Epidemiology of influenza-like illness in the Amazon Basin of Peru, 2008-2009.

BackgroundData addressing the incidence and epidemiology of influenza and influenza-like illness (ILI) in tropical regions of the world is scarce, particularly for the neotropics of South America.MethodsWe conducted active, population-based surveillance for ILI across 45 city blocks within the Amazon Basin city of Iquitos, Peru. Demographic data and household characteristics were collected for all participants, and participating households were visited three times weekly to inquire about ILI (fever plus cough or sore throat) among household residents. Nasal and oropharyngeal swabs were collected from participants with ILI and tested for influenza virus infection.ResultsBetween May 1, 2008 and July 8, 2009, we monitored 10,341 participants for ILI for a total of 11,569.5 person-years. We detected 459 ILI episodes, with 252 (54.9%) of the participants providing specimens. Age-adjusted incidence of ILI was estimated to be 46.7 episodes/1000 person-years. Influenza A and B viruses were detected in 25 (9.9%) and 62 (24.6%) specimens of ILI patients, respectively, for an estimated age-adjusted incidence rate of 16.5 symptomatic influenza virus infections/1000 person-years. Risk factors for ILI included age, household crowding, and use of wood as cooking fuel. For influenza virus infection specifically, age and use of wood as a cooking fuel were also identified as risk factors, but no effect of household crowding was observed.ConclusionsOur results represent the initial population-based description of the epidemiology of ILI in the Amazon region of Peru, which will be useful for developing region-specific strategies for reducing the burden of respiratory disease

Approximate Analytical Solutions to the Initial Data Problem of Black Hole Binary Systems

We present approximate analytical solutions to the Hamiltonian and momentum constraint equations, corresponding to systems composed of two black holes with arbitrary linear and angular momentum. The analytical nature of these initial data solutions makes them easier to implement in numerical evolutions than the traditional numerical approach of solving the elliptic equations derived from the Einstein constraints. Although in general the problem of setting up initial conditions for black hole binary simulations is complicated by the presence of singularities, we show that the methods presented in this work provide initial data with $l_1$ and $l_\infty$ norms of violation of the constraint equations falling below those of the truncation error (residual error due to discretization) present in finite difference codes for the range of grid resolutions currently used. Thus, these data sets are suitable for use in evolution codes. Detailed results are presented for the case of a head-on collision of two equal-mass M black holes with specific angular momentum 0.5M at an initial separation of 10M. A straightforward superposition method yields data adequate for resolutions of $h=M/4$, and an "attenuated" superposition yields data usable to resolutions at least as fine as $h=M/8$. In addition, the attenuated approximate data may be more tractable in a full (computational) exact solution to the initial value problem.Comment: 6 pages, 5 postscript figures. Minor changes and some points clarified. Accepted for publication in Phys. Rev.

Evolution systems for non-linear perturbations of background geometries

The formulation of the initial value problem for the Einstein equations is at the heart of obtaining interesting new solutions using numerical relativity and still very much under theoretical and applied scrutiny. We develop a specialised background geometry approach, for systems where there is non-trivial a priori knowledge about the spacetime under study. The background three-geometry and associated connection are used to express the ADM evolution equations in terms of physical non-linear deviations from that background. Expressing the equations in first order form leads naturally to a system closely linked to the Einstein-Christoffel system, introduced by Anderson and York, and sharing its hyperbolicity properties. We illustrate the drastic alteration of the source structure of the equations, and discuss why this is likely to be numerically advantageous.Comment: 12 pages, 3 figures, Revtex v3.0. Revised version to appear in Physical Review

Changes in the Viral Distribution Pattern after the Appearance of the Novel Influenza A H1N1 (pH1N1) Virus in Influenza-Like Illness Patients in Peru

Background: We describe the temporal variation in viral agents detected in influenza like illness (ILI) patients before and after the appearance of the ongoing pandemic influenza A (H1N1) (pH1N1) in Peru between 4-January and 13-July 2009. Methods: At the health centers, one oropharyngeal swab was obtained for viral isolation. From epidemiological week (EW) 1 to 18, at the US Naval Medical Research Center Detachment (NMRCD) in Lima, the specimens were inoculated into four cell lines for virus isolation. In addition, from EW 19 to 28, the specimens were also analyzed by real time-polymerase-chainreaction (rRT-PCR). Results: We enrolled 2,872 patients: 1,422 cases before the appearance of the pH1N1 virus, and 1,450 during the pandemic. Non-pH1N1 influenza A virus was the predominant viral strain circulating in Peru through (EW) 18, representing 57.8% of the confirmed cases; however, this predominance shifted to pH1N1 (51.5%) from EW 19–28. During this study period, most of pH1N1 cases were diagnosed in the capital city (Lima) followed by other cities including Cusco and Trujillo. In contrast, novel influenza cases were essentially absent in the tropical rain forest (jungle) cities during our study period. The city of Iquitos (Jungle) had the highest number of influenza B cases and only one pH1N1 case. Conclusions: The viral distribution in Peru changed upon the introduction of the pH1N1 virus compared to previous months. Although influenza A viruses continue to be the predominant viral pathogen, the pH1N1 virus predominated over the other influenza A viruses

Grazing Collisions of Black Holes via the Excision of Singularities

We present the first simulations of non-headon (grazing) collisions of binary black holes in which the black hole singularities have been excised from the computational domain. Initially two equal mass black holes $m$ are separated a distance $\approx10m$ and with impact parameter $\approx2m$. Initial data are based on superposed, boosted (velocity $\approx0.5c$) solutions of single black holes in Kerr-Schild coordinates. Both rotating and non-rotating black holes are considered. The excised regions containing the singularities are specified by following the dynamics of apparent horizons. Evolutions of up to $t \approx 35m$ are obtained in which two initially separate apparent horizons are present for $t\approx3.8m$. At that time a single enveloping apparent horizon forms, indicating that the holes have merged. Apparent horizon area estimates suggest gravitational radiation of about 2.6% of the total mass. The evolutions end after a moderate amount of time because of instabilities.Comment: 2 References corrected, reference to figure update

Las variaciones en colesterol-HDL tras bypass gástrico proximal son independientes de la evolución ponderal

Fundamento. La cirugía bariátrica posee efectos beneficiosos sobre el perfil lipídico en pacientes con obesidad mórbida que pueden atenuarse con la recuperación ponderal. El presente estudio se ha llevado a cabo para evaluar el perfil lipídico antes y a lo largo de los seis años consiguientes a la realización de bypass gástrico proximal (BPG). Material y métodos. Se han estudiado 177 pacientes (135 mujeres) con obesidad mórbida (IMC 44,2+0,4 kg/m2) de 42,4+0,9 años de edad antes, 3,6,9, 12,24,36,48,60 y 72 meses después de realizar BPG. En todas las revisiones se evaluó el tratamiento hipolipemiante, antropometría (IMC, cintura), composición corporal (Bod-Pod) y determinaciones de colesterol total (CT), colesterol-LDL (LDL-C), colesterol-HDL (HDL-C), triglicéridos (TG), glucosa e insulina. Resultados. El BPG indujo marcada reducción de IMC (nadir IMC a 18 meses 28,3+0,4 kg/m2 p<0,001) y grasa corporal consiguiendo una pérdida de exceso IMC del 84,1% y del exceso de porcentaje de grasa del 87% que disminuyó al 65,6 y 38,3% (ambos p<0,005 respecto a nadir) respectivamente a los 6 años del BPG, indicando recuperación de peso y grasa corporal. Los valores de TG alcanzaron el 70% a los 60 meses, los de LDL-C el 70,6% a los 18 meses y los de HDL-C el 197% del valor pre-intervención a los 48 meses. La elevación de HDL-C aumentó durante la fase de recuperación ponderal de forma continuada (p<0,001). Tanto los cocientes CT/HDL-C como TG/HDL-C se normalizaron de forma mantenida durante los 6 años de seguimiento. Conclusiones. Estos resultados confirman la mejoría de todas las fracciones lipídicas 6 años después del BPG, con especial mención a HDL-C, que mantuvo progresión creciente incluso durante la recuperación ponderal, reduciendo la tasa de dislipemia a los 6 años del BPG.Background. Bariatric surgery has multiple beneficial effects on lipid profile in patients with morbid obesity. However, these changes can be attenuated by weight regain. This retrospective study was designed to assess the effects of gastric bypass (GBP) on different lipid fractions over a 6 year follow-up. Patients and Methods. We studied 177 patients (135 women) with morbid obesity (BMI 44.2+0.4 kg/m2) aged 42.4+0.9 years before and 3, 6, 9, 12, 24, 36, 48, 60 and 72 months after laparoscopic proximal GBP. Anthropometry, body composition measurement (Bod-Pod) and fasting blood samples were taken in all evaluations to measure total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), glucose and insulin. Results. GPB was followed by a significant BMI reduction (nadir BMI at 18 m 28.3+0.4 kg/m2p<0,001) and fat mass decrease (p<0,001). Maximal percentage of excess BMI lost was 84.1% and that of body fat was 87% 18 months after GBP. These numbers decreased to 65.6% and 38.3% (p<0,005 vs nadir) respectively 72 months after the operation, indicating both weight and fat mass regain. TG and LDL-C values decreased 30% with respect to preoperative levels, while HDL-C increased 97% over initial values. This HDL-C increase was progressive even over the weight regain phase. Both TC/HDL-C and TG/HDL-C ratios normalized after GBP and values were sustained over the weight regain period until the end of the study. Conclusions. These results confirm the beneficial effects of GBP on all lipid fractions, which are maintained over 6 years of follow-up. Globally, the rise in HDL-C seems to be independent of weight or fat mass changes, since it increases even over the weight regain phase, so contributing to a reduction in the prevalence of dyslipidaemia and to cardiovascular risk reduction

Opinion dynamics: models, extensions and external effects

Recently, social phenomena have received a lot of attention not only from social scientists, but also from physicists, mathematicians and computer scientists, in the emerging interdisciplinary field of complex system science. Opinion dynamics is one of the processes studied, since opinions are the drivers of human behaviour, and play a crucial role in many global challenges that our complex world and societies are facing: global financial crises, global pandemics, growth of cities, urbanisation and migration patterns, and last but not least important, climate change and environmental sustainability and protection. Opinion formation is a complex process affected by the interplay of different elements, including the individual predisposition, the influence of positive and negative peer interaction (social networks playing a crucial role in this respect), the information each individual is exposed to, and many others. Several models inspired from those in use in physics have been developed to encompass many of these elements, and to allow for the identification of the mechanisms involved in the opinion formation process and the understanding of their role, with the practical aim of simulating opinion formation and spreading under various conditions. These modelling schemes range from binary simple models such as the voter model, to multi-dimensional continuous approaches. Here, we provide a review of recent methods, focusing on models employing both peer interaction and external information, and emphasising the role that less studied mechanisms, such as disagreement, has in driving the opinion dynamics. [...]Comment: 42 pages, 6 figure

Characterizing the Epidemiology of the 2009 Influenza A/H1N1 Pandemic in Mexico

Gerardo Chowell and colleagues address whether school closures and other social distancing strategies were successful in reducing pandemic flu transmission in Mexico by analyzing the age- and state-specific incidence of influenza morbidity and mortality in 32 Mexican states

Circulating Strains of Human Respiratory Syncytial Virus in Central and South America

Human respiratory syncytial virus (HRSV) is a major cause of viral lower respiratory tract infections among infants and young children. HRSV strains vary genetically and antigenically and have been classified into two broad subgroups, A and B (HRSV-A and HRSV-B, respectively). To date, little is known about the circulating strains of HRSV in Latin America. We have evaluated the genetic diversity of 96 HRSV strains by sequencing a variable region of the G protein gene of isolates collected from 2007 to 2009 in Central and South America. Our results show the presence of the two antigenic subgroups of HRSV during this period with the majority belonging to the genotype HRSV-A2