Enteral nutrition (EN) is recommended as the preferred route for early nutrition therapy in critically ill adults over parenteral nutrition (PN). A recent large randomized controlled trial (RCT) ...showed no outcome differences between the two routes. The objective of this systematic review was to evaluate the effect of the route of nutrition (EN versus PN) on clinical outcomes of critically ill patients.
An electronic search from 1980 to 2016 was performed identifying relevant RCTs. Individual trial data were abstracted and methodological quality of included trials scored independently by two reviewers. The primary outcome was overall mortality and secondary outcomes included infectious complications, length of stay (LOS) and mechanical ventilation. Subgroup analyses were performed to examine the treatment effect by dissimilar caloric intakes, year of publication and trial methodology. We performed a test of asymmetry to assess for the presence of publication bias.
A total of 18 RCTs studying 3347 patients met inclusion criteria. Median methodological score was 7 (range, 2-12). No effect on overall mortality was found (1.04, 95 % CI 0.82, 1.33, P = 0.75, heterogeneity I(2) = 11 %). EN compared to PN was associated with a significant reduction in infectious complications (RR 0.64, 95 % CI 0.48, 0.87, P = 0.004, I(2) = 47 %). This was more pronounced in the subgroup of RCTs where the PN group received significantly more calories (RR 0.55, 95 % CI 0.37, 0.82, P = 0.003, I(2) = 0 %), while no effect was seen in trials where EN and PN groups had a similar caloric intake (RR 0.94, 95 % CI 0.80, 1.10, P = 0.44, I(2) = 0 %; test for subgroup differences, P = 0.003). Year of publication and methodological quality did not influence these findings; however, a publication bias may be present as the test of asymmetry was significant (P = 0.003). EN was associated with significant reduction in ICU LOS (weighted mean difference WMD -0.80, 95 % CI -1.23, -0.37, P = 0.0003, I(2) = 0 %) while no significant differences in hospital LOS and mechanical ventilation were observed.
In critically ill patients, the use of EN as compared to PN has no effect on overall mortality but decreases infectious complications and ICU LOS. This may be explained by the benefit of reduced macronutrient intake rather than the enteral route itself.
Bioaerosols are relevant for public health and may play an important role in the climate system, but their atmospheric abundance, properties, and sources are not well understood. Here we show that ...the concentration of airborne biological particles in a North American forest ecosystem increases significantly during rain and that bioparticles are closely correlated with atmospheric ice nuclei (IN). The greatest increase of bioparticles and IN occurred in the size range of 2–6 μm, which is characteristic for bacterial aggregates and fungal spores. By DNA analysis we found high diversities of airborne bacteria and fungi, including groups containing human and plant pathogens (mildew, smut and rust fungi, molds, Enterobacteriaceae, Pseudomonadaceae). In addition to detecting known bacterial and fungal IN (Pseudomonas sp., Fusarium sporotrichioides), we discovered two species of IN-active fungi that were not previously known as biological ice nucleators (Isaria farinosa and Acremonium implicatum). Our findings suggest that atmospheric bioaerosols, IN, and rainfall are more tightly coupled than previously assumed.
Uterine leiomyomata (UL) are the most common neoplasms of the female reproductive tract and primary cause for hysterectomy, leading to considerable morbidity and high economic burden. Here we conduct ...a GWAS meta-analysis in 35,474 cases and 267,505 female controls of European ancestry, identifying eight novel genome-wide significant (P < 5 × 10
) loci, in addition to confirming 21 previously reported loci, including multiple independent signals at 10 loci. Phenotypic stratification of UL by heavy menstrual bleeding in 3409 cases and 199,171 female controls reveals genome-wide significant associations at three of the 29 UL loci: 5p15.33 (TERT), 5q35.2 (FGFR4) and 11q22.3 (ATM). Four loci identified in the meta-analysis are also associated with endometriosis risk; an epidemiological meta-analysis across 402,868 women suggests at least a doubling of risk for UL diagnosis among those with a history of endometriosis. These findings increase our understanding of genetic contribution and biology underlying UL development, and suggest overlapping genetic origins with endometriosis.
A promising approach to the fabrication of materials with nanoscale features is the transfer of liquid-crystalline structure to polymers. However, this has not been achieved in systems with full ...three-dimensional periodicity. Here we demonstrate the fabrication of self-assembled three-dimensional nanostructures by polymer templating blue phase I, a chiral liquid crystal with cubic symmetry. Blue phase I was photopolymerized and the remaining liquid crystal removed to create a porous free-standing cast, which retains the chiral three-dimensional structure of the blue phase, yet contains no chiral additive molecules. The cast may in turn be used as a hard template for the fabrication of new materials. By refilling the cast with an achiral nematic liquid crystal, we created templated blue phases that have unprecedented thermal stability in the range -125 to 125 °C, and that act as both mirrorless lasers and switchable electro-optic devices. Blue-phase templated materials will facilitate advances in device architectures for photonics applications in particular.
We report the discovery of eight new giant planets, and updated orbits for four known planets, orbiting dwarf and subgiant stars using the CORALIE, HARPS, and MIKE instruments as part of the ...Calan-Hertfordshire Extrasolar Planet Search. The planets have masses in the range 1.1-5.4 M sub( J)'s, orbital periods from 40 to 2900 d, and eccentricities from 0.0 to 0.6. They include a double-planet system orbiting the most massive star in our sample (HD147873), two eccentric giant planets (HD128356b and HD154672b), and a rare 14 Herculis analogue (HD224538b). We highlight some population correlations from the sample of radial velocity detected planets orbiting nearby stars, including the mass function exponential distribution, confirmation of the growing body of evidence that low-mass planets tend to be found orbiting more metal-poor stars than giant planets, and a possible period-metallicity correlation for planets with masses >0.1 M sub( J), based on a metallicity difference of 0.16 dex between the population of planets with orbital periods less than 100 d and those with orbital periods greater than 100 d.
We present the spectroscopic analysis of a large sample of late-M, L, and T dwarfs from the United Kingdom Deep Infrared Sky Survey. Using the YJHK photometry from the Large Area Survey and the ...red-optical photometry from the Sloan Digital Sky Survey we selected a sample of 262 brown dwarf candidates and we have followed-up 196 of them using the echelle spectrograph X-shooter on the Very Large Telescope. The large wavelength coverage (0.30–2.48 μm) and moderate resolution (R ∼ 5000–9000) of X-shooter allowed us to identify peculiar objects including 22 blue L dwarfs, 2 blue T dwarfs, and 2 low-gravity M dwarfs. Using a spectral indices-based technique, we identified 27 unresolved binary candidates, for which we have determined the spectral type of the potential components via spectral deconvolution. The spectra allowed us to measure the equivalent width of the prominent absorption features and to compare them to atmospheric models. Cross-correlating the spectra with a radial velocity standard, we measured the radial velocity of our targets, and we determined the distribution of the sample, which is centred at −1.7 ± 1.2 km s−1 with a dispersion of 31.5 km s−1. Using our results, we estimated the space density of field brown dwarfs and compared it with the results of numerical simulations. Depending on the binary fraction, we found that there are (0.85 ± 0.55) × 10−3 to (1.00 ± 0.64) × 10−3 objects per cubic parsec in the L4–L6.5 range, (0.73 ± 0.47) × 10−3 to (0.85 ± 0.55) × 10−3 objects per cubic parsec in the L7–T0.5 range, and (0.74 ± 0.48) × 10−3 to (0.88 ± 0.56) × 10−3 objects per cubic parsec in the T1–T4.5 range. We notice that there seems to be an excess of objects in the L–T transition with respect to the late-T dwarfs, a discrepancy that could be explained assuming a higher binary fraction than expected for the L–T transition, or that objects in the high-mass end and low-mass end of this regime form in different environments, i.e. following different initial mass functions.
We report the discovery of a peculiar L dwarf from the United Kingdom Infrared Deep Sky Survey Large Area Survey, ULAS J222711−004547. The very red infrared photometry (MKO J − K = 2.79 ± 0.06, WISE ...W1−W2 = 0.65 ± 0.05) of ULAS J222711−004547 makes it one of the reddest brown dwarfs discovered so far. We obtained a moderate resolution spectrum of this target using the XSHOOTER spectrograph on the Very Large Telescope, and we classify it as L7pec, confirming its very red nature. Comparison to theoretical models suggests that the object could be a low-gravity L dwarf with a solar or higher than solar metallicity. Nonetheless, the match of such fits to the spectral energy distribution is rather poor, and this and other less red peculiar L dwarfs pose new challenges for the modelling of ultracool atmospheres, especially to the understanding of the effects of condensates and their sensitivity to gravity and metallicity. We determined the proper motion of ULAS J222711−004547 using the data available in the literature, and we find that its kinematics do not suggest membership of any of the known young associations. We show that applying a simple de-reddening curve to its spectrum allows it to resemble the spectra of the L7 spectroscopic standards without any spectral features that distinguish it as a low-metallicity or low-gravity dwarf. Given the negligible interstellar reddening of the field containing our target, we conclude that the reddening of the spectrum is mostly due to an excess of dust in the photosphere of the target. De-reddening the spectrum using extinction curves for different dust species gives surprisingly good results and suggests a characteristic grain size of ∼0.5 μm. We show that by increasing the optical depth, the same extinction curves allow the spectrum of ULAS J222711−004547 to resemble the spectra of unusually blue L dwarfs and even slightly metal-poor L dwarfs. Grains of similar size also yield very good fits when de-reddening other unusually red L dwarfs in the L5-L7.5 range. These results suggest that the diversity in near-infrared colours and spectra seen in late L dwarfs could be due to differences in the optical thickness of the dust cloud deck.
During visually guided behaviors, mere hundreds of milliseconds can elapse between a sensory input and its associated behavioral response. How spikes occurring at different times are integrated to ...drive perception and action remains poorly understood. We delivered random trains of optogenetic stimulation (white noise) to excite inhibitory interneurons in V1 of mice of both sexes while they performed a visual detection task. We then performed a reverse correlation analysis on the optogenetic stimuli to generate a neuronal-behavioral kernel, an unbiased, temporally precise estimate of how suppression of V1 spiking at different moments around the onset of a visual stimulus affects detection of that stimulus. Electrophysiological recordings enabled us to capture the effects of optogenetic stimuli on V1 responsivity and revealed that the earliest stimulus-evoked spikes are preferentially weighted for guiding behavior. These data demonstrate that white noise optogenetic stimulation is a powerful tool for understanding how patterns of spiking in neuronal populations are decoded in generating perception and action.
During visually guided actions, continuous chains of neurons connect our retinas to our motoneurons. To unravel circuit contributions to behavior, it is crucial to establish the relative functional position(s) that different neural structures occupy in processing and relaying the signals that support rapid, precise responses. To address this question, we randomly inhibited activity in mouse V1 throughout the stimulus-response cycle while the animals did many repetitions of a visual task. The period that led to impaired performance corresponded to the earliest stimulus-driven response in V1, with no effect of inhibition immediately before or during late stages of the stimulus-driven response. This approach offers experimenters a powerful method for uncovering the temporal weighting of spikes from stimulus to response.
We report the discovery of 76 new T dwarfs from the UKIRT Infrared Deep Sky Survey (UKIDSS) Large Area Survey (LAS). Near-infrared broad- and narrow-band photometry and spectroscopy are presented for ...the new objects, along with Wide-field Infrared Survey Explorer (WISE) and warm-Spitzer photometry. Proper motions for 128 UKIDSS T dwarfs are presented from a new two epoch LAS proper motion catalogue. We use these motions to identify two new benchmark systems: LHS 6176AB, a T8p+M4 pair and HD 118865AB, a T5.5+F8 pair. Using age constraints from the primaries and evolutionary models to constrain the radii, we have estimated their physical properties from their bolometric luminosity. We compare the colours and properties of known benchmark T dwarfs to the latest model atmospheres and draw two principal conclusions. First, it appears that the H − 4.5 and J − W2 colours are more sensitive to metallicity than has previously been recognized, such that differences in metallicity may dominate over differences in T
eff when considering relative properties of cool objects using these colours. Secondly, the previously noted apparent dominance of young objects in the late-T dwarf sample is no longer apparent when using the new model grids and the expanded sample of late-T dwarfs and benchmarks. This is supported by the apparently similar distribution of late-T dwarfs and earlier type T dwarfs on reduced proper motion diagrams that we present. Finally, we present updated space densities for the late-T dwarfs, and compare our values to simulation predictions and those from WISE.
We have searched the Wide-field Infrared Survey Explorer first data release for widely separated (≤10 000 au) late T dwarf companions to Hipparcos and Gliese stars. We have discovered a new binary ...system containing a K-band suppressed T8p dwarf WISEP J142320.86+011638.1 and the mildly metal poor (Fe/H =−0.38 ± 0.06) primary BD +01° 2920 (HIP 70319), a G1 dwarf at a distance of 17.2 pc. This new benchmark has T
eff= 680 ± 55 K and a mass of 20-50M
Jup. Its spectral properties are well modelled except for known discrepancies in the Y and K bands. Based on the well-determined metallicity of its companion, the properties of BD +01° 2920B imply that the currently known T dwarfs are dominated by young low-mass objects. We also present an accurate proper motion for the T8.5 dwarf WISEP J075003.84+272544.8.
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