Archivio Istituzionale della Ricerca- Università del Piemonte Orientale
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The Dermatology Fast Track as a Model for Integrated Care Pathways Between Emergency Medicine and Outpatient Specialty Services
Get PDFSearch for heavy neutral Higgs bosons A and H in the tt ̄Z channel in proton-proton collisions at 13 TeV
No full textA direct search for new heavy neutral Higgs bosons [Figure presented] and [Figure presented] in the [Figure presented] channel is presented, targeting the process [Figure presented] with [Figure presented]. For the first time, the channel with decays of the [Figure presented] boson to muons or electrons in association with all-hadronic decays of the [Figure presented] system is targeted. The analysis uses proton-proton collision data collected at the CERN LHC with the CMS experiment at s=13TeV, which correspond to an integrated luminosity of 138fb−1. No signal is observed. Upper limits on the product of the cross section and branching fractions are derived for narrow resonances [Figure presented] and [Figure presented] with masses up to 2100 and 2000 GeV, respectively, assuming [Figure presented] boson production through gluon fusion. The results are also interpreted within two-Higgs-doublet models, where [Figure presented] and [Figure presented] are CP-odd and CP-even states, respectively, complementing and substantially extending the reach of previous searches
«Per dotare tre fanciulle oneste». I 300 anni dell'Opera Pia don Stefano Mazzucchi
No full textLa monografia racconta la storia dell'Opera Pia Mazzucchi di Pruno e Volegno (LU), soffermandosi sul funzionamento e la gestione della comunità da parte di questa istituzion
Search for flavor-changing neutral current interactions of the top quark mediated by a Higgs boson in proton-proton collisions at 13 TeV
No full textA search for flavor-changing neutral current interactions of the top quark (t) and the Higgs boson (H)is presented. The search is based on proton-proton collision data collected in 2016–2018 at a center-of-mass energy of 13 TeV with the CMS detector at the LHC, and corresponding to an integrated luminosity of 138 fb−1. Events containing a pair of leptons with the same-sign electric charge and at least one jet are considered. The results are used to constrain the branching fraction (B) of the top quark decaying to a Higgs boson and an up (u) or charm (c) quark. No significant excess above the estimated background was found. The observed (expected) upper limits at a 95% confidence level are found to be 0.072% (0.059%) for B(t → Hu) and 0.043% (0.062%) for B(t → Hc). These results are combined with two other searches performed by the CMS Collaboration for flavor-changing neutral current interactions of top quarks and Higgs bosons in final states where the Higgs boson decays to either a pair of photons or a pair of bottom quarks. The resulting observed (expected) upper limits at the 95% confidence level are 0.019% (0.027%) for B(t → Hu) and 0.037% (0.035%) for B(t → Hc)
Measurement of (Formula presented) and (Formula presented) Production Cross Sections at (Formula presented) and 13.6 TeV
No full textA measurement is presented of the cross section in proton-proton collisions for the production of two (Formula presented) bosons and one (Formula presented) boson. It is based on data recorded by the CMS experiment at the CERN LHC at center-of-mass energies (Formula presented) and 13.6 TeV, corresponding to an integrated luminosity of (Formula presented). Events with four charged leptons (electrons or muons) in the final state are selected. Both nonresonant (Formula presented) production and (Formula presented) production, with the Higgs boson decaying into two (Formula presented) bosons, are reported. For the first time, the two processes are measured separately in a simultaneous fit. Combining the two modes, signal strengths relative to the standard model (SM) predictions of (Formula presented) and (Formula presented) are measured for (Formula presented) and 13.6 TeV, respectively. The observed (expected) significance for the triboson signal is 3.8 (2.5) standard deviations for (Formula presented), thus providing the first evidence for triboson production at this center-of-mass energy. Combining the two modes and the two center-of-mass energies, the inclusive signal strength relative to the SM prediction is measured to be (Formula presented), with an observed (expected) significance of 4.5 (5.0) standard deviations
«Festa monferrina senza ballo». Luoghi e contesti della predicazione giovanile di Giovanni Bosco
No full textStudy design and rationale of the AZIMUTH trial: a smartphone, app-based, E-health-integrated model of care for heart failure patients
No full textAims Despite advancements in disease-modifying therapies, the rate of hospitalizations in patients with heart failure (HF) remains high, with an increased risk of future adverse events and healthcare costs. In this context, the AZIMUTH study aims to evaluate the large-scale applicability of a smartphone app-based model of care to improve the quality of care and clinical outcomes of HF patients. Methods The AZIMUTH trial is a multicentre, prospective, pragmatic, interventional, single-cohort study enrolling HF patients. Three and results hundred patients will be recruited from four different sites. For comparative analyses, historical data from participating hospitals for the 6 months before enrolment and propensity-matching score analyses from GENERATOR HF DataMart, will be used. The estimated duration of the study is 6 months. During the whole observational period, the patients are asked to provide information regarding their clinical status, transmit remote clinical parameters, and periodically answer validated questionnaires, the Kansas City Cardiomyopathy Questionnaire Health and Morisky Medication Adherence Scale 8-item, on a mobile application, through which healthcare providers implement therapeutic adjustments and remote clinical assessments. The primary objective of this study is to evaluate the feasibility, usability, and perceived benefits for key stakeholders (patients and clinical staff) of the AZIMUTH digital platform in the enrolled patients when compared to standard of care. Secondary endpoints will be the description of the rate of hospital readmissions, ambulatory visits and prescribed therapy in the 6 months following enrolment in the experimental group compared to both the historical and propensity-matched cohorts. Conclusion The AZIMUTH aims to enhance HF management by leveraging digital technologies to support the care process and enhance monitoring, engagement, and personalized treatment for HF patients
Machine-learning phenotyping of patients with functional mitral regurgitation undergoing transcatheter edge-to-edge repair: the MITRA-AI study
No full textAims Severe functional mitral regurgitation (FMR) may benefit from mitral transcatheter edge-to-edge repair (TEER), but selection of patients remains to be optimized. Objectives The aim of this study was to use machine-learning (ML) approaches to uncover concealed connections between clinical, echocardiographic, and haemodynamic data associated with patients’ outcomes. Methods Consecutive patients undergoing TEER from 2009 to 2020 were included in the MITRA-AI registry. The primary endpoint and results was a composite of cardiovascular death or heart failure (HF) hospitalization at 1 year. External validation was performed on the Mitrascore cohort. 822 patients were included. The composite primary endpoint occurred in 250 (30%) patients. Four clusters with decreasing risk of the primary endpoint were identified (42, 37, 25, and 20% from Cluster 1 to Cluster 4, respectively). Clusters were combined into a high-risk (Clusters 1 and 2) and a low-risk phenotype (Clusters 3 and 4). High-risk phenotype patients had larger left ventriculars (LVs) (>107 mL/m2), lower left ventricular ejection fraction (<35%), and more prevalent ischaemic aetiology compared with low-risk phenotype patients. Within low-risk groups, permanent atrial fibrillation amplified that of HF hospitalizations. In the Mitrascore cohort, the incidence of the primary endpoint was 48, 52, 35, and 42% across clusters. Conclusion A ML analysis identified meaningful clinical phenotypic presentations in FMR undergoing TEER, with significant differences in terms of cardiovascular death and HF hospitalizations, confirmed in an external validation cohort
Reduction of Thrombus Burden With Short-Term, Low-Dose Rivaroxaban Use in Acute Myocardial Infarction: The ARISE-ARMYDA 7 Randomized Trial
No full textBACKGROUND: Managing large coronary thrombus burden (LCTB) in patients with ST-segment– elevation myocardial infarction (STEMI) remains challenging. Although deferred stenting emerged to potentially improve outcomes in this high-risk population, the optimal antithrombotic regimen remains unclear. The ARISE-ARMYDA 7 (Alternative Anti-Thrombotic Pathways in Acute Myocardial Infarction–Antiplatelet Therapy for Reduction of Myocardial Damage 7) trial evaluated low-dose rivaroxaban in addition to dual antiplatelet therapy for LCTB reduction in patients with STEMI managed with deferred stenting. METHODS: This single-center, randomized, pilot study included patients with STEMI with angiographic evidence of LCTB undergoing primary percutaneous coronary intervention and deferred stenting. Patients were randomized to rivaroxaban 2.5 mg BID plus aspirin and ticagrelor or aspirin plus ticagrelor alone. Thrombus burden was assessed by optical coherence tomography at baseline and after 5 to 7 days of treatment. The primary end point was reduction of thrombus score after this period. RESULTS: A total of 40 patients with STEMI and LCTB were randomized 1:1. Posttreatment thrombus score at re-optical coherence tomography imaging was significantly lower in the rivaroxaban arm (39 [27–52] versus 82 [50–111] in controls, P=0.005). Relative reduction of the thrombus score versus baseline was greater with rivaroxaban use (61% [50%–81%] versus 36% [0%–50%], P=0.002). The relative thrombus volume decrease was 77% with rivaroxaban versus 39% in the control arm (P=0.001). Deferred stenting was safe, with no abrupt vessel closures, distal embolization, or no reflow. Clinical outcomes at 30 days, including major adverse cardiovascular events and bleeding complications, were not significantly different. CONCLUSIONS: The ARISE-ARMYDA 7 trial shows that adding low-dose rivaroxaban to dual antiplatelet therapy significantly reduces thrombus burden in patients with STEMI with LCTB, while maintaining a favorable safety profile