Beacon Health System

Abstract We present the description of the instruments and the first results of the PRime-focus Infrared Microlensing Experiment (PRIME). PRIME is the first dedicated near-infrared (NIR) microlensing survey telescope, and is located at the South African Astronomical Observatory in Sutherland, South Africa. Among its class, it offers one of the widest fields of view in the NIR regime. PRIME’s main goals are (1) to study planetary formation by measuring the frequency and mass function of planets. In particular, we compare results from the central Galactic bulge (GB), accessible only in the NIR by PRIME, with those from the outer GB by optical surveys. (2) To conduct concurrent observations with NASA’s Nancy Grace Roman Space Telescope. Due to the different lines of sight between the ground and space, we detect slight variations in light curves, known as “space-based parallax.” This effect allows us to measure the mass of lens systems and their distance from the Earth. It is the only method to measure the mass of free-floating planets down to Earth mass. We began the GB survey in 2024 February and analyzed images through 2025 June 1, identifying 486 microlensing candidates and over a thousand variable stars, including Mira variables, which are useful for studying the Galactic structure. We issue real-time alerts for follow-up observations, supporting exoplanet searches and the chemical evolution studies in the GB. During the off-bulge season, we conduct an all-sky grid survey and target-of-opportunity observations of transients, including gravitational-wave events, γ -ray bursts, and other science.

Abstract Background Vital signs assessment can be crucial. However, such assessments are time-consuming and so are not always prioritised. Measuring vital signs before doctor visits may therefore be an effective and efficient strategy. We piloted a pre-clinic vital signs assessment (PCVSA) within a primary care centre to determine its feasibility and acceptability. Methods A mixed methods cross-sectional design was piloted. Study participants included adult patients and practice staff. Patients had vital signs assessed by a Primary Care Assistant before GP visits. Data collected concerned participants’ study engagement, the timings of PCVSA / GP visits, and surveys / interviews investigating participants’ experiences. Results Sixteen patients and four staff participated. The mean PCVSA was 2mins23secs (SD = 38.8) and the mean GP visit was 9mins21secs (SD = 252.4). Patients said the PCVSA was a ‘Positive experience’ (87%), ‘Helpful’ (81%), ‘Valuable’ (44%), and ‘Interesting’ (38%). The GP said the PCVSA was either ‘Helpful’ (n=8, 54%) or ‘Extremely Helpful’ (n=7, 47%) in each of their consultations, and that it improved engagement with 80% of patients, allowed them to spend more time gaining understanding of the conditions of 93% of patients, and enhanced productivity in 73% of consultations. The GP strongly agreed that collecting PCVSA data before appointments would benefit patients over time. Qualitative interviews with practice staff yielded three themes: (1) Improved patient engagement and efficient consultation, (2) Time-saving potential, and (3) Practicing in general practice and associated challenges. Conclusion The PCVSA pilot showed good feasibility and acceptability as indicated by high participant engagement, short PCVSA and GP visit times (albeit GP visit times did not measure non-patient facing clinical activity), and positive feedback from patients and staff. Introducing PCVSA in healthcare settings may have potential in terms of improving the standard and efficiency of care. Author summary Checking vital signs is important for patient care, as it helps doctors assess, monitor, and make clinical decisions. However, it is often overlooked to save time for other tasks considered more urgent. A new approach called ‘pre-clinic vital signs assessment’ (PCVSA), where patients’ vital signs are measured before their one-on-one visit with the doctor, may help address this issue. This study tested the PCVSA at a primary care centre in Dublin, Ireland, to see if it could improve care quality, save time, and be accepted by both staff and patients. On average, the PCVSA took 2 minutes and 23 seconds, while the typical doctor visit lasted 9 minutes and 21 seconds. Most patients and staff saw the PCVSA as useful, highlighting its benefits for better patient-doctor communication and timesaving. Some concerns were raised about the extra demand it might place on clinic resources. Overall, the findings suggest that PCVSA could positively impact the quality and efficiency of care in primary care settings, with future research needed to explore its benefits in larger and more varied clinics.

Background:The COVID-19 pandemic has had a significant impact on delivery of NHS care. We have developed the OpenSAFELY Service Restoration Observatory (SRO) to develop key measures of primary care activity and describe the trends in these measures throughout the COVID-19 pandemic.Methods:With the approval of NHS England, we developed an open source software framework for data management and analysis to describe trends and variation in clinical activity across primary care electronic health record (EHR) data on 48 million adults.We developed SNOMED-CT codelists for key measures of primary care clinical activity such as blood pressure monitoring and asthma reviews, selected by an expert clinical advisory group and conducted a population cohort-based study to describe trends and variation in these measures January 2019-December 2021, and pragmatically classified their level of recovery one year into the pandemic using the percentage change in the median practice level rate.Results:We produced 11 measures reflective of clinical activity in general practice. A substantial drop in activity was observed in all measures at the outset of the COVID-19 pandemic. By April 2021, the median rate had recovered to within 15% of the median rate in April 2019 in six measures. The remaining measures showed a sustained drop, ranging from a 18.5% reduction in medication reviews to a 42.0% reduction in blood pressure monitoring. Three measures continued to show a sustained drop by December 2021.Conclusions:The COVID-19 pandemic was associated with a substantial change in primary care activity across the measures we developed, with recovery in most measures. We delivered an open source software framework to describe trends and variation in clinical activity across an unprecedented scale of primary care data. We will continue to expand the set of key measures to be routinely monitored using our publicly available NHS OpenSAFELY SRO dashboards with near real-time data.Funding:This research used data assets made available as part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058).The OpenSAFELY Platform is supported by grants from the Wellcome Trust (222097/Z/20/Z); MRC (MR/V015757/1, MC_PC-20059, MR/W016729/1); NIHR (NIHR135559, COV-LT2-0073), and Health Data Research UK (HDRUK2021.000, 2021.0157).

The COVID-19 pandemic has disrupted healthcare activity across a broad range of clinical services. The NHS stopped non-urgent work in March 2020, later recommending services be restored to near-normal levels before winter where possible. To describe changes in the volume and variation of coded clinical activity in general practice across six clinical areas: cardiovascular disease, diabetes, mental health, female and reproductive health, screening and related procedures, and processes related to medication. With the approval of NHS England, a cohort study was conducted of 23.8 million patient records in general practice, in situ using OpenSAFELY. Common primary care activities were analysed using Clinical Terms Version 3 codes and keyword searches from January 2019 to December 2020, presenting median and deciles of code usage across practices per month. Substantial and widespread changes in clinical activity in primary care were identified since the onset of the COVID-19 pandemic, with generally good recovery by December 2020. A few exceptions showed poor recovery and warrant further investigation, such as mental health (for example, for 'Depression interim review' the median occurrences across practices in December 2020 was down by 41.6% compared with December 2019). Granular NHS general practice data at population-scale can be used to monitor disruptions to healthcare services and guide the development of mitigation strategies. The authors are now developing real-time monitoring dashboards for the key measures identified in this study, as well as further studies using primary care data to monitor and mitigate the indirect health impacts of COVID-19 on the NHS.