The Anomalous Early Afterglow of GRB 050801

The ROTSE-IIIc telescope at the H.E.S.S. site, Namibia, obtained the earliest detection of optical emission from a Gamma-Ray Burst (GRB), beginning only 21.8 s from the onset of Swift GRB 050801. The optical lightcurve does not fade or brighten significantly over the first ~250 s, after which there is an achromatic break and the lightcurve declines in typical power-law fashion. The Swift/XRT also obtained early observations starting at 69 s after the burst onset. The X-ray lightcurve shows the same features as the optical lightcurve. These correlated variations in the early optical and X-ray emission imply a common origin in space and time. This behavior is difficult to reconcile with the standard models of early afterglow emission.Comment: 5 pages, 1 figure. Accepted for publication in ApJ Letter

Exploring invasiveness and versatility of used microhabitats of the globally invasive Gambusia holbrooki.

Introductions of non-native species can lead to severe impacts, including the decline of ecosystem function through deleterious impacts on species diversity. The successful establishment of non-native species in new environments is the first barrier a species must overcome, ultimately depending on its ability to either cope with or adapt to local site-specific conditions. Despite the widespread distribution and ecological consequences of many freshwater invaders, site-specific and climatic preferences are often unknown, as in the case of the Eastern mosquitofish Gambusia holbrooki, a global invader considered as a pervasive threat to endemic species. Here, we determined the ecological features and preferred site-specific conditions of G. holbrooki in Türkiye, which spans a wide range of diverse biogeographically distinct ecosystems, by surveying populations from 130 localities in 2016 and 2017. Gambusia holbrooki were detected by hand-net in 48 of these sites (19 lotic, 29 lentic). It showed a preference for shallow waters with medium sized rocks, and abundances differed spatially across a latitudinal gradient and was influenced predominantly by variations in pH. The only other factors predicting its presence were low current velocities and gravel substrate, highlighting its ecological versatility in utilising a wide range of microhabitats. Bioclimatic models suggest that G. holbrooki is found in areas with an average annual temperature ranging from 10 to 20 °C, but with temperature not being a limiting factor to its invasion. Gambusia holbrooki shows a preference for xeric freshwater ecosystems and endorheic basins, as well as temperate coastal rivers, temperate upland rivers, temperate floodplain rivers and wetlands, and tropical and subtropical coastal rivers. These results, particularly the wide occurrence with only few limiting factors, emphasise the invasion potential of mosquitofish and should substantiate the need for localised invasive species management and conservation efforts, particularly in smaller or insular areas where mosquitofish and endemic fish species co-exist

Turner syndrome and associated problems in turkish children: A multicenter study

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population. Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014. Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosi) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto’s thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%. Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespan. © Journal of Clinical Research in Pediatric Endocrinology

Seroprevalence and risk factors for toxoplasma infection among pregnant women in Aydin province, Turkey

BACKGROUND: The aims of the present study were to determine the prevalence of toxoplasmosis in pregnant women at first trimester of their pregnancy and to follow up the seroconversion for next two trimesters, and to identify the risk factors and possible contamination routes in Aydin province, Turkey. METHOD: The sample size was calculated as 423 on a prevalence of 50%, d=0.05 at a confidence level of 95% with 10% addition. It was a cross-sectional study with multistage sampling. After a questionnaire applied to the pregnant women, anti-Toxoplasma IgG antibodies were studied with ELISA and IFA, values in conflict with DA test, where IgM antibodies were studied with ELISA and for borderline or positive values of IgM avidity test was used. RESULTS: The mean age of 389 (92.9%) of pregnant women in the study was 24.28+/-4.56 years, the seroprevalence of anti-Toxoplasma IgG antibodies for toxoplasmosis was 30.1%. Seroprevalence was increased with age (p=0.001) and with drinking water consumption other than bottled water (p=0.042). No significant relations were observed between anti-Toxoplasma IgG antibodies and education level, being native or migrant, abortion history, consumption of meat, vegetable and milk/milk products, personal or kitchen hygiene habits, cat owning at home of the pregnant women. No IgM antibody was detected. CONCLUSION: One of every three pregnant women in Aydin was at risk of toxoplasmosis at the first trimester of their pregnancy. Increased seroprevalance with age was a predictable result because of increasing time of exposure. Increased seroprevalence with consumption of municipal and uncontrolled water (well/spring water) supplies was similar with latest epidemiological findings

Specifying and Validating Probabilistic Inputs for Prescriptive Models of Decision Making over Time

Optimization models for making decisions over time in uncertain environments rely on probabilistic inputs, such as scenario trees for stochastic mathematical programs. The quality of model outputs, i.e., the solutions obtained, depends on the quality of these inputs. However, solution quality is rarely assessed in a rigorous way. The connection between validation of model inputs and quality of the resulting solution is not immediate. This chapter discusses some efforts to formulate realistic probabilistic inputs and subsequently validate them in terms of the quality of solutions they produce. These include formulating probabilistic models based on statistical descriptions understandable to decision makers; conducting statistical tests to assess the validity of stochastic process models and their discretization; and conducting re-enactments to assess the quality of the formulation in terms of solution performance against observational data. Studies of long-term capacity expansion in service industries, including electric power, and short-term scheduling of thermal electricity generating units provide motivation and illustrations. The chapter concludes with directions for future research

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 < 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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries