Rapid late-time X-ray brightening of the tidal disruption event OGLE16aaa

Stars that pass too close to a super-massive black hole may be disrupted by strong tidal forces. OGLE16aaa is one such tidal disruption event (TDE) which rapidly brightened and peaked in the optical/UV bands in early 2016 and subsequently decayed over the rest of the year. OGLE16aaa was detected in an XMM-Newton X-ray observation on June 9, 2016 with a flux slightly below the Swift/XRT upper limits obtained during the optical light curve peak. Between June 16-21, 2016, Swift/XRT also detected OGLE16aaa and based on the stacked spectrum, we could infer that the X-ray luminosity had jumped up by more than a factor of ten in just one week. No brightening signal was seen in the simultaneous optical/UV data to cause the X-ray luminosity to exceed the optical/UV one. A further XMM-Newton observation on November 30, 2016 showed that almost a year after the optical/UV peak, the X-ray emission was still at an elevated level, while the optical/UV flux decay had already leveled off to values comparable to those of the host galaxy. In all X-ray observations, the spectra were nicely modeled with a 50-70 eV thermal component with no intrinsic absorption, with a weak X-ray tail seen only in the November 30 XMM-Newton observation. The late-time X-ray behavior of OGLE16aaa strongly resembles the tidal disruption events ASASSN-15oi and AT2019azh. We were able to pinpoint the time delay between the initial optical TDE onset and the X-ray brightening to $182 \pm 5$ days, which may possibly represent the timescale between the initial circularization of the disrupted star around the super-massive black hole and the subsequent delayed accretion. Alternatively, the delayed X-ray brightening could be related to a rapid clearing of a thick envelope that covers the central X-ray engine during the first six months.Comment: 8 pages, 2 figures, Accepted for publication in A&

Grotta Romanelli (Southern Italy, Apulia). Legacies and issues in excavating a key site for the Pleistocene of the Mediterranean

Grotta Romanelli, located on the Adriatic coast of southern Apulia (Italy), is considered a key site for the Mediterranean Pleistocene for its archaeological and palaeontological contents. The site, discovered in 1874, was re-evaluated only in 1900, when P. E. Stasi realised that it contained the first evidence of the Palaeolithic in Italy. Starting in 1914, G. A. Blanc led a pioneering excavation campaign, for the first-time using scientific methods applied to systematic palaeontological and stratigraphical studies. Blanc proposed a stratigraphic framework for the cave. Different dating methods (C-14 and U/Th) were used to temporally constrain the deposits. The extensive studies of the cave and its contents were mostly published in journals with limited distribution and access, until the end of the 1970s, when the site became forgotten. In 2015, with the permission of the authorities, a new excavation campaign began, led by a team from Sapienza University of Rome in collaboration with IGAG CNR and other research institutions. The research team had to deal with the consequences of more than 40 years of inactivity in the field and the combined effect of erosion and legal, as well as illegal, excavations. In this paper, we provide a database of all the information published during the first 70 years of excavations and highlight the outstanding problems and contradictions between the chronological and geomorphological evidence, the features of the faunal assemblages and the limestone artefacts

Noise reduction and spatial resolution in CT imaging with the ASIR iterative reconstruction algorithm at different doses and contrasts – a phantom study

Aims and objectives The aim of this study was to quantitatively assess noise reduction and spatial resolution in computed tomography (CT) imaging with the ASIR (Adaptive Statistical Iterative Reconstruction, GE Healthcare) reconstruction algorithm at different kVp, mAs and contrasts. Methods and materials Acquisitions of the Catphan-504 phantom were performed on a PET/CT scanner (Discovery-710, GE Healthcare). CT images were reconstructed using both filtered back projection (FBP) and ASIR with different percentages of reconstruction (20%, 40%, 60%, 80%, 100%). The image noise was estimated for different values of scanning parameters (i.e. tube-load, kilovoltage, pitch, slice thickness). Then, 3D/2D/1D noise power spectrum was estimated. Also, spatial resolution was assessed by obtaining the modulation transfer function (MTF) for a wide range of scanning parameters values and different contrast objects by the circular Edge Spread Function method (using CTP404 modulus) and the Point Spread Function method (using CTP528 modulus). . Results Image noise decreased (up to 50% as compared to FBP) with increasing the percentage of ASIR reconstruction (behaviour more relevant for higher spatial frequencies). Only for low tube load (<56 mAs) and low contrast objects (polistirene with respect to PMMA) acquisitions, MTF analysis showed that ASIR-reconstructed images were characterized by an appreciable reduction in spatial resolution, when compared to FBP-reconstructed images. Conclusion When compared to FBP, ASIR allows a relevant noise reduction without appreciably affecting image quality, except for very low dose and contrast acquisitions

Disappearance of quasi-periodic-eruptions (QPEs) in GSN 069, simultaneous X-ray re-brightening, and predicted QPE re-appearance

We study the short- and long-timescale properties of quasi-periodic eruptions (QPEs) in GSN 069 and its overall X-ray evolution over the past 11 yr using 11 XMM-Newton and 1 Chandra observations from December 2010 to December 2021. QPEs are a transient phenomenon in GSN 069 last detected in January 2020 with a life-time between 1 and 5.5 yr. On short timescales, the QPE intensity and recurrence time oscillate defining alternating strong/weak QPEs and long/short recurrence times. The quiescent level variability in observations with QPEs exhibits a quasi-periodic oscillation (QPO) at the average observation-dependent recurrence time peaking with a delay of a few hr w.r.t. the preceding QPE. A significant late-time X-ray re-brightening starting with the QPE disappearance is observed in the long-term light curve of the quiescent emission, and the overall X-ray evolution follows the relation expected from constant-area blackbody emission. QPEs in GSN 069 are consistent with being produced by repeating tidal stripping events of a white dwarf (WD) donor in a highly eccentric orbit around the supermassive black hole, one QPE being produced at each pericenter passage. Our data suggest that the WD was partially disrupted when QPEs disappeared in GSN 069, giving rise to the observed X-ray re-brightening. We predict the re-appearance of QPEs in GSN 0699 in the near future with different recurrence times than currently detected QPEs, as the surviving core will again suffer a series of tidal stripping events at pericenter passage.Comment: Submitted to A&A. Comments welcom

Overcoming barriers to the effective management of severe asthma in Italy

Introduction: People with severe asthma (SA) often have poor disease control and quality of life, and are at high risk of exacerbations, lung function decline and asthma-related death. The present expert opinion article aimed to identify unmet needs in the management of SA in Italy, and propose possible solutions to address these needs. Methods: At five multidisciplinary events in Italy, attendees identified factors that interfered with the effective management of SA and suggested how these barriers could be overcome. A core group of 12 Italian experts (pulmonologists, general practitioners, allergists, payers and patients) identified the main issues and proposed possible solutions based on the results from the meetings and relevant articles from the literature. Results and Conclusions: We reviewed the gap between real-world practice and guide-lines, oral corticosteroid overuse, SA-related mortality, and barriers to effective SA treat-ment. Common themes were lack of awareness about SA among both patients and clinicians, and lack of networking/information exchange between those involved in the treatment of SA. Participants agreed on the need to implement patient education and create multidisciplinary groups of specialists to improve SA management through multidisciplinary educational initiatives, meetings with local experts, development of a flow chart for referral/connection with local experts and specialized centers. Clinical instruments that might help specialists improve SA management included referral networks, integrated care pathways, phenotyping and treatment algorithms, exacerbation tracking, and examination of electronic medical records for patients with uncontrolled asthma. The following actions need to be implemented in Italy: i) maximize the use of advanced therapies, eg, biologics; ii) increase/improve education for physicians and patients; iii) improve multidisciplinary communication and care coordination; iv) introduce regional and local protocols for SA diagnosis and treatment; and v) change the structure of healthcare services to reduce specialist waiting times and facilitate access to biologic therapies

Literature search on risk factors for sarcoma: PubMed and Google Scholar may be complementary sources

<p>Abstract</p> <p>Background</p> <p>Within the context of a European network dedicated to the study of sarcoma the relevant literature on sarcoma risk factors was collected by searching PubMed and Google Scholar, the two information storage and retrieval databases which can be accessed without charge. The present study aims to appraise the relative proficiency of PubMed and Google Scholar.</p> <p>Findings</p> <p>Unlike PubMed, Google Scholar does not allow a choice between "Human" and "Animal" studies, nor between "Classical" and other types of studies. As a result, searches with Google Scholar produced high numbers of citations that have to be filtered. Google Scholar resulted in a higher sensitivity (proportion of relevant articles, meeting the search criteria), while PubMed in a higher specificity (proportion of lower quality articles not meeting the criteria, that are not retrieved). Concordance between Google Scholar and PubMed was as low as 8%.</p> <p>Conclusions</p> <p>This study focused just on one topic. Although further studies are warranted, PM and GS appear to be complementary and their integration could greatly improve the search of references in medical research.</p

Developing search strategies for clinical practice guidelines in SUMSearch and Google Scholar and assessing their retrieval performance

<p>Abstract</p> <p>Background</p> <p>Information overload, increasing time constraints, and inappropriate search strategies complicate the detection of clinical practice guidelines (CPGs). The aim of this study was to provide clinicians with recommendations for search strategies to efficiently identify relevant CPGs in SUMSearch and Google Scholar.</p> <p>Methods</p> <p>We compared the retrieval efficiency (retrieval performance) of search strategies to identify CPGs in SUMSearch and Google Scholar. For this purpose, a two-term GLAD (GuideLine And Disease) strategy was developed, combining a defined CPG term with a specific disease term (MeSH term). We used three different CPG terms and nine MeSH terms for nine selected diseases to identify the most efficient GLAD strategy for each search engine. The retrievals for the nine diseases were pooled. To compare GLAD strategies, we used a manual review of all retrievals as a reference standard. The CPGs detected had to fulfil predefined criteria, e.g., the inclusion of therapeutic recommendations. Retrieval performance was evaluated by calculating so-called diagnostic parameters (sensitivity, specificity, and "Number Needed to Read" [NNR]) for search strategies.</p> <p>Results</p> <p>The search yielded a total of 2830 retrievals; 987 (34.9%) in Google Scholar and 1843 (65.1%) in SUMSearch. Altogether, we found 119 unique and relevant guidelines for nine diseases (reference standard). Overall, the GLAD strategies showed a better retrieval performance in SUMSearch than in Google Scholar. The performance pattern between search engines was similar: search strategies including the term "guideline" yielded the highest sensitivity (SUMSearch: 81.5%; Google Scholar: 31.9%), and search strategies including the term "practice guideline" yielded the highest specificity (SUMSearch: 89.5%; Google Scholar: 95.7%), and the lowest NNR (SUMSearch: 7.0; Google Scholar: 9.3).</p> <p>Conclusion</p> <p>SUMSearch is a useful tool to swiftly gain an overview of available CPGs. Its retrieval performance is superior to that of Google Scholar, where a search is more time consuming, as substantially more retrievals have to be reviewed to detect one relevant CPG. In both search engines, the CPG term "guideline" should be used to obtain a comprehensive overview of CPGs, and the term "practice guideline" should be used if a less time consuming approach for the detection of CPGs is desired.</p

Similar levels of efficacy of two different maintenance doses of adalimumab on clinical severity and quality of life of patients with hidradenitis suppurativa

Adalimumab is the only biologic agent approved for the treatment of moderate-to-severe hidradenitis suppurativa (HS) patients (i.e., with Hurley II or III), which is recommended in two different maintenance doses (i.e., 40 mg weekly or 80 mg every two weeks). We conducted a prospective multicentric study to measure outcomes related to the severity of disease and quality of life (QoL) of patients affected by moderate-to-severe HS, treated with adalimumab at a maintenance dosing of 40 mg or 80 mg. Assessments were performed at baseline (T0) and after 32 weeks of treatment (T32). We enrolled 85 moderate-to-severe HS Italian patients, 43 men (50.6%) and 42 women, aged between 16 and 62 years (median 31 years, interquartile range 24.4-43.8). Statistically significant improvements were observed for clinical status (with a mean reduction of 7.1 points for the International Hidradenitis Suppurativa Severity Score System (IHS4)), pain levels (3.1 mean decrease in VAS), and QoL (3.4 mean improvement in DLQI score). Patients with no comorbidities, and those with higher levels of perceived pain showed significantly greater improvement in QoL than their counterpart from T0 to T32. As for the proportion of patients who at follow-up reached the minimal clinical important difference (MCID) in QoL, significantly higher proportions of success were observed for age (patients in the 29-39 category), pain (patients with higher reported pain), and Hurley stage III. While both treatment regimen groups (i.e., 40 vs. 80 mg) improved significantly, no statistical differences were observed when comparing the two treatment dosages