Apparent high metallicity in 3-4 keV galaxy clusters: the inverse iron-bias in action in the case of the merging cluster Abell 2028

Recent work based on a global measurement of the ICM properties find evidence for an increase of the iron abundance in galaxy clusters with temperature around 2-4 keV up to a value about 3 times larger than that typical of very hot clusters. We have started a study of the metal distribution in these objects from the sample of Baumgartner et al. (2005), aiming at resolving spatially the metal content of the ICM. We report here on a 42ks XMM observation of the first object of the sample, the cluster Abell 2028. The XMM observation reveals a complex structure of the cluster over scale of 300 kpc, showing an interaction between two sub-clusters in cometary-like configurations. At the leading edges of the two substructures cold fronts have been detected. The core of the main subcluster is likely hosting a cool corona. We show that a one-component fit for this region returns a biased high metallicity. This inverse iron bias is due to the behavior of the fitting code in shaping the Fe-L complex. In presence of a multi-temperature structure of the ICM, the best-fit metallicity is artificially higher when the projected spectrum is modeled with a single temperature component and it is not related to the presence of both Fe-L and Fe-K emission lines in the spectrum. After accounting for the bias, the overall abundance of the cluster is consistent with the one typical of hotter, more massive clusters. We caution the interpretation of high abundances inferred when fitting a single thermal component to spectra derived from relatively large apertures in 3-4 keV clusters, because the inverse iron bias can be present. Most of the inferences trying to relate high abundances in 3-4 keV clusters to fundamental physical processes will likely have to be revised.Comment: 13 pages, 8 figures.Accepted for publication in Astronomy and Astrophysycs. Minor changes to match published versio

The Jet of 3C 17 and the Use of Jet Curvature as a Diagnostic of the X-ray Emission Process

We report on the X-ray emission from the radio jet of 3C 17 from Chandra observations and compare the X-ray emission with radio maps from the VLA archive and with the optical-IR archival images from the Hubble Space Telescope. X-ray detections of two knots in the 3C 17 jet are found and both of these features have optical counterparts. We derive the spectral energy distribution for the knots in the jet and give source parameters required for the various X-ray emission models, finding that both IC/CMB and synchrotron are viable to explain the high energy emission. A curious optical feature (with no radio or X-ray counterparts) possibly associated with the 3C 17 jet is described. We also discuss the use of curved jets for the problem of identifying inverse Compton X-ray emission via scattering on CMB photons.Comment: 6 pages, 6 figure (3 in color), 4 tables, ApJ accepte

A textbook example of ram-pressure stripping in the Hydra A/A780 cluster

In the current epoch, one of the main mechanisms driving the growth of galaxy clusters is the continuous accretion of group-scale halos. In this process, the ram pressure applied by the hot intracluster medium on the gas content of the infalling group is responsible for stripping the gas from its dark-matter halo, which gradually leads to the virialization of the infalling gas in the potential well of the main cluster. Using deep wide-field observations of the poor cluster Hydra A/A780 with XMM-Newton and Suzaku, we report the discovery of an infalling galaxy group 1.1 Mpc south of the cluster core. The presence of a substructure is confirmed by a dynamical study of the galaxies in this region. A wake of stripped gas is trailing behind the group over a projected scale of 760 kpc. The temperature of the gas along the wake is constant at kT ~ 1.3 keV, which is about a factor of two less than the temperature of the surrounding plasma. We observe a cold front pointing westwards compared to the peak of the group, which indicates that the group is currently not moving in the direction of the main cluster, but is moving along an almost circular orbit. The overall morphology of the group bears remarkable similarities with high-resolution numerical simulations of such structures, which greatly strengthens our understanding of the ram-pressure stripping process

Extended X-ray emission in radio galaxies: the peculiar case of 3C 305

Extended X-ray structures are common in Active Galactic Nuclei (AGNs). Here we present the first case of a Compact Steep Spectrum (CSS) radio galaxy, 3C 305, in which the X-ray radiation appears to be associated with the optical emission line region, dominated by the [O III]5007. On the basis of a morphological study, performed using the comparison between the X-rays, the optical and the radio band, we argue that the high energy emission has a thermal nature and it is not directly linked to the radio jet and hotspots of this source. Finally, we discuss the origin of the extended X-ray structure connected with the optical emission line region following two different interpretations: as due to the interaction between matter outflows and shock-heated environment gas, or as due to gas photoionized by nuclear emission.Comment: 5 pages, 2 figures, Accepted for publication in The ApJL Comments: references and affilitations correcte

Induction of Labor According to Medical Indications: A Critical Evaluation through a Prospective Study

Background: The induction of labor (IOL) is a common obstetric intervention, steadily increasing (one out four pregnancies) in the last years. This procedure should be considered only when there is a medical indication, and when the benefits outweigh the maternal and/or fetal risks of waiting for spontaneous onset of labor. Therefore, this study aims to compare the efficacy of the IOL in terms of induction to delivery time, mode of delivery, and neonatal well-being among different evidence-based and non-evidence-based indications. Methods: This prospective study was conducted at the University Hospital of Modena, between January and December 2020. We included singleton pregnant women undergoing IOL, at the term. Intrauterine deaths, small for gestational age fetuses <5th centile as well women with hypertensive disorders were excluded. Women have been subdivided into 3 groups based on the indication to IOL: premature rupture of membranes (PROM), post-date pregnancy (>41 weeks + 3 days), and non-evidence-based indications (NEBI). The primary outcome is the time occurring between IOL and delivery (TIME), analyzing separately by parity. Moreover, mode of delivery and neonatal wellbeing were evaluated. Results: A total of 585 women underwent IOL in the study period. Overall, the median TIME between IOL and delivery was 19 hours, and the mean cesarean section CS rate was 15.5% (91/585). Pregnancies induced for postdate and non-evidencebased indications registered respectively a significantly higher mean time (p < 0.001), compared with women induced for PROM. This occurred both in nulliparous and multiparous women. Moreover, at multivariate analysis, the IOL TIME ≥24 hours was significantly influenced by Bishop score (p = 0.000) and NEBI (p = 0.02) in nulliparous and by gestational age (p = 0.000) and NEBI (p = 0.02) in multiparous. Moreover, CS rate was significantly influenced by Bishop score (p = 0.003) in nulliparous and by gestational age (p = 0.01) in multiparous. Finally, neonatal intensive care unit (NICU) admission resulted significantly influenced only by gestational age (p = 0.002) in multiparous. Conclusions: Our study confirms that IOL in non-evidence-based indications, leads to an increase in induction to delivery time comparing with women induced for PROM, both in nulliparous and multiparous women, thus it should be justified and carefully evaluated. Further randomized controlled trials (RCT) conducted in European/Italian settings are needed to determine the perinatal outcomes of IOL in non-evidence-based indications

Restarting a prisoner's life onto a supportive path leading to RESETtlement in the community: The RESET Study

Executive Summary The potential of not having secure accommodation upon release from prison is a major problem for prisoners with mental health needs. This study focused on evaluating an intervention that supported prisoners upon their release from prison with the primary objective being to support them in finding accommodation release from prison service. In September, 2019 there were 83,518 prisoners detained in England and Wales (Her Majesty’s Prison and Probation Service, 2019). The period of transition from prison to the community has been acknowledged as a confusing and chaotic experience for many which is intensified by being homeless. A recent survey ascertained that 36% of people found rough sleeping had previously been in prison (CHAIN, 2018). Being homeless is viewed as a major factor in the likelihood of reoffending (Homeless Link, 2018) and not engaging with support services (health services, GP services, welfare benefits) (Williamson, 2007). It has been estimated that over 90% of prisoners have one or more psychiatric disorders (psychosis, neurosis, personality disorder, hazardous drinking and drug dependency). The period directly before and following release from prison is a highly stressful and isolating experience that exacerbates mental health problems (Theurer & Lovell, 2008; The Mental Welfare Commission for Scotland, 2017). Hopkins & Thornicroft (2014) have also reported that prisoners with mental health problems have twenty-nine times the rate of all-cause mortality during the first two weeks after release compared to the general population and are 8.3 times more likely to commit suicide in the twelve months following release from prison compared to the general population. Hancock et al (2018) has proposed that secure housing is the most important factor in ensuring a positive transition from prison to the community for people with mental health problems due to: • It is impossible to address mental health support and treatment before a person has stable accommodation • without housing they are lost to care. If someone does not have a fixed address, they are difficult to locate and connect with which makes it hard to provide support • housing helps break a cycle of returning to poor previous relationships and routines Providing support for prisoners with mental health needs upon their release has the potential to be an important factor in helping reintegrate this cohort into the community through helping to find secure accommodation, improving health and wellbeing, engaging with services, re-establishing contacts with family and friends and reducing reoffending. The Bradley Report (2009) noted if prisoners receive the support they need inside prisons, they were more likely to engage with services outside prison. The report added for the resettlement of prisoners with mental health needs into the community to be successful, it was important to ensure that the engagement that had started in prisons continued once prisoners leave the prison gate. However, the evidence for the effectiveness of existing services approaches is limited. Hopkin et al (2018) undertook a systematic review examining interventions for prisoners with diagnosed mental health conditions that targeted the transition period between prison and the community. Thirteen studies were found (with only two in the UK). The conclusions drawn were that there was some evidence that the interventions examined could improve contact between service users and mental health and other services. However, evidence that it reduced reoffending was equivocal and none on of the studies had examined whether the intervention improved access to secure accommodation. During the period of the study, the standard care package offered to prisoners upon their release was based on the government’s Transforming Rehabilitation strategy aimed to reduce reoffending and to provide a seamless transition between prison and the community by developing “Through the Gate” services (Ministry of Justice, 2013). The Through the Gate service was delivered by the newly commissioned local Community Rehabilitation Companies (CRCs) to help prisoners maintain or find accommodation; aid with finance, benefits and debt; and to support them to enter education, training and employment. It has been noted that prisoners with mental health needs present different challenges, have multiple and complex needs and require a more focused approach than the support provided by the CRCs. In addition, limitations in the amount of support and assistance offered to prisoners with mental health needs and, in particular, the lack of planning and arrangements for suitable accommodation were identified by Her Majesty’s Inspectorate of Probation reports (HMIP, 2019). To provide intensive support to those who had offended but also have identified mental health needs, Oxleas NHS Foundation Trust commissioned Clarion Housing (at the time known as Centra) and Nacro to provide a resettlement service for prisoners with mental health needs upon their release; the Supporting Prisoners upon Release Service (RESET) Intervention service. Clarion Housing worked from HMP Elmley, HMP Rochester and HMP Stamford Hill, while Nacro and Clarion Housing operated in London from HMP ISIS, HMP Belmarsh and HMP Thameside. The threshold for meeting the criteria for receiving support was that service users must have had limited community support in place, high rates of reoffending, and meet at least step 3 on the Oxleas stepped care model. The RESET service was based on the principles of the Critical Time Intervention (CTI) approach. CTI is a structured, time limited intervention developed in the USA in the 1990s to prevent recurrent homelessness in transient individuals with severe and mental illness moving from hospital care into the community. In CTI, case managers provided support for up to nine months to strengthen times with family, friends and service providers and to provide practical and emotional support during the transition in to the community. Studies had found significantly reduced number of homelessness for those users receiving CTI (Susser et al, 1997). The main elements of the RESET service were: • A short-term (12 week) support service to prisoners with an identified level of mental health need • The focus was in obtaining appropriate safe and secure accommodation, access to welfare benefits, re-engagement with health services and strengthening links with family and community support services • Referrals to the service were made through the Mental Health Inreach team at each prison • Work began before release to develop rapport with service user, to try to secure accommodation, and start to fill out necessary paperwork • On the day of release, the support co-ordinator would meet the service user at the gate • The main aim in first day is to ensure the individual has some form of housing • Any released prisoner would be escorted to all crucial appointments on the day, such as probation and local authority housing • Support was provided to ensure that the service users had all the essentials for the first few days i.e. correct medication, scripts and planned appointments • The support co-ordinator worked intensively during the first week of service users release and then gradually reduced their level of contact The overall aim of this study was to evaluate the impact of the RESET service. The specified objectives were to examine the: • Participants’ housing situation • Rate of reoffending • Number of hospital admissions • Number on maintained benefits • Number of contacts with mental health and GP services • Level of engagement with services • Number in employment or education • The service user’s views of the RESET servic

Chandra Observations of 3C Radio Sources with z<0.3: Nuclei, Diffuse Emission, Jets and Hotspots

We report on our Chandra Cycle 9 program to observe half of the 60 (unobserved by Chandra) 3C radio sources at z<0.3 for 8 ksec each. Here we give the basic data: the X-ray intensity of the nuclei and any features associated with radio structures such as hot spots and knots in jets. We have measured fluxes in soft, medium and hard bands and are thus able to isolate sources with significant intrinsic column density. For the stronger nuclei, we have applied the standard spectral analysis which provides the best fit values of X-ray spectral index and column density. We find evidence for intrinsic absorption exceeding a column density of 10^{22} cm^{-2} for one third of our sources.Comment: 12 pages, 37 figures (the complete version of the paper with all figures is available on line, see appendix for details), ApJ accepte

Management of High-Risk Hypercholesterolemic Patients and PCSK9 Inhibitors Reimbursement Policies: Data from a Cohort of Italian Hypercholesterolemic Outpatients.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are effective and safe lipid-lowering treatments (LLT). The primary endpoint of the study was to assess the prevalence of patients eligible for treatment with PCSK9 inhibitors in a real-life clinical setting in Italy before and after the recent enlargement of reimbursement criteria. For this study, we consecutively considered the clinical record forms of 6231 outpatients consecutively admitted at the Lipid Clinic of the University Hospital of Bologna (Italy). Patients were stratified according to whether they were allowed or not allowed to access to treatment with PCSK9 inhibitors based on national prescription criteria and reimbursement rules issued by the Italian Medicines Agency (AIFA). According to the indications of the European Medicines Agency (EMA), 986 patients were candidates to treatment with PCSK9 inhibitors. However, following the prescription criteria issued by AIFA, only 180 patients were allowed to access to PCSK9 inhibitors before reimbursement criteria enlargement while 322 (+14.4%) with the current ones. Based on our observations, low-cost tailored therapeutic interventions for individual patients can significantly reduce the number of patients potentially needing treatment with PCSK9 inhibitors among those who are not allowed to access to the treatment. The application of enlarged reimbursement criteria for PCSK9 inhibitors could mildly improve possibility to adequately manage high-risk hypercholesterolemic subjects in the setting of an outpatient lipid clinic