The Spectrometer/Telescope for Imaging X-rays (STIX)

Aims. The Spectrometer Telescope for Imaging X-rays (STIX) on Solar Orbiter is a hard X-ray imaging spectrometer, which covers the energy range from 4 to 150 keV. STIX observes hard X-ray bremsstrahlung emissions from solar flares and therefore provides diagnostics of the hottest (⪆10 MK) flare plasma while quantifying the location, spectrum, and energy content of flare-accelerated nonthermal electrons. Methods. To accomplish this, STIX applies an indirect bigrid Fourier imaging technique using a set of tungsten grids (at pitches from 0.038 to 1 mm) in front of 32 coarsely pixelated CdTe detectors to provide information on angular scales from 7 to 180 arcsec with 1 keV energy resolution (at 6 keV). The imaging concept of STIX has intrinsically low telemetry and it is therefore well-suited to the limited resources available to the Solar Orbiter payload. To further reduce the downlinked data volume, STIX data are binned on board into 32 selectable energy bins and dynamically-adjusted time bins with a typical duration of 1 s during flares. Results. Through hard X-ray diagnostics, STIX provides critical information for understanding the acceleration of electrons at the Sun and their transport into interplanetary space and for determining the magnetic connection of Solar Orbiter back to the Sun. In this way, STIX serves to link Solar Orbiter’s remote and in-situ measurements

Prevalence of HIV and hepatitis C markers among a cadaver population in Milan.

AIMS: To examine the distribution of serological markers for HIV and hepatitis C virus (HCV) infection in a medicolegal population; to compare prevalence of HIV and HCV markers and cause of death; and to evaluate the risk of potential infection to personnel involved in medicolegal incidents and procedures. METHODS: Blood samples were collected at necropsy from 328 males and 69 females, aged 16 to 50 years at time of death, and tested for antibodies to HIV and HCV. The individuals were classified according to cause of death and whether there was known antemortem risk of infection. RESULTS: Overall, 134 subjects gave positive test results: 20 for anti-HIV, 69 for anti-HCV, and 45 for both. By cause of death, the total number of positives (and negatives) with the pairs of figures referring, respectively, to patients with and without known antemortem risks were: natural causes 3 (1), 8 (32); AIDS 2 (0), 0 (0); homicide 0 (2), 5 (24); suicide 3 (0), 9 (69); road traffic accidents 1 (0), 9 (81); other accidents 2 (3), 1 (12); drug overdose 74 (17), 7 (9); unknown causes 3 (2), 7 (11). CONCLUSIONS: The cases tested represented a predominantly young male population with a high prevalence of serological markers for HIV and HCV infection. The distribution of HIV and HCV positivity varied with the cause of death, probably reflecting the known association between high risk behaviour and infection. However, a substantial number of cases with no known risks also had markers for HIV and HCV, suggesting that there is a large unrecognised pool of potential infection in medicolegal practice

La formazione del medico specializzando in medicina legale nell’ambito della gestione del rischio clinico: stato dell’arte e proposte normative per i nuovi piani formativi

La gestione del rischio clinico, quale strumento per migliorare la qualità e l’appropriatezza delle prestazioni sanitarie, sta acquisendo negli ultimi anni un ruolo sempre più centrale nelle politiche di Clinical Governance. Uno dei principali fattori alla base di tale ascesa è la necessità di arginare il crescente contenzioso nell’ambito della responsabilità sanitaria con strumenti che permettano di mappare il profilo di rischio delle strutture ospedaliere e territoriali e, al contempo, di porre in essere strumenti di prevenzione/correzione delle criticità rilevate. Tale necessità è stata resa ancora più cogente dall’introduzione di franchigie assicurative molto elevate (anche oltre il milione di euro) e dal ritiro di molte compagnie assicurative dal mercato della medical malpractice, che ha indotto diverse aziende (in taluni casi intere Regioni) ad attivare sistemi di autogestione dei sinistri

Linea Guida SIOT-- Prevenzione delle infezioni in chirurgia ortopedica

La prevenzione delle infezioni del sito chirurgico (ISC) costituisce una priorità nell’ambito degli obiettivi del Sistema Sanitario Nazionale. Le conseguenze negative che le infezioni postoperatorie comportano (morbilità, durata dell’ospedalizzazione, mortalità) rappresentano eventi particolarmente gravi sia per il singolo paziente sia per la collettività, in considerazione delle risorse assistenziali necessarie per trattarle. In un contesto sanitario globale nel quale si è affermata la medicina basata sulle prove di efficacia, cioè la evidence-based medicine (EBM), tutti gli interventi medici vanno riconsiderati alla luce di quanto desumibile dalla letteratura valutata secondo rigorosi criteri metodologici, a maggior ragione quando le prove sono disponibili e unanimemente condivise. L’obiettivo di questo documento è passare in rassegna le evidenze scientifiche desunte da Linee Guida (LG) accreditate e recenti riguardo le varie metodiche di prevenzione delle infezioni, al fine di stabilire quelle che presentano prove affidabili a sostegno e che meritano di essere condivise, implementate e che in definitiva rappresentano un indicatore della qualità dell’assistenza che siamo in grado di fornire ai nostri pazienti. La SIOT, al termine di un percorso complesso che ha coinvolto collaboratori di diverse specialità e ambiti professionali, ha prodotto la presente LG quale strumento valido e aggiornato per gestire al meglio la prevenzione delle ISC perioperatorie

Exploration of the APC/beta-catenin (WNT) pathway and a histologic classification system for pulmonary artery intimal sarcoma: a study of 18 cases

APC, a tumor suppressor gene in the Wnt pathway, stabilizes beta-catenin and controls cell growth. Mutation of APC or beta-catenin leads to nuclear accumulation of beta-catenin and transcription of cyclin D1/cyclin A. Pulmonary artery sarcoma (PAS) were studied by morphologic, immunohistochemical, and molecular genetic methods of the Wnt pathway. Eighteen cases were included: mean age 52 years, primary intraluminal location with typical clinical presentation. PAS were classified as epithelioid (n = 4) or malignant fibrous histiocytoma (MFH; spindled/pleomorphic, n = 4), myxofibrosarcoma (n = 8), and one each hemangiopericytoma-like or malignant inflammatory myofibroblastic tumor-like. The tumor cells demonstrated vimentin, focal actins, and rare focal desmin positivity. All but one were grade 2 or 3 by FNCLCC grading. Alteration in chromosome 5q21 (APC) was found in 4/14 PAS by LOH, mostly epithelioid-type; an MFH-type case demonstrated microsatellite instability (MSI) and nuclear beta-catenin. Cyclin D1 was expressed in seven tumors, all myxofibrosarcoma-type. No mutations were detected in APC or beta-catenin. In summary, PAS are predominantly intermediate grade myxofibrosarcoma in middle-aged males, and fatal in two-thirds of patients. Despite myofibroblastic phenotype, APC/beta-catenin pathway changes are rare. Cyclin D1, only expressed in the myxofibrosarcoma-type, is likely transcribed via factors other than beta-catenin

The Spectrometer/Telescope for Imaging X-rays (STIX)

Aims. The Spectrometer Telescope for Imaging X-rays (STIX) on Solar Orbiter is a hard X-ray imaging spectrometer, which covers the energy range from 4 to 150 keV. STIX observes hard X-ray bremsstrahlung emissions from solar flares and therefore provides diagnostics of the hottest (\ue2\uaa\u2020 10 MK) flare plasma while quantifying the location, spectrum, and energy content of flare-accelerated nonthermal electrons. Methods. To accomplish this, STIX applies an indirect bigrid Fourier imaging technique using a set of tungsten grids (at pitches from 0.038 to 1 mm) in front of 32 coarsely pixelated CdTe detectors to provide information on angular scales from 7 to 180 arcsec with 1 keV energy resolution (at 6 keV). The imaging concept of STIX has intrinsically low telemetry and it is therefore well-suited to the limited resources available to the Solar Orbiter payload. To further reduce the downlinked data volume, STIX data are binned on board into 32 selectable energy bins and dynamically-adjusted time bins with a typical duration of 1 s during flares. Results. Through hard X-ray diagnostics, STIX provides critical information for understanding the acceleration of electrons at the Sun and their transport into interplanetary space and for determining the magnetic connection of Solar Orbiter back to the Sun. In this way, STIX serves to link Solar Orbiter's remote and in-situ measurements. \ua9 2020 ESO