Peculiar Glitch of PSR J1119-6127 and Extension of the Vortex Creep Model

Glitches are sudden changes in rotation frequency and spin-down rate, observed from pulsars of all ages. Standard glitches are characterized by a positive step in angular velocity ($\Delta\Omega$ $>$ $0$) and a negative step in the spin-down rate ($\Delta \dot \Omega$ $<$ $0$) of the pulsar. There are no glitch-associated changes in the electromagnetic signature of rotation-powered pulsars in all cases so far. For the first time, in the last glitch of PSR J1119-6127, there is clear evidence for changing emission properties coincident with the glitch. This glitch is also unusual in its signature. Further, the absolute value of the spin-down rate actually decreases in the long term. This is in contrast to usual glitch behaviour. In this paper we extend the vortex creep model in order to take into account these peculiarities. We propose that a starquake with crustal plate movement towards the rotational poles of the star induces inward vortex motion which causes the unusual glitch signature. The component of the magnetic field perpendicular to the rotation axis will decrease, giving rise to a permanent change in the pulsar external torque.Comment: accepted by MNRAS, 10 pages, 2 figure

B12 Vitamin and Folat Prevelance of Children and Adolescents in Diyarbakır

The most common cause of megaloblastic anemia in childhood are vitamin B12 and folat deficiency. Folat and vitamin B12 play a role in DNA synthessis in gastrointestinal, urogenital,nerves and hemotopoetic cells. The diagnosis of megaloblastic anemia is easy and the treatment cost is low.In this study, the prevalence of vitamin B12 and folat deficiencies in 889 students were determined. Vitamin B12 and folat levels in blood samples were measured via RİAThe average age were betwen 12 and 22 years. Of this students 294(%33,1) were female and 595 (%66,9) were male. The incidence of vitamin B12 deficiency was found to be 2.2%, while folat deficiency was 21.8%. The mean vitamin B12 level was 331,51±144,05 pg/mL (325,60±138,91 in pg/mL male, 343,48±153,48 pg/mL in female), the mean folat level was 5,42±2,12 ng/ml (5,23±2,11 ng/ml in male, 5,80±2,10 ng/ml in female).The prevelance of folat deficiency in our region was higher than other countries, possibly due to low socioeconomical status, improper or inadequate food intake and low educational status

Long-term evolution of dim isolated neutron stars

The X-ray dim isolated neutron stars (XDINs) have periods in the same range as the anomalous X-ray pulsars (AXPs) and the soft gamma-ray repeaters (SGRs). We apply the fallback disc model, which explains the period clustering and other properties of AXP/SGRs, to the six XDINs with measured periods and period derivatives. Present properties of XDINs are obtained in evolutionary scenarios with surface dipole magnetic fields B-0 similar to 10(12) G. The XDINs have gone through an accretion epoch with rapid spin-down earlier, and have emerged in their current state, with the X-ray luminosity provided by neutron star cooling and no longer by accretion. Our results indicate that the known XDINs are not likely to be active radio pulsars, as the low B-0, together with their long periods place these sources clearly below the 'death valley'

Nonlinear interglitch dynamics, the braking index of the Vela pulsar and the time to the next glitch

The interglitch timing of the Vela pulsar is characterized by a constant second derivative of the rotation rate. This takes over after the post-glitch exponential relaxation and is completed at about the time of the next glitch. The vortex creep model explains the second derivatives in terms of nonlinear response to the glitch. We present interglitch timing fits to the present sample covering 16 large glitches, taking into account the possibility that in some glitches part of the step in the spin-down rate may involve a ‘persistent shift’, as observed in the Crab pulsar. Modifying the expression for the time between glitches with this hypothesis leads to better agreement with the observed interglitch time intervals. We extrapolate the interglitch model fits to obtain spin-down rates just prior to each glitch and use these to calculate the braking index n = 2.81 ± 0.12. The next glitch should occur around 2017 December 22, ±197 d if no persistent shift is involved, but could occur as early as 2016 July 27, ±152 d if the 2013 glitch gave rise to a typical Vela persistent shift. Note added: Literally while we were submitting the first version of this paper on 2016 December 12, we saw ATel # 9847 announcing a Vela pulsar glitch which has arrived 138 d after our prediction with a persistent shift, within the 1σ uncertainty of 152 d

A normative spatiotemporal MRI atlas of the fetal brain for automatic segmentation and analysis of early brain growth.

Longitudinal characterization of early brain growth in-utero has been limited by a number of challenges in fetal imaging, the rapid change in size, shape and volume of the developing brain, and the consequent lack of suitable algorithms for fetal brain image analysis. There is a need for an improved digital brain atlas of the spatiotemporal maturation of the fetal brain extending over the key developmental periods. We have developed an algorithm for construction of an unbiased four-dimensional atlas of the developing fetal brain by integrating symmetric diffeomorphic deformable registration in space with kernel regression in age. We applied this new algorithm to construct a spatiotemporal atlas from MRI of 81 normal fetuses scanned between 19 and 39 weeks of gestation and labeled the structures of the developing brain. We evaluated the use of this atlas and additional individual fetal brain MRI atlases for completely automatic multi-atlas segmentation of fetal brain MRI. The atlas is available online as a reference for anatomy and for registration and segmentation, to aid in connectivity analysis, and for groupwise and longitudinal analysis of early brain growth

Proanthocyanidin to prevent formation of the reexpansion pulmonary edema

<p>Abstract</p> <p>Background</p> <p>We aimed to investigate the preventive effect of Proanthocyanidine (PC) in the prevention of RPE formation.</p> <p>Methods</p> <p>Subjects were divided into four groups each containing 10 rats. In the Control Group (CG): RPE wasn't performed. Then subjects were followed up for three days and they were sacrificed after the follow up period. Samplings were made from tissues for measurement of biochemical and histopathologic parameters. In the Second Group (PCG): The same protocol as CG was applied, except the administration of PC to the subjects. In the third RPE Group (RPEG): Again the same protocol as CG was applied, but as a difference, RPE was performed. In the Treatment Group (TG): The same protocol as RPEG was applied except the administration of PC to the subjects.</p> <p>Results</p> <p>In RPEG group, the most important histopathological finding was severe pulmonary edema with alveolar damage and acute inflammatory cells. These findings were less in the TG group. RPE caused increased MDA levels, and decreased GPx, SOD and CAT activity significantly in lung tissue.</p> <p>Conclusion</p> <p>PC decreased MDA levels. Oxidative stress plays an important role in pathophysiology of RPE and PC treatment was shown to be useful to prevent formation of RPE.</p

Comparison of plasma endothelin levels between osteoporotic, osteopenic and normal subjects

BACKGROUND: It has been demonstrated that endothelins (ET) have significant roles in bone remodeling, metabolism and physiopathology of several bone diseases. We aimed to investigate if there was any difference between the plasma ET levels of osteoporotic patients and normals. METHODS: 86 patients (70 women and 16 men) with a mean age of 62.6 (ranges: 51–90) years were included in this study. Patients were divided into groups of osteoporosis, osteopenia and normal regarding reported T scores of DEXA evaluation according to the suggestions of World Health Organization. According to these criteria 19, 43 and 24 were normal, osteopenic and osteoporotic respectively. Then total plasma level of ET was measured in all patients with monoclonal antibody based sandwich immunoassay (EIA) method. One-way analysis of variance test was used to compare endothelin values between normals, osteopenics and osteoporotics. RESULTS: Endothelin total plasma level in patients was a mean of 98.36 ± 63.96, 100.92 ± 47.2 and 99.56 ± 56.6 pg/ml in osteoporotic, osteopenic and normal groups respectively. The difference between groups was not significant (p > 0.05). CONCLUSION: No significant differences in plasma ET levels among three groups of study participants could be detected in this study

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6&nbsp;years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P &lt; 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100&nbsp;years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P &lt; 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P &lt; 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223