a New Transmission Spectrum of HD 97658b

Recent years have seen increasing interest in the characterization of sub-Neptune-sized planets because of their prevalence in the Galaxy, contrasted with their absence in our solar system. HD 97658 is one of the brightest stars hosting a planet of this kind, and we present the transmission spectrum of this planet by combining four Hubble Space Telescope transits, 12 Spitzer/IRAC transits, and eight MOST transits of this system. Our transmission spectrum has a higher signal-to-noise ratio than those from previous works, and the result suggests that the slight increase in transit depth from wavelength 1.1–1.7 μm reported in previous works on the transmission spectrum of this planet is likely systematic. Nonetheless, our atmospheric modeling results are inconclusive, as no model provides an excellent match to our data. Nonetheless, we find that atmospheres with high C/O ratios (C/O ≳ 0.8) and metallicities of ≳100× solar metallicity are favored. We combine the mid-transit times from all of the new Spitzer and MOST observations and obtain an updated orbital period of P = 9.489295 ± 0.000005, with a best-fit transit time center at T₀ = 2456361.80690 ± 0.00038 (BJD). No transit timing variations are found in this system. We also present new measurements of the stellar rotation period (34 ± 2 days) and stellar activity cycle (9.6 yr) of the host star HD 97658. Finally, we calculate and rank the Transmission Spectroscopy Metric of all confirmed planets cooler than 1000 K and with sizes between 1 R⊕ and 4 R⊕. We find that at least a third of small planets cooler than 1000 K can be well characterized using James Webb Space Telescope, and of those, HD 97658b is ranked fifth, meaning that it remains a high-priority target for atmospheric characterization

The California Legacy Survey I. A Catalog of 178 Planets from Precision Radial Velocity Monitoring of 719 Nearby Stars over Three Decades

We present a high-precision radial velocity (RV) survey of 719 FGKM stars, which host 164 known exoplanets and 14 newly discovered or revised exoplanets and substellar companions. This catalog updated the orbital parameters of known exoplanets and long-period candidates, some of which have decades-longer observational baselines than they did upon initial detection. The newly discovered exoplanets range from warm sub-Neptunes and super-Earths to cold gas giants. We present the catalog sample selection criteria, as well as over 100,000 radial velocity measurements, which come from the Keck-HIRES, APF-Levy, and Lick-Hamilton spectrographs. We introduce the new RV search pipeline RVSearch that we used to generate our planet catalog, and we make it available to the public as an open-source Python package. This paper is the first study in a planned series that will measure exoplanet occurrence rates and compare exoplanet populations, including studies of giant planet occurrence beyond the water ice line, and eccentricity distributions to explore giant planet formation pathways. We have made public all radial velocities and associated data that we use in this catalog.Comment: Accepted to ApJ

Bright Opportunities for Atmospheric Characterization of Small Planets: Masses and Radii of K2-3 b, c, and d and GJ3470 b from Radial Velocity Measurements and Spitzer Transits

We report improved masses, radii, and densities for four planets in two bright M-dwarf systems, K2-3 and GJ3470, derived from a combination of new radial velocity and transit observations. Supplementing K2 photometry with follow-up Spitzer transit observations refined the transit ephemerides of K2-3 b, c, and d by over a factor of 10. We analyze ground-based photometry from the Evryscope and Fairborn Observatory to determine the characteristic stellar activity timescales for our Gaussian Process fit, including the stellar rotation period and activity region decay timescale. The stellar rotation signals for both stars are evident in the radial velocity data and is included in our fit using a Gaussian process trained on the photometry. We find the masses of K2-3 b, K2-3 c, and GJ3470 b to be 6.48{}-0.93+0.99, 2.14{}-1.04+1.08, and 12.58{}-1.28+1.31 M ⊕, respectively. K2-3 d was not significantly detected and has a 3σ upper limit of 2.80 M ⊕. These two systems are training cases for future TESS systems; due to the low planet densities (ρ < 3.7 g cm-3) and bright host stars (K < 9 mag), they are among the best candidates for transmission spectroscopy in order to characterize the atmospheric compositions of small planets

The TESS-Keck Survey. XV. Precise Properties of 108 TESS Planets and Their Host Stars

We present the stellar and planetary properties for 85 TESS Objects of Interest (TOIs) hosting 108 planet candidates which comprise the TESS-Keck Survey (TKS) sample. We combine photometry, high-resolution spectroscopy, and Gaia parallaxes to measure precise and accurate stellar properties. We then use these parameters as inputs to a lightcurve processing pipeline to recover planetary signals and homogeneously fit their transit properties. Among these transit fits, we detect significant transit-timing variations among at least three multi-planet systems (TOI-1136, TOI-1246, TOI-1339) and at least one single-planet system (TOI-1279). We also reduce the uncertainties on planet-to-star radius ratios $R_p/R_\star$ across our sample, from a median fractional uncertainty of 8.8$\%$ among the original TOI Catalog values to 3.0$\%$ among our updated results. With this improvement, we are able to recover the Radius Gap among small TKS planets and find that the topology of the Radius Gap among our sample is broadly consistent with that measured among Kepler planets. The stellar and planetary properties presented here will facilitate follow-up investigations of both individual TOIs and broader trends in planet properties, system dynamics, and the evolution of planetary systems.Comment: Accepted at The Astronomical Journal; 21 pages, 9 figure

The TESS-Keck Survey. XVI. Mass Measurements for 12 Planets in Eight Systems

With JWST's successful deployment and unexpectedly high fuel reserves, measuring the masses of sub-Neptunes transiting bright, nearby stars will soon become the bottleneck for characterizing the atmospheres of small exoplanets via transmission spectroscopy. Using a carefully curated target list and more than two years' worth of APF-Levy and Keck-HIRES Doppler monitoring, the TESS-Keck Survey is working toward alleviating this pressure. Here we present mass measurements for 11 transiting planets in eight systems that are particularly suited to atmospheric follow-up with JWST. We also report the discovery and confirmation of a temperate super-Jovian-mass planet on a moderately eccentric orbit. The sample of eight host stars, which includes one subgiant, spans early-K to late-F spectral types ($T_\mathrm{eff} =$ 5200--6200 K). We homogeneously derive planet parameters using a joint photometry and radial velocity modeling framework, discuss the planets' possible bulk compositions, and comment on their prospects for atmospheric characterization.Comment: Accepted for publication in The Astronomical Journal on 2023-Jun-22. 60 pages, 17 Tables, 28 Figure