Context. The Gl 486 system consists of a very nearby, relatively bright, weakly active M3.5V star at just 8 pc with a warm transiting rocky planet of about 1.3 R⨁ and 3.0 M⨁. It is ideal for both ...transmission and emission spectroscopy and for testing interior models of telluric planets.
Aims. To prepare for future studies, we aim to thoroughly characterise the planetary system with new accurate and precise data collected with state-of-the-art photometers from space and spectrometers and interferometers from the ground.
Methods. We collected light curves of seven new transits observed with the CHEOPS space mission and new radial velocities obtained with MAROON-X at the 8.1m Gemini North telescope and CARMENES at the 3.5m Calar Alto telescope, together with previously published spectroscopic and photometric data from the two spectrographs and TESS. We also performed near-infrared interferometric observations with the CHARA Array and new photometric monitoring with a suite of smaller telescopes (AstroLAB, LCOGT, OSN, TJO). This extraordinary and rich data set was the input for our comprehensive analysis.
Results. From interferometry, we measure a limb-darkened disc angular size of the star Gl 486 at θLDD = 0.390 ± 0.018 mas. Together with a corrected Gaia EDR3 parallax, we obtain a stellar radius R* = 0.339 ± 0.015 R⨀. We also measure a stellar rotation period at Prot = 49.9 ± 5.5 days, an upper limit to its XUV (5–920 Å) flux informed by new Hubble/STIS data, and, for the first time, a variety of element abundances (Fe, Mg, Si, V, Sr, Zr, Rb) and C/O ratio. Moreover, we imposed restrictive constraints on the presence of additional components, either stellar or sub-stellar, in the system. With the input stellar parameters and the radial-velocity and transit data, we determine the radius and mass of the planet Gl 486 b at Rp = 1.343+0.063-0.062 R⨀ and Mp = 3.00+0.13-0.13 M⨁, with relative uncertainties of the planet radius and mass of 4.7% and 4.2%, respectively. From the planet parameters and the stellar element abundances, we infer the most probable models of planet internal structure and composition, which are consistent with a relatively small metallic core with respect to the Earth, a deep silicate mantle, and a thin volatile upper layer. With all these ingredients, we outline prospects for Gl 486 b atmospheric studies, especially with forthcoming James Webb Space Telescope (Webb) observations.
Co-orbital objects, also known as trojans, are frequently found in simulations of planetary system formation. In these configurations, a planet shares its orbit with other massive bodies. It is still ...unclear why there have not been any co-orbitals discovered thus far in exoplanetary systems or even pairs of planets found in such a 1:1 mean motion resonance. Reconciling observations and theory is an open subject in the field. The main objective of the TROY project is to conduct an exhaustive search for exotrojans using diverse observational techniques. In this work, we analyze the radial velocity time series informed by transits, focusing the search around low-mass stars. We employed the alpha-test method on confirmed planets searching for shifts between spectral and photometric mid-transit times. This technique is sensitive to mass imbalances within the planetary orbit, allowing us to identify non-negligible co-orbital masses. Among the 95 transiting planets examined, we find one robust exotrojan candidate with a significant 3-sigma detection. Additionally, 25 exoplanets show compatibility with the presence of exotrojan companions at a 1-sigma level, requiring further observations to better constrain their presence. For two of those weak candidates, we find dimmings in their light curves within the predicted Lagrangian region. We established upper limits on the co-orbital masses for either the candidates and null detections. Our analysis reveals that current high-resolution spectrographs effectively rule out co-orbitals more massive than Saturn around low-mass stars. This work points out to dozens of targets that have the potential to better constraint their exotrojan upper mass limit with dedicated radial velocity observations. We also explored the potential of observing the secondary eclipses of the confirmed exoplanets to enhance the exotrojan search.
We search for atmospheric constituents for the UHJ WASP-178 b with two ESPRESSO transits using the narrow-band and cross-correlation techniques, focusing on the detections of NaI, H\(\alpha\), ...H\(\beta\), H\(\gamma\), MgI, FeI and FeII. Additionally, we show parallel photometry used to obtain updated and precise stellar, planetary and orbital parameters. We report the resolved line detections of NaI (5.5 and 5.4 \(\sigma\)), H\(\alpha\) (13 \(\sigma\)), H\(\beta\) (7.1 \(\sigma\)), and tentatively MgI (4.6 \(\sigma\)). In cross-correlation, we confirm the MgI detection (7.8 and 5.8 \(\sigma\)) and additionally report the detections of FeI (12 and 10 \(\sigma\)) and FeII (11 and 8.4 \(\sigma\)), on both nights separately. The detection of MgI remains tentative, however, due to the differing results between both nights, as well as compared with the narrow-band derived properties. None of our resolved spectral lines probing the mid- to upper atmosphere show significant shifts relative to the planetary rest frame, however H\(\alpha\) and H\(\beta\) exhibit line broadenings of 39.6 \(\pm\) 2.1 km/s and 27.6 \(\pm\) 4.6 km/s, respectively, indicating the onset of possible escape. WASP-178 b differs from similar UHJ with its lack of strong atmospheric dynamics in the upper atmosphere, however the broadening seen for FeI (15.66 \(\pm\) 0.58 km/s) and FeII (11.32 \(\pm\) 0.52 km/s) could indicate the presence of winds in the mid-atmosphere. Future studies on the impact of the flux variability caused by the host star activity might shed more light on the subject. Previous work indicated the presence of SiO cloud-precursors in the atmosphere of WASP-178 b and a lack of MgI and FeII. However, our results suggest that a scenario where the planetary atmosphere is dominated by MgI and FeII is more likely. In light of our results, we encourage future observations to further elucidate these atmospheric properties.
The Gl 486 system consists of a very nearby, relatively bright, weakly active M3.5 V star at just 8 pc with a warm transiting rocky planet of about 1.3 R_Terra and 3.0 M_Terra that is ideal for both ...transmission and emission spectroscopy and for testing interior models of telluric planets. To prepare for future studies, we collected light curves of seven new transits observed with the CHEOPS space mission and new radial velocities obtained with MAROON-X/Gemini North and CARMENES/Calar Alto telescopes, together with previously published spectroscopic and photometric data from the two spectrographs and TESS. We also performed interferometric observations with the CHARA Array and new photometric monitoring with a suite of smaller telescopes. From interferometry, we measure a limb-darkened disc angular size of the star Gl 486. Together with a corrected Gaia EDR3 parallax, we obtain a stellar radius. We also measure a stellar rotation period at P_rot ~ 49.9 d, an upper limit to its XUV (5-920 AA) flux with new Hubble/STIS data, and, for the first time, a variety of element abundances (Fe, Mg, Si, V, Sr, Zr, Rb) and C/O ratio. Besides, we impose restrictive constraints on the presence of additional components, either stellar or substellar, in the system. With the input stellar parameters and the radial-velocity and transit data, we determine the radius and mass of the planet Gl 486 b at R_p = 1.343+/0.063 R_Terra and M_p = 3.00+/-0.13 M_Terra. From the planet parameters and the stellar element abundances, we infer the most probable models of planet internal structure and composition, which are consistent with a relatively small metallic core with respect to the Earth, a deep silicate mantle, and a thin volatile upper layer. With all these ingredients, we outline prospects for Gl 486 b atmospheric studies, especially with forthcoming James Webb Space Telescope observations (abridged).
To prove that 7-day courses of antibiotics for bloodstream infections caused by members of the Enterobacterales (eBSIs) allow a reduction in patients' exposure to antibiotics while achieving clinical ...outcomes similar to those of 14-day schemes.
A randomized trial was performed. Adult patients developing eBSI with appropriate source control were assigned to 7 or 14 days of treatment, and followed 28 days after treatment cessation; treatments could be resumed whenever necessary. The primary endpoint was days of treatment at the end of follow-up. Clinical outcomes included clinical cure, relapse of eBSI and relapse of fever. A superiority margin of 3 days was set for the primary endpoint, and a non-inferiority margin of 10% was set for clinical outcomes. Efficacy and safety were assessed together with a DOOR/RADAR (desirability of outcome ranking and response adjusted for duration of antibiotic risk) analysis.
248 patients were assigned to 7 (n = 119) or 14 (n = 129) days of treatment. In the intention-to-treat analysis, median days of treatment at the end of follow-up were 7 and 14 days (difference 7, 95%CI 7–7). The non-inferiority margin was also met for clinical outcomes, except for relapse of fever (–0.2%, 95%CI –10.4 to 10.1). The DOOR/RADAR showed that 7-day schemes had a 77.7% probability of achieving better results than 14-day treatments.
7-day schemes allowed a reduction in antibiotic exposure of patients with eBSI while achieving outcomes similar to those of 14-day schemes. The possibility of relapsing fever in a limited number of patients, without relevance to final outcomes, may not be excluded, but was overcome by the benefits of shortening treatments.
The global crisis of bacterial resistance urges the scientific community to implement intervention programs in healthcare facilities to promote an appropriate use of antibiotics. However, the ...clinical benefits or the impact on resistance of these interventions has not been definitively proved.
We designed a quasi-experimental intervention study with an interrupted time-series analysis. A multidisciplinary team conducted a multifaceted educational intervention in our tertiary-care hospital over a 5-year period. The main activity of the program consisted of peer-to-peer educational interviews between counselors and prescribers from all departments to reinforce the principles of the proper use of antibiotics. We assessed antibiotic consumption, incidence density of Candida and multidrug-resistant (MDR) bacteria bloodstream infections (BSIs) and their crude death rate per 1000 occupied bed days (OBDs).
A quick and intense reduction in antibiotic consumption occurred 6 months after the implementation of the intervention (change in level, -216.8 defined daily doses per 1000 OBDs; 95% confidence interval, -347.5 to -86.1), and was sustained during subsequent years (average reduction, -19,9%). In addition, the increasing trend observed in the preintervention period for the incidence density of candidemia and MDR BSI (+0.018 cases per 1000 OBDs per quarter; 95% confidence interval, -.003 to .039) reverted toward a decreasing trend of -0.130 per quarter (change in slope, -0.029; -.051 to -.008), and so did the mortality rate (change in slope, -0.015; -.021 to -.008).
This education-based antimicrobial stewardship program was effective in decreasing the incidence and mortality rate of hospital-acquired candidemia and MDR BSI through sustained reduction in antibiotic use.
Background. It is necessary to develop a safe alternative to isoniazid for tuberculosis prophylaxis in liver transplant recipients. This study was designed to investigate the efficacy and safety of ...levofloxacin. Methods. An open-label, prospective, multicenter, randomized study was conducted to compare the efficacy and safety of levofloxacin (500 mg q24h for 9 months) initiated in patients awaiting liver transplantation and isoniazid (300 mg q24h for 9 months) initiated post-transplant when liver function was stabilized. Efficacy was measured by tuberculosis incidence at 18 months after transplantation. All adverse events related to the medication were recorded. Results. CONSORT guidelines were followed in order to present the results. The safety committee suspended the study through a safety analysis when 64 patients had been included (31 in the isoniazid arm and 33 in the levofloxacin arm). The reason for suspension was an unexpected incidence of severe tenosynovitis in the levofloxacin arm (18.2%). Although the clinical course was favorable in all cases, tenosynovitis persisted for 7 weeks in some patients. No patients treated with isoniazid, developed tenosynovitis. Only 32.2% of patients randomized to isoniazid (10/31) and 54.5% of patients randomized to levofloxacin (18/33, P = .094) completed prophylaxis. No patient developed tuberculosis during the study follow-up (median 270 days). Conclusions. Levofloxacin prophylaxis of tuberculosis in liver transplant candidates is associated with a high incidence of tenosynovitis that limits its potential utility.
Abstract Cytomegalovirus (CMV) infection remains a major complication of solid organ transplantation. Because of management of CMV is variable among transplant centers, in 2011 the Spanish ...Transplantation Infection Study Group (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) developed consensus guidelines for the prevention and treatment of CMV infection in solid organ transplant recipients. Since then, new publications have clarified or questioned the aspects covered in the previous document. For that reason, a panel of experts revised the evidence on CMV management, including immunological monitoring, diagnostics, prevention, vaccines, indirect effects, treatment, drug resistance, immunotherapy, investigational drugs, and pediatric issues. This document summarizes the recommendations.
The impact of human immunodeficiency virus (HIV) infection on patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC) is uncertain. This study aimed to assess the outcome of ...a prospective Spanish nationwide cohort of HIV‐infected patients undergoing LT for HCC (2002‐2014). These patients were matched (age, gender, year of LT, center, and hepatitis C virus (HCV) or hepatitis B virus infection) with non‐HIV‐infected controls (1:3 ratio). Patients with incidental HCC were excluded. Seventy‐four HIV‐infected patients and 222 non‐HIV‐infected patients were included. All patients had cirrhosis, mostly due to HCV infection (92%). HIV‐infected patients were younger (47 versus 51 years) and had undetectable HCV RNA at LT (19% versus 9%) more frequently than non‐HIV‐infected patients. No significant differences were detected between HIV‐infected and non‐HIV‐infected recipients in the radiological characteristics of HCC at enlisting or in the histopathological findings for HCC in the explanted liver. Survival at 1, 3, and 5 years for HIV‐infected versus non‐HIV‐infected patients was 88% versus 90%, 78% versus 78%, and 67% versus 73% (P = 0.779), respectively. HCV infection (hazard ratio = 7.90, 95% confidence interval 1.07‐56.82) and maximum nodule diameter >3 cm in the explanted liver (hazard ratio = 1.72, 95% confidence interval 1.02‐2.89) were independently associated with mortality in the whole series. HCC recurred in 12 HIV‐infected patients (16%) and 32 non‐HIV‐infected patients (14%), with a probability of 4% versus 5% at 1 year, 18% versus 12% at 3 years, and 20% versus 19% at 5 years (P = 0.904). Microscopic vascular invasion (hazard ratio = 3.40, 95% confidence interval 1.34‐8.64) was the only factor independently associated with HCC recurrence. Conclusions: HIV infection had no impact on recurrence of HCC or survival after LT. Our results support the indication of LT in HIV‐infected patients with HCC. (Hepatology 2016;63:488–498)
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