345 research outputs found
Costs and effects of on-demand treatment of hereditary angioedema in Italy : a prospective cohort study of 167 patients
Objectives To explore treatment behaviours in a cohort of Italian patients with hereditary angioedema due to complement C1-inhibitor deficiency (C1-INH-HAE), and to estimate how effects and costs of treating attacks in routine practice differed across available on-demand treatments. Design Cost analyses and survival analyses using attack-level data collected prospectively for 1 year. Setting National reference centre for C1-INH-HAE. Participants 167 patients with proved diagnosis of C1-INH-HAE, who reported data on angioedema attacks, including severity, localisation and duration, treatment received, and use of other healthcare services. Interventions Attacks were treated with either icatibant, plasma-derived C1-INH (pdC1-INH) or just supportive care. Main outcome measures Treatment efficacy in reducing attack duration and the direct costs of acute attacks. Results Overall, 133 of 167 patients (79.6%) reported 1508 attacks during the study period, with mean incidence of 11 attacks per patient per year. Only 78.9% of attacks were treated in contrast to current guidelines. Both icatibant and pdC1-INH significantly reduced attack duration compared with no treatment (median times from onset 7, 10 and 47 hours, respectively), but remission rates with icatibant were 31% faster compared with pdC1-INH (HR 1.31, 95% CI 1.14 to 1.51). However, observed treatment behaviours suggest patterns of suboptimal dosing for pdC1-INH. The average cost per attack was \u20ac1183 (SD \u20ac789) resulting in \u20ac1.58 million healthcare costs during the observation period (\u20ac11 912 per patient per year). Icatibant was 54% more expensive than pdC1-INH, whereas age, sex and prophylactic treatment were not associated to higher or lower costs. Conclusions Both icatibant and pdC1-INH significantly reduced attack duration compared with no treatment, however, icatibant was more effective but also more expensive. Treatment behaviours and suboptimal dosing of pdC1-INH may account for the differences, but further research is needed to define their role
HeII emitters in the VIMOS VLT Deep Survey: PopIII star formation or peculiar stellar populations in galaxies at 2<z<4.6?
The aim of this work is to identify HeII emitters at 2<z<4.6 and to constrain
the source of the hard ionizing continuum that powers the HeII emission. We
have assembled a sample of 277 galaxies with a high quality spectroscopic
redshift at 2<z<4.6 from the VVDS survey, and we have identified 39 HeII1640A
emitters. We study their spectral properties, measuring the fluxes, equivalent
widths (EW) and FWHM for most relevant lines. About 10% of galaxies at z~3 show
HeII in emission, with rest frame equivalent widths EW0~1-7A, equally
distributed between galaxies with Lya in emission or in absorption. We find 11
high-quality HeII emitters with unresolved HeII line (FWHM_0<1200km/s), 13
high-quality emitters with broad He II emission (FWHM_0>1200km/s), 3 AGN, and
an additional 12 possible HeII emitters. The properties of the individual broad
emitters are in agreement with expectations from a W-R model. On the contrary,
the properties of the narrow emitters are not compatible with such model,
neither with predictions of gravitational cooling radiation produced by gas
accretion. Rather, we find that the EW of the narrow HeII line emitters are in
agreement with expectations for a PopIII star formation, if the episode of star
formation is continuous, and we calculate that a PopIII SFR of 0.1-10 Mo yr-1
only is enough to sustain the observed HeII flux. We conclude that narrow HeII
emitters are either powered by the ionizing flux from a stellar population rare
at z~0 but much more common at z~3, or by PopIII star formation. As proposed by
Tornatore et al. (2007), incomplete ISM mixing may leave some small pockets of
pristine gas at the periphery of galaxies from which PopIII may form, even down
to z~2 or lower. If this interpretation is correct, we measure at z~3 a SFRD in
PopIII stars of 10^6Mo yr^-1 Mpc^-3 qualitatively comparable to the value
predicted by Tornatore et al. (2007).Comment: accepted for publication in A&
Studying the evolution of large-scale structure with the VIMOS-VLT Deep Survey
The VIMOS-VLT Deep Survey (VVDS) currently offers a unique combination of
depth, angular size and number of measured galaxies among surveys of the
distant Universe: ~ 11,000 spectra over 0.5 deg2 to I_{AB}=24 (VVDS-Deep),
35,000 spectra over ~ 7 deg2 to I_{AB}=22.5 (VVDS-Wide). The current ``First
Epoch'' data from VVDS-Deep already allow investigations of galaxy clustering
and its dependence on galaxy properties to be extended to redshifts ~1.2-1.5,
in addition to measuring accurately evolution in the properties of galaxies up
to z~4. This paper concentrates on the main results obtained so far on galaxy
clustering. Overall, L* galaxies at z~ 1.5 show a correlation length r_0=3.6\pm
0.7. As a consequence, the linear galaxy bias at fixed luminosity rises over
the same range from the value b~1 measured locally, to b=1.5 +/- 0.1. The
interplay of galaxy and structure evolution in producing this observation is
discussed in some detail. Galaxy clustering is found to depend on galaxy
luminosity also at z~ 1, but luminous galaxies at this redshift show a
significantly steeper small-scale correlation function than their z=0
counterparts. Finally, red galaxies remain more clustered than blue galaxies
out to similar redshifts, with a nearly constant relative bias among the two
classes, b_{rel}~1.4, despite the rather dramatic evolution of the
color-density relation over the same redshift range.Comment: 14 pages. Extended, combined version of two invited review papers
presented at: 1) XXVIth Astrophysics Moriond Meeting: "From Dark Halos to
Light", March 2006, proc. edited by L.Tresse, S. Maurogordato and J. Tran
Thanh Van (Editions Frontieres); 2) Vulcano Workshop 2006 "Frontier Objects
in Astrophysics and Particle Physics", May 2006, proc. edited by F.
Giovannelli & G. Mannocchi, Italian Physical Society (Editrice Compositori,
Bologna
Patient engagement with antibiotic messaging in secondary care: a qualitative feasibility study of the âreview & reviseâ experience
Background: We aimed to investigate and optimise the acceptability and usefulness of a patient leaflet about antibiotic prescribing decisions made during hospitalisation, and to explore individual patient experiences and preferences regarding the process of antibiotic prescription âreview & reviseâ which is a key strategy to minimise antibiotic overuse in hospitals.
Methods: In this qualitative study, run within the feasibility study of a large, cluster-randomised stepped wedge trial of 36 hospital organisations, a series of semi-structured, think-aloud telephone interviews were conducted and data were analysed using thematic analysis. Fifteen adult patients who had experienced a recent acute medical hospital admission during which they had been prescribed antimicrobials and offered a patient leaflet about antibiotic prescribing were recruited to the study.
Results: Participants reacted positively to the leaflet, reporting that it was both an accessible and important source of information which struck the appropriate balance between informing and reassuring. Participants all valued open communication with clinicians, and were keen to be involved in antibiotic prescribing decisions, with individuals reporting positive experiences regarding antibiotic prescription changes or stopping. Many participants had prior experience or knowledge of antibiotics and resistance, and generally welcomed efforts to reduce antibiotic usage. Overall, there was a feeling that healthcare professionals (HCPs) are trusted experts providing the most appropriate treatment for individual patient conditions.
Conclusions: This study offers novel insights into how patients within secondary care are likely to respond to messages advocating a reduction in the use of antibiotics through the âreview & reviseâ approach. Due to the level of trust that patients place in their care provider, encouraging HCPs within secondary care to engage patients with greater communication and information provision could provide great advantages in the drive to reduce antibiotic use. It may also be beneficial for HCPs to view patient experiences as cumulative events that have the potential to impact future behaviour around antibiotic use. Finally, pre-testing messages about antibiotic prescribing and resistance is vital to dispelling any misconceptions either around effectiveness of treatment for patients, or perceptions of how messages may be received
The VIRMOS deep imaging survey: III. ESO/WFI deep U-band imaging of the 0226-04 deep field
In this paper we describe the U-band imaging of the F02 deep field, one of
the fields in the VIRMOS Deep Imaging Survey. The observations were done at the
ESO/MPG 2.2m telescope at La Silla (Chile) using the 8k x 8k Wide-Field Imager
(WFI). The field is centered at alpha(J2000)=02h 26m 00s and
delta(J2000)=-04deg 30' 00", the total covered area is 0.9 deg**2 and the
limiting magnitude (50% completeness) is U(AB) ~ 25.4 mag. Reduction steps,
including astrometry, photometry and catalogue extraction, are first discussed.
The achieved astrometric accuracy (RMS) is ~ 0.2" with reference to the I-band
catalog and ~ 0.07" internally (estimated from overlapping sources in different
exposures). The photometric accuracy including uncertainties from photometric
calibration, is < 0.1 mag. Various tests are then performed as a quality
assessment of the data. They include: (i) the color distribution of stars and
galaxies in the field, done together with the BVRI data available from the
VIMOS survey; (ii) the comparison with previous published results of U-band
magnitude-number counts of galaxies.Comment: 10 pages, 13 figures, accepted for publication on Astronomy and
Astrophysic
The VLA-VIRMOS Deep Field I. Radio observations probing the microJy source population
We have conducted a deep survey (r.m.s noise 17 microJy) with the Very Large
Array (VLA) at 1.4 GHz, with a resolution of 6 arcsec, of a 1 square degree
region included in the VIRMOS VLT Deep Survey. In the same field we already
have multiband photometry down to I(AB)=25, and spectroscopic observations will
be obtained during the VIRMOS VLT survey. The homogeneous sensitivity over the
whole field has allowed to derive a complete sample of 1054 radio sources (5
sigma limit). We give a detailed description of the data reduction and of the
analysis of the radio observations, with particular care to the effects of
clean bias and bandwidth smearing, and of the methods used to obtain the
catalogue of radio sources. To estimate the effect of the resolution bias on
our observations we have modelled the effective angular-size distribution of
the sources in our sample and we have used this distribution to simulate a
sample of radio sources. Finally we present the radio count distribution down
to 0.08 mJy derived from the catalogue. Our counts are in good agreement with
the best fit derived from earlier surveys, and are about 50 % higher than the
counts in the HDF. The radio count distribution clearly shows, with extremely
good statistics, the change in the slope for the sub-mJy radio sources.Comment: 13 pages, Accepted for publication in Astronomy & Astrophysic
The VIMOS VLT Deep Survey - Evolution of the luminosity functions by galaxy type up to z=1.5 from first epoch data
From the first epoch observations of the VVDS up to z=1.5 we have derived
luminosity functions (LF) of different spectral type galaxies. The VVDS data,
covering ~70% of the life of the Universe, allow for the first time to study
from the same sample and with good statistical accuracy the evolution of the
LFs by galaxy type in several rest frame bands from a purely magnitude selected
sample. The magnitude limit of the VVDS allows the determination of the faint
end slope of the LF with unprecedented accuracy. Galaxies have been classified
in four spectral classes, using their colours and redshift, and LFs have been
derived in the U, B, V, R and I rest frame bands from z=0.05 to z=1.5. We find
a significant steepening of the LF going from early to late types. The M*
parameter is significantly fainter for late type galaxies and this difference
increases in the redder bands. Within each of the galaxy spectral types we find
a brightening of M* with increasing redshift, ranging from =< 0.5 mag for early
type galaxies to ~1 mag for the latest type galaxies, while the slope of the LF
of each spectral type is consistent with being constant with redshift. The LF
of early type galaxies is consistent with passive evolution up to z~1.1, while
the number of bright early type galaxies has decreased by ~40% from z~0.3 to
z~1.1. We also find a strong evolution in the normalization of the LF of latest
type galaxies, with an increase of more than a factor 2 from z~0.3 to z~1.3:
the density of bright late type galaxies in the same redshift range increases
of a factor ~6.6. These results indicate a strong type-dependent evolution and
identifies the latest spectral types as responsible for most of the evolution
of the UV-optical luminosity function out to z=1.5.Comment: 18 pages with encapsulated figures, revised version after referee's
comments, accepted for publication in A&
The VIMOS VLT Deep Survey - First epoch VVDS-Deep survey: 11564 spectra with 17.5<=IAB<=24, and the redshift distribution over 0< z <=5
This paper presents the ``First Epoch'' sample from the VIMOS VLT Deep Survey
(VVDS). The VVDS goals, observations, data reduction with VIPGI, and redshift
measurement with KBRED are discussed. Data have been obtained with the VIsible
Multi Object Spectrograph (VIMOS) on the ESO-VLT UT3, allowing to observe ~600
slits simultaneously at R~230. A total of 11564 objects have been observed in
the VVDS-02h and VVDS-CDFS Deep fields over a total area of 0.61deg^2, selected
solely on the basis of apparent magnitude 17.5 <=I_{AB} <=24. The VVDS covers
the redshift range 0 < z <= 5. It is successfully going through the ``redshift
desert'' 1.5<z<2.2, while the range 2.2<z<2.7 remains of difficult access
because of the VVDS wavelength coverage.A total of 9677 galaxies have a
redshift measurement, 836 are stars, 90 are AGNs, and a redshift could not be
measured for 961 objects. There are 1065 galaxies with a measured redshift
z>1.4. The survey reaches a redshift measurement completeness of 78% overall
(93% including less reliable objects), with a spatial sampling of the
population of galaxies of 25% and ~30% in the VVDS-02h and VVDS-CDFS. The
redshift accuracy measured from repeated observations with VIMOS and comparison
to other surveys is ~276km/s. From this sample we present for the first time
the redshift distribution of a magnitude limited spectroscopic sample down to
IAB=24. The redshift distribution has a median of z=0.62, z=0.65, z=0.70, and
z=0.76, for magnitude limited samples with IAB<=22.5, 23, 23.5, and 24. A high
redshift tail above redshift 2 and up to redshift 5 becomes readily apparent
for IAB>23.5, probing the bright star forming population of galaxies. This
sample provides an unprecedented dataset to study galaxy evolution over 90% of
the life of the universeComment: 30 pages, accepted 22-Feb-05 in A&
The VIMOS-VLT Deep Survey - The evolution of galaxy clustering per spectral type to z~1.5
We measure the evolution of clustering for galaxies with different spectral
types from 6495 galaxies with 17.5<=I_AB<=24 and measured spectroscopic
redshift in the first epoch VIMOS-VLT Deep Survey. We classify our sample into
4 classes, based on the fit of well-defined galaxy spectral energy
distributions on observed multi-color data. We measure the projected function
wp(rp) and estimate the best-fit parameters for a power-law real-space
correlation function. We find the clustering of early-spectral-type galaxies to
be markedly stronger than that of late-type galaxies at all redshifts up to
z<=1.2. At z~0.8, early-type galaxies display a correlation length
r_0=4.8+/-0.9h^{-1}Mpc, while late types have r_0=2.5+/-0.4h^{-1}Mpc. The
clustering of these objects increases up to r_0=3.42+/-0.7h^{-1}Mpc for z~1.4.
The relative bias between early- and late-type galaxies within our
magnitude-limited survey remains approximately constant with b~1.7-1.8 from
z~=0.2 up to z~=1, with indications for a decrease at z>1.2, due to the growth
in clustering of the star-forming population. We find similar results when
splitting the sample into `red' and `blue' galaxies using the observed color
bi-modality. When compared to the expected linear growth of mass fluctuations,
a natural interpretation of these observations is that: (a) the assembly of
massive early type galaxies is already mostly complete in the densest dark
matter halos at z~=1; (b) luminous late-type galaxies are located in
higher-density, more clustered regions of the Universe at z~=1.5 than at
present, indicating that star formation activity is progressively increasing,
going back in time, in the higher-density peaks that today are mostly dominated
by old galaxies.Comment: 12 pages, Accepted on 11-Feb-06 for publication in Astronomy and
Astrophysic
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