Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Disfluências e velocidade de fala em produção espontânea e em leitura oral em indivíduos gagos e não gagos

PURPOSE: To investigate and characterize temporal parameters of speech in spontaneous situation and in oral reading in people who stutter and who do not stutter, and investigate the relation among these variables. METHODS: Thirty participants aged between 17 and 59 years, with a minimum of 08 years of scholar education, constituted the Study Group, composed by 15 people who stutter and the Control Group with 15 people who did not stutter. Subjects on the Control and Study Group were matched by gender, age and education level. After anamnesis it was made: brief neuropsychological assessment, specific stuttering assessment and specific oral reading assessment. Disfluencies were analyzed and it was calculated speech rate on spontaneous production and oral reading. RESULTS: There were more disfluencies in spontaneous speech than in text oral reading in both groups. As to speech rate, in the Control Group, pseudoword and text reading were positively correlated, and in the Study Group, all variables were positively correlated. CONCLUSION: Speech rate and disfluencies analysis characterized both groups, either in spontaneous speech and reading situations which evidenced performance profiles differentiated by speech rate, frequency and disfluency typology. Investigation showed that people who stutter present lower values of speech rate, as well as higher occurrence of disfluencies, either on spontaneous speech and oral reading, in comparison to people who do not stutter.OBJETIVO: Investigar e caracterizar a velocidade de fala e as rupturas da fala em situação espontânea e em leitura oral, em indivíduos gagos e não gagos e investigar a relação entre essas variáveis. MÉTODOS: Trinta participantes com idades entre 17 e 59 anos e, no mínimo, oito anos de escolaridade, constituíram o Grupo Estudo, com 15 indivíduos gagos, e o Grupo Controle, com 15 indivíduos não gagos. Os indivíduos do Grupo Controle e do Grupo Estudo foram pareados por idade, gênero e nível de escolaridade. Após anamnese, foram realizadas as seguintes avaliações: neuropsicológica breve, específica da gagueira e específicas da leitura. As disfluências foram analisadas e calculou-se a velocidade da fala espontânea e na leitura oral. RESULTADOS: Ocorreram mais disfluências na fala espontânea que na leitura oral de texto, em ambos os grupos. Em relação à velocidade, no Grupo Controle, a leitura de pseudopalavras e de texto correlacionaram-se positivamente e no Grupo Estudo, todas as variáveis correlacionaram-se positivamente. CONCLUSÃO: A análise da velocidade e das rupturas de fala caracterizou ambos os grupos, tanto em situação de fala espontânea, quanto na leitura que evidencia perfis de desempenho diferenciados pela velocidade de fala, frequência e tipologia das rupturas. A investigação demonstra que indivíduos gagos apresentaram valores mais baixos de velocidade, assim como maior ocorrência de disfluências, tanto na fala espontânea quanto na leitura oral, em comparação com indivíduos não gagos.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Departamento de FonoaudiologiaUNIFESP, Depto. de FonoaudiologiaSciEL

A multi-centre randomized controlled trial comparing electrothermal arthroscopic capsulorrhaphy versus open inferior capsular shift for patients with shoulder instability: Protocol implementation and interim performance: Lessons learned from conducting a multi-centre RCT [ISRCTN68224911; NCT00251160]

BACKGROUND: The shoulder is the most frequently dislocated joint in the body. Multiple causes and pathologies account for the various types of shoulder instability. Multi-directional instability (MDI) and multi-directional laxity with antero-inferior instability (MDL-AII) are similar in pathology, less common and more difficult to treat. These instabilities are caused by ligamentous capsular redundancy. When non-operative management fails for these patients, quality of life is significantly impaired and surgical treatment is required to tighten the ligaments and joint capsule. The current reference (gold) standard treatment for MDI/MDL-AII is an open inferior capsular shift (ICS) surgical procedure. An alternative treatment involves arthroscopic thermal shrinkage of redundant capsular tissue to tighten the joint. However, there is a lack of scientific evidence to support the use of this technique called, electrothermal arthroscopic capsulorrhaphy (ETAC). This trial will compare the effectiveness of ETAC to open ICS in patients with MDI and MDL-AII, using patient-based quality of life outcome assessments. METHODS: This study is a multi-centre randomized clinical trial with a calculated sample size of 58 patients (p = 0.05, 80% power). Eligible patients are clinically diagnosed with MDI or MDL-AII and have failed standardized non-operative management. A diagnostic shoulder arthroscopy is performed to confirm eligibility, followed by intra-operative randomization to the ETAC or ICS surgical procedure. The primary outcome is the disease-specific quality of life questionnaire (Western Ontario Shoulder Instability Index), measured at baseline, 3, 6, 12 and 24 months. Secondary outcomes include shoulder-specific measures (American Shoulder and Elbow Surgeons Score and Constant Score). Other outcomes include recurrent instability, complications and operative time. The outcome measurements will be compared on an intention-to-treat basis, using two-sample independent t-tests to assess statistical significance. A Generalized Estimated Equations (GEE) analysis will determine whether there is an effect over time. DISCUSSION: This ongoing trial has encountered unexpected operational and practical issues, including slow patient enrollment due to high intra-operative exclusion rates. However, the authors have a greater understanding of multi-directional laxity in the shoulder and anticipate the results of this trial will provide the medical community with the best scientific clinical evidence on the efficacy of ETAC compared to open ICS