Endovascular repair for acute traumatic transection of the descending thoracic aorta: experience of a single centre with a 12-years follow up

Background: Most blunt aortic injuries occur in the proximal proximal descending aorta causing acute transection of this vessel. Generally, surgical repair of the ruptured segment of aorta is associated with high rates of morbidity and mortality and in this view endovascular treatment seems to be a valid and safer alternative. Aim of this article is to review our experience with endovascular approach for the treatment of acute traumatic rupture of descending thoracic aorta. Methods: From April 2002 to November 2014, 11 patients (9 males and 2 females) were referred to our Department with a diagnosis of acute transection of thoracic aorta. Following preoperative Computed Tomography (CT) evaluation, thoracic endovascular aortic repair (TEVAR) with left subclavian artery coverage was performed. Follow-up consisted clinical and instrumental (CT, Duplex ultrasound) controls at discharge, 1, 3 and 6 months and yearly thereafter. Results: At 12-year follow up, the overall survival for the entire patients cohort was 100 %, no major or minor neurological complications and no episode of left arm claudication occurred. Cardiovascular, respiratory and bleeding complications, in the early period, was represented by minor, non fatal events. No stent graft failure, collapse, leak or distal migration were detected at CT scan during the entire follow up period. Conclusions: According to our experience, despite the small number of patient population, TEVAR procedure with with left subclavian artery coverage, performed in emergency settings, seems to provide excellent long term results. Trials registration: The protocol was registered at a public trials registry, www.clinicaltrials.gov (trial identifier NCT02376998)

Boosting the performance of the ASTRI SST-2M prototype: reflective and anti-reflective coatings

ASTRI is a Flagship Project of the Italian Ministry of Education, University and Research, led by the Italian National Institute of Astrophysics, INAF. One of the main aims of the ASTRI Project is the design, construction and verification on-field of a dual mirror (2M) end-to-end prototype for the Small Size Telescope (SST) envisaged to become part of the Cherenkov Telescope Array. The ASTRI SST-2M prototype adopts the Schwarzschild-Couder design, and a camera based on SiPM (Silicon Photo Multiplier); it will be assembled at the INAF astronomical site of Serra La Nave on mount Etna (Catania, Italy) within mid 2014, and will start scientific validation phase soon after. The peculiarities of the optical design and of the SiPM bandpass pushed towards specifically optimized choices in terms of reflective coatings for both the primary and the secondary mirror. In particular, multi-layer dielectric coatings, capable of filtering out the large Night Sky Background contamination at wavelengths $lambda gtrsim 700$ nm have been developed and tested, as a solution for the primary mirrors. Due to the conformation of the ASTRI SST-2M camera, a reimaging system based on thin pyramidal light guides could be optionally integrated aiming to increase the fill factor. An anti-reflective coating optimized for a wide range of incident angles faraway from normality was specifically developed to enhance the UV-optical transparency of these elements. The issues, strategy, simulations and experimental results are thoroughly presented

Swift-XRT observation of 34 new INTEGRAL/IBIS AGNs: discovery of Compton thick and other peculiar sources

For a significant number of the sources detected at high energies (>10 keV) by the INTEGRAL/IBIS and Swift/BAT instruments there is either a lack information about them in the 2-10 keV range or they are totally unidentified. Herein, we report on a sample of 34 IBIS AGN or AGN candidate objects for which there is X-ray data in the Swift/XRT archive. Thanks to these X-ray follow up observations, the identification of the gamma ray emitters has been possible and the spectral shape in terms of photon index and absorption has been evaluated for the first time for the majority of our sample sources. The sample, enlarged to include 4 more AGN already discussed in the literature, has been used to provide photon index and column density distribution. We obtain a mean value of 1.88 with a dispersion of 0.12, i.e. typical of an AGN sample. Sixteen objects (47%) have column densities in excess of 10^{22} cm^{-2} and, as expected, a large fraction of the absorbed sources are within the Sey 2 sample. We have provided a new diagnostic tool (NH versus F(2-10)keV/F(20-100)keV softness ratio) to isolate peculiar objects; we find at least one absorbed Sey 1 galaxy, 3 Compton thick AGN candidates; and one secure example of a "true" type 2 AGN. Within the sample of 10 still unidentified objects, 3 are almost certainly AGN of type 2; 3 to 4 have spectral slopes typical of AGN; and two are located high on the galactic plane and are strong enough radio emitters so that can be considered good AGN candidates.Comment: 15 pages, 5 figures, ApJ accepte

1SXPS: A deep Swift X-ray Telescope point source catalog with light curves and spectra

We present the 1SXPS (Swift-XRT Point Source) catalog of 151,524 X-ray point-sources detected by the Swift-XRT in 8 years of operation. The catalog covers 1905 square degrees distributed approximately uniformly on the sky. We analyze the data in two ways. First we consider all observations individually, for which we have a typical sensitivity of ~3e-13 erg/cm2/s (0.3--10 keV). Then we co-add all data covering the same location on the sky: these images have a typical sensitivity of ~9e-14 erg/cm2/s (0.3--10 keV). Our sky coverage is nearly 2.5 times that of 3XMM-DR4, although the catalog is a factor of ~1.5 less sensitive. The median position error is 5.5" (90% confidence), including systematics. Our source detection method improves on that used in previous XRT catalogs and we report >68,000 new X-ray sources. The goals and observing strategy of the Swift satellite allow us to probe source variability on multiple timescales, and we find ~30,000 variable objects in our catalog. For every source we give positions, fluxes, time series (in four energy bands and two hardness ratios), estimates of the spectral properties, spectra and spectral fits for the brightest sources, and variability probabilities in multiple energy bands and timescales.Comment: 27 pages, 19 figures; accepted for publication in ApJS. The accompanying website, http://www.swift.ac.uk/1SXPS is live; the Vizier entry should be available shortl

Weak proactive cognitive/motor brain control accounts for poor children's behavioral performance in speeded discrimination tasks

Background: Motor and inhibitory control rely on frontal cortex activity, which is known to reach full maturation only in late adolescence. The development of inhibitory control has been studied using event-related potentials (ERP), focusing on reactive processing (i.e. the N2 and the P3 components). Scarce information exists concerning pre-stimulus activity as that represented by the Bereinshafstpotential (BP) and by the prefrontal negativity (pN). Further, no literature exists concerning the post-stimulus components originating within the anterior insula (pN1, pP1, pP2). This study aims at associating children performance with these motor-cognitive processing in frontal brain areas. Methods: High-resolution EEG recordings were employed to measure ERPs from 18 children (12 years old) and 18 adults (28 years old) during a visuo-motor discriminative response task. Response time (RT), commission (CE) and omission errors, and RT variability were compared between groups. At brain level, two pre-stimulus (BP and pN) and seven post-stimulus (P1; pN1; N1; pP1; N2; pP2; P3) ERP components were compared between groups. Results: Children showed slower and more variable RTs and poorer inhibition (higher CEs) than adults. At electrophysiological level, children presented smaller BP and pN. After stimulus onset, children showed lower amplitude of N1, pP1, P3, and pP2 components. The P1, pP1, N2 and P3 were delayed compared to adults. Conclusions: Our results demonstrate that children are characterized by less intense task-related proactive activities in frontal cortex, which may account for subsequent poor and delayed reactive processing and, thus, for inaccurate and slow performance

The Impact of COVID-19 on doctors well-being: Results of a web survey during the lockdown in Italy

OBJECTIVE: On March 12, 2020, the World Health Organization (WHO) declared the outbreak of a new Coronavirus disease (COVID-19), to be a pandemic. From the be- ginning, Italy (in particular the Northern re- gions) was the first large European country to be hit and one of the most affected coun- tries worldwide. This had a significant impact on the workload and psychological health of health workers. The aim of this web-based cross-sectional study is to assess the con- sequences of the COVID-19 pandemic on Ital- ian doctors’ well-being and psychological dis- tress, in respect of demographic and occu- pational characteristics, lifestyle and habits during the lockdown period.PATIENTS AND METHODS: We conducted a web-based cross-sectional survey based on Google® Forms to collect data. The participa- tion was available during the lockdown period that started in Italy on March 9, 2020 and it was voluntary and anonymous. The question- naire explored demographic and occupational variables, lifestyle and habits during the lock- down, perceived well-being and psychological distress. Multivariate logistic regression models were fitted. RESULTS: Our study reported the very alarm- ing psychological conditions of Italian doctors, especially among those who worked in the most affected regions, where a level of psychological distress of 93.8% and poor well-being of 58.9% were registered. These percentages were even higher in the case of female hospital workers with low job seniority, and those caring for COVID-19 patients. CONCLUSIONS: Our findings reported a sig- nificant psychosocial impact of the COVID-19 outbreak on Italian doctors, particularly among those working in the most affected regions of the country. Further studies are necessary to better understand the effects of the COVID-1

Neuropsychiatric symptoms and syndromes in a large cohort of newly diagnosed, untreated patients with Alzheimer disease.

Objectives: Neuropsychiatric symptoms are common in patients with Alzheimer disease (AD). Treatment for both AD and psychiatric disturbances may affect the clinical observed pattern and comorbidity. The authors aimed to identify whether particular neuropsychiatric syndromes occur in untreated patients with AD, establish the severity of syndromes, and investigate the relationship between specific neuropsychiatric syndromes and AD disease severity. Design: Cross-sectional, multicenter, clinical study. Participants: A total of 1,015 newly diagnosed, untreated outpatients with AD from five Italian memory clinics were consecutively enrolled in the study from January 2003 to December 2005. Measurements: All patients underwent thorough examination by clinical neurologists/geriatricians, including neuropsychiatric symptom evaluation with the Neuropsychiatric Inventory. Results: Factor analysis revealed five distinct neuropsychiatric syndromes: the apathetic syndrome (as unique syndrome) was the most frequent, followed by affective syndrome (anxiety and depression), psychomotor (agitation, irritability, and aberrant motor behavior), psychotic (delusions and hallucinations), and manic (disinhibition and euphoria) syndromes. More than three quarters of patients with AD presented with one or more of the syndromes (N 790, 77.8%), and more than half exhibited clinically significant severity of symptoms (N 603, 59.4%). With the exception of the affective one, all syndromes showed an increased occurrence with increasing severity of dementia. Conclusions: The authors’ study supports the use of a syndrome approach for neuropsychiatric evaluation in patients with AD. Individual neuropsychiatric symptoms can be reclassified into five distinct psychiatric syndromes. Clinicians should incorporate a thorough psychiatric and neurologic examination of patients with AD and consider therapeutic strategies that focus on psychiatric syndromes, rather than specific individual symptoms

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