Phase III studies on novel oral anticoagulants for stroke prevention in atrial fibrillation -a look beyond the excellent results

In this overview we address the three phase III studies that compared new oral anticoagulants (dabigatran, rivaroxaban and apixaban) with warfarin in the setting of stroke prevention in atrial fibrillation. Strengths and weaknesses of the studies were examined in detail through indirect comparison. We analyze and comment the inclusion and exclusion criteria, the characteristics of randomized patients, the primary efficacy and safety end points and side effects. All new oral anticoagulants resulted in being non-inferior to vitamin K antagonists in reducing stroke or systemic embolism in patients with atrial fibrillation. Dabigatran 150 mg and apixaban were superior to vitamin K antagonists. Importantly, new oral anticoagulants significantly reduced hemorrhagic stroke in all three studies. Major differences among new oral anticoagulants include the way they are eliminated and side effects. Both dabigatran and apixaban were tested in low- to moderate-risk patients (mean CHADS2 [Congestive heart failure, Hypertension, Age, Diabetes, Stroke] score = 2.1-2.2) whereas rivaroxaban was tested in high-risk patients (mean CHADS2 score = 3.48) and at variance with dabigatran and apixaban was administered once daily. Apixaban significantly reduced mortality from any cause. The choice of a new oral anticoagulant should take into account these and other differences between the new drugs

Soil deformation analysis through fluid-dynamic modelling and DInSAR measurements: a focus on groundwater withdrawal in the Ravenna area (Italy)

This study aims at assessing the deformation processes affecting an area NW of the city of Ravenna (northern Italy), caused by groundwater withdrawal activities. In situ data, geologic and structural maps, piezometric measurements, underground water withdrawal volumes, and satellite C-band SAR data were used to jointly exploit two different techniques: 1) fluid-dynamic and geomechanical modelling (by RSE S.p.A), and 2) Differential Synthetic Aperture Radar Interferometry (DInSAR) analysis (by CNR - IREA). The results of the comparative analysis presented in this work brought new evidence about the contribution of groundwater withdrawal to the total subsidence affecting the area during the 2000-2017 time interval. In particular, they show an increase of the subsidence from year 2000 to 2010 and a decrease from year 2010 to 2017. These results are generally in line with groundwater withdrawal data that report a reduction of the extracted water volumes during the considered temporal interval. Meantime, they show a delay effect in the subsidence process, partially recovered during the 2010-2017 thanks to a stabilisation of the extracted groundwater volumes. The presented results shade new light on the groundwater withdrawal contribution to the subsidence of the analysed zone, although further investigations are foreseen to better clarify the ongoing scenario

Hypernuclear spectroscopy with K−^- at rest on 7^7Li, 9^9Be, 13^{13}C and 16^{16}O

The FINUDA experiment collected data to study the production of hypernuclei on different nuclear targets. The hypernucleus formation occurred through the strangeness-exchange reaction K^-_{stop} + \; ^AZ \rightarrow \; ^A_{\Lambda}Z + \pi^-. From the analysis of the momentum of the emerging $\pi^-$, binding energies and formation probabilities of $^7_{\Lambda}$Li, $^9_{\Lambda}$Be, $^{13}_{\Lambda}$C and $^{16}_{\Lambda}$O have been measured and are here presented. The behavior of the formation probability as a function of the atomic mass number A is also discussed.Comment: Accepted for publication in PL

The A(Kstop−,π±Σ∓)A′A(K^-_{stop},\pi^\pm\Sigma^\mp)A' reaction on p-shell nuclei

This letter is concerned with the study of the $K^-_{stop}A\rightarrow \pi^\pm\Sigma^\mp A'$ reaction in p-shell nuclei, i.e., $^{6,7}Li$, $^9Be$, $^{13}C$ and $^{16}O$. The $\pi^\pm\Sigma^\mp / K^-_{stop}$ emission rates are reported as a function of $A$. These rates are discussed in comparison with previous findings. The ratio $\pi^-\Sigma^+/\pi^+\Sigma^-$ in p-shell nuclei is found to depart largely from that on hydrogen, which provides support for large in-medium effects possibly generated by the sub-threshold $\Lambda(1405)$. The continuum momentum spectra of prompt pions and free sigmas are also discussed as well as the $\pi^\pm\Sigma^\mp$ missing mass behavior and the link with the reaction mechanism. The apparatus used for the investigation is the FINUDA spectrometer operating at the DA$\Phi$NE $\phi$-factory (LNF-INFN, Italy).Comment: 14 pages, 5 figures, accepted for publication in Phys. Lett.

Annihilation of low energy antiprotons in silicon

The goal of the AE$\mathrm{\bar{g}}$IS experiment at the Antiproton Decelerator (AD) at CERN, is to measure directly the Earth's gravitational acceleration on antimatter. To achieve this goal, the AE$\mathrm{\bar{g}}$IS collaboration will produce a pulsed, cold (100 mK) antihydrogen beam with a velocity of a few 100 m/s and measure the magnitude of the vertical deflection of the beam from a straight path. The final position of the falling antihydrogen will be detected by a position sensitive detector. This detector will consist of an active silicon part, where the annihilations take place, followed by an emulsion part. Together, they allow to achieve 1$$ precision on the measurement of $\bar{g}$ with about 600 reconstructed and time tagged annihilations. We present here, to the best of our knowledge, the first direct measurement of antiproton annihilation in a segmented silicon sensor, the first step towards designing a position sensitive silicon detector for the AE$\mathrm{\bar{g}}$IS experiment. We also present a first comparison with Monte Carlo simulations (GEANT4) for antiproton energies below 5 MeVComment: 21 pages in total, 29 figures, 3 table

Prospects for measuring the gravitational free-fall of antihydrogen with emulsion detectors

The main goal of the AEgIS experiment at CERN is to test the weak equivalence principle for antimatter. AEgIS will measure the free-fall of an antihydrogen beam traversing a moir\'e deflectometer. The goal is to determine the gravitational acceleration g for antihydrogen with an initial relative accuracy of 1% by using an emulsion detector combined with a silicon micro-strip detector to measure the time of flight. Nuclear emulsions can measure the annihilation vertex of antihydrogen atoms with a precision of about 1 - 2 microns r.m.s. We present here results for emulsion detectors operated in vacuum using low energy antiprotons from the CERN antiproton decelerator. We compare with Monte Carlo simulations, and discuss the impact on the AEgIS project.Comment: 20 pages, 16 figures, 3 table

An improved determination of the two--nucleon induced non mesonic weak decay of Λ\Lambda-hypernuclei

The decay of $\Lambda$-hypernuclei without pion emission, known as Non Mesonic Weak Decay (NMWD), gives an effective tool to investigate $\Delta$S=1 four-baryon interactions. It was theoretically suggested that the two-nucleon induced mechanism could play a substantial role in reproducing the observed NMWD decay rates and nucleon spectra, but at present no direct evidence of such a mechanism has been obtained. The FINUDA experiment, exploiting the possibility to detect both charged and neutral particles coming from the hypernucleus decay, has allowed us to deduce the relative weight of the two nucleon induced decay rate to the total NMWD rate. The value of $\Gamma_{2N}$/$\Gamma_{NMWD}$=0.24$\pm$${0.03_{stat}}^{+0.03_{sys}}_{{-{0.02_{sys}}}}$ has been deduced, with an error reduced by a factor more than two compared with the previous assessment.Comment: 10 pages, 3 figure

Neutron-proton coincidences from Non-Mesonic Weak Decay of p-shell Lambda-hypernuclei and determination of the two-nucleon induced process

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Physicians’ Perceptions of Clinical Utility of a Digital Health Tool for Electronic Patient-Reported Outcome Monitoring in Real-Life Hematology Practice. Evidence From the GIMEMA-ALLIANCE Platform

Digital health tools are increasingly being used in cancer care and may include electronic patient-reported outcome (ePRO) monitoring systems. We examined physicians’ perceptions of usability and clinical utility of a digital health tool (GIMEMA-ALLIANCE platform) for ePRO monitoring in the real-life practice of patients with hematologic malignancies. This tool allows for the collection and assessment of ePROs with real-time graphical presentation of results to medical staff. Based on a predefined algorithm, automated alerts are sent to medical staff. Participating hematologists completed an online survey on their experience with the platform. Of the 201 patients invited to participate between December 2020 and June 2021 (cut-off date for current analysis), 180 (90%) agreed to enter the platform and had a median age of 57 years. Twenty-three hematologists with a median age of 42 years and an average of 17 years of experience in clinical practice were surveyed. All hematologists agreed or strongly agreed that the platform was easy to use, and 87%, agreed or strongly agreed that ePROs data were useful to enhance communication with their patients. The majority of physicians (78%) accessed the platform at least once per month to consult the symptom and health status profile of their patients. The frequency of access was independent of physician sex (p=0.393) and years of experience in clinical practice (p=0.404). In conclusion, our preliminary results support the clinical utility, from the perspective of the treating hematologist, of integrating ePROs into the routine cancer care of patients with hematologic malignancies