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Background: In intensive care units (ICUs), both continuous and intermittent feeding are commonly used for early enteral nutrition (EN). However, whether continuous feeding is a preferable feeding modality compared to intermittent feeding remains unclear. Therefore, this meta-analysis assessed the clinical efficacy of both EN feeding modalities in critically ill patients. Methods: The PubMed, Embase, and Cochrane Library databases were searched from their inception dates to December 29, 2022. The search did not involve language restrictions (PROSPERO CRD42022371756). Randomized controlled trials (RCTs) comparing the clinical efficacy and safety of continuous feeding and intermittent feeding in critically ill patients in ICUs were included. Results: We included 13 RCTs involving 785 patients. Compared with intermittent feeding, continuous feeding was associated with a lower mortality rate (relative risk [RR], 0.68; 95% confidence interval [CI], 0.47, 0.98; p = 0.04) but a higher risk of constipation (RR, 1.57; 95% CI, 1.02, 2.43; p = 0.04). Trial sequential analysis (TSA) for mortality rate presented a cumulative Z-curve crossing the traditional boundary, but the curve did not cross the TSA boundary for benefit. No significant differences were found in the aspiration/pneumonia rate (RR, 1.19; 95% CI, 0.51, 2.75; p = 0.69), diarrhea rate (RR, 0.82; 95% CI, 0.58, 1.16; p = 0.26), or increased gastric residual volumes (RR, 1.05; 95% CI, 0.58, 1.90; p = 0.86) between the groups. Conclusion: Despite the low certainty of evidence, compared with intermittent feeding, continuous feeding may reduce the mortality rate in critically ill patients in ICU. Additional studies are needed to provide more evidence and validate the findings. [ABSTRACT FROM AUTHOR]

It is nearly impossible to separate two interleaved phonebooks by pulling their spines. The very slight force exerted by the outer sheets of the assembly is amplified as the exponential of the square of the number of sheets, meaning that even a small number of sheets can create a highly resistant system. We present a systematic and detailed study of the influences of the normal external force and the geometrical parameters of the booklets on the assembly strength. We conclude that the paper-paper adhesion force between the two outer sheets, on the order of a few mN , is the one amplified by the interleaved-book system. The two-phonebook experiment—which has attracted the attention of students and the non-scientific public all around the world as an outstanding demonstration of the strength of friction—appears to also be a spectacular macroscopic manifestation of the microscopic coupling of friction and adhesion. [ABSTRACT FROM AUTHOR]

Critically ill children frequently fail to achieve adequate energy intake, and some care practices, such as the measurement of gastric residual volume (GRV), may contribute to this problem. We compared outcomes in two similar European Paediatric Intensive Care Units (PICUs): one which routinely measures GRV (PICU-GRV) to one unit that does not (PICU-noGRV). An observational pilot comparison study was undertaken. Eighty-seven children were included in the study, 42 (PICU-GRV) and 45 (PICU-noGRV). There were no significant differences in the percentage of energy targets achieved in the first 4 days of PICU admission although PICU-noGRV showed more consistent delivery of median (and IQR) energy targets and less under and over feeding for PICU-GRV and PICU-noGRV: day 1 37 (14-72) vs 44 (0-100), day 2 97 (53-126) vs 100 (100-100), day 3 84 (45-112) vs 100 (100-100) and day 4 101 (63-124) vs 100 (100-100). The incidence of vomiting was higher in PICU-GRV. No necrotising enterocolitis was confirmed in either unit, and ventilator-acquired pneumonia rates were not significantly different (7.01 vs 12 5.31 per 1000 ventilator days; p = 0.70) between PICU-GRV and PICU-noGRV units.Conclusions: The practice of routine gastric residual measurement did not significantly impair energy targets in the first 4 days of PICU admission. However, not measuring GRV did not increase vomiting, ventilator-acquired pneumonia or necrotising enterocolitis, which is the main reason clinicians cite for measuring GRV. What is known: • The practice of routinely measuring gastric residual volume is widespread in critical care units • This practice is increasingly being questioned in critically ill patients, both as a practice that increases • The likelihood of delivering inadequate enteral nutrition amounts and as a tool to assess feeding tolerance What is new: • Not routinely measuring gastric residual volume did not increase adverse events of ventilator acquired pneumonia, necrotising enterocolitis or vomiting. • In the first 4 days of PICU stay, energy target achievement was not significantly different, but the rates of under and over feeding were higher in the routine GRV measurement unit. [ABSTRACT FROM AUTHOR]

The use of nasal high-flow oxygen therapy (NHFOT) has become increasingly common in hospitals across Europe, Asia, and North America. These high utility devices provide an efficient and comfortable access points for providing supplemental oxygen to patients with variety of respiratory disorders. They are relatively easy to set up, and clinicians and patients alike give very positive feedback about their ease of use and comfort for patients in the hospital setting. However, it remains uncertain whether NHFOT improves patient survival or even reduces respiratory complications. Outcome data in adult populations are few and frequently underpowered to guide physicians for their widespread use in hospital setting. In this article, we present a review of the current technology and available studies pertinent to NHFOT. [ABSTRACT FROM AUTHOR]

Abstract.: We investigated the formation of a contact between a smooth sphere of elastomer and a micro-patterned elastomer substrate. We focussed our attention on the transition between a contact only established at the top of the pillars, and a mixed contact with a central zone of full contact surrounded by a top contact corona, which was observed when the normal load was increased. The full contact zone always nucleated with a finite radius, and the transition appears to be a first-order transition, with a hysteresis due to the creation of an adhesive zone between the pillars. We propose to include the effect of the new inter-pillar adhesion to produce a realistic treatment of the mechanics of these complex contacts. This new approach quantitatively accounts for the evolution of the observed jump in the radius of the full contact with the geometrical parameters of the pattern. Graphical abstract: [ABSTRACT FROM AUTHOR]

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To evaluate the impact of metamorphosis on the vertical distribution and feeding activity of sole, So lea solea, larvae passing from offshore spawning grounds to the Bay of Vilaine, sampling series at fixed stations were carried out in April 1991 and April 1993 at depths from 50 to 30 m. Comparisons between plankton and bottom sampling series indicated differences in vertical distribution of larvae in pre-metamorphic and metamorphic steps. Metamorphosing larvae displayed a tendency to concentrate in the lower part of the water column, mainly during the day. Gut contents, analysed for prey identification, fullness index and carbon content, indicated that metamorphosing larvae fed mostly on plankton. Variations in fullness index were observed not only during the day, but also depended on tide and wind-induced mixing conditions. Larvae sampled in mixed spring-tide waters had highly variable carbon estimates, resulting in unclear diel activity. More larvae fed actively at neap-tide, which allowed the observation of a diurnal feeding activity through hourly changes in carbon estimates. It is concluded that immigrating sole were not yet able to settle but prepared themselves for demersal life (i) without undergoing starvation and (ii) by modifying the patterns of vertical distributions. The presence of a larval swimbladder suggests they can adjust their vertical movements, depending on tidal cycles, which could in turn favour coastal accumulation of metamorphosing larvae and pulses of new settlers entering the nursery grounds. [ABSTRACT FROM AUTHOR]