Ices in the edge-on disk CRBR 2422.8-3423: Spitzer spectroscopy and Monte Carlo radiative transfer modeling

We present 5.2-37.2 micron spectroscopy of the edge-on circumstellar disk CRBR 2422.8-3423 obtained using the InfraRed Spectrograph (IRS) of the Spitzer Space Telescope. The IRS spectrum is combined with ground-based 3-5 micron spectroscopy to obtain a complete inventory of solid state material present along the line of sight toward the source. We model the object with a 2D axisymmetric (effectively 3D) Monte Carlo radiative transfer code. It is found that the model disk, assuming a standard flaring structure, is too warm to contain the very large observed column density of pure CO ice, but is possibly responsible for up to 50% of the water, CO2 and minor ice species. In particular the 6.85 micron band, tentatively due to NH4+, exhibits a prominent red wing, indicating a significant contribution from warm ice in the disk. It is argued that the pure CO ice is located in the dense core Oph-F in front of the source seen in the submillimeter imaging, with the CO gas in the core highly depleted. The model is used to predict which circumstances are most favourable for direct observations of ices in edge-on circumstellar disks. Ice bands will in general be deepest for inclinations similar to the disk opening angle, i.e. ~70 degrees. Due to the high optical depths of typical disk mid-planes, ice absorption bands will often probe warmer ice located in the upper layers of nearly edge-on disks. The ratios between different ice bands are found to vary by up to an order of magnitude depending on disk inclination due to radiative transfer effects caused by the 2D structure of the disk. Ratios between ice bands of the same species can therefore be used to constrain the location of the ices in a circumstellar disk. [Abstract abridged]Comment: 49 pages, accepted for publication in Ap

Routine laboratory parameters to support decision on parenteral nutrition in palliative care

IntroductionParenteral nutrition (PN) is widely used in palliative care (PC), but there is limited evidence to support its use at the end of life (EOL). This aim of this was to investigate the relationship between routine laboratory parameters and survival in patients receiving PN, and to develop a decision tree model to support clinicians decide whether to start or forgo PN.MethodsThe laboratory parameters of 113 patients with advanced diseases who were admitted to a specialized palliative care unit (PCU) were analyzed at two points in time: T0 = before PN, T1 = two weeks after initiation of PN. Univariate Mann-Whitney U-tests and multivariate linear regression models, as well as a decision tree analysis were computed; all in relation to survival time.ResultsThe final regression model was significant with p = 0.001 (adjusted R2 = 0.15) and included two predictors for survival time after PN initiation: the CRP/albumin ratio and urea at T1 (ps = 0.019). Decision tree analysis revealed three important predictors for classification of survival time after PN initiation: CRP, urea, and LDH (all at T0).DiscussionThe decision tree model may help to identify patients likely to benefit from PN, thus supporting the clinical decision whether or not to start PN

Tea Consumption Enhances Endothelial-Dependent Vasodilation; a Meta-Analysis

Background: Tea consumption is associated with a lower risk of cardiovascular disease including stroke. Direct effects of tea components on the vasculature, particularly the endothelium, may partly explain this association. Objective: We performed a meta-analysis of controlled human intervention studies on the effect of tea on flow-mediated dilation (FMD) of the brachial artery, a measurement of endothelial function, which is suggested to be associated with cardiovascular risk. Methods: Human intervention studies were identified by systematic search of the databases Medline, Embase, Chemical Abstracts and Biosis through March 2009 and by hand-searching related articles. Studies were selected based on predefined criteria: intervention with tea as the sole experimental variable, placebo-controlled design, and no missing data on FMD outcome or its variability. A random effects model was used to calculate the pooled overall effect on FMD due to the intake of tea. The impact of various subject and treatment characteristics was investigated in the presence of heterogeneity. Results: In total, 9 studies from different research groups were included with 15 relevant study arms. The overall absolute increase in FMD of tea vs. placebo was 2.6 % of the arterial diameter (95 % CI: 1.8-3.3%; P-value,0.001) for a median daily dose of 500 mL of tea (2–3 cups). This is a relative increase of approximately 40 % compared to the average FMD of 6.3% measured under placebo or baseline conditions. There was significant heterogeneity between studies (P-value,0.001) tha