Nightside condensation of iron in an ultra-hot giant exoplanet

Ultra-hot giant exoplanets receive thousands of times Earth's insolation. Their high-temperature atmospheres (>2,000 K) are ideal laboratories for studying extreme planetary climates and chemistry. Daysides are predicted to be cloud-free, dominated by atomic species and substantially hotter than nightsides. Atoms are expected to recombine into molecules over the nightside, resulting in different day-night chemistry. While metallic elements and a large temperature contrast have been observed, no chemical gradient has been measured across the surface of such an exoplanet. Different atmospheric chemistry between the day-to-night ("evening") and night-to-day ("morning") terminators could, however, be revealed as an asymmetric absorption signature during transit. Here, we report the detection of an asymmetric atmospheric signature in the ultra-hot exoplanet WASP-76b. We spectrally and temporally resolve this signature thanks to the combination of high-dispersion spectroscopy with a large photon-collecting area. The absorption signal, attributed to neutral iron, is blueshifted by -11+/-0.7 km s-1 on the trailing limb, which can be explained by a combination of planetary rotation and wind blowing from the hot dayside. In contrast, no signal arises from the nightside close to the morning terminator, showing that atomic iron is not absorbing starlight there. Iron must thus condense during its journey across the nightside.Comment: Published in Nature (Accepted on 24 January 2020.) 33 pages, 11 figures, 3 table

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Fundamental physics with ESPRESSO: Precise limit on variations in the fine-structure constant towards the bright quasar HE 0515−4414

The strong intervening absorption system at redshift 1.15 towards the very bright quasar HE 0515−4414 is the most studied absorber for measuring possible cosmological variations in the fine-structure constant, α. We observed HE 0515−4414 for 16.1 h with the Very Large Telescope and present here the first constraint on relative variations in α with parts-per-million (ppm) precision from the new ESPRESSO spectrograph: Δα/α = 1.3 ± 1.3stat ± 0.4sys ppm. The statistical uncertainty (1σ) is similar to the ensemble precision of previous large samples of absorbers and derives from the high signal-to-noise ratio achieved (≈105 per 0.4 km s−1 pixel). ESPRESSO’s design, and the calibration of our observations with its laser frequency comb, effectively removed wavelength calibration errors from our measurement. The high resolving power of our ESPRESSO spectrum (R = 145 000) enabled the identification of very narrow components within the absorption profile, allowing a more robust analysis of Δα/α. The evidence for the narrow components is corroborated by their correspondence with previously detected molecular hydrogen and neutral carbon. The main remaining systematic errors arise from ambiguities in the absorption profile modelling, effects from redispersing the individual quasar exposures, and convergence of the parameter estimation algorithm. All analyses of the spectrum, including systematic error estimates, were initially blinded to avoid human biases. We make our reduced ESPRESSO spectrum of HE 0515−4414 publicly available for further analysis. Combining our ESPRESSO result with 28 measurements, from other spectrographs, in which wavelength calibration errors have been mitigated yields a weighted mean Δα/α = −0.5 ± 0.5stat ± 0.4sys ppm at redshifts 0.6−2.4

Fundamental physics with E

Observations of metal absorption systems in the spectra of distant quasars allow one to constrain a possible variation of the fine-structure constant throughout the history of the Universe. Such a test poses utmost demands on the wavelength accuracy and previous studies were limited by systematics in the spectrograph wavelength calibration. A substantial advance in the field is therefore expected from the new ultra-stable high-resolution spectrograph ESPRESS

Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p &lt; 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p &lt; 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Immunocompromised patients with acute respiratory distress syndrome : Secondary analysis of the LUNG SAFE database

The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Patients attended: Scabies, Impetigo and demographic data

A dataset that contains information on patients who received a facility or community-based assessment of Scabies . It contains six variables – age, gender, scabies assessment status, impetigo assessment status, site location, and treatment round number. Data was collected by the DerMalawi project through integrated skin diseases clinics and Tele-dermatology care that they established in 2015 in the Nkhotakota and Salima health districts in Malawi

K2-111: An old system with two planets in near-resonance

This paper reports on the detailed characterisation of the K2-111 planetary system with K2, WASP, and ASAS-SN photometry as well as high-resolution spectroscopic data from HARPS-N and ESPRESSO. The host, K2-111, is confirmed to be a mildly evolved ($\log g=4.17$), iron-poor ([Fe/H]$=-0.46$), but alpha-enhanced ([$\alpha$/Fe]$=0.27$), chromospherically quiet, very old thick disc G2 star. A global fit, performed by using PyORBIT shows that the transiting planet, K2-111b, orbits with a period $P_b=5.3518\pm0.0004$ d, and has a planet radius of $1.82^{+0.11}_{-0.09}$ R$_\oplus$ and a mass of $5.29^{+0.76}_{-0.77}$ M$_\oplus$, resulting in a bulk density slightly lower than that of the Earth. The stellar chemical composition and the planet properties are consistent with K2-111b being a terrestrial planet with an iron core mass fraction lower than the Earth. We announce the existence of a second signal in the radial velocity data that we attribute to a non-transiting planet, K2-111c, with an orbital period of $15.6785\pm 0.0064$ days, orbiting in near-3:1 mean-motion resonance with the transiting planet, and a minimum planet mass of $11.3\pm1.1$ M$_\oplus$. Both planet signals are independently detected in the HARPS-N and ESPRESSO data when fitted separately. There are potentially more planets in this resonant system, but more well-sampled data are required to confirm their presence and physical parameters