2,913 research outputs found

    Il nodulo unico della tiroide

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    A Random Shuffle Method to Expand a Narrow Dataset and Overcome the Associated Challenges in a Clinical Study: A Heart Failure Cohort Example

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    Heart failure (HF) affects at least 26 million people worldwide, so predicting adverse events in HF patients represents a major target of clinical data science. However, achieving large sample sizes sometimes represents a challenge due to difficulties in patient recruiting and long follow-up times, increasing the problem of missing data. To overcome the issue of a narrow dataset cardinality (in a clinical dataset, the cardinality is the number of patients in that dataset), population-enhancing algorithms are therefore crucial. The aim of this study was to design a random shuffle method to enhance the cardinality of an HF dataset while it is statistically legitimate, without the need of specific hypotheses and regression models. The cardinality enhancement was validated against an established random repeated-measures method with regard to the correctness in predicting clinical conditions and endpoints. In particular, machine learning and regression models were employed to highlight the benefits of the enhanced datasets. The proposed random shuffle method was able to enhance the HF dataset cardinality (711 patients before dataset preprocessing) circa 10 times and circa 21 times when followed by a random repeated-measures approach. We believe that the random shuffle method could be used in the cardiovascular field and in other data science problems when missing data and the narrow dataset cardinality represent an issue

    Longevity of Replaced ICD/CRT-D

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    Longevity of Replaced ICD/CRT-D Introduction The longevity of defibrillators (ICD) is extremely important from both a clinical and economic perspective. We studied the reasons for device replacement, the longevity of removed ICD, and the existence of possible factors associated with shorter service life. Methods and Results Consecutive patients who underwent ICD replacement from March 2013 to May 2015 in 36 Italian centers were included in this analysis. Data on replaced devices were collected. A total of 953 patients were included in this analysis. In 813 (85%) patients the reason for replacement was battery depletion, while 88 (9%) devices were removed for clinical reasons and the remaining 52 because of system failure (i.e., lead or ICD generator failure or a safety advisory indication). The median service life was 5.9 years (25th–75th percentile, 4.9–6.9) for single- and dual-chamber ICD and 4.9 years (25th–75th percentile, 4.0–5.7) for CRT-D. On multivariate analysis, the factors CRT-D device, SC/DC ICD generator from Biotronik, percentage of ventricular pacing, and the occurrence of a system failure were positively associated with a replacement procedure. By contrast, the device from Boston Scientific was an independent protective factor against replacement. Considerable differences were seen in battery duration in both ICD and CRT-D. Specifically, Biotronik devices showed the shortest longevity among ICD and Boston Scientific showed the longest longevity among CRT-D (log-rank test, P < 0.001 for pairwise comparisons). Conclusion Several factors were associated with shorter service life of ICD devices: CRT-D, occurrence of system failure and percentage of ventricular pacing. Our results confirmed significant differences among manufacturers

    The discovery, monitoring and environment of SGR J1935+2154

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    We report on the discovery of a new member of the magnetar class, SGR J1935+2154, and on its timing and spectral properties measured by an extensive observational campaign carried out between 2014 July and 2015 March with Chandra and XMM–Newton (11 pointings). We discovered the spin period of SGR J1935+2154 through the detection of coherent pulsations at a period of about 3.24 s. The magnetar is slowing down at a rate of P˙=1.43(1)×10−11 s s−1 and with a decreasing trend due to a negative Pš of −3.5(7) × 10−19 s s−2. This implies a surface dipolar magnetic field strength of ∌2.2 × 1014 G, a characteristic age of about 3.6 kyr and a spin-down luminosity Lsd ∌1.7 × 1034 erg s−1. The source spectrum is well modelled by a blackbody with temperature of about 500 eV plus a power-law component with photon index of about 2. The source showed a moderate long-term variability, with a flux decay of about 25 per cent during the first four months since its discovery, and a re-brightening of the same amount during the second four months. The X-ray data were also used to study the source environment. In particular, we discovered a diffuse emission extending on spatial scales from about 1 arcsec up to at least 1 arcmin around SGR J1935+2154 both in Chandra and XMM–Newton data. This component is constant in flux (at least within uncertainties) and its spectrum is well modelled by a power-law spectrum steeper than that of the pulsar. Though a scattering halo origin seems to be more probable we cannot exclude that part, or all, of the diffuse emission is due to a pulsar wind nebula.NR is supported by an NWO Vidi Grant, and by grants AYA2012-39303 and SGR2014-1073. This work is partially supported by the European COST ActionMP1304 (NewCOMPSTAR)

    Virological and immunological features of SARS-CoV-2-infected children who develop neutralizing antibodies

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    As the global COVID-19 pandemic progresses, it is paramount to gain knowledge on adaptive immunity to SARS-CoV-2 in children to define immune correlates of protection upon immunization or infection. We analyzed anti-SARS-CoV-2 antibodies and their neutralizing activity (PRNT) in 66 COVID-19-infected children at 7 (\ub12) days after symptom onset. Individuals with specific humoral responses presented faster virus clearance and lower viral load associated with a reduced in&nbsp;vitro infectivity. We demonstrated that the frequencies of SARS-CoV-2-specific CD4+CD40L+ T&nbsp;cells and Spike-specific B cells were associated with the anti-SARS-CoV-2 antibodies and the magnitude of neutralizing activity. The plasma proteome confirmed the association between cellular and humoral SARS-CoV-2 immunity, and PRNT+ patients show higher viral signal transduction molecules (SLAMF1, CD244, CLEC4G). This work sheds lights on cellular and humoral anti-SARS-CoV-2 responses in children, which may drive future vaccination trial endpoints and quarantine measures policies

    The X-Ray Outburst of the Galactic Center Magnetar over Six Years of Chandra Observations

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    The magnetar SGR J1745−2900, discovered at a distance of parsecs from the Milky Way central black hole, Sagittarius A*, represents the closest pulsar to a supermassive black hole ever detected. Furthermore, its intriguing radio emission has been used to study the environment of the black hole, as well as to derive a precise position and proper motion for this object. The discovery of SGR J1745−2900 has led to interesting debates about the number, age, and nature of pulsars expected in the Galactic center region. In this work, we present extensive X-ray monitoring of the outburst of SGR J1745−2900 using the Chandra X-ray Observatory, the only instrument with the spatial resolution to distinguish the magnetar from the supermassive black hole (2"4 angular distance). It was monitored from its outburst onset in 2013 April until 2019 August, collecting more than 50 Chandra observations for a total of more than 2.3 Ms of data. Soon after the outburst onset, the magnetar emission settled onto a purely thermal emission state that cooled from a temperature of about 0.9–0.6 keV over 6 yr. The pulsar timing properties showed at least two changes in the period derivative, increasing by a factor of about 4 during the outburst decay. We find that the long-term properties of this outburst challenge current models for the magnetar outbursts.N.R., D.V., and A.B. are supported by the H2020 ERC Consolidator Grant “MAGNESIA” under grant agreement No. 817661 (PI: Rea). N.R., F.C.Z., D.V., A.B., and D.F.T. also acknowledge support from grants SGR2017-1383 and PGC2018-095512-BI00. F.C.Z. is supported by a Juan de la Cierva fellowship. A.P. acknowledges financial support from grants ASI/INAF I/037/12/0, ASI/INAF 2017-14-H.0 (PI: Belloni) and from INAF grant “Sostegno alla ricerca scientifica main streams dell’INAF,” Presidential Decree 43/2018 (PI: Belloni). D.H. acknowledges support from the Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant, the Fonds de recherche du QuĂ©bec–Nature et Technologies (FRQNT) Nouveaux Chercheurs program, and the Canadian Institute for Advanced Research (CIFAR). G.L.I., S.M., and R.T. have been partially supported by PRIN-MIUR 2017. J.A.P. acknowledges support by the Generalitat Valenciana (PROMETEO/2019/071) and by Agencia Estatal de InvestigaciĂłn (PGC2018-095984-B-I00). G.P. is supported by the H2020 ERC Consolidator Grant “Hot Milk” under grant agreement No. 865637. L.S. acknowledges financial contributions from ASI-INAF agreements 2017-14-H.O and I/037/12/0 and from “iPeska” research grant (PI: Andrea Possenti) funded under the INAF call PRIN-SKA/CTA (resolution 70/2016). We acknowledge support from the PHAROS COST Action (CA16214)

    MITS: the Multi-Imaging Transient Spectrograph for SOXS

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    The Son Of X-Shooter (SOXS) is a medium resolution spectrograph R~4500 proposed for the ESO 3.6 m NTT. We present the optical design of the UV-VIS arm of SOXS which employs high efficiency ion-etched gratings used in first order (m=1) as the main dispersers. The spectral band is split into four channels which are directed to individual gratings, and imaged simultaneously by a single three-element catadioptric camera. The expected throughput of our design is >60% including contingency. The SOXS collaboration expects first light in early 2021. This paper is one of several papers presented in these proceedings describing the full SOXS instrument

    Optical design of the SOXS spectrograph for ESO NTT

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    An overview of the optical design for the SOXS spectrograph is presented. SOXS (Son Of X-Shooter) is the new wideband, medium resolution (R>4500) spectrograph for the ESO 3.58m NTT telescope expected to start observations in 2021 at La Silla. The spectroscopic capabilities of SOXS are assured by two different arms. The UV-VIS (350-850 nm) arm is based on a novel concept that adopts the use of 4 ion-etched high efficiency transmission gratings. The NIR (800- 2000 nm) arm adopts the '4C' design (Collimator Correction of Camera Chromatism) successfully applied in X-Shooter. Other optical sub-systems are the imaging Acquisition Camera, the Calibration Unit and a pre-slit Common Path. We describe the optical design of the five sub-systems and report their performance in terms of spectral format, throughput and optical quality. This work is part of a series of contributions describing the SOXS design and properties as it is about to face the Final Design Review.Comment: 9 pages, 9 figures, published in SPIE Proceedings 1070

    The VIS detector system of SOXS

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    SOXS will be a unique spectroscopic facility for the ESO NTT telescope able to cover the optical and NIR bands thanks to two different arms: the UV-VIS (350-850 nm), and the NIR (800-1800 nm). In this article, we describe the design of the visible camera cryostat and the architecture of the acquisition system. The UV-VIS detector system is based on a e2v CCD 44-82, a custom detector head coupled with the ESO continuous ow cryostats (CFC) cooling system and the NGC CCD controller developed by ESO. This paper outlines the status of the system and describes the design of the different parts that made up the UV-VIS arm and is accompanied by a series of contributions describing the SOXS design solutions.Comment: 9 pages, 13 figures, to be published in SPIE Proceedings 1070

    The Acquisition Camera System for SOXS at NTT

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    SOXS (Son of X-Shooter) will be the new medium resolution (R∌\sim4500 for a 1 arcsec slit), high-efficiency, wide band spectrograph for the ESO-NTT telescope on La Silla. It will be able to cover simultaneously optical and NIR bands (350-2000nm) using two different arms and a pre-slit Common Path feeding system. SOXS will provide an unique facility to follow up any kind of transient event with the best possible response time in addition to high efficiency and availability. Furthermore, a Calibration Unit and an Acquisition Camera System with all the necessary relay optics will be connected to the Common Path sub-system. The Acquisition Camera, working in optical regime, will be primarily focused on target acquisition and secondary guiding, but will also provide an imaging mode for scientific photometry. In this work we give an overview of the Acquisition Camera System for SOXS with all the different functionalities. The optical and mechanical design of the system are also presented together with the preliminary performances in terms of optical quality, throughput, magnitude limits and photometric properties.Comment: 9 pages, 7 figures, SPIE conferenc
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