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We report results from the preliminary trials of Colibri, a dedicated fast-photometry array for the detection of small Kuiper Belt objects (KBOs) through serendipitous stellar occultations. Colibri’s novel data processing pipeline analyzed 4000 star hours with two overlapping-field EMCCD cameras, detecting no KBOs and one false positive occultation event in a high ecliptic latitude field. No occultations would be expected at these latitudes, allowing these results to provide a control sample for the upcoming main Colibri campaign. The empirical false positive rate found by the processing pipeline is consistent with the 0.002% simulation-determined false positive rate. We also describe Colibri’s software design, kernel sets for modeling stellar occultations, and method for retrieving occultation parameters from noisy diffraction curves. Colibri’s main campaign will begin in mid-2018, operating at a 40 Hz sampling rate.

Background Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings. Methods A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874. Results Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d  = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d  = 0.90, 95%CI (0.09, 1.70), choice provided, d  = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. Conclusions Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables.

To determine the safety and efficacy of enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit (MICU). This descriptive study included patients aged 18 to 89 years admitted to the MICU between July 1, 2007, and June 30, 2012, who received scheduled opioids and at least 1 dose of enteral naloxone. All data were obtained from electronic charting systems. Efficacy was assessed by evaluating time to bowel movement (BM), number of naloxone doses until BM, and ability to tolerate tube feeds after receipt of enteral naloxone. Safety was assessed by comparing opioid requirements, heart rates, and systolic blood pressures before and during naloxone treatment. Fifteen of the 16 patients included in the final analysis passed BMs during the study period. The median time to BM was 24.4 hours. The median number of naloxone doses received prior to passing a BM was 3. Seventy-eight percent of patients who were not receiving tube feeds at the time of naloxone administration received continuous tube feeds after naloxone initiation. No adverse effects associated with use of enteral naloxone were noted. Enteral naloxone appears safe for the treatment of opioid-induced constipation in the MICU. Enteral naloxone may be effective in treating opioid-induced constipation; however, further studies are warranted.

Change history: In this Letter, the Acknowledgements section should have included the following sentence: “The National Radio Astronomy Observatory is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc.”. This omission has been corrected online.

Massive galaxy clusters have been found that date to times as early as three billion years after the Big Bang, containing stars that formed at even earlier epochs1,2,3. The high-redshift progenitors of these galaxy clusters—termed ‘protoclusters’—can be identified in cosmological simulations that have the highest overdensities (greater-than-average densities) of dark matter4,5,6. Protoclusters are expected to contain extremely massive galaxies that can be observed as luminous starbursts7. However, recent detections of possible protoclusters hosting such starbursts8,9,10,11 do not support the kind of rapid cluster-core formation expected from simulations12: the structures observed contain only a handful of starbursting galaxies spread throughout a broad region, with poor evidence for eventual collapse into a protocluster. Here we report observations of carbon monoxide and ionized carbon emission from the source SPT2349-56. We find that this source consists of at least 14 gas-rich galaxies, all lying at redshifts of 4.31. We demonstrate that each of these galaxies is forming stars between 50 and 1,000 times more quickly than our own Milky Way, and that all are located within a projected region that is only around 130 kiloparsecs in diameter. This galaxy surface density is more than ten times the average blank-field value (integrated over all redshifts), and more than 1,000 times the average field volume density. The velocity dispersion (approximately 410 kilometres per second) of these galaxies and the enormous gas and star-formation densities suggest that this system represents the core of a cluster of galaxies that was already at an advanced stage of formation when the Universe was only 1.4 billion years old. A comparison with other known protoclusters at high redshifts shows that SPT2349-56 could be building one of the most massive structures in the Universe today.

Purpose: Individuals who were assigned female sex at birth (AFAB) but do not conform to the gender binary (i.e., transgender/genderqueer) often do not seek out necessary sexual health care, including Papanicolaou (Pap) tests, placing them at heightened risk of cervical cancer. Despite growing awareness, scant research has focused on the sexual health care experiences of this population in Midwestern and rural states. Methods: We used two approaches to develop a more detailed understanding of factors that determine sexual health care use. Seventeen transgender/genderqueer AFAB individuals completed a quantitative knowledge survey then participated in a semistructured qualitative interview to further elaborate their experiences with sexual health care services as well as the motivators and barriers related to accessing the health care system. We produced descriptive summaries of quantitative data and conducted a thematic analysis of interview transcripts. Results: The sample was mostly young adults, of whom nearly all were white and 65% self-identified as transgender men. Participants displayed good knowledge about human papillomavirus (HPV) and Pap tests; however, 41% rated themselves as “unaware” and 59% rated themselves as “aware but not well informed” about HPV. Fifty-nine percent had ever obtained a Pap test. We identified one facilitating factor (health care provider's role and relationship) and three inhibiting factors (availability of competent care; distress about seeking sexual health care; health care setting characteristics) related to obtaining Pap tests. Conclusion: As this study was conducted in the U.S. Midwest, findings extend the geographic scope of existing knowledge and may inform future risk reduction interventions and clinical practice.

We report results from the preliminary trials of Colibri, a dedicated fast-photometry array for the detection of small Kuiper Belt objects (KBOs) through serendipitous stellar occultations. Colibri's novel data processing pipeline analyzed 4000 star hours with two overlapping-field EMCCD cameras, detecting no KBOs and one false positive occultation event in a high ecliptic latitude field. No occultations would be expected at these latitudes, allowing these results to provide a control sample for the upcoming main Colibri campaign. The empirical false positive rate found by the processing pipeline is consistent with the 0.002% simulation-determined false positive rate. We also describe Colibri's software design, kernel sets for modeling stellar occultations, and method for retrieving occultation parameters from noisy diffraction curves. Colibri's main campaign will begin in mid-2018, operating at a 40 Hz sampling rate.

We present the discovery by the TESS mission of one transiting Neptune-sized planet, TOI-6223 b and two transiting super-Earths, TOI-1743 b and TOI-5799 b. We validate these planets using a statistical validation method, multi-color light curves and other ancillary observations. We combined TESS and ground-based photometric data to constrain the physical properties of the planets. TOI-6223-b is slightly larger than Neptune (\\(R_p=5.12^+0.24_-0.25\\) \\(R_\\)) orbiting an early M dwarf in 3.86 days, and it has an equilibrium temperature of \\(T_ eq=71414\\) K. TOI-1743 b orbits its M4V star every 4.27 days. It has a radius of \\(R_p=1.83^+0.11_-0.10\\) \\(R_\\) and an equilibrium temperature of \\(T_ eq=485^+14_-13\\) K. TOI-5799 b has a radius of \\(R_p=1.733^+0.096_-0.090\\) \\(R_\\), and an equilibrium temperature of \\(T_ eq=50516\\) K orbits an M2 dwarf in 4.17 days. We also present the discovery of an additional transiting planet, TOI-5799 c, that we identified in the TESS data and validated using the SHERLOCK pipeline. TOI-5799 c is a super-Earth with a radius of \\(R_p=1.76^+0.11_-0.10\\) \\(R_\\). Its orbital period and its equilibrium temperature are 14.01 days and \\(T_ eq=33711\\) K, which place it near the inner edge of the habitable zone of its star.We show that these planets are suitable for both radial velocity follow-up and atmospheric characterization. They orbit bright (< 11 \\(K_mag\\)) early M dwarfs, making them accessible for precise mass measurements. The combination of the planet sizes and stellar brightness of their host stars also make them suitable targets for atmospheric exploration with the JWST. Such studies may provide insights into planet formation and evolution, as TOI-1743-b, TOI-5799-b, and TOI-5799-c lie within the so-called radius valley, while TOI-6223-b is located on the Neptunian ridge in the period-radius plane.

Background: To combat the high prevalence of physical inactivity among children, there is an urgent need to develop and implement real-world interventions and policies that promote physical activity (PA) and reduce sedentary behaviour (SB). To inform policy makers, the current body of evidence for children's PA/SB interventions needs to be translated. Objectives: The current systematic review and meta-analysis aimed to identify modifiable determinants of device-measured PA and SB targeted in available intervention studies with randomized controlled trial (RCT) and controlled trial (CT) designs in children and early adolescents (5-12 years) and to quantify the effects of the interventions within their respective settings on the determinants of PA/SB and the outcomes PA and SB. Methods: A systematic search was conducted in MEDLINE, PsycINFO, Web of Science, SPORTDiscus and CENTRAL. Studies were considered if they were randomized controlled trials (RCTs) or controlled trials (CTs), included children and/or early adolescents (5-12 years; henceforth termed children), measured PA and/or SB using device-based methods and measured PA and/or SB and determinants of PA/SB at least at two timepoints. Risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB2) for RCTs and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) for CTs. The quality of the generated evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Robust Bayesian meta-analysis was conducted to quantify the effects of the interventions on the determinants of PA/SB, and the outcomes PA and SB, stratifying by study design, duration of PA/SB measurement, intervention setting and duration of follow-up measurement. Study characteristics and interventions were summarized. Results: Thirty-eight studies were included with a total sample size of n = 14,258 (67% girls). Settings identified were school, family/home, community and combinations of these. The review identified 38 modifiable determinants, spanning seven categories on individual, interpersonal and physical environmental levels, with 66% of determinants on the individual level. Overall, the results indicated trivial-to-moderate effects of the interventions on the determinants of PA and SB, with mostly trivial level of evidence for the presence of an effect (as indicated by a small Bayes factor; BF10 ( 3.00). The exceptions were moderate effects on parental PA modelling in the family/home setting and SB measured during specific parts of the school day. Higher quality of evidence was found in the family/home setting compared with other settings. Discussion: Overall, the results indicated that interventions have neither been effective in modifying the determinants of PA/SB, nor changing the PA/SB outcomes in children. In general, the approach in the current review revealed the breadth of methodological variability in children's PA interventions. Research is needed to address novel approaches to children's PA research and to identify potential determinants to inform policy and future interventions. (Autor).