Occurence and Luminosity Functions of Giant Radio Halos from Magneto-Turbulent Model

We calculate the probability to form giant radio halos (~ 1 Mpc size) as a function of the mass of the host clusters by using a Statistical Magneto-Turbulent Model (Cassano & Brunetti, these proceedings). We show that the expectations of this model are in good agreement with the observations for viable values of the parameters. In particular, the abrupt increase of the probability to find radio halos in the more massive galaxy clusters (M > 2x10^{15} solar masses) can be well reproduced. We calculate the evolution with redshift of such a probability and find that giant radio halos can be powered by particle acceleration due to MHD turbulence up to z~0.5 in a LCDM cosmology. Finally, we calculate the expected Luminosity Functions of radio halos (RHLFs). At variance with previous studies, the shape of our RHLFs is characterized by the presence of a cut-off at low synchrotron powers which reflects the inefficiency of particle acceleration in the case of less massive galaxy clusters.Comment: 4 pages, to appear in a dedicated issue of the Journal of the Korean Astronomical Society (JKAS). Proceedings of the "International conference on Cosmic Rays and Magnetic Fields in Large Scale Structure", Busan, Korea, 200

The cosmic X-ray background and the population of the most heavily obscured AGNs

We report on an accurate measurement of the CXB in the 15-50 keV range performed with the Phoswich Detection System (PDS) instrument aboard the BeppoSAX satellite. We establish that the most likely CXB intensity level at its emission peak (26-28 keV) is ~40 keV/cm2/s/sr, a value consistent with that derived from the best available CXB measurement obtained over 25 years ago with the first High Energy Astronomical Observatory satellite mission (HEAO-1; Gruber et al. 1999), whose intensity, lying well below the extrapolation of some lower energy measurements performed with focusing telescopes, was questioned in the recent years. We find that 90% of the acceptable solutions of our best fit model to the PDS data give a 20-50 keV CXB flux lower than 6.5E-08 erg/cm2/s/sr, which is 12% higher than that quoted by Gruber et al. (1999) when we use our best calibration scale. This scale gives a 20-50 keV flux of the Crab Nebula of 9.22E-09 erg/cm2/s, which is in excellent agreement with the most recent Crab Nebula measurements and 6% smaller than that assumed by Gruber et al. (1999). In combination with the CXB synthesis models we infer that about 25% of the intensity at ~30 keV arises from extremely obscured, Compton thick AGNs (absorbing column density N_H > 1.0E+24 H/cm2), while a much larger population would be implied by the highest intensity estimates. We also infer a mass density of supermassive BHs of ~3.0E+05 Msol/Mpc3. The summed contribution of resolved sources (Moretti et al. 2003) in the 2-10 keV band exceeds our best fit CXB intensity extrapolated to lower energies, but it is within our upper limit, so that any significant contribution to the CXB from sources other than AGNs, such as star forming galaxies and diffuse Warm-Hot Intergalactic Medium (WHIM), is expected to be mainly confined below a few keV.Comment: Accepted for publication in ApJ Main: 30 pages, 3 Tables, 8 Figures. Many revisions due to the change of the Journa

The Northern Cross fast radio burst project–I: overview and pilot observations at 408 MHz

Fast radio bursts (FRBs) remain one of the most enigmatic astrophysical sources. Observations have significantly progressed over the last few years, due to the capabilities of new radio telescopes and the refurbishment of existing ones. Here, we describe the upgrade of the Northern Cross radio telescope, operating in the 400–416 MHz frequency band, with the ultimate goal of turning the array into a dedicated instrument to survey the sky for FRBs

The Northern Cross Fast Radio Burst project -- III. The FRB-magnetar connection in a sample of nearby galaxies

Fast radio bursts (FRBs) are millisecond radio transients observed at cosmological distances. The nature of their progenitors is still a matter of debate, although magnetars are invoked by most models. The proposed FRB-magnetar connection was strengthened by the discovery of an FRB-like event from the Galactic magnetar SGR J1935+2154. In this work, we aim to investigate how prevalent magnetars such as SGR J1935+2154 are within FRB progenitors. We carried out an FRB search in a sample of seven nearby (< 12 Mpc) galaxies with the Northern Cross radio telescope for a total of 692 h. We detected one 1.8 ms burst in the direction of M101 with a fluence of $58 \pm 5$ Jy ms. Its dispersion measure of 303 pc cm$^{-3}$ places it most-likely beyond M101. Considering that no significant detection comes indisputably from the selected galaxies, we place a 38 yr$^{-1}$ upper limit on the total burst rate (i.e. including the whole sample) at the 95\% confidence level. This upper limit constrains the event rate per magnetar $\lambda_{\rm mag} < 0.42$ magnetar$^{-1}$ yr$^{-1}$ or, if combined with literature observations of a similar sample of nearby galaxies, it yields a joint constraint of $\lambda_{\rm mag} < 0.25$ magnetar$^{-1}$ yr$^{-1}$. We also provide the first constraints on the expected rate of FRBs hypothetically originating from ultraluminous X-ray (ULX) sources, since some of the galaxies observed during our observational campaign host confirmed ULXs. We obtain $< 13$ yr$^{-1}$ per ULX for the total sample of galaxies observed. Our results indicate that bursts with energies $E>10^{34}$ erg from magnetars like SGR J1935+2154 appear more rarely compared to previous observations and further disfavour them as unique progenitors for the cosmological FRB population, leaving more space open to the contribution from a population of more exotic magnetars, not born via core-collapsed supernovae.Comment: 9 pages, 4 figures, published in A&

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P &lt; 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

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 &lt; 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