Caratteristiche principali dell'emissione di regioni HII

In questo elaborato ci si ripropone di studiare l'emissione delle regioni HII. Si può definire una regione HII come una zona molto calda di idrogeno ionizzato, che si trova in un background di idrogeno neutro più freddo. Vengono analizzati i processi di emissione nel continuo e in riga, e analizzate in particolare le nebulose planetarie

The self-confinement of electrons and positrons from dark matter

Radiative emissions from electrons and positrons generated by dark matter (DM) annihilation or decay are one of the most investigated signals in indirect searches of WIMPs. Ideal targets must have large ratio of DM to baryonic matter. However, such ``dark'' systems have a poorly known level of magnetic turbulence, which determines the residence time of the electrons and positrons and therefore also the strength of the expected signal. This typically leads to significant uncertainties in the derived DM bounds. In a novel approach, we compute the self-confinement of the DM-induced electrons and positrons. Indeed, they themselves generate irregularities in the magnetic field, thus setting a lower limit on the presence of the magnetic turbulence. We specifically apply this approach to dwarf spheroidal galaxies. Finally, by comparing the expected synchrotron emission with radio data from the direction of the Draco galaxy collected at the Giant Metre Radio Telescope, we show that the proposed approach can be used to set robust and competitive bounds on WIMP DM.Comment: 18 pages, 10 figures. v2: minor revision, matches published versio

The probability of galaxy-galaxy strong lensing events in hydrodynamical simulations of galaxy clusters

Meneghetti et al. (2020) recently reported an excess of galaxy-galaxy strong lensing (GGSL) in galaxy clusters compared to expectations from the LCDM cosmological model. Theoretical estimates of the GGSL probability are based on the analysis of numerical hydrodynamical simulations in the LCDM cosmology. We quantify the impact of the numerical resolution and AGN feedback scheme adopted in cosmological simulations on the predicted GGSL probability and determine if varying these simulation properties can alleviate the gap with observations. We repeat the analysis of Meneghetti et al. (2020) on cluster-size halos simulated with different mass and force resolutions and implementing several independent AGN feedback schemes. We find that improving the mass resolution by a factor of ten and twenty-five, while using the same galaxy formation model that includes AGN feedback, does not affect the GGSL probability. We find similar results regarding the choice of gravitational softening. On the contrary, adopting an AGN feedback scheme that is less efficient at suppressing gas cooling and star formation leads to an increase in the GGSL probability by a factor between three and six. However, we notice that such simulations form overly massive subhalos whose contribution to the lensing cross-section would be significant while their Einstein radii are too large to be consistent with the observations. The primary contributors to the observed GGSL cross-sections are subhalos with smaller masses, that are compact enough to become critical for lensing. The population with these required characteristics appears to be absent in simulations.Comment: 13 pages, 11 figures. Submitted for publication on Astronomy and Astrophysic

Associations between depressive symptoms and disease progression in older patients with chronic kidney disease: results of the EQUAL study

Background Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex. Methods CKD patients (>= 65 years; estimated glomerular filtration rate <= 20 mL/min/1.73 m(2)) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off <= 70; 0-100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confounders. Results Overall kidney function decline in 1326 patients was -0.12 mL/min/1.73 m(2)/month. A total of 515 patients showed depressive symptoms. No significant association was found between depressive symptoms and kidney function over time (P = 0.08). Unlike women, men with depressive symptoms had an increased mortality rate compared with those without symptoms [adjusted hazard ratio 1.41 (95% confidence interval 1.03-1.93)]. Depressive symptoms were not significantly associated with a higher hazard of dialysis initiation, or with the combined outcome (i.e. dialysis initiation and all-cause mortality). Conclusions There was no significant association between depressive symptoms at baseline and decline in kidney function over time in older patients with advanced CKD. Depressive symptoms at baseline were associated with a higher mortality rate in men

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

An high-precision strong lensing model of the galaxy cluster PSZ1 G311.65-18.48

Strong gravitational lensing is one of the best performing methods to study the mass distribution in the central regions of galaxy clusters. The progress witnessed recently on the lens modeling techniques was made possible by the several observational programs conducted with the Hubble Space Telescope (HST) and complemented by spectroscopic observations of a relatively large number of massive galaxy clusters. In this work we use a new method to combine lensing and galaxy kinematics measurements to conduct a strong lensing analysis of the cluster PSZ1 G311.65-18.48, with the aim of constructing a parametric lens model of the mass distribution in its core. We use HST observations conducted in several bands, complemented with VLT/MUSE spectroscopic observations. The multiple image and cluster member catalogues are the main ingredients required for the construction of a parametric lens model with the software Lenstool. Throughout this thesis we describe the process that led to the construction of the cluster final model, which evolved through several intermediate steps where the model complexity increased progressively. The aim was to recover the mass distribution which minimizes the differences between observed and model-predicted multiple image positions. Our resulting reference model is the first lens model for this galaxy cluster ever published and reproduces the observed multiple images with very high accuracy. It can be used for several applications, including the characterization of the source producing the famous Sunburst Arc, or predicting the re-appearance of the possible transient source recently reported by Vanzella et al. (2020)

Blood reactive oxygen metabolites (ROMs) and total antioxidant status (TAS) in patients with laryngeal squamous cell carcinoma after surgical treatment

[No abstract available