A persistent ultraviolet outflow from an accreting neutron star binary transient.

All disc-accreting astrophysical objects produce powerful disc winds. In compact binaries containing neutron stars or black holes, accretion often takes place during violent outbursts. The main disc wind signatures during these eruptions are blue-shifted X-ray absorption lines, which are preferentially seen in disc-dominated 'soft states'1,2. By contrast, optical wind-formed lines have recently been detected in 'hard states', when a hot corona dominates the luminosity3. The relationship between these signatures is unknown, and no erupting system has as yet revealed wind-formed lines between the X-ray and optical bands, despite the many strong resonance transitions in this ultraviolet (UV) region4. Here we report that the transient neutron star binary Swift J1858.6-0814 exhibits wind-formed, blue-shifted absorption lines associated with C IV, N V and He II in time-resolved UV spectroscopy during a luminous hard state, which we interpret as a warm, moderately ionized outflow component in this state. Simultaneously observed optical lines also display transient blue-shifted absorption. Decomposing the UV data into constant and variable components, the blue-shifted absorption is associated with the former. This implies that the outflow is not associated with the luminous flares in the data. The joint presence of UV and optical wind features reveals a multi-phase and/or spatially stratified evaporative outflow from the outer disc5. This type of persistent mass loss across all accretion states has been predicted by radiation-hydrodynamic simulations6 and helps to explain the shorter-than-expected duration of outbursts7.

Injuries according to the percentage of adult height in an elite soccer academy.

OBJECTIVES: This study aimed to ascertain if there is a defined pattern of injury related to the percentage of attained adult height and classify injuries according to maturity status bands. DESIGN: Prospective cohort study. METHODS: From 1998-2019, 63 elite male soccer players of at least the U12 category from a Spanish LaLiga club's academy were followed until reaching their final height. Medical staff recorded injuries following the FIFA consensus and measured height 2-3 times per season. The percentage of adult height at which each injury occurred was calculated using the player's closest height to the injury and his final adult height. Injuries were classified in maturity bands, pre-peak-height-velocity (PHV) <88%, circa-PHV 88%-96%, and post-PHV >96%. RESULTS: There were 509 injuries among the 63 players. Growth-related injuries occurred at a median (IQR) of 91.2% (86.7%-95.2%) of adult height, predominating in pre-PHV and PHV bands. Muscle injuries predominantly occurred at post-PHV, with 77.78% of those conditions occurring within that time frame and at 98.7% (96%-99.5%) of adult height. Likewise, knee and ankle joint/ligament injuries predominated at post-PHV (87% and 65% of total cases, respectively) occurring at 99.0% (97.9%-99.9%) and 98.4% (89.2%-99.4%) of adult height, respectively. CONCLUSIONS: Injuries follow a specific pattern according to the percentage of adult height.

Modulation of Slow-Wave Sleep: Implications for Psychiatry.

PURPOSE OF REVIEW: The objectives of this review are to examine and integrate existing empirical evidence regarding the impact of slow-wave sleep (SWS) modulation on memory and executive function performance in individuals with psychiatric disorders, and to examine the feasibility of integrating SWS modulation into psychiatric care. RECENT FINDINGS: SWS modulation in individuals with psychiatric disorders resulted in changes to SWS across multiple psychiatric disorders, using all stimulation methods. SWS stimulation was associated with improved cognitive performance. SWS modulation using acoustic stimulation resulted in improved cognitive performance in children with ADHD, and the use of transcranial stimulation was associated with improved cognitive performance in individuals with mild cognitive impairment. Significant relationships between changes in SWS and cognitive improvement were found for individual with mild cognitive impairment following the use of acoustic or transcranial stimulation night. Our review reveals partial support to the potential efficacy of SWS modulation as a transdiagnostic intervention that uses sleep to improve cognitive functions of individuals diagnosed with psychiatric disorders and cognitive deficits. It further highlights multiple barriers pertaining to the feasibility of integrating SWS modulation into clinical practice and proposes ways to improve it.

An evolving jet from a strongly magnetized accreting X-ray pulsar.

Relativistic jets are observed throughout the Universe and strongly affect their surrounding environments on a range of physical scales, from Galactic binary systems1 to galaxies and clusters of galaxies2. All types of accreting black hole and neutron star have been observed to launch jets3, with the exception of neutron stars with strong magnetic fields4,5 (higher than 1012 gauss), leading to the conclusion that their magnetic field strength inhibits jet formation6. However, radio emission recently detected from two such objects could have a jet origin, among other possible explanations7,8, indicating that this long-standing idea might need to be reconsidered. But definitive observational evidence of such jets is still lacking. Here we report observations of an evolving jet launched by a strongly magnetized neutron star accreting above the theoretical maximum rate given by the Eddington limit. The radio luminosity of the jet is two orders of magnitude fainter than those seen in other neutron stars with similar X-ray luminosities9, implying an important role for the properties of the neutron star in regulating jet power. Our result also shows that the strong magnetic fields of ultra-luminous X-ray pulsars do not prevent such sources from launching jets.

Effect of extended-release dexmethylphenidate and mixed amphetamine salts on sleep: a double-blind, randomized, crossover study in youth with attention-deficit hyperactivity disorder.

OBJECTIVE: We sought to determine the dose-response effects of extended-release (ER) dexmethylphenidate (d-MPH) and ER mixed amphetamine salts (MAS) on objective measures of sleep. METHODS: This was an 8-week, double-blind, placebo-controlled, randomized, two period, crossover study of youth with attention-deficit hyperactivity disorder (ADHD) as confirmed by the Kiddie Schedule for Affective Disorders for School-Age Children-Present and Lifetime version (K-SADS-PL). Children aged 10-17 years were recruited from clinical practice, colleague referrals, and flyers. Participants were randomized to initially receive either d-MPH or MAS. During each 4-week drug period, children received three dose levels (10, 20, and 25/30 mg) in ascending order, with placebo substituted for active medication in a randomized fashion during 1 week of the study. After 4 weeks, participants were switched to the alternative medication for another 4 weeks of treatment. The main outcome measure was sleep duration as measured by actigraphy. Children, parents, and researchers were blinded to drug, dose, and placebo status. RESULTS: Sixty-five participants met the inclusion criteria and were enrolled in the study. Of these, 37 participants with sufficient sleep data for analysis were included. Sleep schedule measures showed a significant effect for dose on sleep start time (F(1,36) = 6.284; p < 0.05), with a significantly later sleep start time when children were receiving 20- or 30-mg doses, compared with placebo (p < 0.05). A significant dose effect was found on actual sleep duration (F(1,36) = 8.112; p < 0.05), with significantly shorter actual sleep duration for subjects receiving 30 mg compared with those receiving placebo (p < 0.05). There were no significant differences on sleep duration or sleep schedule between the two stimulant medications. The trial is complete and closed to follow-up. CONCLUSIONS: Higher stimulant doses were associated with reduced sleep duration and later sleep start times, regardless of medication class. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00393042.

Current concepts in MRI of rectus femoris musculotendinous (myotendinous) and myofascial injuries in elite athletes.

Rectus femoris injuries are extremely common in athletes, particularly in soccer players, rugby player, and sprinters. Magnetic resonance imaging (MRI) plays a key role in diagnosis, prognosis, and rehabilitation of these injuries. The current article discusses current concepts in the diagnosis and treatment of rectus femoris injuries in elite athletes, including a discussion of the less well known myofascial injuries and key prognostic factors as seen at MR imaging.

Examination of fatigue development in elite soccer in a hot environment: a multi-experimental approach.

The study examines fatigue in elite soccer played in hot conditions. High-profile soccer players (n=20) were studied during match play at ∼31 °C. Repeated sprint and jump performances were assessed in rested state and after a game and activity profile was examined. Additionally, heart rate (HR), blood lactate, muscle temperature and body mass changes were determined. Repeated sprint and jump performances were reduced (P<0.05) by 2.6% and 8.2%, respectively, after the game. The fatigue index in the repeated sprint test was 6.0±0.7% after the game compared with 1.7±1.0% at rest (P<0.05). High-intensity running was 57±4% lower (P<0.05) during the last 15-min interval of the game compared with the first 15-min period. No differences were observed in mean HR or blood lactates between halves. Muscle temperature was 40.5±0.4 °C after the first half, which was 0.8±0.2 °C higher (P<0.05) than after the second half. Net fluid loss during the game was >2% of the body mass. Correlations were observed between net-fluid loss and repeated sprint test fatigue index after the game (r=0.73, P<0.05) and Yo-Yo intermittent recovery, level 1 test performance and high-intensity running during the final 15 min of the game (r=0.51, P<0.05). The study provides direct evidence of compromised repeated sprint and jump performances induced by soccer match play and pronounced reduction in high-intensity running toward the end of an elite game played in a hot environment. This fatigue could be associated training status and hyperthermia/dehydration.

Effect of medetomidine infusion on the anaesthetic requirements of desflurane in dogs.

The objective of this paper was to evaluate the effect of constant rate infusion of medetomidine on the anaesthetic requirements of desflurane in dogs. For this, six healthy dogs were studied. Measurements for baseline were taken in the awake, unsedated dogs, then each dog received intravenously (i.v.) three anaesthetic protocols: M (no medetomidine infusion), M0.5 (infusion of medetomidine at 0.5 microg/kg/h, i.v.) or M1 (infusion of medetomidine at 1 microg/kg/h, i.v.). All dogs were sedated with medetomidine (2 microg/kg, i.v.) and measurements repeated in 10 min. Induction of anaesthesia was delivered with propofol (3 mg/kg, i.v.) and maintained with desflurane for 90 min to achieve a defined surgical plane of anaesthesia in all cases. After tracheal intubation infusion of medetomidine was initiated and maintained until the end of anaesthesia. Cardiovascular, respiratory, arterial pH (pHa) and arterial blood gas tensions (PaO(2), PaCO(2)) variables were measured during the procedure. End tidal desflurane concentration (EtDES) was recorded throughout anaesthesia. Time to extubation, time to sternal recumbency and time to standing were also noted. Heart rate and respiratory rate were significantly decreased during sedation in all protocols compared to baseline values. Mean heart rate, mean arterial pressure, systolic arterial pressure, diastolic arterial pressure, respiratory rate, tidal volume, arterial oxygen saturation, end-tidal CO(2), pHa, PaO(2), and PaCO(2) during anaesthesia were similar for all protocols. EtDES for M (8.6 +/- 0.8%) was statistically higher than for M0.5 (7.6 +/- 0.5%) and M1 (7.3 +/- 0.7%) protocols. Infusion of medetomidine reduces desflurane concentration required to maintain anaesthesia in dogs.

Comparison of romifidine and medetomidine pre-medication in propofol-isoflurane anaesthetised dogs.

The objective of this paper was to evaluate romifidine as a pre-medicant in dogs prior to propofol-isoflurane anaesthesia, and to compare it with medetomidine. For this, eight healthy dogs were anaesthetised. Each dog received three pre-anaesthetic protocols: R40 (romifidine, 40 microg/kg, IV), R80 (romifidine, 80 microg/kg, IV) or MED (medetomidine, 10 microg/kg, IV). Induction of anaesthesia was delivered with propofol and maintained with isoflurane. The following variables were studied before sedative administration and 10 min after sedative administration: heart rate (HR), mean arterial pressure (MAP), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) and respiratory rate (RR). During maintenance, the following variables were recorded at 5-min intervals: HR, MAP, SAD, DAP, arterial oxygen saturation (SpO(2)), end-tidal CO(2)(EtCO(2)), end-tidal concentration of isoflurane (EtISO) required for maintenance of anaesthesia and tidal volume (TV). Time to extubation, time to sternal recumbency and time to standing were also registered. HR and RR experimented a significantly decreased during sedation in all protocols respect to baseline values. Mean HR, MAP, SAP, DAP, SpO(2), EtCO(2), and TV during anaesthesia were similar for the three protocols. End tidal of isoflurane concentration was statistically similar for all protocols. Recovery time for R40 was significantly shorter than in R80 and MED. The studied combination of romifidine, propofol and isoflurane appears to be an effective drug combination for inducing and maintaining general anaesthesia in healthy dogs.

Dexmedetomidine or medetomidine premedication before propofol-desflurane anaesthesia in dogs.

The objective of this study was to evaluate dexmedetomidine as a premedicant in dogs prior to propofol-desflurane anaesthesia, and to compare it with medetomidine. Six healthy dogs were anaesthetized. Each dog received intravenously (i.v.) five preanaesthetic protocols: D1 (dexmedetomidine, 1 microg/kg, i.v.), D2 (dexmedetomidine, 2 microg/kg, i.v.), M1 (medetomidine, 1 microg/kg, i.v.), M2 (medetomidine, 2 microg/kg, i.v.), or M4 (medetomidine, 4 microg/kg, i.v.). Anaesthesia was induced with propofol (2.3-3.3 mg/kg) and maintained with desflurane. The following variables were studied: heart rate (HR), mean arterial pressure, systolic arterial pressure, diastolic arterial pressure, respiratory rate (RR), arterial oxygen saturation, end-tidal CO2, end-tidal concentration of desflurane (EtDES) required for maintenance of anaesthesia and tidal volume. Arterial blood pH (pHa) and arterial blood gas tensions (PaO2, PaCO2) were measured during anaesthesia. Time to extubation, time to sternal recumbency and time to standing were also recorded. HR and RR decreased significantly during sedation in all protocols. Cardiorespiratory variables during anaesthesia were statistically similar for all protocols. EtDES was significantly different between D1 (8.1%) and D2 (7.5%), and between all doses of medetomidine. Desflurane requirements were similar for D1 and M2, and for D2 and M4 protocols. No statistical differences were observed in recovery times. The combination of dexmedetomidine, propofol and desflurane appears to be effective for induction and maintenance of general anaesthesia in healthy dogs.

Fluorangiographic alterations in a dog with suspected iatrogenic partial carotid artery occlusion.

During routine fluorescein angiography, a healthy female dog demonstrated abnormal delayed filling of retinal and choroidal vessels. Fluorangiographic times were increased four- to fivefold with respect to reference values. Fluorescein angiography, using the same protocol, was repeated two weeks later and a fluorangiogram within reference values was obtained. The abnormal results in the first procedure were suspected to have resulted from partial occlusion of the carotid artery secondary to the restraining method used.

Physiological and performance responses to a 6-day taper in middle-distance runners: influence of training frequency.

The purpose of this investigation was to examine the influence of training frequency on performance and some physiological responses during a 6-day taper. After 18 weeks of training, 9 male middle-distance runners were assigned to a high frequency taper (HFT, n = 5) or a moderate frequency taper (MFT, n = 4), consisting of training daily or resting every third day of the taper. Taper consisted of an 80% nonlinear progressive reduction in high intensity interval training. Blood samples were obtained, and 800 m performance and peak blood lactate ([La] peak ) measured before and after taper. Performance improved significantly after HFT (121.8 +/- 4.7 vs 124.2 +/- 4.9 s, p < 0.05), but not after MFT (126.6 +/- 2.8 vs 127.1 +/- 2.1 s). Neutrophils (2.89 +/- 0.68 vs 2.56 +/- 0.61 10 (3) x mm(-3)), granulocytes (3.08 +/- 0.70 vs 2.77 +/- 0.66 10 (3) x mm(-3)), haptoglobin (79.7 +/- 47.9 vs 60.7 +/- 33.6 mg x dl(-1)), total testosterone (7.39 +/- 1.67 vs 5.52 +/- 0.88 microg x l(-1)) and [La] peak (15.5 +/- 1.5 vs 14.4 +/- 2.0 mmol x l(-1)) significantly increased with taper. [La] peak correlated with performance time before taper (r = -0.76, p < 0.05), and change in [La] peak with change in serum cortisol (r = -0.75, p < 0.05) and total testosterone:cortisol ratio (r = 0.82, p < 0.01). In conclusion, training daily during a 6-day taper brought about significant performance gains, whereas resting every third day did not. High [La] peak and a hormonal milieu propitious to anabolic processes seemed to be necessary for optimum performance.

Effects of sevoflurane, isoflurane and halotane anaesthesia on fluorescein angiographic phases of dogs: a comparative study.

A fluorescein angiography method was developed to compare the onset and the total duration of the fluorangiographic phases between three anaesthetic protocols in six healthy mixed-breed dogs. The animals were anaesthetized three times. Each dog received, as pre-anaesthetic protocol, atropine (10 micrograms/kg intramuscularly), and as a sedative, romifidine (80 micrograms/kg intravenously). Fifteen minutes later, induction of anaesthesia was delivered with propofol (1 mg/kg intravenously) and maintained either with sevoflurane (SEVO group), isoflurane (ISO group) or halothane (HAL group) for 30 min in all cases. Some angiographic, cardiovascular and respiratory variables were registered during the procedure. Recovery times were also registered. Angiographic variables recorded were: onset of the arterial phase (TA), onset of the arteriovenous phase (TAV), onset of the venous phase (TV), complete arterial phase duration (I1), complete arteriovenous phase duration (I2) and I1 plus I2 (I3). Mean heart rate, mean arterial pressure, systolic arterial pressure, diastolic arterial pressure, respiratory rate, tidal volume, arterial oxygen saturation and end-tidal CO2 during SEVO and ISO anaesthesia, were similar in dogs. Minute ventilation and rectal temperature were higher in dogs with SEVO than ISO. HAL produced higher arterial pressures and a lower arterial oxygen saturation than ISO and SEVO. Mean respiratory rate, rectal temperature and minute ventilation were higher in HAL. Pulse rate, end-tidal CO2 and tidal volume were similar in the dogs of the three groups. No differences in recovery times were found. The fluorescein angiographic times were within the normal range. There were no significant differences between protocols in I1, I2 or I3. HAL produced a significant increase of all temporal variables (TA, TAV and TV) when compared with ISO; TA was higher in HAL than SEVO-treated dogs. All protocols appear to be safe and effective for inducing and maintaining general anaesthesia in healthy dogs for performing fluorescein angiography.

Vascular changes in cyclosporine A-induced hypertension and nephrotoxicity in spontaneously hypertensive rats on high-sodium diet.

Functional and morphological changes of blood vessels in cyclosporine A (CsA)-induced hypertension and nephrotoxicity were studied in spontaneously hypertensive rats (SHR). The role of the L-arginine-nitric oxide (NO) pathway and the importance of oxidative stress in CsA toxicity were also assessed. SHR (7-8 week old) on a high-sodium diet were treated with CsA (5 mg kg(-1) d(-1) s.c.) for 6 weeks. A proportion of the rats were treated concomitantly with the NO precursor L-arginine (1.7 g kg(-1)d(-1) p.o.). CsA elevated blood pressure and caused renal dysfunction and morphological nephrotoxicity. CsA also impaired mesenteric and renal arterial function and caused structural damage to intrarenal and extrarenal small arteries and arterioles. Medial atrophy of the mesenteric resistance vessels and decreased viability of smooth muscle cells of the thoracic aorta were observed. Renal and arterial damage was associated with the presence of inflammatory cells. CsA did not affect markers of the L-arginine-NO pathway (urinary cyclic GMP excretion or endothelial or inducible NO synthase expression in kidney, aorta or heart) or oxidative stress (urinary excretion of 8-isoprostaglandin F2alpha, plasma urate concentration or total radical trapping capacity). Concomitant L-arginine treatment did not affect CsA-induced changes in blood pressure or histological findings but tended to alleviate the arterial dysfunction. The renal and cardiovascular toxicity of CsA was associated with arterial dysfunction and morphological changes in small arteries and arterioles in SHR on a high-sodium diet. The findings did not support the role of oxidative stress or a defect in the L-arginine-NO pathway.

Exercise intensity and load during mass-start stage races in professional road cycling.

PURPOSE: To evaluate exercise intensity and load during mass-start stages in professional road cycling, using competition heart rate (HR) recordings. METHODS: Seventeen world-class cyclists performed an incremental laboratory test during which maximal power output (Wmax), maximal HR (HRmax), onset of blood lactate accumulation (OBLA), lactate threshold (LT), and a HR-power output relationship were assessed. An OBLAZONE (HROBLA +/- 3 beats.min-1) and an LTZONE (HRLT +/- 3 beats.min-1) were described. HR was monitored during 125 flat (< 13 km uphill, < 800-m altitude change; FLAT), 99 semi-mountainous (13-35 km uphill, 800- to 2000-m altitude change; SEMO), and 86 high-mountain (> 35 km uphill, > 2000-m altitude change; HIMO) stages. Each cyclist's competition power output was estimated from competition HR and individual HR-power output relationships. Competition training impulse (TRIMP) values and time spent at "easy," "moderate," and "hard" zones were estimated from HR and race duration. RESULTS: Average %HRmax were 61 +/- 5%, 58 +/- 6%, and 51 +/- 7% in HIMO, SEMO, and FLAT stages, respectively, and estimated average power outputs were 246 +/- 44, 234 +/- 43, and 192 +/- 45 W. Competition HR values relative to HROBLA and HRLT were, respectively, 69 +/- 6, 79 +/- 9% in HIMO; 65 +/- 7, 74 +/- 11% in SEMO; and 57 +/- 8, 65 +/- 10% in FLAT stages. The amount of TRIMP in HIMO, SEMO, and FLAT stages were, respectively, 215 +/- 38, 172 +/- 31, and 156 +/- 31. Percentage time spent in the "moderate" and "hard" zones was highest in HIMO (22 +/- 14, 5 +/- 6%) followed by SEMO (15 +/- 13, 5 +/- 5%) and FLAT (9 +/- 7, 2 +/- 2%) stages. CONCLUSIONS: %HRmax, time distribution around HROBLA and HRLT, TRIMP, and load zones reflected the physiological demands of different mass-start cycling stage categories. The knowledge of these demands could be useful for planning precompetition training strategies.

Long-term intake of milk peptides attenuates development of hypertension in spontaneously hypertensive rats.

Effect of long-term intake of isoleucine-proline-proline (IPP) and valine-proline-proline (VPP), or a sour milk product containing these peptides on development of hypertension was investigated in spontaneously hypertensive rats (SHR). Six-week-old SHR were given: 1) water (control group), 2) IPP and VPP dissolved in water (peptide group) or 3) sour milk containing IPP and VPP (sour milk group) for 12 weeks. Systolic blood pressure (SBP) was measured by tail-cuff method. Development of hypertension was attenuated in the groups receiving tripeptides or sour milk as compared to the control group. At the end of treatment period, SBP was 176 +/- 1 mmHg in sour milk group, 181 +/- 2 mmHg in peptide group, and 193 +/- 1 mmHg in control group (P < 0.001). After treatment withdrawal, SBP rose gradually reaching the level of control group within four weeks' follow-up. In functional bioassay of ACE inhibitory activity, effect of the tripeptides on angiotensin I or angiotensin II-induced contraction in rat mesenteric arteries was evaluated. IPP inhibited the angiotensin I-induced contraction, whereas the angiotensin II-induced contraction remained unaltered. In conclusion, long-term intake of IPP and VPP, or a sour milk containing these tripeptides attenuated the development of hypertension in SHR. One possible mechanism underlying this effect is ACE inhibition.

Propofol or thiopentone as induction agents in romifidine-sedated and halothane-N2O-anesthetized dogs: a preliminary study.

The objective of this paper was to evaluate the use of romifidine as a premedicant in dogs before general anesthesia induced with propofol or thiopentone and maintained with halothane-N2O. Fifteen healthy dogs were anesthetized twice. Each dog received, as preanesthetic protocol, atropine (10 microg/kg, IM) and romifidine (40 microg/kg, IM); induction was delivered with propofol or thiopentone and anesthesia was maintained with halothane and N2O for 1 h. Some cardiovascular and respiratory variables and recovery times were recorded. Induction doses of propofol or thiopentone and the percentage of halothane necessary for maintaining anesthesia were also registered. Thiopentone as an induction agent is more respiratory depressive but is less hypotensive than propofol. Thiopentone reduces further the percentage of halothane necessary for maintaining the anesthesia. However, the quality of recovery is poorer, as the time to extubation is longer and the dogs occasionally had a violent recovery. The combination of romifidine, atropine, propofol, halothane, and N2O appears to be an effective combination for inducing and maintaining general anesthesia in healthy dogs.

Embarazo gemelar ectópico en una misma trompa / Unilateral tubal twin pregnancy

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