Magnetar-like activity from the central compact object in the SNR RCW103

The 6.67 hr periodicity and the variable X-ray flux of the central compact object (CCO) at the center of the SNR RCW 103, named 1E 161348-5055, have been always difficult to interpret within the standard scenarios of an isolated neutron star or a binary system. On 2016 June 22, the Burst Alert Telescope (BAT) onboard Swift detected a magnetar-like short X-ray burst from the direction of 1E 161348-5055, also coincident with a large long-term X-ray outburst. Here we report on Chandra, NuSTAR, and Swift (BAT and XRT) observations of this peculiar source during its 2016 outburst peak. In particular, we study the properties of this magnetar-like burst, we discover a hard X-ray tail in the CCO spectrum during outburst, and we study its long-term outburst history (from 1999 to July 2016). We find the emission properties of 1E 161348-5055 consistent with it being a magnetar. However in this scenario, the 6.67 hr periodicity can only be interpreted as the rotation period of this strongly magnetized neutron star, which therefore represents the slowest pulsar ever detected, by orders of magnitude. We briefly discuss the viable slow-down scenarios, favoring a picture involving a period of fall-back accretion after the supernova explosion, similarly to what is invoked (although in a different regime) to explain the "anti-magnetar" scenario for other CCOs.Comment: 6 pages, 3 figures. To be published in the Astrophysical Journal Letters; replaced to match the version accepted for publication on 2016 August 1

Listeria Infection during Biologic Therapy: An Update

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Upper Endoscopy in Patients with Extra-Oesophageal Reflux Symptoms: A Multicentre Study

Background: There are no evidence-based recommendations for performing upper gastrointestinal endoscopy (UGIE) in patients with extra-oesophageal symptoms of gastro-oesophageal reflux disease (GORD). However, UGIEs are often performed in clinical practice in these patients. We aimed to assess the prevalence of gastro-oesophageal lesions in patients with atypical GORD symptoms. Methods: Patients complaining of at least one extra-oesophageal GORD symptom and undergoing UGIE in seven centres were prospectively enrolled. Clinically relevant lesions (Barrett's oesophagus, erosive oesophagitis, gastric precancerous conditions, peptic ulcer, cancer, and H. pylori infection) were statistically compared between groups regarding GORD symptoms (atypical vs. both typical and atypical), type of atypical symptoms, age, and presence of hiatal hernia. Results: Two hundred eleven patients were enrolled (male/female: 74/137; mean age: 55.5 ± 14.7 years). Barrett's oesophagus was detected in 4 (1.9%), erosive oesophagitis in 12 (5.7%), gastric precancerous conditions in 22 (10.4%), and H. pylori infection in 38 (18%) patients. Prevalence of clinically relevant lesions was lower in patients with only atypical GORD symptoms (28.6 vs. 42.5%; p = 0.046; χ2 test), in patients ≤50 years (20 vs. 44.8%; p = 0.004; χ2 test), and in those in ongoing proton pump inhibitor (PPI) therapy (21.1 vs. 40.2%; p = 0.01; χ2 test). No clinically relevant lesions were detected in patients ≤50 years, without alarm symptoms, and receiving PPI therapy. Hiatal hernia was diagnosed in only 6 patients with cardiologic and in 41 patients with ear-nose-throat symptoms (11.3 vs. 35.1%; p = 0.03; χ2 test). Conclusions: Clinically relevant lesions are uncommon among young (≤50 years) patients with extra-oesophageal GORD symptoms. Hiatal hernia is not more prevalent in patients with cardiologic symptoms and suspicion of GORD. The usefulness of UGIE in these patients is questionable

Gazing at the ultraslow magnetar in RCW 103 with NuSTAR and Swift

We report on a new NuSTAR observation and on the ongoing Swift X-Ray Telescope monitoring campaign of the peculiar source 1E 161348–5055, located at the centre of the supernova remnant RCW 103, which is recovering from its last outburst in 2016 June. The X-ray spectrum at the epoch of the NuSTAR observation can be described by either two absorbed blackbodies (kTBB1 ∼ 0.5 keV, kTBB2 ∼ 1.2 keV) or an absorbed blackbody plus a power law (kTBB1∼ 0.6 keV, Γ ∼ 3.9). The observed flux was ∼9 × 10−12 erg s−1 cm−2, ∼3 times lower than what observed at the outburst onset, but about one order of magnitude higher than the historical quiescent level. A periodic modulation was detected at the known 6.67 h periodicity. The spectral decomposition and evolution along the outburst decay are consistent with 1E 161348–5055 being a magnetar, the slowest ever detected.The results reported in this paper are based on observations obtained with Swift and NuSTAR. Swift is a NASA mission with participation of the Italian Space Agency and the UK Space Agency. The NuSTAR mission is a project led by the Californian Institute of Technology. AB, PE, and NR are supported by an NWO Vidi Grant (PI: Rea). FCZ and NR are supported by grants AYA2015-71042-P and SGR2014-1073. We thank the PHAROS COST Action (CA16214) for partial support and the referee for the comments

COVID-19 teleassistance and teleconsultation: a matched case-control study (MIRATO project, Lombardy, Italy)

BackgroundDuring the COVID-19 pandemic, telemedicine has been recognised as a powerful modality to shorten the length of hospital stay and to free up beds for the sicker patients. Lombardy, and in particular the areas of Bergamo, Brescia, and Milan, was one of the regions in Europe most hit by the COVID-19 pandemic. The primary aim of the MIRATO project was to compare the incidence of severe events (hospital readmissions and mortality) in the first three months after discharge between COVID-19 patients followed by a Home-Based Teleassistance and Teleconsultation (HBTT group) program and those discharged home without Telemedicine support (non-HBTT group).MethodsThe study was designed as a matched case-control study. The non-HBTT patients were matched with the HBTT patients for sex, age, presence of COVID-19 pneumonia and number of comorbidities. After discharge, the HBTT group underwent a telecare nursing and specialist teleconsultation program at home for three months, including monitoring of vital signs and symptoms. Further, in this group we analysed clinical data, patients' satisfaction with the program, and quality of life.ResultsFour hundred twenty-two patients per group were identified for comparison. The median age in both groups was 70 ± 11 years (62% males). One or more comorbidities were present in 86% of the HBTT patients and 89% in the non-HBTT group (p = ns). The total number of severe events was 17 (14 hospitalizations and 3 deaths) in the HBTT group and 40 (26 hospitalizations and 16 deaths) in the non-HBTT group (p = 0.0007). The risk of hospital readmission or death after hospital discharge was significantly lower in HBTT patients (Log-rank Test p = 0.0002). In the HBTT group, during the 3-month follow-up, 5,355 teleassistance contacts (13 ± 4 per patient) were performed. The number of patients with one or more symptoms declined significantly: from 338 (78%) to 183 (45%) (p < 0.00001). Both the physical (ΔPCS12: 5.9 ± 11.4) component and the mental (ΔMCS12: 4.4 ± 12.7) component of SF-12 improved significantly (p < 0.0001). Patient satisfaction with the program was very high in all participants.ConclusionsCompared to usual care, an HBTT program can reduce severe events (hospital admissions/mortality) at 3-months from discharge and improve symptoms and quality of life.Clinical trial registrationwww.ClinicalTrials.gov, NCT04898179

The multi-outburst activity of the magnetar in Westerlund I

After two major outbursts in 2006 and 2011, on 2017 May 16 the magnetar CXOU J164710.2−455216, hosted within the massive star cluster Westerlund I, emitted a short (∼20 ms) burst, which marked the onset of a new active phase. We started a long-term monitoring campaign with Swift (45 observations), Chandra (five observations), and NuSTAR (four observations) from the activation until 2018 April. During the campaign, Swift Burst Alert Telescope (BAT) registered the occurrence of multiple bursts, accompanied by two other enhancements of the X-ray persistent flux. The long time span covered by our observations allowed us to study the spectral and the timing evolution of the source. After ∼11 months since the 2017 May outburst onset, the observed flux was ∼15 times higher than its historical minimum level and a factor of ∼3 higher than the level reached after the 2006 outburst. This suggests that the crust has not fully relaxed to the quiescent level, or that the source quiescent level has changed following the multiple outburst activities in the past 10 yr or so. This is another case of multiple outbursts from the same source on a yearly time-scale, a somehow recently discovered behaviour in magnetars.AB, NR, and PE are supported by an NWO Vidi Grant (PI: Rea). NR is also supported by grants AYA2015-71042-P and SGR 2014-1073. PE acknowledges funding in the framework of the project ‘Understanding the X-ray Variable and Transient Sky’ (ULTraS), ASI-INAF contract no. 2017-14-H.0. JAP acknowledges support by the Spanish MINECO/FEDER grant AYA2015-66899-C2-2-P, and the grant of Generalitat Valenciana PROMETEOII-2014-069. FCZ is supported by grants AYA2015-71042-P and SGR 2014-1073. DG acknowledges the financial support of the UnivEarthS Labex program at Sorbonne Paris Citeé (ANR-10-LABX-0023 and ANR-11-IDEX-0005-02). We thank the referee for his comments and the COST Action PHAROS (CA16214) for partial support

Investigating the high-frequency spectral features of SNRs Tycho, W44, and IC443 with the Sardinia Radio Telescope

The main characteristics in the radio continuum spectra of Supernova Remnants (SNRs) result from simple synchrotron emission. In addition, electron acceleration mechanisms can shape the spectra in specific ways, especially at high radio frequencies. These features are connected to the age and the peculiar conditions of the local interstellar medium interacting with the SNR. Whereas the bulk radio emission is expected at up to 20-50 GHz, sensitive high-resolution images of SNRs above 10 GHz are lacking and are not easily achievable, especially in the confused regions of the Galactic Plane. In the framework of the early science observations with the Sardinia Radio Telescope in February-March 2016, we obtained high-resolution images of SNRs Tycho, W44, and IC443 that provided accurate integrated flux density measurements at 21.4 GHz: 8.8 ± 0.9 Jy for Tycho, 25 ± 3 Jy for W44, and 66 ± 7 Jy for IC443. We coupled the SRT measurements with radio data available in the literature in order to characterize the integrated and spatially resolved spectra of these SNRs, and to find significant frequency- and region-dependent spectral slope variations. For the first time, we provide direct evidence of a spectral break in the radio spectral energy distribution of W44 at an exponential cutoff frequency of 15 ± 2 GHz. This result constrains the maximum energy of the accelerated electrons in the range 6-13 GeV, in agreement with predictions indirectly derived from AGILE and Fermi-LAT gamma-ray observations. With regard to IC443, our results confirm the noticeable presence of a bump in the integrated spectrum around 20-70 GHz that could result from a spinning dust emission mechanism

First detection of X-ray polarization from the accreting neutron star 4U 1820-303

This paper reports the first detection of polarization in the X-rays for atoll-source 4U 1820-303, obtained with the Imaging X-ray Polarimetry Explorer (IXPE) at 99.999% confidence level (CL). Simultaneous polarimetric measurements were also performed in the radio with the Australia Telescope Compact Array (ATCA). The IXPE observations of 4U 1820-303 were coordinated with Swift-XRT, NICER, and NuSTAR aiming to obtain an accurate X-ray spectral model covering a broad energy interval. The source shows a significant polarization above 4 keV, with a polarization degree of 2.0(0.5)% and a polarization angle of -55(7) deg in the 4-7 keV energy range, and a polarization degree of 10(2)% and a polarization angle of -67(7) deg in the 7-8 keV energy bin. This polarization also shows a clear energy trend with polarization degree increasing with energy and a hint for a position-angle change of about 90 deg at 96% CL around 4 keV. The spectro-polarimetric fit indicates that the accretion disk is polarized orthogonally to the hard spectral component, which is presumably produced in the boundary/spreading layer. We do not detect linear polarization from the radio counterpart, with a 99.97% upper limit of 50% at 7.25 GHz

X-ray pulsar GRO J1008−-57 as an orthogonal rotator

X-ray polarimetry is a unique way to probe geometrical configuration of highly-magnetized accreting neutron stars (X-ray pulsars). GRO J1008$-$57 is the first transient X-ray pulsar observed at two different flux levels by the Imaging X-ray Polarimetry Explorer (IXPE) during its outburst in November 2022. The polarization properties were found to be independent of the source luminosity, with the polarization degree varying between non-detection to about 15% over the pulse phase. Fitting the phase-resolved spectro-polarimetric data with the rotating vector model allowed us to estimate the pulsar inclination (130 deg, which is in good agreement with the orbital inclination), the position angle (75 deg) of the pulsar spin axis, and the magnetic obliquity (74 deg). This makes GRO J1008$-$57 the first confidently identified X-ray pulsar as a nearly orthogonal rotator. The results are discussed in the context of the neutron star atmosphere models and theories of pulsars' axis alignment.Comment: 11 pages, 7 figures, submitted to A&A. arXiv admin note: text overlap with arXiv:2209.0244

An explainable model of host genetic interactions linked to COVID-19 severity

We employed a multifaceted computational strategy to identify the genetic factors contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing (WES) dataset of a cohort of 2000 Italian patients. We coupled a stratified k-fold screening, to rank variants more associated with severity, with the training of multiple supervised classifiers, to predict severity based on screened features. Feature importance analysis from tree-based models allowed us to identify 16 variants with the highest support which, together with age and gender covariates, were found to be most predictive of COVID-19 severity. When tested on a follow-up cohort, our ensemble of models predicted severity with high accuracy (ACC = 81.88%; AUCROC = 96%; MCC = 61.55%). Our model recapitulated a vast literature of emerging molecular mechanisms and genetic factors linked to COVID-19 response and extends previous landmark Genome-Wide Association Studies (GWAS). It revealed a network of interplaying genetic signatures converging on established immune system and inflammatory processes linked to viral infection response. It also identified additional processes cross-talking with immune pathways, such as GPCR signaling, which might offer additional opportunities for therapeutic intervention and patient stratification. Publicly available PheWAS datasets revealed that several variants were significantly associated with phenotypic traits such as "Respiratory or thoracic disease", supporting their link with COVID-19 severity outcome.A multifaceted computational strategy identifies 16 genetic variants contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing dataset of a cohort of Italian patients