Analysis of Growth and Prevalence of Malnutrition during Total Parenteral Nutrition Weaning: A Methodological Demonstration

Background: Total Parenteral Nutrition (TPN) is a life-saving intervention which provides nutrition to premature infants with immature gut functioning. Though essential for nutrition provision in the first days of life, TPN is not without risk. Therefore, it is important to introduce feedings into the gut and to wean off TPN when able. During this weaning phase, calorie and protein deficits have been observed to occur. Very few studies have investigated TPN weaning periods, and there are no studies on malnutrition associated with the TPN weaning period in premature infants. Methods: This study employed a retrospective chart review, with medical records from a Level IV Midwest Neonatal Intensive Care Unit (NICU). Subjects were premature infants born between November 1, 2017 and June 30, 2018, weighing less than 1500 grams at birth, who received TPN for greater than two days during their hospital stay. Z-scores for weight, length, and head circumference were calculated and the change in weight z-score was used to assign malnutrition categories based on recommendations from the proposed methodology. Pearson’s Chi-Square for association and Kendall’s tau correlation tests were conducted to assign significance between differences and to understand relationships between variables. Results: There was a significant positive correlation between TPN wean length and overall malnutrition, indicating that malnutrition incidence increased as TPN wean length increased. Analysis of change in weight z-score indicated a 50% prevalence of any form of malnutrition at two weeks of age. Upon further investigation, there was a significant difference in means of TPN wean length between each form of malnutrition (mild, moderate, and severe). Conclusion: The results of this study support the emerging concept that the TPN weaning period is a phase when malnutrition can start to develop in premature infants. This study demonstrates how the proposed malnutrition criteria can be combined with TPN weaning data to add to an overall picture of growth during the NICU stay. Future research is warranted to confirm these findings with a larger sample and to establish TPN weaning protocol standards

Climate, snowmelt dynamics and atmospheric deposition interact to control dissolved organic carbon export from a northern forest stream over 26 years

Increasing concentrations of dissolved organic carbon (DOC) have been identified in many freshwater systems over the last three decades. Studies have generally nominated atmospheric deposition as the key driver of this trend, with changes in climatic factors also contributing. However, there is still much uncertainty concerning net effects of these drivers on DOC concentrations and export dynamics. Changes in climate and climate mediated snowfall dynamics in northern latitudes have not been widely considered as causal factors of changes in long-term DOC trends, despite their disproportionate role in annual DOC export. We leveraged long-term datasets (1988–2013) from a first-order forested tributary of Lake Superior to understand causal factors of changes in DOC concentrations and exports from the watershed, by simultaneously evaluating atmospheric deposition, temperature, snowmelt timing, and runoff. We observed increases in DOC concentrations of approximately 0.14 mg C l−1 yr−1 (mean = 8.12 mg C l−1) that were related with declines in sulfate deposition (0.03 mg SO24− l−1 yr−1). Path analysis revealed that DOC exports were driven by runoff related to snowmelt, with peak snow water equivalences generally being lower and less variable in the 21st century, compared with the 1980s and 1990s. Mean temperatures were negatively related (direct effects) to maximum snow water equivalences (−0.71), and in turn had negative effects on DOC concentrations (−0.58), the timing of maximum discharge (−0.89) and DOC exports (indirect effect, −0.41). Based on these trends, any future changes in climate that lessen the dominance of snowmelt on annual runoff dynamics—including an earlier peak discharge—would decrease annual DOC export in snowmelt dominated systems. Together, these findings further illustrate complex interactions between climate and atmospheric deposition in carbon cycle processes, and highlight the importance of long-term monitoring efforts for understanding the consequences of a changing climate

A phase 1 study evaluating the pharmacokinetics, safety and tolerability of repeat dosing with a human IL-13 antibody (CAT-354) in subjects with asthma

<p>Abstract</p> <p>Background</p> <p>IL-13 has been implicated in the development of airway inflammation and hyperresponsiveness. This study investigated the multiple-dose pharmacokinetics and safety profile of human anti-IL-13 antibody (CAT-354) in adults with asthma.</p> <p>Methods</p> <p>This was a multiple-dose, randomised, double-blind, placebo-controlled phase 1 study in asthmatics (forced expiratory volume in 1 second [FEV₁] ≥ 80% predicted). Subjects were randomised to receive three intravenous infusions of CAT-354 (1 mg/kg, 5 mg/kg or 10 mg/kg) or placebo at 28-day intervals. Blood samples were taken for pharmacokinetic measurements. Safety was assessed by adverse events, vital signs, ECGs, laboratory and pulmonary function parameters.</p> <p>Results</p> <p>Twenty-three subjects (aged 21-60 years, FEV₁88-95% predicted) received ≥ 1 dose of study medication. The half-life of CAT-354 was 12-17 days and was dose-independent. The maximum serum concentration and area under the curve were dose-dependent. Clearance (2.2-2.6 mL/day/kg) and volume of distribution (44-57 mL/kg) were both low and dose-independent. The observed maximum serum concentration after each dose increased slightly from dose 1 through dose 3 at all dose levels, consistent with an accumulation ratio of 1.4 to 1.7 for area under the curve. Most adverse events were deemed mild to moderate and unrelated to study medication. One SAE was reported and deemed unrelated to study drug. There were no effects of clinical concern for vital signs, ECG, laboratory or pulmonary parameters.</p> <p>Conclusions</p> <p>CAT-354 exhibited linear pharmacokinetics and an acceptable safety profile. These findings suggest that at the doses tested, CAT-354 can be safely administered in multiple doses to patients with asthma.</p> <p>Trial registration</p> <p>NCT00974675.</p

Qubits from tight knots and bent nano-bars

We propose a novel mechanism for creating a qubit based on a tight knot, that is a nano-quantum wire system so small and so cold as to be quantum coherent with respect to curvature-induced effects. To establish tight knots as legitimate candidates for qubits, we propose an effective curvature-induced potential that produces the two-level system and identify the tunnel coupling between the two local states. We propose also a different design of nano-mechanical qubit based on twisted nano-rods. We describe how both devices can be manipulated. Also we outline possible decoherence channels, detection schemes and experimental setups

Self-Regulation of Emotion, Functional Impairment, and Comorbidity Among Children With AD/HD

Objective: This study investigated the role of self-regulation of emotion in relation to functional impairment and comorbidity among children with and without AD/HD. Method: A total of 358 probands and their siblings participated in the study, with 74% of the sample participants affected by AD/HD. Parent-rated levels of emotional lability served as a marker for self-regulation of emotion. Results: Nearly half of the children affected by AD/HD displayed significantly elevated levels of emotional lability versus 15% of those without this disorder. Children with AD/HD also displayed significantly higher rates of functional impairment, comorbidity, and treatment service utilization. Emotional lability partially mediated the association between AD/HD status and these outcomes. Conclusion: Findings lent support to the notion that deficits in the self-regulation of emotion are evident in a substantial number of children with AD/HD and that these deficits play an important role in determining functional impairment and comorbidity outcomes

Exploration of the Southern California Borderland

E/V Nautilus cruise NA075 returned to the Southern California Continental Borderland, an area that remains largely unexplored. Part of the broader North America-Pacific plate boundary, this region extends ~300 km west of the San Andreas Fault and displays an unusually rugged physiography. During the cruise, the multibeam sonar mapped ~5,200 km2 of seafloor, and ROVs Hercules and Argus were deployed for 16 dives to explore geological and biological targets (Figure 1) and collect samples

Lowering water table reduces carbon sink strength and carbon stocks in northern peatlands

Peatlands at high latitudes have accumulated \u3e400 Pg carbon (C) because saturated soil and cold temperatures suppress C decomposition. This substantial amount of C in Arctic and Boreal peatlands is potentially subject to increased decomposition if the water table (WT) decreases due to climate change, including permafrost thaw-related drying. Here, we optimize a version of the Organizing Carbon and Hydrology In Dynamic Ecosystems model (ORCHIDEE-PCH4) using site-specific observations to investigate changes in CO and CH fluxes as well as C stock responses to an experimentally manipulated decrease of WT at six northern peatlands. The unmanipulated control peatlands, with the WT (seasonal max up to 45 cm) below the surface, currently act as C sinks in most years (58 ± 34 g C m year ; including 6 ± 7 g C-CH m year emission). We found, however, that lowering the WT by 10 cm reduced the CO sink by 13 ± 15 g C m year and decreased CH emission by 4 ± 4 g CH m year , thus accumulating less C over 100 years (0.2 ± 0.2 kg C m ). Yet, the reduced emission of CH , which has a larger greenhouse warming potential, resulted in a net decrease in greenhouse gas balance by 310 ± 360 g CO m year . Peatlands with the initial WT close to the soil surface were more vulnerable to C loss: Non-permafrost peatlands lost \u3e2 kg C m over 100 years when WT is lowered by 50 cm, while permafrost peatlands temporally switched from C sinks to sources. These results highlight that reductions in C storage capacity in response to drying of northern peatlands are offset in part by reduced CH emissions, thus slightly reducing the positive carbon climate feedbacks of peatlands under a warmer and drier future climate scenario

Sensory determinants of behavioral dynamics in Drosophila thermotaxis

Complex animal behaviors are built from dynamical relationships between sensory inputs, neuronal activity, and motor outputs in patterns with strategic value. Connecting these patterns illuminates how nervous systems compute behavior. Here, we study Drosophila larva navigation up temperature gradients toward preferred temperatures (positive thermotaxis). By tracking the movements of animals responding to fixed spatial temperature gradients or random temperature fluctuations, we calculate the sensitivity and dynamics of the conversion of thermosensory inputs into motor responses. We discover three thermosensory neurons in each dorsal organ ganglion (DOG) that are required for positive thermotaxis. Random optogenetic stimulation of the DOG thermosensory neurons evokes behavioral patterns that mimic the response to temperature variations. In vivo calcium and voltage imaging reveals that the DOG thermosensory neurons exhibit activity patterns with sensitivity and dynamics matched to the behavioral response. Temporal processing of temperature variations carried out by the DOG thermosensory neurons emerges in distinct motor responses during thermotaxis

The California Legacy Survey III. On The Shoulders of (Some) Giants: The Relationship between Inner Small Planets and Outer Massive Planets

We use a high-precision radial velocity survey of FGKM stars to study the conditional occurrence of two classes of planets: close-in small planets (0.023--1 au, 2--30 Earth masses) and distant giant planets (0.23--10 au, 30--6000 Earth masses). We find that $41^{+15}_{-13}\%$ of systems with a close-in, small planet also host an outer giant, compared to $17.6^{+2.4}_{-1.9}\%$ for stars irrespective of small planet presence. This implies that small planet hosts may be enhanced in outer giant occurrence compared to all stars with $1.7\sigma$ significance. Conversely, we estimate that $42^{+17}_{-13}\%$ of cold giant hosts also host an inner small planet, compared to $27.6^{+5.8}_{-4.8}\%$ of stars irrespective of cold giant presence. We also find that more massive and close-in giant planets are not associated with small inner planets. Specifically, our sample indicates that small planets are less likely to host outer giant companions more massive than approximately 120 Earth masses and within 0.3--3 au than to host less massive or more distant giant companions, with $\sim$2.2$\sigma$ confidence. This implies that massive gas giants within 0.3--3 au may suppress inner small planet formation. Additionally, we compare the host-star metallicity distributions for systems with only small planets and those with both small planets and cold giants. In agreement with previous studies, we find that stars in our survey that only host small planets have a metallicity distribution that is consistent with the broader solar-metallicity-median sample, while stars that host both small planets and gas giants are distinctly metal-rich with $\sim$2.3$\sigma$ confidence.Comment: Reposted on arxiv after journal acceptance and alterations in response to reviewer comment

Focused fluid seepage related to variations in accretionary wedge structure, Hikurangi margin, New Zealand

Hydrogeological processes influence the morphology, mechanical behavior, and evolution of subduction margins. Fluid supply, release, migration, and drainage control fluid pressure and collectively govern the stress state, which varies between accretionary and nonaccretionary systems. We compiled over a decade of published and unpublished acoustic data sets and seafloor observations to analyze the distribution of focused fluid expulsion along the Hikurangi margin, New Zealand. The spatial coverage and quality of our data are exceptional for subduction margins globally. We found that focused fluid seepage is widespread and varies south to north with changes in subduction setting, including: wedge morphology, convergence rate, seafloor roughness, and sediment thickness on the incoming Pacific plate. Overall, focused seepage manifests most commonly above the deforming backstop, is common on thrust ridges, and is largely absent from the frontal wedge despite ubiquitous hydrate occurrences. Focused seepage distribution may reflect spatial differences in shallow permeability architecture, while diffusive fluid flow and seepage at scales below detection limits are also likely. From the spatial coincidence of fluids with major thrust faults that disrupt gas hydrate stability, we surmise that focused seepage distribution may also reflect deeper drainage of the forearc, with implications for pore-pressure regime, fault mechanics, and critical wedge stability and morphology. Because a range of subduction styles is represented by 800 km of along-strike variability, our results may have implications for understanding subduction fluid flow and seepage globally