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- Camelio, Giovanni, et al.
(författare)
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Evolution of a proto-neutron star with a nuclear many-body equation of state : Neutrino luminosity and gravitational wave frequencies
- 2017
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Ingår i: Physical Review D. - 2470-0010 .- 2470-0029. ; 96:4
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Tidskriftsartikel (refereegranskat)abstract
- In a core-collapse supernova, a huge amount of energy is released in the Kelvin-Helmholtz phase subsequent to the explosion, when the proto-neutron star cools and deleptonizes as it loses neutrinos. Most of this energy is emitted through neutrinos, but a fraction of it can be released through gravitational waves. We model the evolution of a proto-neutron star in the Kelvin-Helmholtz phase using a general relativistic numerical code, and a recently proposed finite temperature, many-body equation of state; from this we consistently compute the diffusion coefficients driving the evolution. To include the many-body equation of state, we develop a new fitting formula for the high density baryon free energy at finite temperature and intermediate proton fraction. We estimate the emitted neutrino signal, assessing its detectability by present terrestrial detectors, and we determine the frequencies and damping times of the quasinormal modes which would characterize the gravitational wave signal emitted in this stage.
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| 2. |
- Grande, Giulia, et al.
(författare)
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Detection and Prediction of Incident Alzheimer Dementia over a 10-Year or Longer Medical History : A Population-Based Study in Primary Care
- 2020
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 49, s. 384-389
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the crucial role played by general practitioners in the identification and care of people with cognitive impairment, few data are available on how they may improve the early recognition of patients with Alzheimer dementia (AD), especially those with long (i.e., 10 years and longer) medical history. Aims: To investigate the occurrence and the predictors of AD during a 10-year or longer period prior AD diagnosis in primary care patients aged 60 years or older. Materials and Methods: A cohort study with a nested case-control analysis has been conducted. Data were extracted from the Italian Health Search Database (HSD), an Italian database with primary care data. AD cases have been defined in accordance with the International Classification of Diseases, ninth edition (ICD-9-CM) codes and coupled with the use of anti-dementia drugs. Prevalence and incidence rates of AD have been calculated. To test the association between candidate predictors, being identified in a minimum period of 10 years, and incident cases of AD, we used a multivariate conditional logistic regression model. Results: As recorded in the primary care database, AD prevalence among patients aged 60 years or older was 0.8% during 2016, reaching 2.4% among nonagenarians. Overall, 1,889 incident cases of AD have been identified, with an incidence rate as high as 0.09% person-year. Compared with 18,890 matched controls, history of hallucinations, agitation, anxiety, aberrant motor behavior, and memory deficits were positively associated with higher odds of AD (p < 0.001 for all) diagnosis. A previous diagnosis of depression and diabetes and the use of low-dose aspirin and non-steroidal anti-inflammatory drugs were associated with higher odds of AD (p < 0.05 for all). Conclusion: Our findings show that, in accordance with primary care records, 1% of patients aged 60 years and older have a diagnosis of AD, with an incident AD diagnosis of 0.1% per year. AD is often under-reported in primary care settings; yet, several predictors identified in this study may support general practitioners to early identify patients at risk of AD.
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| 3. |
- Grande, Giulia, et al.
(författare)
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Development and internal validation of a prognostic model for 15-year risk of Alzheimer dementia in primary care patients
- 2022
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Ingår i: Neurological Sciences. - : Springer Science and Business Media LLC. - 1590-1874 .- 1590-3478. ; 43:10, s. 5899-5908
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Tidskriftsartikel (refereegranskat)abstract
- Background The exploitation of routinely collected clinical health information is warranted to optimize the case detection and diagnostic workout of Alzheimer's disease (AD). We aimed to derive an AD prediction score based on routinely collected primary care data.Methods We built a cohort selecting 199,978 primary care patients 60 +part of the Health Search Database between January 2002 and 2009, followed up until 2019 to detect incident AD cases. The cohort was randomly divided into a derivation and validation sub-cohort. To identify AD and non-AD cases, we applied a clinical algorithm that involved two clinicians. According to a nested case-control design, AD cases were matched with up to 10 controls based on age, sex, calendar period, and follow-up duration. Using the derivation sub-cohort, 32 potential AD predictors (sociodemographic, clinical, drug-related, etc.) were tested in a logistic regression and selected to build a prediction model. The predictive performance of this model was tested on the validation sub-cohort by mean of explained variation, calibration, and discrimination measurements.Results We identified 3223 AD cases. The presence of memory disorders, hallucinations, anxiety, and depression and the use of NSAIDs were associated with future AD. The combination of the predictors allowed the production of a predictive score that showed an explained variation (pseudo-R-2) for AD occurrence of 13.4%, good calibration parameters, and an area under the curve of 0.73 (95% CI: 0.71-0.75). In accordance with this model, 7% of patients presented with a high-risk score for developing AD over 15 years.Conclusion An automated risk score for AD based on routinely collected clinical data is a promising tool for the early case detection and timely management of patients by the general practitioners.
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| 4. |
- Vetrano, Davide L., et al.
(författare)
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Primary care costs due to prodromal Alzheimer disease : a real-world study in patients with a 10-year or longer medical history
- 2022
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Ingår i: Current Medical Research and Opinion. - : Informa UK Limited. - 0300-7995 .- 1473-4877. ; 38:5, s. 743-747
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to estimate primary care costs of prodromal signs/symptoms of Alzheimer disease (AD), during a 10-year or longer period preceding AD diagnosis, in relation to costs cumulated in the general population for the same reasons.Methods: Nested case-control study involving 1889 AD cases and 18,890 controls aged 60+ from the Italian primary care Health Search Database (HSD). AD incident cases were through the International Classification of Diseases, 9th edition. Costs related to drugs, diagnostic tests and specialist referrals triggered by prodromal AD signs and/or symptoms were quantified and compared with costs cumulated by non-AD counterparts.Results: During the pre-diagnosis 10-year or longer period, prodromal signs and symptoms trigger diagnostic and therapeutic costs 55% higher than those cumulated in general population for the same clinical reasons. After accounting for patients' comorbidity and regional differences, the mean cost related to diagnostic and therapeutic procedures, and those related to specialist referrals, amounted to 854.1 euro(SD: 630.6 euro) in AD incident cases vs. 527.3 euro(SD: 446.2) cumulated in patients not developing AD.Conclusion: Prodromal AD manifestations are associated with primary care costs that resulted higher than those cumulated in the general population aged 60+. It remains to be elucidated if earlier dementia diagnoses would be associated with reduced costs triggered by the same clinical signs and symptoms.
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