Clinical prognostic factors for older people: A systematic review and meta-analysis

Objective: To explore the accuracy and precision of prognostic tools used in older people in predicting mortality, hospitalization, and nursing home admission across different settings and timings. Design: Systematic review and meta-analysis of prospective and retrospective studies. Data sources: A systematic search from database inception until 01st February 2023 was run in Medline, Embase, Cinhal, Cochrane Library. Eligibility criteria: Studies were eligible if they reported accuracy (area under the curve [AUC]) and/or precision (C-index) for the prognostic index in relation to any of the following outcomes: mortality, hospitalization, and nursing home admission. Data extraction and synthesis: Two independent reviewers extracted data. Data were pooled using a random effects model. The risk of bias was assessed with the Quality in Prognosis Studies (QUIPS) tool. If more than three studies for the same setting and time were available, a meta-analysis was performed and evaluated using the GRADE tool; other data were reported descriptively. Results: Among 16,082 studies initially considered, 159 studies with a total of 2398856 older people (mean age: 78 years) were included. The majority of the studies was carried out in hospital or medical wards. In the community setting, only two tools (Health Assessment Tool and the Multidimensional Prognostic Index, MPI) had good precision for long-term mortality. In emergency department setting, Barthel Index had an excellent accuracy in predicting short-term mortality. In medical wards, the MPI had a moderate certainty of the evidence in predicting short-term mortality (13 studies; 11,787 patients; AUC=0.79 and 4 studies; 3915 patients; C-index=0.82). Similar findings were available for MPI when considering longer follow-up periods. When considering nursing home and surgical wards, the literature was limited. The risk of bias was generally acceptable; observed bias was mainly owing to attrition and confounding. Conclusions: Several tools are used to predict poor prognosis in geriatric patients, but only those derived from a multidimensional evaluation have the characteristics of precision and accuracy

Enabling planetary science across light-years. Ariel Definition Study Report

Ariel, the Atmospheric Remote-sensing Infrared Exoplanet Large-survey, was adopted as the fourth medium-class mission in ESA's Cosmic Vision programme to be launched in 2029. During its 4-year mission, Ariel will study what exoplanets are made of, how they formed and how they evolve, by surveying a diverse sample of about 1000 extrasolar planets, simultaneously in visible and infrared wavelengths. It is the first mission dedicated to measuring the chemical composition and thermal structures of hundreds of transiting exoplanets, enabling planetary science far beyond the boundaries of the Solar System. The payload consists of an off-axis Cassegrain telescope (primary mirror 1100 mm x 730 mm ellipse) and two separate instruments (FGS and AIRS) covering simultaneously 0.5-7.8 micron spectral range. The satellite is best placed into an L2 orbit to maximise the thermal stability and the field of regard. The payload module is passively cooled via a series of V-Groove radiators; the detectors for the AIRS are the only items that require active cooling via an active Ne JT cooler. The Ariel payload is developed by a consortium of more than 50 institutes from 16 ESA countries, which include the UK, France, Italy, Belgium, Poland, Spain, Austria, Denmark, Ireland, Portugal, Czech Republic, Hungary, the Netherlands, Sweden, Norway, Estonia, and a NASA contribution

Free Electron Laser Performance within the EuPRAXIA Facility

Over the past 90 years, particle accelerators have evolved into powerful and widely used tools for basic research, industry, medicine, and science. A new type of accelerator that uses plasma wakefields promises gradients as high as some tens of billions of electron volts per meter. This would allow much smaller accelerators that could be used for a wide range of fundamental and applied research applications. One of the target applications is a plasma-driven free-electron laser (FEL), aiming at producing tunable coherent light using electrons traveling in the periodic magnetic field of an undulator. In this work, the plasma-based electron beams with the most promising qualities, designed in the framework of EuPRAXIA, are analyzed in terms of the FEL performance

B cell activation in peripheral blood and lymph nodes during HIV infection

BACKGROUND: The spontaneous in-vitro antibody synthesis observed in unstimulated lymphocyte cultures from HIV-infected patients closely reflects the in-vivo activation of the B cell compartment; however, the mechanisms underlying this phenomenon are far from clear. METHODS: We compared the ability of peripheral blood mononuclear cells (PBMC) and lymph-node cells (LNC) from 10 HIV-infected patients to produce in vitro HIV-specific and total Ig spontaneously, and we correlated these parameters with tumour necrosis factor alpha (TNF-alpha) expression by CD4 T cells, viral dissemination in the organism, and the extent of HIV spread into lymph-node germinal centres, measured by in-situ hybridization (ISH). RESULTS: In-vitro spontaneous synthesis of both HIV-specific and total antibody was significantly higher in PBMC than in LNC; the two variables showed a good correlation in LNC, but not in PBMC. In both compartments, no correlation was found between B cell activation and the percentage of CD4 T cells expressing TNF-alpha, which was increased compared with seronegative donors. Furthermore, no correlation was found between in-vitro spontaneous antibody synthesis and the number of T cells containing proviral HIV in PBMC and LNC, or the plasma levels of HIV RNA. On the contrary, a good correlation was found between HIV-specific B cell activation and the extent of viral spread into lymph-node germinal centres, evaluated by ISH. CONCLUSION: These data suggest that the adhesion of HIV virions to the follicular dendritic cell network in lymph-node germinal centres may primarily contribute to sustaining the steady B cell activation observed in HIV-infected patients

FEL Design Elements of SABINA: A Free Electron Laser For THz-MIR Polarized Radiation Emission

SABINA, acronym of “Source of Advanced Beam Imaging for Novel Applications ”, will be a self-amplified spontaneous emission Free Electron Laser (SASE FEL) providing a wide spectral range (from THz to MIR) of intense, short and variable polarization pulses for investigation in physics, chemistry, biology, cultural heritage, and material science. In order to reach these goals high brightness electron beams within a 30-100 MeV energy range, produced at SPARC photo-injector, will be transported up to an APPLE-X undulator through a dogleg. Space charge effects and Coherent Synchrotron Radiation (CSR) effects must be held under control to preserve beam quality. Studies on beam transport along the undulator and of the properties of the radiation field have been performed with “Genesis 1.3” simulation code. A downstream THz optics photon delivery systems has also been designed to transport radiation on the long path from the undulator exit up to user experimental area

The Sabina Terahertz/Infrared Beamline at SPARC-Lab Facility

Following the EU Terahertz (THz) Road Map [1], high-intensity, ps-long, THz)/Infrared (IR) radiation is going to become a fundamental spectroscopy tool for probing and control quantum materials ranging from graphene [2], and Topological Insulators, to strongly correlated oxides [3-6] and novel superconductors [7, 8]. In the framework of the SABINA project a novel THz/IR beamline based on an APPLE-X undulator emission will be developed at the SPARC-Lab facility at LNF- INFN. Light will be propagated from the SPARC-Lab to a new user lab facility nearly 25 m far away from the SPARC laboratory. This beamline will cover a broad spectral region from 3 THz to 30 THz, showing ps- pulses and energy of hundreds of μJ with variable polarization from linear to circular. The corresponding electric fields up to 10 MV/cm, are able to induce non-linear phenomena in many quantum systems. The beamline, open to user experiments, will be equipped with a 5 T magnetic cryostat, and will be synchronized with a fs laser for THz/IR pump, VIS/UV probe experiment