The dense molecular gas in the z∼6\rm z\sim6 QSO SDSS J231038.88+185519.7 resolved by ALMA

We present ALMA observations of the CO(6-5) and [CII] emission lines and the sub-millimeter continuum of the $z\sim6$ quasi-stellar object (QSO) SDSS J231038.88+185519.7. Compared to previous studies, we have analyzed a synthetic beam that is ten times smaller in angular size, we have achieved ten times better sensitivity in the CO(6-5) line, and two and half times better sensitivity in the [CII] line, enabling us to resolve the molecular gas emission. We obtain a size of the dense molecular gas of $2.9\pm0.5$ kpc, and of $1.4\pm0.2$ kpc for the 91.5 GHz dust continuum. By assuming that CO(6-5) is thermalized, and by adopting a CO--to--$H_2$ conversion factor $\rm \alpha_{CO} = 0.8~ M_{\odot}~K^{-1}~ (km/s)^{-1} ~pc^{2}$, we infer a molecular gas mass of $\rm M(H_2)=(3.2 \pm0.2) \times 10^{10}\rm M_{\odot}$. Assuming that the observed CO velocity gradient is due to an inclined rotating disk, we derive a dynamical mass of $\rm M_{dyn}~sin^2(i) = (2.4\pm0.5) \times 10^{10}~ M_{\odot}$, which is a factor of approximately two smaller than the previously reported estimate based on [CII]. Regarding the central black hole, we provide a new estimate of the black hole mass based on the C~IV emission line detected in the X-SHOOTER/VLT spectrum: $\rm M_{BH}=(1.8\pm 0.5) \times 10^{9}~ M_{\odot}$. We find a molecular gas fraction of $\rm \mu=M(H_2)/M^*\sim4.4$, where $\rm M^*\approx M_{dyn} - M(H_2)-M(BH)$. We derive a ratio $v_{rot}/\sigma \approx 1-2$ suggesting high gas turbulence, outflows/inflows and/or complex kinematics due to a merger event. We estimate a global Toomre parameter $Q\sim 0.2-0.5$, indicating likely cloud fragmentation. We compare, at the same angular resolution, the CO(6-5) and [CII] distributions, finding that dense molecular gas is more centrally concentrated with respect to [CII]. We find that the current BH growth rate is similar to that of its host galaxy.Comment: A&A in pres

Poynting-Robertson effect on black-hole-driven winds

Layers of ionized plasma, in the form of winds ejected from the accretion disk of Supermassive Black Holes (SMBHs) are frequently observed in Active Galactic Nuclei (AGNs). Winds with a velocity often exceeding $0.1c$ are called Ultra-Fast-Outflows (UFOs) and thanks to their high power they can play a key role in the co-evolution between the SMBH and the host galaxy. In order to construct a proper model of the properties of these winds, it is necessary to consider special relativistic corrections due to their very high velocities. We present a derivation of the Poynting-Robertson effect (P-R effect) and apply it to the description of the dynamics of UFOs. The P-R effect is a special relativistic correction which breaks the isotropy of the radiation emitted by a moving particle funneling the radiation in the direction of motion. As a result of the conservation of the four-momentum, the emitting particles are subjected to a drag force and decelerate. We provide a derivation of the drag force caused by the P-R effect starting from general Lorentz transformations and assuming isotropic emission in the gas reference frame. Then, we derive the equations to easily implement this drag force in future simulations. Finally, we apply them in a toy model in which the gas particles move radially under the influence of the gravitation force, the radiation pressure and the drag due to the P-R effect. P-R effect plays an important role in determining the velocity profile of the wind. For a wind launched from $r_0=10r_s$ (where $r_S$ stands for the Schwarzschild radius), the asymptotic velocity reached by the wind is between $10$% and $24$% smaller than the one it would possess if we neglect the effect. This shows that the P-R effect should be taken into account when studying the dynamics of high-velocity, photoionized outflows in general.Comment: Accepted for publication on Astronomy & Astrophysics. 7 pages, 4 figure

Management of patients with lymphoma and COVID-19: Narrative review and evidence-based practical recommendations

Patients with hematologic malignancies can be immunocompromized because of their disease, anti-cancer therapy, and concomitant immunosuppressive treatment. Furthermore, these patients are usually older than 60 years and have comorbidities. For all these reasons they are highly vulnerable to infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and have an increased risk of developing severe/critical Coronavirus disease 2019 (COVID-19) compared to the general population. Although COVID-19 vaccination has proven effective in reducing the incidence of severe/critical disease, vaccinated patients with lymphoma may not be protected as they often fail to develop a sufficient antiviral immune response. There is therefore an urgent need to address the management of patients with lymphoma and COVID-19 in the setting of the ongoing pandemic. Passive immunization with monoclonal antibodies against SARS-CoV-2 is a currently available complementary drug strategy to active vaccination for lymphoma patients, while monoclonal antibodies and antiviral drugs (remdesivir, ritonavir-boosted nirmatrelvir, and molnupiravir) have proven effective in preventing the progression to severe/critical COVID-19. In this narrative review we present the most recent data documenting the characteristics and outcomes of patients with concomitant lymphoma and COVID-19. Our ultimate goal is to provide practice-oriented guidance in the management of these vulnerable patients from diagnosis to treatment and follow-up of lymphoma. To this purpose, we will first provide an overview of the main data concerning prognostic factors and fatality rate of lymphoma patients who develop COVID-19; the outcomes of COVID-19 vaccination will also be addressed. We will then discuss current COVID-19 prophylaxis and treatment options for lymphoma patients. Finally, based on the literature and our multidisciplinary experience, we will summarize a set of indications on how to manage patients with lymphoma according to COVID-19 exposure, level of disease severity and former history of infection, as typically encountered in clinical practice

Speed limits for radiation-driven SMBH winds

Context. Ultra-fast outflows (UFOs) have become an established feature in analyses of the X-ray spectra of active galactic nuclei (AGN). According to the standard picture, they are launched at accretion disc scales with relativistic velocities, up to 0.3-0.4 times the speed of light. Their high kinetic power is enough to induce an efficient feedback on a galactic scale, possibly contributing to the co-evolution between the central supermassive black hole (SMBH) and the host galaxy. It is, therefore, of paramount importance to gain a full understanding of UFO physics and, in particular, of the forces driving their acceleration and the relation to the accretion flow from which they originate.Aims. In this paper, we investigate the impact of special relativity effects on the radiative pressure exerted onto the outflow. The radiation received by the wind decreases for increasing outflow velocity, v, implying that the standard Eddington limit argument has to be corrected according to v. Due to the limited ability of the radiation to counteract the black hole gravitational attraction, we expect to find lower typical velocities with respect to the non-relativistic scenario.Methods. We integrated the relativistic-corrected outflow equation of motion for a realistic set of starting conditions. We concentrated on a range of ionisations, column densities, and launching radii consistent with those typically estimated for UFOs. We explore a one-dimensional, spherical geometry and a three-dimensional setting with a rotating, thin accretion disc.Results. We find that the inclusion of special relativity effects leads to sizeable differences in the wind dynamics and that v is reduced up to 50% with respect to the non-relativistic treatment. We compare our results with a sample of UFOs from the literature and we find that the relativistic-corrected velocities are systematically lower than the reported ones, indicating the need for an additional mechanism, such as magnetic driving, to explain the highest velocity components. Finally, we note that these conclusions, derived for AGN winds, are generally applicable

Decreasing incidence of gastric MALT lymphomas in the era of anti-Helicobacter pylori interventions: results from a population-based study on extranodal marginal zone lymphomas

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On the importance of special relativistic effects in modelling ultra-fast outflows

Outflows are observed in a variety of astrophysical sources. Remarkably, ultra-fast ($v\geq 0.1c$), outflows in the UV and X-ray bands are often seen in AGNs. Depending on their energy and mass outflow rate, respectively $\dot{E}_{out}, \dot{M}_{out}$, such outflows may play a key role in regulating the AGN-host galaxy co-evolution process through cosmic time. It is therefore crucial to provide accurate estimates of the wind properties. Here, we concentrate on special relativistic effects concerning the interaction of light with matter moving at relativistic speed relatively to the source of radiation. Our aim is to assess the impact of these effects on the observed properties of the outflows and implement a relativistic correction in the existing spectral modelling routines. We define a simple procedure to incorporate relativistic effects in radiative transfer codes. Following this procedure, we run a series of simulations to explore the impact of these effects on the simulated spectra, for different $v$ and column densities of the outflow. The observed optical depth is usually considered a proxy for the wind $N_H$, independently on its velocity. However, our simulations show that the observed optical depth of an outflow with a given column density $N_H$ decreases rapidly as the velocity of the wind approaches relativistic values. This, in turn, implies that when estimating $N_H$ from the optical depth, it is necessary to include a velocity-dependent correction, already for moderate velocities (e.g. $v \geq 0.05c$). This correction linearly propagates to the derived $\dot{M}_{out}, \dot{E}_{out}$. As an example of these effects, we calculate the relativistically corrected values of $\dot{M}_{out}$ and $\dot{E}_{out}$ for a sample of $\sim 30$ Ultra-Fast Outflows taken from the literature, and find correction factors of $20-120 \%$ within the observed range of outflowing velocities.Comment: 6 pages, 5 figures. Accepted for publication in A&

A diachronic-comparative analysis for the identification of the most powerful prognostic index for localized diffuse large B-cell lymphoma

BACKGROUND: In the rituximab era, the conventional International Prognostic index (IPI) lost at least in part its predictive power, while the National Comprehensive Cancer Network-IPI (NCCN-IPI) seems to be a new and valid prognosticator. However, it has not yet been evaluated in patients with localized disease and it has not been compared with the modified IPI (mIPI) of the pre-rituximab era. In order to evaluate the different prognosticators and to assess the importance of rituximab and radiotherapy (RT), we carried out the so far largest retrospective analysis of patients with localized diffuse large B-cell lymphoma (DLBCL). PATIENTS AND METHODS: We retrospectively assessed clinical and therapeutical data of 1405 patients treated in from 1987 to 2012 in 10 cancer centers in Italy and 1 in Austria. RESULTS: All patients underwent an anthracycline containing polychemotherapy and 254 additional rituximab. The median follow-up was 5.7 years (range 0.1-23 years). The 5-year overall survival (OS) was 75%, being significantly superior in those who underwent additional rituximab, while RT consolidation did not improve the outcome of those who received immunochemotherapy. Patients with extranodal disease benefited from the addition of rituximab, while RT did not improve OS of the immunochemotherapy subgroup. In the pre-rituximab era, the mIPI showed a better performance than the others. In rituximab-treated patients, the NCCN-IPI had the highest discriminant value and the 5-years OS varied significantly (P < 0.001) between the three risk groups and was 98% in low-risk patients, 82% in those with a low-intermediate risk and 57% among high-intermediate and high-risk cases. CONCLUSIONS: The NCCN-IPI is so far the best prognosticator for patients with localized DLBCL who underwent R-CHOP(-like). The addition of rituximab is indispensable regardless of the risk category and site of involvement, while the addition of RT should be reserved to those cases who are ineligible to rituximab

A multicenter retrospective clinical study of CD5/CD10-negative chronic B cell leukemias.

CD5-negative chronic B cell lymphoproliferative disorders in leukemic phase (B-CLPD) are heterogeneous and relatively uncommon pathologies that often lack a histopathological definition because of the absence of accessible pathological tissue. We describe the clinical features and evolution-related variables of 156 patients with CD5/CD10-negative B-CLPD (median age 66 years, range 25-86). The median follow-up was 51 months (range 6-216), and overall 3- and 5-year survival was respectively 87 and 76%; 50 patients needed therapy at diagnosis, 56 during follow-up, and 50 remained untreated until the last control. A combined clinical, histological, cytomorphological, immunophenotypical, and cytogenetic diagnostic approach allowed the complete classification of only a minority of patients as being affected by splenic marginal zone or lymphoplasmacytic lymphoma; the majority of cases remained unclassifiable. Multivariate analysis showed that the clinicohematological variables adversely related to overall survival were serum LDH levels and age, whereas high serum LDH levels, hemoglobin levels of <11 g/dl, and splenomegaly related to treatment-free time (in "wait and see" cases); only splenomegaly related to time to progression (in treated patients). In conclusion, our retrospective study describes the clinical features and variables related to evolution in a large group of patients with CD5/CD10-negative chronic B-cell lymphoid leukemias and underlines the fact that a probable lymphoplasmacytic or marginal zone normal cell origin can be supposed in such leukemic forms, but never surely demonstrated

The Muon Spectrometer Barrel Level-1 Trigger of the ATLAS Experiment at LHC

The proton-proton beam crossing at the LHC accelerator at CERN will have a rate of 40 MHz at the project luminosity. The ATLAS Trigger System has been designed in three levels in order to select only interesting physics events reducing from that rate of 40 MHz to the foreseen storage rate of about 200 Hz. The First Level reduces the output rate to about 100 kHz. The ATLAS Muon Spectrometer has been designed to perform stand-alone triggering and measurement of muon transverse momentum up to 1 TeV/c with good resolution (from 3% at 10 GeV/c up to 10% at 1 TeV/c). In the Barrel region of the Muon Spectrometer the Level-1 trigger is given by means of three layers of Resistive Plate Chamber detectors (RPC): a gaseous detector working in avalanche mode composed by two plates of high-resistivity bakelite and two orthogonal planes of read-out strips. The logic of the Level-1 barrel muon trigger is based on the search of patterns of RPC hits in the three layers consistent with a high transverse momentum muon track originated from the interaction vertex. The associated trigger electronics is based on dedicated processors, the Coincidence Matrix boards, performing space coincidences and time gates and providing the RPC readout as well. A detailed simulation of the ATLAS Experiment and of both the hardware components and the logic of the Level-1 Muon Trigger in the barrel of the Muon Spectrometer has been performed. This simulation has been used not only to evaluate the performances of the system but also to define the hardware set-up such as the cabling of both the trigger detectors and the trigger electronics modules. A description of both the Level-1 Muon Trigger system in the barrel and the RPC detectors, with their cosmic rays quality tests, will be presented together with the trigger performances and rates calculations evaluated for muons over a wide range of pT and preliminary studies on the impact of accidental triggers due to low energy background particles in the experimental area