The ionization structure of multiple shell planetary nebulae: I. NGC 2438

In recent times an increasing number of extended haloes and multiple shells around planetary nebulae have been discovered. These faint extensions to the main nebula trace the mass-loss history of the star, modified by the subsequent evolution of the nebula. Integrated models predict that some haloes may be recombining, and not in ionization equilibrium. But parameters such as the ionization state and thus the contiguous excitation process are not well known. The haloes are very extended, but faint in surface brightness - 10^3 times below the main nebula. The observational limits lead to the need of an extremely well studied main nebula, to model the processes in the shells and haloes of one object. NGC2438 is a perfect candidate to explore the physical characteristics of the halo. Long-slit spectroscopic data were obtained. These data are supplemented by imaging data from the HST archive, and archival VLA observations. The use of diagnostic diagrams draws limits for physical properties in the models. CLOUDY is used to model the nebular properties, and to derive a more accurate distance and ionized mass. We derive an accurate extinction E(B-V)=0.16, and distance of 1.9kpc. This puts the nebula behind the nearby open cluster M46. The low-excitation species are found to be dominated by clumps. The emission line ratios show no evidence for shocks. We find the shell in ionization equilibrium: a significant amount of UV radiation infiltrates the inner nebula. Thus the shell still seems to be ionized. The spatially resolved CLOUDY model supports the hypothesis that photoionization is the dominant process in this nebula, far out into the shell. Previous models predicted that the shell would be recombining, but this is not confirmed by the data. We note that these models used a smaller distance, and therefore different input parameters, than derived by us.Comment: Accepted for publication in A&A (13 pages, 15 figures, 8 tables

Extracorporeal liver assist device to exchange albumin and remove endotoxin in acute liver failure: Results of a pivotal pre-clinical study

Background & AimsIn acute liver failure, severity of liver injury and clinical progression of disease are in part consequent upon activation of the innate immune system. Endotoxaemia contributes to innate immune system activation and the detoxifying function of albumin, critical to recovery from liver injury, is irreversibly destroyed in acute liver failure. University College London-Liver Dialysis Device is a novel artificial extracorporeal liver assist device, which is used with albumin infusion, to achieve removal and replacement of dysfunctional albumin and reduction in endotoxaemia. We aimed to test the effect of this device on survival in a pig model of acetaminophen-induced acute liver failure.MethodsPigs were randomised to three groups: Acetaminophen plus University College London-Liver Dialysis Device (n=9); Acetaminophen plus Control Device (n=7); and Control plus Control Device (n=4). Device treatment was initiated two h after onset of irreversible acute liver failure.ResultsThe Liver Dialysis Device resulted in 67% reduced risk of death in acetaminophen-induced acute liver failure compared to Control Device (hazard ratio=0.33, p=0.0439). This was associated with 27% decrease in circulating irreversibly oxidised human non-mercaptalbumin-2 throughout treatment (p=0.046); 54% reduction in overall severity of endotoxaemia (p=0.024); delay in development of vasoplegia and acute lung injury; and delay in systemic activation of the TLR4 signalling pathway. Liver Dialysis Device-associated adverse clinical effects were not seen.ConclusionsThe survival benefit and lack of adverse effects would support clinical trials of University College London-Liver Dialysis Device in acute liver failure patients

Minimally invasive treatment of patients with bronchobiliary fistula: a case series

<p>Abstract</p> <p>Introduction</p> <p>Bronchobiliary fistula is an uncommon complication secondary to hepatobiliary surgery. Bilioptysis is a pathognomic finding for bronchobiliary fistulas. Diagnosis may be easily established in the light of clinical history, which can be aided by imaging studies to pinpoint the exact location. Some diagnostic procedures such as endoscopic retrograde cholangiopancreatectomy are also useful for treatment.</p> <p>Case presentation</p> <p>We present three Turkish patients with bronchobiliary fistula secondary to previous hepatic surgery due to hydatid cyst in two, a 19-year-old and a 47-year-old man, and iatrogenic trauma of the common bile duct by endoscopy in a 35-year-old man. All of the patients were successfully treated by minimally invasive methods including percutaneous drainage and endoscopic retrograde cholangiopancreatography.</p> <p>Conclusion</p> <p>We suggest that bronchobiliary fistula could be managed through conservative treatment methods which do not require in-hospital follow-up, particularly in uncomplicated cases. Otherwise, surgical management can be unavoidable.</p

Characterizing the gamma-ray long-term variability of PKS 2155-304 with H.E.S.S. and Fermi-LAT

Studying the temporal variability of BL Lac objects at the highest energies provides unique insights into the extreme physical processes occurring in relativistic jets and in the vicinity of super-massive black holes. To this end, the long-term variability of the BL Lac object PKS 2155-304 is analyzed in the high (HE, 100 MeV 200 GeV) gamma-ray domain. Over the course of ~9 yr of H.E.S.S observations the VHE light curve in the quiescent state is consistent with a log-normal behavior. The VHE variability in this state is well described by flicker noise (power-spectral-density index {\ss}_VHE = 1.10 +0.10 -0.13) on time scales larger than one day. An analysis of 5.5 yr of HE Fermi LAT data gives consistent results ({\ss}_HE = 1.20 +0.21 -0.23, on time scales larger than 10 days) compatible with the VHE findings. The HE and VHE power spectral densities show a scale invariance across the probed time ranges. A direct linear correlation between the VHE and HE fluxes could neither be excluded nor firmly established. These long-term-variability properties are discussed and compared to the red noise behavior ({\ss} ~ 2) seen on shorter time scales during VHE-flaring states. The difference in power spectral noise behavior at VHE energies during quiescent and flaring states provides evidence that these states are influenced by different physical processes, while the compatibility of the HE and VHE long-term results is suggestive of a common physical link as it might be introduced by an underlying jet-disk connection.Comment: 11 pages, 16 figure

An inter-comparison exercise of mesoscale flow models applied to an ideal case simulation

An exercise is described aiming at the comparison of the results of seven mesoscale models used for the simulation of an ideal circulation case. The exercise foresees the simulation of the flow over an ideal sea–land interface including ideal topography in order to verify model deviations on a controlled case. All models involved use the same initial and boundary conditions, circulation and temperature forcings as well as grid resolution in the horizontal and simulate the circulation over a 24-h period of time. The model differences at start are reduced to the minimum by the case specification and consist mainly of the parameterisation and numerical formulation of the fundamental equations of the atmospheric flow. The exercise reveals that despite the reduction of the differences in the case configuration, the differences in model results are still remarkable. An ad hoc investigation using one model of the original seven identifies the treatment of the boundary conditions, the parameterisation of the horizontal diffusion and of the surface heat flux as the main cause for the model deviations. The analysis of ideal cases represents a revealing and interesting exercise to be performed after the validation of models against analytical solution but prior to the application to real cases

Oxytocin Enhances Social Recognition by Modulating Cortical Control of Early Olfactory Processing

Oxytocin promotes social interactions and recognition of conspecifics that rely on olfaction in most species. The circuit mechanisms through which oxytocin modifies olfactory processing are incompletely understood. Here, we observed that optogenetically induced oxytocin release enhanced olfactory exploration and same-sex recognition of adult rats. Consistent with oxytocin’s function in the anterior olfactory cortex, particularly in social cue processing, region-selective receptor deletion impaired social recognition but left odor discrimination and recognition intact outside a social context. Oxytocin transiently increased the drive of the anterior olfactory cortex projecting to olfactory bulb interneurons. Cortical top-down recruitment of interneurons dynamically enhanced the inhibitory input to olfactory bulb projection neurons and increased the signal-to-noise of their output. In summary, oxytocin generates states for optimized information extraction in an early cortical top-down network that is required for social interactions with potential implications for sensory processing deficits in autism spectrum disorders

Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure.

Acute‐on‐chronic liver failure (ACLF) in cirrhosis is characterized by acute decompensation (AD), organ failure(s), and high short‐term mortality. Recently, we have proposed (systemic inflammation [SI] hypothesis) that ACLF is the expression of an acute exacerbation of the SI already present in decompensated cirrhosis. This study was aimed at testing this hypothesis and included 522 patients with decompensated cirrhosis (237 with ACLF) and 40 healthy subjects. SI was assessed by measuring 29 cytokines and the redox state of circulating albumin (HNA2), a marker of systemic oxidative stress. Systemic circulatory dysfunction (SCD) was estimated by plasma renin (PRC) and copeptin (PCC) concentrations. Measurements were performed at enrollment (baseline) in all patients and sequentially during hospitalization in 255. The main findings of this study were: (1) Patients with AD without ACLF showed very high baseline levels of inflammatory cytokines, HNA2, PRC, and PCC. Patients with ACLF showed significantly higher levels of these markers than those without ACLF; (2) different cytokine profiles were identified according to the type of ACLF precipitating event (active alcoholism/acute alcoholic hepatitis, bacterial infection, and others); (3) severity of SI and frequency and severity of ACLF at enrollment were strongly associated. The course of SI and the course of ACLF (improvement, no change, or worsening) during hospitalization and short‐term mortality were also strongly associated; and (4) the strength of association of ACLF with SI was higher than with SCD. Conclusion: These data support SI as the primary driver of ACLF in cirrhosis