The generalised NMSSM at one loop: fine tuning and phenomenology

We determine the degree of fine tuning needed in a generalised version of the NMSSM that follows from an underlying Z4 or Z8 R symmetry. We find that it is significantly less than is found in the MSSM or NMSSM and extends the range of Higgs mass that have acceptable fine tuning up to Higgs masses of mh ~ 130 GeV. For universal boundary conditions analogous to the CMSSM the phenomenology is rather MSSM like with the singlet states typically rather heavy. For more general boundary conditions the singlet states can be light, leading to interesting signatures at the LHC and direct detection experiments.Comment: 20 pages, 9 figures, matches published versio

Hitting sbottom in natural SUSY

We compare the experimental prospects of direct stop and sbottom pair production searches at the LHC. Such searches for stops are of great interest as they directly probe for states that are motivated by the SUSY solution to the hierarchy problem of the Higgs mass parameter - leading to a "Natural" SUSY spectrum. Noting that sbottom searches are less experimentally challenging and scale up in reach directly with the improvement on b-tagging algorithms, we discuss the interplay of small TeV scale custodial symmetry violation with sbottom direct pair production searches as a path to obtaining strong sub-TeV constraints on stops in a natural SUSY scenario. We argue that if a weak scale natural SUSY spectrum does not exist within the reach of LHC, then hopes for such a spectrum for large regions of parameter space should sbottom out. Conversely, the same arguments make clear that a discovery of such a spectrum is likely to proceed in a sbottom up manner.Comment: 18 pages, 8 figures,v2 refs added, JHEP versio

A precision study of the fine tuning in the DiracNMSSM

Recently the DiracNMSSM has been proposed as a possible solution to reduce the fine tuning in supersymmetry. We determine the degree of fine tuning needed in the DiracNMSSM with and without non-universal gaugino masses and compare it with the fine tuning in the GNMSSM. To apply reasonable cuts on the allowed parameter regions we perform a precise calculation of the Higgs mass. In addition, we include the limits from direct SUSY searches and dark matter abundance. We find that both models are comparable in terms of fine tuning, with the minimal fine tuning in the GNMSSM slightly smaller.Comment: 20 pages + appendices, 10 figure

The broad spectrum of unbearable suffering in end of life cancer studied in dutch primary care

<p>Abstract</p> <p>Background</p> <p>Unbearable suffering most frequently is reported in end-of-life cancer patients in primary care. However, research seldom addresses unbearable suffering. The aim of this study was to comprehensively investigate the various aspects of unbearable suffering in end-of-life cancer patients cared for in primary care.</p> <p>Methods</p> <p>Forty four general practitioners recruited end-of-life cancer patients with an estimated life expectancy of half a year or shorter. The inclusion period was three years, follow-up lasted one additional year. Practices were monitored bimonthly to identify new cases. Unbearable aspects in five domains and overall unbearable suffering were quantitatively assessed (5-point scale) through patient interviews every two months with a comprehensive instrument. Scores of 4 (serious) or 5 (hardly can be worse) were defined unbearable. The last interviews before death were analyzed. Sources providing strength to bear suffering were identified through additional open-ended questions.</p> <p>Results</p> <p>Seventy six out of 148 patients (51%) requested to participate consented; the attrition rate was 8%, while 8% were alive at the end of follow-up. Sixty four patients were followed up until death; in 60 patients interviews were complete. Overall unbearable suffering occurred in 28%. A mean of 18 unbearable aspects was present in patients with serious (score 4) overall unbearable suffering. Overall, half of the unbearable aspects involved the domain of traditional medical symptoms. The most frequent unbearable aspects were weakness, general discomfort, tiredness, pain, loss of appetite and not sleeping well (25%-57%). The other half of the unbearable aspects involved the domains of function, personhood, environment, and nature and prognosis of disease. The most frequent unbearable aspects were impaired activities, feeling dependent, help needed with housekeeping, not being able to do important things, trouble accepting the situation, being bedridden and loss of control (27%-55%). The combination of love and support was the most frequent source (67%) providing strength to bear suffering.</p> <p>Conclusions</p> <p>Overall unbearable suffering occurred in one in every four end-of-life cancer patients. Half of the unbearable aspects involved medical symptoms, the other half concerned psychological, social and existential dimensions. Physicians need to comprehensively assess suffering and provide psychosocial interventions alongside physical symptom management.</p

Naturalness of the Non-Universal MSSM in the light of the recent Higgs results

We analyse the naturalness of the Minimal Supersymmetric Standard Model (MSSM) in the light of recent LHC results from the ATLAS and CMS experiments. We study non-universal boundary conditions for the scalar and the gaugino sector, with fixed relations between some of the soft breaking parameters, and find a significant reduction of fine-tuning for non-universal gaugino masses. For a Higgs mass of about 125 GeV, as observed recently, we find parameter regions with a fine-tuning of O(10), taking into account experimental and theoretical uncertainties. These regions also survive after comparison with simplified model searches in ATLAS and CMS. For a fine-tuning less than 20 the lightest neutralino is expected to be lighter than about 400 GeV and the lighter stop can be as heavy as 3.5 TeV. On the other hand, the gluino mass is required to be above 1.5 TeV. For non-universal gaugino masses, we discuss which fixed GUT scale ratios can lead to a reduced fine-tuning and find that the recent Higgs results have a strong impact on which ratio is favoured. We also discuss the naturalness of GUT scale Yukawa relations, comparing the non-universal MSSM with the CMSSM.Comment: 24 pages, 8 figures; version accepted for publication in JHE

Baryon Resonances in the Double Pion Channel at Jefferson Lab (CEBAF): Experimental and Physical Analysis Status and Perspectives

Decay of light quark excited baryons in the double pion channel is discussed, as a particular way of investigating poorly know baryon resonances and searching for "missing states" predicted by quark models. A possible approach to the data analysis is discussed and some preliminary data from the CLAS collaboration at Jefferson Laboratory are presented

Epigenetic management of major psychosis

Epigenetic mechanisms are thought to play a major role in the pathogenesis of the major psychoses (schizophrenia and bipolar disorder), and they may be the link between the environment and the genome in the pathogenesis of these disorders. This paper discusses the role of epigenetics in the management of major psychosis: (1) the role of epigenetic drugs in treating these disorders. At present, there are three categories of epigenetic drugs that are being actively investigated for their ability to treat psychosis: drugs inhibiting histone deacetylation; drugs decreasing DNA methylation; and drugs targeting microRNAs; and (2) the role of epigenetic mechanisms in electroconvulsive therapy in these disorders

Dunno if you've any plans for the future: medical student indirect questioning in simulated oncology interviews

<p>Abstract</p> <p>Background</p> <p>This exploratory study investigated the motives of medical students (N = 63) for using indirect questions of the type <it>I don't know if </it>[you have already heard about chemotherapies], <it>I don't know how </it>[you are], or <it>I don't know what </it>[you do for a living] in simulated patient interviews during a communication skills course.</p> <p>Methods</p> <p><it>I don't know </it>questions (IDK-Qs) were observed during the initial evaluation of students' communication skills; they were systematically identified through video screening and subjected to a qualitative content and discourse analysis considering their context, their content, their intent and their effect on the simulated patients. To evaluate the specificity of medical students' IDK-Qs, the data were compared with a data set of oncologists (N = 31) conducting simulated patient interviews in the context of a Communication Skills Training (CST).</p> <p>Results</p> <p>During the interviews, 41.3% of the students asked 1-6 IDK-Qs. The IDK-Qs were attributed to three content categories: medical/treatment questions (N = 24); lifestyle/psychosocial questions (N = 18); and "inviting questions" questions (N = 11). Most of the IDK-Qs had an exploratory function (46/53), with simulated patients providing detailed responses or asking for more information (36/53). IDK-Qs were rare in the oncologist sample compared to the student sample (5 vs. 53 occurrences).</p> <p>Conclusions</p> <p>IDK-Qs showed a question design difference between medical students and oncologists in simulated patient interviews. Among other reasons for this difference, the possible function of IDK-Qs as a protective linguistic strategy and marker for psychological discomfort is discussed.</p

Reporting of euthanasia and physician-assisted suicide in the Netherlands: descriptive study

Background: An important principle underlying the Dutch Euthanasia Act is physicians' responsibility to alleviate patients' suffering. The Dutch Act states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering (unbearable and hopeless), the information provided to the patient, the presence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians to report euthanasia to a review committee. We studied which arguments Dutch physicians use to substantiate their adherence to the criteria and which aspects attract review committees' attention. Methods: We examined 158 files of reported euthanasia and physician-assisted suicide cases that were approved by the review committees. We studied the physicians' reports and the verdicts of the review committees by using a checklist. Results: Physicians reported that the patient's request had been well-considered because the patient was clear-headed (65%) and/or had repeated the request several times (23%). Unbearable suffering was often substantiated with physical symptoms (62%), function loss (33%), dependency (28%) or deterioration (15%). In 35%, physicians reported that there had been alternatives to relieve patients' suffering which were refused by the majority. The nature of the relationship with the consultant was sometimes unclear: the consultant was reported to have been an unknown colleague (39%), a known colleague (21%), otherwise (25%), or not clearly specified in the report (24%). Review committees relatively often scrutinized the consultation (41%) and the patient's (unbearable) suffering (32%); they had few questions about possible alternatives (1%). Conclusion: Dutch physicians substantiate their adherence to the criteria in a variable way with an emphasis on physical symptoms. The information they provide is in most cases sufficient to enable adequate review. Review committees' control seems to focus on (unbearable) suffering and on procedural issues