Explore the vast range of titles available.

The binary neutron star merger event GW170817 was detected through both electromagnetic radiation and gravitational waves. Its afterglow emission may have been produced by either a narrow relativistic jet or an isotropic outflow. High-spatial-resolution measurements of the source size and displacement can discriminate between these scenarios. We present very-long-baseline interferometry observations, performed 207.4 days after the merger by using a global network of 32 radio telescopes. The apparent source size is constrained to be smaller than 2.5 milli–arc seconds at the 90% confidence level. This excludes the isotropic outflow scenario, which would have produced a larger apparent size, indicating that GW170817 produced a structured relativistic jet. Our rate calculations show that at least 10% of neutron star mergers produce such a jet.

Two views of Christmas γ-ray burst The Christmas γ-ray burst of 25 December 2010 (GRB 101225A, first detected by the Swift orbiting observatory) was a very unusual event. It was long lasting without the typical decreasing trend, its X-ray afterglow faded rapidly and its spectrum was atypical. Two papers in this issue offer very different explanations for these puzzling properties. Sergio Campana's group favours a comet crashing onto a neutron star as the cause of the outburst. Christina Thöne's group prefers a more conventional supernova mechanism, in this case involving a merger between a helium star and a neutron star. The tidal disruption of a solar-mass star around a supermassive black hole has been extensively studied analytically 1 , 2 and numerically 3 . In these events, the star develops into an elongated banana-shaped structure. After completing an eccentric orbit, the bound debris falls into the black hole, forming an accretion disk and emitting radiation 4 , 5 , 6 . The same process may occur on planetary scales if a minor body passes too close to its star. In the Solar System, comets fall directly into our Sun 7 or onto planets 8 . If the star is a compact object, the minor body can become tidally disrupted. Indeed, one of the first mechanisms invoked to produce strong gamma-ray emission involved accretion of comets onto neutron stars in our Galaxy 9 . Here we report that the peculiarities of the ‘Christmas’ gamma-ray burst (GRB 101225A 10 ) can be explained by a tidal disruption event of a minor body around an isolated Galactic neutron star. This would indicate either that minor bodies can be captured by compact stellar remnants more frequently than occurs in the Solar System or that minor-body formation is relatively easy around millisecond radio pulsars. A peculiar supernova associated with a gamma-ray burst provides an alternative explanation 11 .

Aims/hypothesis Incretins are hormones released by enteroendocrine cells in response to meals, depending upon absorption of nutrients. The present study aimed to elucidate the mechanisms through which a high-fat diet (HFD) induces insulin resistance and insulin hypersecretion by focusing on the effects on enteroendocrine cells, especially those secreting glucose-dependent insulinotropic polypeptide (GIP). Methods Forty male Wistar rats, 4 months old, were randomised into two groups; one group received a chow diet and the other one received a purified tripalmitin-based HFD ad libitum. An OGTT was performed every 10 days and histological and immunofluorescence evaluations of the duodenum were obtained at 60 days from the beginning of the diets. Plasma glucose, insulin, GIP and glucagon-like peptide-1 (GLP-1) levels were measured. Immunofluorescence analysis of duodenal sections for pancreatic duodenal homeobox-1 (PDX-1), KI67, GLP-1, GIP and insulin were performed. Results Compared with chow diet, HFD induced a progressive significant increase of the glucose, insulin and GIP responses to OGTT, whereas GLP-1 circulating levels were reduced over time. After 60 days of HFD, cellular agglomerates of KI67 and PDX-1 positive cells, negative for insulin and GLP-1 but positive for GIP staining, were found inside the duodenal mucosa, and apoptosis was significantly increased. Conclusions/interpretation With the limitation that we could not establish a causal relationship between events, our study shows that HFD stimulates duodenal proliferation of endocrine cells differentiating towards K cells and oversecreting GIP. The progressive increment of GIP levels might represent the stimulus for insulin hypersecretion and insulin resistance.

Gamma-ray bursts are linked to the most distant objects in the Universe, but detecting them is a rare event. With a dedicated near-infrared telescope to observe in tandem with the optical Vera Rubin Observatory, ten or so high-redshift ( z ≳ 6) gamma-ray bursts could potentially be detected every year.

Charcot neuroarthropathy is defined by painful or relatively painless bone and joint deformity in limbs that have lost sensory innervation. With this, Pitocco et al explore on whether the utilization of the alendronate could improve the clinical signs of acute Charcot neuroarthropathy and could stop bone reabsorption. Accounts detailing the results of the study are presented.

Defective plasma antioxidant defenses and enhanced susceptibility to lipid peroxidation in uncomplicated IDDM. S A Santini , G Marra , B Giardina , P Cotroneo , A Mordente , G E Martorana , A Manto and G Ghirlanda Institute of Biological Chemistry, Catholic University School of Medicine, Rome, Italy. Abstract Oxidative stress is postulated to be increased in patients with IDDM. Accumulating evidence suggests that oxidative cell injury caused by free radicals contributes to the development of IDDM complications. On the other side, a decreased efficiency of antioxidant defenses (both enzymatic and nonenzymatic) seems to correlate with the severity of pathological tissue changes in IDDM. Thus, we determined plasma antioxidant defenses, measuring the total radical-trapping antioxidant capacity (TRAP) and the two markers of oxidative stress, lipid hydroperoxides (ROOHs) and conjugated dienes, in 72 patients with well-controlled IDDM and without evident complications, compared with 45 nondiabetic subjects. Compared with control subjects, IDDM patients showed significantly reduced plasma TRAP (669 +/- 131 vs. 955 +/- 104 micromol/l, P < 0.001) and significantly increased levels of ROOHs (7.13 +/- 2.11 vs. 2.10 +/- 0.71 micromol/l, P < 0.001) and conjugated dienes (0.0368 +/- 0.0027 vs. 0.0328 +/- 0.0023 arbitrary units [AU], P < 0.01), especially in the trans-trans conformation (0.0340 +/- 0.0028 vs. 0.0259 +/- 0.0022 AU, P < 0.001), with a concurrent reduction of conjugated dienes in the cis-trans conformation (0.0028 +/- 0.0011 vs. 0.0069 +/- 0.0012 AU, P < 0.001). The oxidative parameters studied did not appear to be correlated with metabolic control (HbA1c levels) and lipid profile (cholesterol or triglyceride levels). The reduced TRAP and the increased ROOH and conjugated diene plasma levels, together with the decreased ratio of cis-trans/trans-trans conjugated dienes, which reflects an altered redox status of plasma, indicate that in IDDM patients, oxidative stress is enhanced and antioxidant defenses are defective, regardless of diabetes duration, metabolic control, or presence of complications.

Observations of the transient associated with the gravitational-wave event GW170817 and γ-ray burst GRB 170817A reveal a bright kilonova with fast-moving ejecta, including lanthanides synthesized by rapid neutron capture. When neutron stars collide Merging neutron stars are potential sources of gravitational waves and have long been predicted to produce jets of material as part of a low-luminosity transient known as a 'kilonova'. There is growing evidence that neutron-star mergers also give rise to short, hard gamma-ray bursts. A group of papers in this issue report observations of a transient associated with the gravitational-wave event GW170817—a signature of two neutron stars merging and a gamma-ray flash—that was detected in August 2017. The observed gamma-ray, X-ray, optical and infrared radiation signatures support the predictions of an outflow of matter from double neutron-star mergers and present a clear origin for gamma-ray bursts. Previous predictions differ over whether the jet material would combine to form light or heavy elements. These papers now show that the early part of the outflow was associated with lighter elements whereas the later observations can be explained by heavier elements, the origins of which have been uncertain. However, one paper (by Stephen Smartt and colleagues) argues that only light elements are needed for the entire event. Additionally, Eleonora Troja and colleagues report X-ray observations and radio emissions that suggest that the 'kilonova' jet was observed off-axis, which could explain why gamma-ray-burst detections are seen as dim. The merger of two neutron stars is predicted to give rise to three major detectable phenomena: a short burst of γ-rays, a gravitational-wave signal, and a transient optical–near-infrared source powered by the synthesis of large amounts of very heavy elements via rapid neutron capture (the r-process) 1 , 2 , 3 . Such transients, named ‘macronovae’ or ‘kilonovae’ 4 , 5 , 6 , 7 , are believed to be centres of production of rare elements such as gold and platinum 8 . The most compelling evidence so far for a kilonova was a very faint near-infrared rebrightening in the afterglow of a short γ-ray burst 9 , 10 at redshift z  = 0.356, although findings indicating bluer events have been reported 11 . Here we report the spectral identification and describe the physical properties of a bright kilonova associated with the gravitational-wave source 12 GW170817 and γ-ray burst 13 , 14 GRB 170817A associated with a galaxy at a distance of 40 megaparsecs from Earth. Using a series of spectra from ground-based observatories covering the wavelength range from the ultraviolet to the near-infrared, we find that the kilonova is characterized by rapidly expanding ejecta with spectral features similar to those predicted by current models 15 , 16 . The ejecta is optically thick early on, with a velocity of about 0.2 times light speed, and reaches a radius of about 50 astronomical units in only 1.5 days. As the ejecta expands, broad absorption-like lines appear on the spectral continuum, indicating atomic species produced by nucleosynthesis that occurs in the post-merger fast-moving dynamical ejecta and in two slower (0.05 times light speed) wind regions. Comparison with spectral models suggests that the merger ejected 0.03 to 0.05 solar masses of material, including high-opacity lanthanides.

The aim of this study was to investigate the severity of coronary artery disease (CAD) and the plaque composition in neuropathic type 2 diabetic subjects with and without Charcot neuroarthropathy (CN) undergoing multidetector computed tomography coronary angiography (MDCT-CA). The study was a single-center, observational, with unmatched case–control design. We selected 17 CN patients and 18 patients with diabetic neuropathy (DN) without CN. In all the patients, multidetector computed tomography was performed to assess the coronary artery calcium score (CACS) and degree of coronary artery stenosis. Patients were classified as positive in the presence of significant CAD if there was at least one stenosis >50 % on MDCT-CA. The invasive coronary angiography was performed in case of significant stenosis detected with MDCT-CA, both as reference to standard and eventually as treatment. Groups were matched for age, sex, and traditional CAD risk factors. As compared to DN individuals, CN exhibited higher rates of significant coronary stenoses ( p  = 0.027; OR 7.7 [1.3–43.5]). However, no significant differences were observed in the CACS, which reflects plaque burden, in the two groups ( p  = 0.759). No significant differences were observed comparing CACS distribution in all subjects for stenosis higher/equal or lower than 50 % ( p  = 0.320). Finally, no significant differences were observed comparing CACS distribution in CN and DN subjects for coronary stenoses higher/equal or lower than 50 %. Our results suggest that CN patients have a higher prevalence of severe coronary plaques compared to DN patients. Nevertheless, coronary plaques in CN patients did not exhibit an increased degree of calcification.

Aims/hypothesis. Induction of tolerance to insulin is achievable in animal models of Type I (insulin-dependent) Diabetes mellitus by oral treatment with this hormone, which can lead to prevention of the disease. In the Diabetes Prevention Trial of Type I diabetes (DPT-1), oral insulin is given with the aim of preventing disease insurgence. We investigated whether if given at diagnosis of Type I diabetes in humans, oral insulin can still act as a tolerogen and therefore preserve residual beta-cell function, which is known to be substantial at diagnosis. Methods. A double-blind trial was carried out in patients (mean age ± SD: 14 ± 8 years) with recent-onset Type I diabetes to whom oral insulin (5 mg daily) or placebo was given for 12 months in addition to intensive subcutaneous insulin therapy. A total of 82 patients with clinical Type I diabetes ( < 4 weeks duration) were studied. Basal C peptide and glycated haemoglobin were measured and the insulin requirement monitored every 3 months up to 1 year. Insulin antibodies were also measured in 27 patients treated with oral insulin and in 18 patients receiving placebo at the beginning of the trial and after 3, 6 and 12 months of treatment. Results. The trial was completed by 80 patients. Overall and without distinction between age at diagnosis, at 3, 6, 9 and 12 months baseline mean C-peptide secretion in patients treated with oral insulin did not differ from that of those patients treated with placebo. In patients younger than 15 years a tendency for lower C-peptide values at 9 and 12 months was observed in the oral insulin group. Insulin requirement at 1 year was similar between the two groups as well as the percentage of glycated haemoglobin. Finally, IgG insulin antibodies were similar in the two groups at each time point. Conclusion/interpretation. The results of this study indicate that the addition of 5 mg of oral insulin does not modify the course of the disease in the first year after diagnosis and probably does not statistically affect the humoral immune response against insulin. [Diabetologia (2000) 43: 1000-1004]