A Quantitative Estimate of the Expected Shortening of the Median Isolation Period of Patients With COVID-19 After the Adoption of a Symptom-Based Strategy

A long period of isolation was observed in patients hospitalized for COVID-19 in Milan over March-September 2020 (45; IQR: 37–54 days). A significantly shorter period would have been observed by the application of May-WHO (22, IQR: 17–30 days, P < 0.001) and October-Italian (26, IQR: 21–34 days, P < 0.001) Guidelines. The adoption of the new symptom-based criteria is likely to lead to a significant reduction in the length of the isolation period with potential social, economic and psychological benefits, particularly in the younger population with mild/moderate disease and no comorbidities. In our opinion, the release from isolation after 21 days from symptoms onset, even without a PCR diagnostic test, in most cases seems the most adequate strategy that could balance precautions to prevent SARS CoV-2 transmission and unnecessary prolonged isolation or overuse of diagnostic testing

The importance of patients' case-mix for the correct interpretation of the hospital fatality rate in COVID-19 disease

OBJECTIVE: We aimed to document data on the epidemiology and factors associated with clinical course leading to death of patients hospitalised with COVID-19. METHODS: Prospective observational cohort study on patients hospitalised with COVID-19 disease in February-24th/May-17th 2020 in Milan, Italy. Uni-multivariable Cox regression analyses were performed. Death's percentage by two-weeks' intervals according to age and disease severity was analysed. RESULTS: A total of 174/539 (32.3%) patients died in hospital over 8228 person-day follow-up; the 14-day Kaplan-Meier probability of death was 29.5% (95%CI: 25.5-34.0). Older age, burden of comorbidities, COVID-19 disease severity, inflammatory markers at admission were independent predictors of increased risk, while several drug-combinations were predictors of reduced risk of in-hospital death. The highest fatality rate, 36.5%, occurred during the 2nd-3rd week of March, when 55.4% of patients presented with severe disease, while a second peak, by the end of April, was related to the admission of older patients (55% ≥80 years) with less severe disease, 30% coming from long-term care facilities. CONCLUSIONS: The unusual fatality rate in our setting is likely to be related to age and the clinical conditions of our patients. These findings may be useful to better allocate resources of the national healthcare system, in case of re-intensification of COVID-19 epidemics

Conceptual Design of a Liquid Helium Vertical Test-Stand for 2m long Superconducting Undulator Coils

Superconducting Undulators (SCUs) can produce higher photon flux and cover a wider photon energy range compared to permanent magnet undulators (PMUs) with the same vacuum gap and period length. To build the know-how to implement superconducting undulators for future upgrades of the European XFEL facility, the test stand SUNDAE1 for the characterization of SCU is being developed. The purpose of SUNDAE1 is the training, tuning and development of new SCU coils by means of precise magnetic field measurements. The experimental setup will allow the characterization of magnets up to 2m in length. These magnets will be immersed in a Helium bath at 4K or 2K temperature. In this article, we describe the experimental setup and highlight its expected performances

SUNDAE1: A Liquid Helium Vertical Test-Stand for 2m Long Superconducting Undulator Coils

Superconducting Undulators (SCUs) can produce higher photon flux and cover a wider photon energy range compared to permanent magnet undulators (PMUs) with the same vacuum gap and period length. To build the know-how to implement superconducting undulators for future upgrades of the European XFEL facility, two magnetic measurement test stands named SUNDAE 1 and 2 (Superconducting UNDulAtor Experiment) are being developed. SUNDAE1 will facilitate research and development on magnet design thanks to the possibility of training new SCU coils and characterizing their magnetic field. The experimental setup will allow the characterization of magnets up to 2m in length. These magnets will be immersed in a Helium bath at 2K or 4K temperature. In this article, we describe the experimental setup and highlight its expected performances

Anxiety and depression symptoms after virological clearance of COVID-19: A cross-sectional study in Milan, Italy

Prevalence of anxiety or depression was investigated in 105 coronavirus disease 2019 (COVID-19) patients at 1 to 3 months from virological clearance by hospital anxiety and depression scale (HADS-A/D). 30% of patients displayed pathological HADS-A/D, 52.4% showed persistent symptoms. Pathological patients with HADS-A/D more commonly reported symptom persistence, even after adjustment for age, gender, and disease severity. Psychological assessments should be encouraged in COVID-19 patients' follow-up

Microphonics control for Project X

The proposed multi-MW Project X facility at Fermilab will employ cavities with bandwidths as narrow as 20 Hz. This combination of high RF power with narrow bandwidths combined requires careful attention to detuning control if these cavities are to be operated successfully. Detuning control for Projects X will require a coordinated effort between the groups responsible for various machine subsystems. Considerable progress in this area has been made over the past year. Detuning levels in the Project X cavities, specifically the Low and High {beta} 650 MHz elliptical types, can have a significant impact on the overall cost of the project. The narrow bandwidths, and the high RF Power requirements, and the large number of these cavities mean that careful attention to detuning control will be required if these cavities are to operate successfully. Limiting cavity detuning in Project X will require a coordinated effort between the groups responsible for various subsystems of the planned machine. Considerable progress towards this goal has been made by each of these groups over the past year

Cannabinoid receptor 2-63 RR variant is independently associated with severe necroinflammation in HIV/HCV coinfected patients.

This is the first study to analyze the impact of the rs35761398 variant of the CNR2 gene leading to the substitution of GLN (Q) of codon 63 of the cannabinoid receptor 2 (CB2) with ARG (R) on the clinical presentation of chronic hepatitis in HIV/HCV coinfected patients.Enrolled in this study were 166 consecutive HIV/HCV coinfected patients, naïve for HCV treatment. A pathologist unaware of the patients' condition graded liver fibrosis, necroinflammation (Ishak) and steatosis. All patients were screened for the CB2 rs35761398 polymorphism.Of the 166 HIV/HCV coinfected patients, 72.9% were males, 42.5% were infected with HCV-genotype-3 and 60.2% had been intravenous drug users. The median age was 40.6 years and the immunological condition good (median CD4+ cells/mm3 = 507, IQR: 398.0-669.5). Thirty-five (21.1%) patients were naive for ART and 131(78.9%) were on ART. The CB2-RR variant was detected in 45.8% of patients, QR in 38.6% and QQ in 15.7%. Patients with CB2-RR showed a necroinflammation score (HAI) ≥9 more frequently than those with CB2-QQ or CB2-QR (32.9% vs. 11.5% and 14.1%, respectively, p≤0.001). In the multivariate analysis, the CB2-RR variant (p = 0.03) and liver fibrosis were both identified as independent predictors of the entity of liver necroinflammation (p = 0.0001).This study shows interesting interplay between the CB2-RR variant and liver necroinflammation in chronic hepatitis patients with HIV/HCV coinfection, an observation of clinical value that coincides with the interest in the use of the CB2 agonists and antagonists in clinical practice emerging from the literature

In vivo evidence that the cannabinoid receptor 2-63 RR variant is associated with the acquisition and/or expansion of HIV infection

The aim of the study was to investigate whether the rs35761398 variants of the cannabinoid receptor 2 (CB2) gene may influence the acquisition of HIV infection and the clinical presentation of HIV/hepatitis C virus (HCV) coinfection

Integration of the European XFEL Accelerating Modules

mopb017 - ISBN 978-3-95450-122-9International audienceThe production of the 103 superconducting accelerating modules for the European XFEL is an international effort

Construction of the S1-global cryomodules for ILC

In an attempt to demonstrate an average accelerating gradient of 31.5 MV/m as in the design of the ILC, the S1-Global project [1] is a cryomodule being constructed by an international collaboration hosted by KEK and including INFN, FNAL, DESY and SLAC. The S1-Global system joins two half-length cryomodules, each 6 m in length and containing 4 cavities, Module-C contains cavities from FNAL and DESY and was constructed by INFN. Module-A contains four KEK cavities and was constructed by KEK. The assembly of the cryomodules started in January 2010, and was just completed in May. In this paper, construction experience of the S1-Global cryomodule is presented