C. Davis

Acupuncture for the relief of cancer-related breathlessness

The palliation of cancer-related breathlessness is challenging and complex. An open pilot study was conducted, exploring the safety and efficacy of acupuncture in 20 patients who were breathless at rest and whose breathlessness was directly related to primary or secondary malignancy. Sternal and LI4 acupuncture points were used. Outcome measures included pulse, respiratory rate, oxygen saturation and patient-rated visual analogue scales of breathlessness, pain, anxiety and relaxation. At each time point the mean values of the variables were calculated and compared to their pre treatment levels (Students t-test). Seventy per cent (14/20) of patients reported marked symptomatic benefit from treatment; there were significant changes in VAS scores of breathlessness, relaxation and anxiety at least up to 6 hours post acupuncture which were measured to be maximal at 90 minutes ( p < 0.005, p < 0.001, respectively). There was a significant reduction in respiratory rate, which was sustained for 90 minutes post acupuncture (p < 0.02). The therapeutic value of acupuncture in the management of breathlessness requires further evaluation.

redMaGiC : selecting luminous red galaxies from the DES Science Verification data

We introduce redMaGiC, an automated algorithm for selecting luminous red galaxies (LRGs). The algorithm was specifically developed to minimize photometric redshift uncertainties in photometric large-scale structure studies. redMaGiC achieves this by self-training the colour cuts necessary to produce a luminosity-thresholded LRG sample of constant comoving density. We demonstrate that redMaGiC photo-zs are very nearly as accurate as the best machine learning-based methods, yet they require minimal spectroscopic training, do not suffer from extrapolation biases, and are very nearly Gaussian. We apply our algorithm to Dark Energy Survey (DES) Science Verification (SV) data to produce a redMaGiC catalogue sampling the redshift range z is an element of [0.2, 0.8]. Our fiducial sample has a comoving space density of 10(-3) (h(-1) Mpc)(-3), and a median photo-z bias (z(spec) - z(photo)) and scatter (sigma(z)/(1 + z)) of 0.005 and 0.017, respectively. The corresponding 5 sigma outlier fraction is 1.4 per cent. We also test our algorithm with Sloan Digital Sky Survey Data Release 8 and Stripe 82 data, and discuss how spectroscopic training can be used to control photo-z biases at the 0.1 per cent level.

COSMOGRAIL: the COSmological MOnitoring of GRAvItational Lenses

This work is supported by the Swiss National Science Foundation (SNSF). S. H. Suyu and D. C. Y. Chao thank the Max Planck Society for support through the Max Planck Research Group for SHS. T. Treu acknowledges support by the National Science Foundation through grant 1450141, by the Packard Foundation through a Packard Research Fellowship and by the UCLA Dean of Physical Sciences. K. Rojas is supported by Becas de Doctorado Nacional CONICYT 2017. T. Anguita and M. Chijani acknowledge support by proyecto FONDECYT 11130630 and by the Ministry for the Economy, Development, and Tourism’s Programa Inicativa Cientifica Milenio through grant IC 12009, awarded to The Millennium Institute of Astrophysics (MAS). M. Tewes acknowledges support from the DFG grant Hi 1495/2-1. J. Garcia-Bellido is supported by the Research Project FPA2015-68048 [MINECO-FEDER], and the Centro de Excelencia Severo Ochoa Program SEV-2012-0249. C. D. Fassnacht acknowledges support from the National Science Foundation grant AST-1312329 and from the UC Davis Physics Department and Dean of Math and Physical Sciences. Funding for the DES Projects has been provided by the US Department of Energy, the US National Science Foundation, the Ministry of Science and Education of Spain, the Science and Technology Facilities Council of the United Kingdom, the Higher Education Funding Council for England, the National Center for Supercomputing Applications at the University of Illinois at Urbana-Champaign, the Kavli Institute of Cosmological Physics at the University of Chicago, the Center for Cosmology and Astro-Particle Physics at the Ohio State University, the Mitchell Institute for Fundamental Physics and Astronomy at Texas A&M University, Financiadora de Estudos e Projetos, Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico and the Ministerio da Ciencia, Tecnologia e Inovacao, the Deutsche Forschungsgemeinschaft and the Collaborating Institutions in the Dark Energy Survey ... The DES data management system is supported by the National Science Foundation under Grant Number AST-1138766. The DES participants from Spanish institutions are partially supported by MINECO under grants AYA2015-71825, ESP2015-88861, FPA2015-68048, SEV-2012-0234, SEV-2012-0249, and MDM-2015-0509, some of which include ERDF funds from the European Union. IFAE is partially funded by the CERCA programme of the Generalitat de Catalunya.

Long-term observations of patients receiving transdermal fentanyl after a randomized trial.

We observed 73 cancer patients receiving transdermal fentanyl for 1-29 (mean 5.5) months immediately after participation in a randomized clinical trial. Of these, 32 received fentanyl until death, 18 were lost to follow-up, 11 required alternative analgesia, and 12 withdrew for other reasons. The median first recorded dose (not necessarily the patients first fentanyl dose) was 75 microg/h. The median final dose was 100 microg/h. All but 3 patients required <300 microg fentanyl/h. In the 16 who received fentanyl for > or =3 months until death, the median dose was unchanged (100 microg/h) 3 months before death and at death; 8/16 required no dosage change. The incidence of constipation, skin reactions, nausea, and vomiting was low. No significant respiratory depression was associated with fentanyl. Most patients (85%) and investigators (86%) rated the treatment as good or excellent. We conclude that long-term treatment with transdermal fentanyl is safe and acceptable to many cancer patients.

End of life care in community hospitals: the perceptions of bereaved family members

Objectives: The perceptions of bereaved family members were obtained to evaluate the nature and quality of end-of-life care in community hospitals. Design: During organizational case studies in six community hospitals in the South East and South West of England, bereaved family members were asked to participate in semi-structured interviews. Participants: Fifty-one interviews were conducted with family members of patients who had received end-of-life care in a community hospital within the previous year. Results: Respondents were very positive about the care they and the patient had received. They valued the convenience of access for frequent and long-stay visiting and the familiarity of the local hospital. Comparisons were made with more negative experiences at their nearest District General Hospital. Issues raised included the noise at the community hospitals, and the lack of contact with qualified nurses. Discussion: The results of this study have implications for UK government initiatives, such as the National Framework for Older People,1 and the Department of Healths ‘Keeping the NHS Local’2.

Dark energy survey year 1 results: the photometric data set for cosmology

We describe the creation, content, and validation of the Dark Energy Survey (DES) internal year-one cosmology data set, Y1A1 GOLD, in support of upcoming cosmological analyses. The Y1A1 GOLD data set is assembled from multiple epochs of DES imaging and consists of calibrated photometric zero-points, object catalogs, and ancillary data products-e.g., maps of survey depth and observing conditions, star galaxy classification, and photometric redshift estimates that are necessary for accurate cosmological analyses. The Y1A1 GOLD wide area object catalog consists of similar to 137 million objects detected in co-added images covering similar to 1800 deg(2) in the DES grizY filters. The 10 sigma limiting magnitude for galaxies is g = 23.4, r = 23.2, i = 22.5, z = 21.8, and Y = 20.1. Photometric calibration of Y1A1 GOLD was performed by combining nightly zero-point solutions with stellar locus regression, and the absolute calibration accuracy is better than 2% over the survey area. DES Y1A1 GOLD is the largest photometric data set at the achieved depth to date, enabling precise measurements of cosmic acceleration at z less than or similar to 1.

Dark Energy Survey Year 1 Results: A Precise H0 Estimate from DES Y1, BAO, and D/H Data

We combine Dark Energy Survey Year 1 clustering and weak lensing data with baryon acoustic oscillations and Big Bang nucleosynthesis experiments to constrain the Hubble constant. Assuming a flat Lambda CDM model with minimal neutrino mass (Sigma m(v), = 0.06 eV), we find H-0 = 67.4(-1.2)(+1.1) km s(-1) Mpc(-1) (68 per cent CL). This result is completely independent of Hubble constant measurements based on the distance ladder, cosmic microwave background anisotropies (both temperature and polarization), and strong lensing constraints. There are now five data sets that: (a) have no shared observational systematics;and (b) each constrains the Hubble constant with fractional uncertainty at the few-per cent level. We compare these five independent estimates, and find that, as a set, the differences between them are significant at the 2.5 sigma level (chi(2)/dof = 24/11, probability to exceed = 1.1 per cent). Having set the threshold for consistency at 30 sigma we combine all five data sets to arrive at H-0 = 69.3(-0.6)(+0.4) km s(-1) Mpc(-1).

Stellar Streams Discovered in the Dark Energy Survey

We perform a search for stellar streams around the Milky Way using the first 3 yr of multiband optical imaging data from the Dark Energy Survey (DES). We use DES data covering ∼5000 deg2 to a depth of g>23.5 with a relative photometric calibration uncertainty of <1%. This data set yields unprecedented sensitivity to the stellar density field in the southern celestial hemisphere, enabling the detection of faint stellar streams to a heliocentric distance of ∼50 kpc. We search for stellar streams using a matched filter in color–magnitude space derived from a synthetic isochrone of an old, metal-poor stellar population. Our detection technique recovers four previously known thin stellar streams: Phoenix, ATLAS, Tucana III, and a possible extension of Molonglo. In addition, we report the discovery of 11 new stellar streams. In general, the new streams detected by DES are fainter, more distant, and lower surface brightness than streams detected by similar techniques in previous photometric surveys. As a by-product of our stellar stream search, we find evidence for extratidal stellar structure associated with four globular clusters: NGC 288, NGC 1261, NGC 1851, and NGC 1904. The ever-growing sample of stellar streams will provide insight into the formation of the Galactic stellar halo, the Milky Way gravitational potential, and the large- and small-scale distribution of dark matter around the Milky Way.

Dark Energy Survey Year 1 results: the impact of galaxy neighbours on weak lensing cosmology with IM3SHAPE

We use a suite of simulated images based on Year 1 of the Dark Energy Survey to explore the impact of galaxy neighbours on shape measurement and shear cosmology. The HOOPOE image simulations include realistic blending, galaxy positions, and spatial variations in depth and point spread function properties. Using the IM3SHAPE maximum-likelihood shape measurement code, we identify four mechanisms by which neighbours can have a non-negligible influence on shear estimation. These effects, if ignored, would contribute a net multiplicative bias of m ~ 0.03-0.09 in the Year One of the Dark Energy Survey (DES Y1) IM3SHAPE catalogue, though the precise impact will be dependent on both the measurement code and the selection cuts applied. This can be reduced to percentage level or less by removing objects with close neighbours, at a cost to the effective number density of galaxies neff of 30 per cent. We use the cosmological inference pipeline of DES Y1 to explore the cosmological implications of neighbour bias and show that omitting blending from the calibration simulation for DES Y1 would bias the inferred clustering amplitude S 8 ≡ σ 8 (Ω m /0.3) 0.5 by 2σ towards low values. Finally, we use the HOOPOE simulations to test the effect of neighbour-induced spatial correlations in the multiplicative bias.We find the impact on the recovered S 8 of ignoring such correlations to be subdominant to statistical error at the current level of precision.

Discontinuity of care at end of life: a qualitative exploration of OOH end of life care

Objective This study aimed to understand the experiences of palliative care patients when accessing or making decisions about out of hours (OOH) services. It also aimed to illuminate barriers and enablers to accessing appropriate and timely care following the introduction of the 2004 New General Medical Services Contract. Method Longitudinal prospective qualitative study using semi-structured interviews and telephone interviews over 6 months and analysed for thematic content. 32 patients defined as receiving palliative care in six General Practices and three hospices selected on the basis of size and rural/urban location in Southern England were recruited. Results Continuity of care was highly valued. Participants described the importance of being known by the healthcare team, and the perceived positive implications continuity could have for the quality of care they received and the trust they had in their care. Various factors prevented participants from seeking help or advice from OOH services, despite having health concerns that may have benefitted from medical assistance. Prior poor experience, limited knowledge of services and knowing who to call and, indeed, when to call were all factors that reportedly shaped participants’ use of OOH services. Conclusions Interpersonal or relationship continuity and management continuity are vital to the process of optimising the patient experience of OOH palliative care. While recent service innovations are tackling some of the issues highlighted, this research reinforces the value patients with palliative care needs places on continuity and the need to improve this aspect of care management.