IMPORTANCE Clostridium difficile infection (CDI) is a major burden in health care and community settings. CDI recurrence is of particular concern because of limited treatment options and associated clinical and infection control issues. Fecal microbiota transplantation (FMT) is a promising, but not readily available, intervention. OBJECTIVE To determine whether frozen-and-thawed (frozen, experimental) FMT is noninferior to fresh (standard) FMT in terms of clinical efficacy among patients with recurrent or refractory CDI and to assess the safety of both types of FMT. DESIGN, SETTING, AND PARTICIPANTS Randomized, double-blind, noninferiority trial enrolling 232 adults with recurrent or refractory CDI, conducted between July 2012 and September 2014 at 6 academic medical centers in Canada. INTERVENTIONS Patients were randomly allocated to receive frozen (n = 114) or fresh (n = 118) FMT via enema. MAIN OUTCOMES AND MEASURES The primary outcome measures were clinical resolution of diarrhea without relapse at 13 weeks and adverse events. Noninferiority margin was set at 15%. RESULTS A total of 219 patients (n = 108 in the frozen FMT group and n = 111 in the fresh FMT group) were included in the modified intention-to-treat (mITT) population and 178 (frozen FMT: n = 91, fresh FMT: n = 87) in the per-protocol population. In the per-protocol population, the proportion of patients with clinical resolution was 83.5% for the frozen FMT group and 85.1% for the fresh FMT group (difference, −1.6% [95% CI,-10.5% to ϱ]; P = .01 for noninferiority). In the mITT population the clinical resolution was 75.0% for the frozen FMT group and 70.3% for the fresh FMT group (difference, 4.7% [95% CI,-5.2% to ϱ]; P < .001 for noninferiority). There were no differences in the proportion of adverse or serious adverse events between the treatment groups. CONCLUSIONS AND RELEVANCE Among adults with recurrent or refractory CDI, the use of frozen compared with fresh FMT did not result in worse proportion of clinical resolution of diarrhea. Given the potential advantages of providing frozen FMT, its use is a reasonable option in this setting.

We present the first measurement of the planet frequency beyond the "snow line," for the planet-to-star mass-ratio interval −4.5 < log q < −2, corresponding to the range of ice giants to gas giants. We find d 2 N pl d log q d log s = (0.36 ± 0.15) dex −2 at the mean mass ratio q = 5 × 10 −4 with no discernible deviation from a flat (Öpik's law) distribution in logprojected separation s. The determination is based on a sample of six planets detected from intensive follow-up observations of high-magnification (A > 200) microlensing events during 2005-2008. The sampled host stars have a typical mass M host ∼ 0.5 M , and detection is sensitive to planets over a range of planet-star-projected separations (s −1 max R E , s max R E), where R E ∼ 3.5 AU (M host /M) 1/2 is the Einstein radius and s max ∼ (q/10 −4.3) 1/3. This corresponds to deprojected separations roughly three times the "snow line." We show that the observations of these events have the properties of a "controlled experiment," which is what permits measurement of absolute planet frequency. High-magnification events are rare, but the survey-plus-follow-up high-magnification channel is very efficient: half of all high-mag events were successfully monitored and half of these yielded planet detections. The extremely high sensitivity of high-mag events leads to a policy of monitoring them as intensively as possible, independent of whether they show evidence of planets. This is what allows us to construct an unbiased sample. The planet frequency derived from microlensing is a factor 8 larger than the one derived from Doppler studies at factor ∼25 smaller star-planet separations (i.e., periods 2-2000 days). However, this difference is basically consistent with the gradient derived from Doppler studies (when extrapolated well beyond the separations from which it is measured). This suggests a universal separation distribution across 2 dex in planet-star separation, 2 dex in mass ratio, and 0.3 dex in host mass. Finally, if all planetary systems were "analogs" of the solar system, our sample would have yielded 18.2 planets (11.4 "Jupiters," 6.4 "Saturns," 0.3 "Uranuses," 0.2 "Neptunes") including 6.1 systems with two or more planet detections. This compares to six planets including one twoplanet system in the actual sample, implying a first estimate of 1/6 for the frequency of solar-like systems.

Because of the development of large-format, wide-field cameras, microlensing surveys are now able to monitor millions of stars with sufficient cadence to detect planets. These new discoveries will span the full range of significance levels including planetary signals too small to be distinguished from the noise. At present, we do not understand where the threshold is for detecting planets. MOA-2011-BLG-293Lb is the first planet to be published from the new surveys, and it also has substantial followup observations. This planet is robustly detected in survey+followup data (∆χ 2 ∼ 5400). The planet/host mass ratio is q = 5.3 ± 0.2 × 10 −3 . The best fit projected separation is s = 0.548 ± 0.005 Einstein radii. However, due to the s ↔ s −1 degeneracy, projected separations of s −1 are only marginally disfavored at ∆χ 2 = 3. A Bayesian estimate of the host mass gives M L = 0.43 +0.27 −0.17 M ⊙ , with a sharp upper limit of M L < 1.2 M ⊙ from upper limits on the lens flux. Hence, the planet mass is m p = 2.4 +1.5 −0.9 M Jup , and the physical projected separation is either r ⊥ ≃ 1.0 AU or r ⊥ ≃ 3.4 AU. We show that survey data alone predict this solution and are able to characterize the planet, but the ∆χ 2 is much smaller (∆χ 2 ∼ 500) than with the followup data. The ∆χ 2 for the survey data alone is smaller than for any other securely detected planet. This event suggests a means to probe the detection threshold, by analyzing a large sample of events like MOA-2011-BLG-293, which have both followup data and high cadence survey data, to provide a guide for the interpretation of pure survey microlensing data.

The spin rate distribution of main belt/Mars crossing (MB/MC) asteroids with diameters 3-15 km is uniform in the range from f = 1 to 9.5 d −1 , and there is an excess of slow rotators with f < 1 d −1 . The observed distribution appears to be controlled by the Yarkovsky-O'Keefe-Radzievskii-Paddack (YORP) effect. The magnitude of the excess of slow rotators is related to the residence time of slowed down asteroids in the excess and the rate of spin rate change outside the excess. We estimated a median YORP spin rate change of ≈ 0.022 d −1 /Myr for asteroids in our sample (i.e., a median time in which the spin rate changes by 1 d −1 is ≈ 45 Myr), thus the residence time of slowed down asteroids in the excess is ≈ 110 Myr. The spin rate distribution of near-Earth asteroids (NEAs) with sizes in the range 0.2 -3 km (∼ 5-times smaller in median diameter than the MB/MC asteroids sample) shows a similar excess of slow rotators, but there is also a concentration of NEAs at fast spin rates with f = 9-10 d −1 . The concentration at fast spin rates is correlated with a narrower distribution of spin rates of primaries of binary systems among NEAs; the difference may be due to the apparently more evolved population of binaries among MB/MC asteroids.

Aims. We report the discovery of a planet with a high planet-to-star mass ratio in the microlensing event MOA-2009-BLG-387, which exhibited pronounced deviations over a 12-day interval, one of the longest for any planetary event. The host is an M dwarf, with a mass in the range 0.07 M < M host < 0.49 M at 90% confidence. The planet-star mass ratio q = 0.0132 ± 0.003 has been measured extremely well, so at the best-estimated host mass, the planet mass is m p = 2.6 Jupiter masses for the median host mass, M = 0.19 M . Methods. The host mass is determined from two "higher order" microlensing parameters. One of these, the angular Einstein radius θ E = 0.31 ± 0.03 mas has been accurately measured, but the other (the microlens parallax π E , which is due to the Earth's orbital motion) is highly degenerate with the orbital motion of the planet. We statistically resolve the degeneracy between Earth and planet orbital effects by imposing priors from a Galactic model that specifies the positions and velocities of lenses and sources and a Kepler model of orbits. Results. The 90% confidence intervals for the distance, semi-major axis, and period of the planet are 3.5 kpc < D L < 7.9 kpc, 1.1 AU < a < 2.7 AU, and 3.8 yr < P < 7.6 yr, respectively.