Damped Lyman-α\alpha absorbers and atomic hydrogen in galaxies: the view of the GAEA model

Using the GAEA semi-analytic model, we analyse the connection between Damped Lyman-$\alpha$ systems (DLAs) and HI in galaxies. Our state-of-the-art semi-analytic model is tuned to reproduce the local galaxy HI mass function, and that also reproduces other important galaxy properties, including the galaxy mass - gas metallicity relation. To produce catalogs of simulated DLAs we throw $10^5$ random lines of sight in a composite simulated volume: dark matter haloes with log$(\frac{M_{200}}{ M_{\odot}}) \geq 11.5$ are extracted from the Millennium Simulation, while for $9.2 \leq \log(\frac{M_{200}}{ M_{\odot}})<11.5$ we use the Millennium II, and for $8 \leq \log(\frac{M_{200}}{M_{\odot}}) < 9.2$ a halo occupation distribution model. At $2 < z < 3$, where observational data are more accurate, our fiducial model predicts the correct shape of the column density distribution function, but its normalization falls short of the observations, with the discrepancy increasing at higher redshift. The agreement with observations is significantly improved increasing both the HI masses and the disk radii of model galaxies by a factor 2, as implemented 'a posteriori' in our $2M-2R$ model. In the redshift range of interest, haloes with $M_{200} \geq {10}^{11} M_{\odot}$ give the major contribution to $\Omega_{\rm DLA}$, and the typical DLA host halo mass is $\sim {10}^{11} M _{\odot}$. The simulated DLA metallicity distribution is in relatively good agreement with observations, but our model predicts an excess of DLAs at low metallicities. Our results suggest possible improvements for the adopted modelling of the filtering mass and metal ejection in low-mass haloes.Comment: 21 pages, 16 figures. Accepted for publication in MNRA

Control and prevention measures for legionellosis in hospitals: A cross-sectional survey in Italy

Risk assessment, environmental monitoring, and the disinfection of water systems are the key elements in preventing legionellosis risk. The Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine, and Public Health and the Italian Multidisciplinary Society for the Prevention of Health Care-Associated Infections carried out a national cross-sectional survey to investigate the measures taken to prevent and control legionellosis in Italian hospitals. A multiple-choice questionnaire was developed, comprising 71 questions regarding hospital location, general characteristics, clinical and environmental surveillance, and control and preventive measures for legionellosis in 2015. Overall, 739 hospitals were enrolled from February to June 2017, and 178 anonymous questionnaires were correctly completed and evaluated (response rate: 24.1%). The survey was conducted using the SurveyMonkey® platform, and the data were analyzed using Stata 12 software. Of the participating hospitals, 63.2% reported at least one case of legionellosis, of which 28.2% were of proven nosocomial origin. The highest case numbers were reported in the Northern Italy, in hospitals with a pavilion structure or cooling towers, and in hospitals with higher numbers of beds, wards and operating theaters. Laboratory diagnosis was performed using urinary antigen testing alone (31.9%), both urinary antigen testing and single antibody titer (17.8%), or with seroconversion also added (21.5%). Culture-based or molecular investigations were performed in 28.8% and 22.1% of the clinical specimens, respectively. The water systems were routinely tested for Legionella in 97.4% of the hospitals, 62% of which detected a positive result (> 1000 cfu/L). Legionella pneumophila serogroup 2–15 was the most frequently isolated species (58.4%). The most common control measures were the disinfection of the water system (73.7%), mostly through thermal shock (37.4%) and chlorine dioxide (34.4%), and the replacement (69.7%) or cleaning (70.4%) of faucets and showerheads. A dedicated multidisciplinary team was present in 52.8% of the hospitals, and 73% of the hospitals performed risk assessment. Targeted training courses were organized in 36.5% of the hospitals, involving nurses (30.7%), physicians (28.8%), biologists (21.5%), technicians (26.4%), and cleaners (11%). Control and prevention measures for legionellosis are present in Italian hospitals, but some critical aspects should be improved. More appropriate risk assessment is necessary, especially in large facilities with a high number of hospitalizations. Moreover, more sensitive diagnostic tests should be used, and dedicated training courses should be implemented

Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial

BackgroundTocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients.MethodsA multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival.ResultsIn the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6-24.0, P=0.52) and 22.4% (97.5% CI: 17.2-28.3, P&lt;0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline.ConclusionsTocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline.Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092)