Macronutrient intake and outcomes of ICU patients with refeeding hypophosphatemia.

BACKGROUND: Normocaloric vs. calorie-restricted feeding in Intensive Care Unit (ICU) patients with refeeding hypophosphatemia (RH) is associated with increased mortality rates. Until now, only total energy provision has been studied. Data on individual macronutrients (proteins, lipids, and carbohydrates) and clinical outcomes are lacking. This study evaluates associations between macronutrient intake among RH patients during the first week of ICU admission and clinical outcomes. METHODS: A single-centre retrospective observational cohort study was conducted among prolonged mechanically ventilated RH ICU patients. The primary outcome was the association of separate macronutrient intakes during the first week of ICU admission with 6-month mortality, adjusted for relevant variables. Other parameters included ICU-, hospital- and 3-month mortality, mechanical ventilation duration and length of ICU and hospital stay. Macronutrient intakes were subsequently analyzed during day 1-3 and day 4-7 of ICU admission. RESULTS: In total, 178 RH patients were included. Six-month all-cause mortality was 29.8%. Higher protein intake during days 1-3 of ICU admission (>0.71 g/kg∗day; HR 2.224, 95%CI 1.261-3.923, p = 0.006), higher age (HR 1.040, 95%CI 1.015-1.066, p = 0.002) and higher APACHE II scores on ICU admission (HR 1.086, 95%CI 1.034-1.140, p = 0.001) were associated with increased 6-month mortality. No differences in other outcomes were observed. CONCLUSION: High protein - not carbohydrate or lipid - intake during the first three days of ICU admission in patients with RH is associated with increased 6-month mortality, but not short-term outcomes. We hypothesize a time-dependent and dose-response relationship between protein intake and mortality in refeeding hypophosphatemia ICU patients, although additional (randomized controlled) studies are needed to confirm this hypothesis.

Gender Specific Brood Cells in the Solitary Bee Colletes halophilus (Hymenoptera; Colletidae).

We studied the reproductive behaviour of the solitary bee Colletes halophilus based on the variation in cell size, larval food amount and larval sex in relation to the sexual size dimorphism in this bee. Brood cells with female larvae are larger and contain more larval food than cells with males. Occasionally males are reared in female-sized cells. We conclude that a female C. halophilus in principal anticipates the sex of her offspring at the moment brood cell construction is started. Additionally a female is able to 'change her mind' about the sex of her offspring during a single brood cell cycle. We present a model that can predict the sex of the larvae in an early stage of development.

Comparing dogs and great apes in their ability to visually track object transpositions.

Knowing that objects continue to exist after disappearing from sight and tracking invisible object displacements are two basic elements of spatial cognition. The current study compares dogs and apes in an invisible transposition task. Food was hidden under one of two cups in full view of the subject. After that both cups were displaced, systematically varying two main factors, whether cups were crossed during displacement and whether the cups were substituted by the other cup or instead cups were moved to new locations. While the apes were successful in all conditions, the dogs had a strong preference to approach the location where they last saw the reward, especially if this location remained filled. In addition, dogs seem to have special difficulties to track the reward when both containers crossed their path during displacement. These results confirm the substantial difference that exists between great apes and dogs with regard to mental representation abilities required to track the invisible displacements of objects.