2,373 research outputs found

    Multidisciplinary approach to COVID-19 and cancer: Consensus from scientific societies in Argentina

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    Introduction: The world is living through an outbreak of an acute respiratory syndrome caused by a new betacoronavirus known as coronavirus 2 (SARS CoV-2), which has been declared an international public health emergency by the World Health Organisation. Cancer patients are a very special population in this setting since they are more susceptible to viral infections than the general population. Several recommendations have been made on this issue, most of them based on expert opinion and institutional experience. It is essential to gather the evidence available for decision making. Objective: To review the evidence available in order to create a multi-institutional position from the perspective of scientific societies in Argentina involved in the management of cancer patients. Methodology: The review included two phases: 1) search and systematic revision of the medical literature; 2) consensus and revision of the document drafted by national scientific societies involved in the management and care of cancer patients using the modified Delphi method. The final results were presented at a videoconference with all the participants. Also, additional comment and recommendations were discussed. The final document was revised and approved for publication by the members of the panel. Results: The consensus panel included 18 representatives from scientific societies from Argentina who assessed the evidence and then made recommendations for the management of cancer patients in our country. International guidelines (CDC; ASCO, NCCN and ESMO) were considered as a background for analysis, as well as institutional guidelines and an open ad hoc survey administered to 114 healthcare professionals from the scientific societies involved in this study. The recommendations are grouped as follows: 1) general care interventions-training of the personnel, cleaning and disinfection of the hospital premises and patient scheduling; 2) treatment decisions-patient care, surgeries, immunosuppressive therapy, radiotherapy and screening; 3) ethical considerations-optimisation of resources, end-of-life care for critically-ill patients; 4) management of hospitalised patients; and 5) wellbeing of the healthcare team. The general recommendation arising from the study is that the management of cancer patients must adapt to the exceptional pandemic status quo without disregarding treatment or cure options. Moreover, healthcare professional accompaniment of all patients should not be neglected. All healthcare professionals must make a significant joint effort to create multidisciplinary teams to discuss the most appropriate measures for each particular situation. Conclusions: The scientific evidence available on this topic worldwide is in progress. This together with the epidemiologically shifting scenario poses unprecedented challenges in the management of cancer amidst this global pandemic. Furthermore, the key role of the healthcare structural organisation appears evident, such as the drafting of clear guidelines for all the stakeholders, adaptability to constant change and an interdisciplinary shared vision through consensus to provide adequate care to our cancer patients in the light of uncertainty and fast-paced change.Fil: Ismael, Julia. Asociaci√≥n Argentina de Oncolog√≠a Clinica; ArgentinaFil: Losco, Federico. Asociaci√≥n Argentina de Oncolog√≠a Clinica; ArgentinaFil: Quildrian, Sergio. No especif√≠ca;Fil: Sanchez, Pablo. No especif√≠ca;Fil: Pincemin, Isabel. Asociaci√≥n Argentina de Medicina y Cuidados Paliativos; ArgentinaFil: Lastiri, Jose. Asociaci√≥n Argentina de Oncolog√≠a Clinica; ArgentinaFil: Bella, Santiago Rafael. Asociaci√≥n Argentina de Oncolog√≠a Clinica; ArgentinaFil: Chinellato, Alejandro. Instituto de Oncolog√≠a de Rosario; ArgentinaFil: Dellamea, Guillermo. Asociaci√≥n de Oncolog√≠a del Chaco; ArgentinaFil: Ahualli, Alejandro. Asociaci√≥n de Onc√≥logos de Cordoba; ArgentinaFil: Rompato, Silvana. Asociaci√≥n Formose√Īa de Oncolog√≠a Clinica; ArgentinaFil: Velez, Julio. Asociaci√≥n Oncolog√≠a Clinica de Corrientes; ArgentinaFil: Escobar, Rafael. Endoscopistas Digestivos de Buenos Aires; ArgentinaFil: Zwenger, Ariel. Consejo Nacional de Investigaciones Cient√≠ficas y T√©cnicas. Centro Cient√≠fico Tecnol√≥gico Conicet - Patagonia Norte; ArgentinaFil: Rosales, Cristina. No especif√≠ca;Fil: Bagnes, Claudia. No especif√≠ca;Fil: Puyol, Jorge. No especif√≠ca;Fil: Niewiadomski, Dario. Sociedad Argentina de Cancerolog√≠a (sac); ArgentinaFil: Smecuol, Edgardo. Sociedad Argentina de Gastroenterologia; ArgentinaFil: Nachman, Fabio. Sociedad Argentina de Gastroenterologia; ArgentinaFil: Gonzalez, Eduardo. Sociedad Argentina de Mastolog√≠a; ArgentinaFil: Ferraris, Gustavo Nestor. Sociedad Argentina de Terapia Radiante; ArgentinaFil: Suppicich, Juan Ramos. Sociedad Argentina de Urolog√≠a; ArgentinaFil: Price, Paola. Sociedad de Cancerolog√≠a de la Plata; ArgentinaFil: Medina, Luis. Sociedad de Oncolog√≠a Clinica de Tucuman; ArgentinaFil: O'Connor, Juan. Asociaci√≥n Argentina de Oncolog√≠a Clinica; Argentin

    Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

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    The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

    Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

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    We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file

    Measurement of the cosmic ray spectrum above 4√ó10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

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    A measurement of the cosmic-ray spectrum for energies exceeding 4√ó10184{\times}10^{18} eV is presented, which is based on the analysis of showers with zenith angles greater than 60‚ąė60^{\circ} detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above 5.3√ó10185.3{\times}10^{18} eV, the "ankle", the flux can be described by a power law E‚ąíő≥E^{-\gamma} with index ő≥=2.70¬Ī0.02‚ÄČ(stat)¬Ī0.1‚ÄČ(sys)\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)} followed by a smooth suppression region. For the energy (EsE_\text{s}) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find Es=(5.12¬Ī0.25‚ÄČ(stat)‚ąí1.2+1.0‚ÄČ(sys))√ó1019E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19} eV.Comment: Replaced with published version. Added journal reference and DO

    First results from the AugerPrime Radio Detector

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    Update of the Offline Framework for AugerPrime

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    Combined fit to the spectrum and composition data measured by the Pierre Auger Observatory including magnetic horizon effects

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    The measurements by the Pierre Auger Observatory of the energy spectrum and mass composition of cosmic rays can be interpreted assuming the presence of two extragalactic source populations, one dominating the flux at energies above a few EeV and the other below. To fit the data ignoring magnetic field effects, the high-energy population needs to accelerate a mixture of nuclei with very hard spectra, at odds with the approximate E‚ąí2^{-2} shape expected from diffusive shock acceleration. The presence of turbulent extragalactic magnetic fields in the region between the closest sources and the Earth can significantly modify the observed CR spectrum with respect to that emitted by the sources, reducing the flux of low-rigidity particles that reach the Earth. We here take into account this magnetic horizon effect in the combined fit of the spectrum and shower depth distributions, exploring the possibility that a spectrum for the high-energy population sources with a shape closer to E‚ąí2^{-2} be able to explain the observations

    A search for ultra-high-energy photons at the Pierre Auger Observatory exploiting air-shower universality

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    The Pierre Auger Observatory is the most sensitive detector to primary photons with energies above ‚ąľ0.2 EeV. It measures extensive air showers using a hybrid technique that combines a fluorescence detector (FD) with a ground array of particle detectors (SD). The signatures of a photon-induced air shower are a larger atmospheric depth at the shower maximum (Xmax_{max}) and a steeper lateral distribution function, along with a lower number of muons with respect to the bulk of hadron-induced background. Using observables measured by the FD and SD, three photon searches in different energy bands are performed. In particular, between threshold energies of 1-10 EeV, a new analysis technique has been developed by combining the FD-based measurement of Xmax_{max} with the SD signal through a parameter related to its muon content, derived from the universality of the air showers. This technique has led to a better photon/hadron separation and, consequently, to a higher search sensitivity, resulting in a tighter upper limit than before. The outcome of this new analysis is presented here, along with previous results in the energy ranges below 1 EeV and above 10 EeV. From the data collected by the Pierre Auger Observatory in about 15 years of operation, the most stringent constraints on the fraction of photons in the cosmic flux are set over almost three decades in energy

    Study on multi-ELVES in the Pierre Auger Observatory

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    Since 2013, the four sites of the Fluorescence Detector (FD) of the Pierre Auger Observatory record ELVES with a dedicated trigger. These UV light emissions are correlated to distant lightning strikes. The length of recorded traces has been increased from 100 őľs (2013), to 300 őľs (2014-16), to 900 őľs (2017-present), to progressively extend the observation of the light emission towards the vertical of the causative lightning and beyond. A large fraction of the observed events shows double ELVES within the time window, and, in some cases, even more complex structures are observed. The nature of the multi-ELVES is not completely understood but may be related to the different types of lightning in which they are originated. For example, it is known that Narrow Bipolar Events can produce double ELVES, and Energetic In-cloud Pulses, occurring between the main negative and upper positive charge layer of clouds, can induce double and even quadruple ELVES in the ionosphere. This report shows the seasonal and daily dependence of the time gap, amplitude ratio, and correlation between the pulse widths of the peaks in a sample of 1000+ multi-ELVES events recorded during the period 2014-20. The events have been compared with data from other satellite and ground-based sensing devices to study the correlation of their properties with lightning observables such as altitude and polarity
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