JWST measurements of 13 C, 18 O, and 17 O in the atmosphere of Super-Jupiter VHS 1256 b

Isotope ratios have recently been measured in the atmospheres of directly imaged and transiting exoplanets from ground-based observations. The arrival of JWST allows us to characterize exoplanetary atmospheres in further detail and opens up wavelengths inaccessible from the ground. In this work we constrain the carbon and oxygen isotopes 13C, 18O, and 17O from CO in the atmosphere of the directly imaged companion VHS 1256 b through retrievals of the ∼4.1–5.3 μm NIRSpec G395H/F290LP observations from the early-release science program (ERS 1386). We detect and constrain 13C16O, 12C18O, and 12C17O at 32σ, 16σ, and 10σ confidence respectively, thanks to the very high signal-to-noise observations. We find the ratio of abundances are more precisely constrained than their absolute values, with 12C/13C=62−2+2 , in between previous measurements for companions (∼30) and isolated brown dwarfs (∼100). The oxygen isotope ratios are 16O/18O=425−28+33 and 16O/17O=1010−100+120 . All of the ratios are lower than the local interstellar medium and solar system, suggesting that abundances of the more minor isotopes are enhanced compared to the primary. This could be driven by isotope fractionation in protoplanetary disks, which can potentially alter the carbon and oxygen ratios through isotope selective photodissociation, gas/ice partitioning, and isotopic exchange reactions. In addition to CO, we constrain 1H 216O and 12C16O2 (the primary isotopologues of both species), but find only upper limits on 12C1H4 and 14N1H3. This work highlights the power of JWST to constrain isotopes in exoplanet atmospheres, with great promise in determining formation histories in the future

Central coordination as an alternative for local coordination in a multicenter randomized controlled trial: the FAITH trial experience

Contains fulltext : 110505.pdf (publisher's version ) (Open Access)BACKGROUND: Surgeons in the Netherlands, Canada and the US participate in the FAITH trial (Fixation using Alternative Implants for the Treatment of Hip fractures). Dutch sites are managed and visited by a financed central trial coordinator, whereas most Canadian and US sites have local study coordinators and receive per patient payment. This study was aimed to assess how these different trial management strategies affected trial performance. METHODS: Details related to obtaining ethics approval, time to trial start-up, inclusion, and percentage completed follow-ups were collected for each trial site and compared. Pre-trial screening data were compared with actual inclusion rates. RESULTS: Median trial start-up ranged from 41 days (P25-P75 10-139) in the Netherlands to 232 days (P25-P75 98-423) in Canada (p = 0.027). The inclusion rate was highest in the Netherlands; median 1.03 patients (P25-P75 0.43-2.21) per site per month, representing 34.4% of the total eligible population. It was lowest in Canada; 0.14 inclusions (P25-P75 0.00-0.28), representing 3.9% of eligible patients (p < 0.001). The percentage completed follow-ups was 83% for Canadian and Dutch sites and 70% for US sites (p = 0.217). CONCLUSIONS: In this trial, a central financed trial coordinator to manage all trial related tasks in participating sites resulted in better trial progression and a similar follow-up. It is therefore a suitable alternative for appointing these tasks to local research assistants. The central coordinator approach can enable smaller regional hospitals to participate in multicenter randomized controlled trials. Circumstances such as available budget, sample size, and geographical area should however be taken into account when choosing a management strategy. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00761813

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

RT-CGM in adults with type 1 diabetes improves both glycaemic and patient-reported outcomes, but independent of each other

Contains fulltext : 214026.pdf (publisher's version ) (Open Access

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar