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

The S-Plus lift: a short-scar, long-flap rhytidectomy

INTRODUCTION: As rhytidectomy is one of the most elective surgical procedures, there is a strong trend toward less aggressive operative techniques. The authors introduce the S-Plus lift, a \u27long flap\u27 superficial musculo-aponeurotic system (SMAS) imbrication technique that diminishes risks, decreases recovery time, and yields long-lasting results. PATIENTS AND METHODS: This paper describes a novel approach to mid-facial rejuvenation that combines the limited incision of an S-lift with two SMASectomies, purse-string suture imbrication of the extended supraplatysmal plane (ESP) and SMAS, and malar soft tissue suspension. SMAS excisions are performed pre-auricularly, and in the region overlying the anterior edge of the parotid gland. Purse-string imbrication sutures are designed to close the SMAS defects, pull the soft tissues of the neck upward, pull the jowl and lower face posteriorly and superiorly, and tighten the platysma. Ancillary purse-string suture lifts the malar fat pad and cheek soft tissues vertically, which achieves mid-face fullness and lifting. Compared to S-lift, the technique extends its efficacy in those patients who have moderate-to-severe mid-facial laxity, prominent nasolabial folds, and platysma redundancy. RESULTS: A review of 144 consecutive S-Plus lifts performed by a single surgeon (SBH), with at least 6 months of follow-up, was performed. Over a 3-year period, 130 (90.3%) females and 14 (9.7%) males underwent S-Plus lift. S-Plus lift as primary rhytidectomy was performed in 132 (91.7%) and as secondary in 12 (8.3%) cases. Complication rate was low and comparable with other techniques of rhytidectomy. CONCLUSIONS: The S-Plus lift is a novel, hybrid technique with pleasing results, short down-time, and high patient satisfaction rate. The technique combines two SMASectomies with purse-string suture imbrication of the ESP and SMAS, and malar fat suture suspension