St\"uckelino Dark Matter in Anomalous U(1)' Models

We study a possible dark matter candidate in the framework of a minimal anomalous $U(1)'$ extension of the MSSM. It turns out that in a suitable decoupling limit the St\"uckelino, the fermionic degree of freedom of the St\"uckelberg multiplet, is the lightest supersymmetric particle (LSP). We compute the relic density of this particle including coannihilations with the next to lightest supersymmetric particle (NLSP) and with the next to next to lightest supersymmetric particle (NNLSP) which are assumed almost degenerate in mass. This assumption is needed in order to satisfy the stringent limits that the Wilkinson Microwave Anisotropy Probe (WMAP) puts on the relic density. We find that the WMAP constraints can be satisifed by different NLSP and NNLSP configurations as a function of the mass gap with the LSP. These results hold in the parameter space region where the model remains perturbative.Comment: 21 pages, 6 figures, improved section 5, revised version published on EPJ

Application of the JA-CHRODIS Integrated Multimorbidity Care Model (IMCM) to a Case Study of Diabetes and Mental Health

The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This study aimed at analyzing the potential applicability of the IMCM. We followed a qualitative approach that comprised two phases: (1) The design of a case study based on empirical clinical data, which consisted of a hypothetical woman with multimorbidity, type 2 diabetes mellitus, mental health, and associated social problems, and (2) the creation of a consensus group to gather the opinions of a multidisciplinary group of experts and consider the potential applicability of the IMCM to our case study. Experts described how care should be delivered to this patient according to each model component, suggested the use of specific rating scales and tools to assess her needs in a comprehensive and regular way, and pointed our crucial health and social resources to improve her care process. Experts also highlighted patient-centered, integrated and tailored care as one of the keystones of quality healthcare. Our results suggest that the IMCM is applicable in complex patients with multimorbidity

Effects of the dose of erythropoiesis stimulating agents on cardiovascular events, quality of life, and health-related costs in hemodialysis patients: the clinical evaluation of the dose of erythropoietins (C.E. DOSE) trial protocol

<p>Abstract</p> <p>Background</p> <p>Anemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are commonly used to increase hemoglobin levels in this population. In observational studies, higher hemoglobin levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to hemoglobin levels around 9-10 g/dL. A systematic review of randomized trials found that targeting higher hemoglobin levels with ESA causes an increased risk of adverse vascular outcomes. It is possible, but has never been formally tested in a randomized trial, that ESA dose rather than targeted hemoglobin concentration itself mediates the increased risk of adverse vascular outcomes. The Clinical Evaluation of the DOSe of Erythropoietins (C.E. DOSE) trial will assess the benefits and harms of a high versus a low fixed ESA dose for the management of anemia in patients with end stage kidney disease.</p> <p>Methods/Design</p> <p>This is a randomized, prospective open label blinded end-point (PROBE) trial due to enrol 2204 hemodialysis patients in Italy. Patients will be randomized 1:1 to 4000 IU/week versus 18000 IU/week of intravenous epoietin alfa or beta, or any other ESA in equivalent doses. The dose will be adjusted only if hemoglobin levels fall outside the 9.5-12.5 g/dL range. The primary outcome will be a composite of all-cause mortality, non fatal stroke, non fatal myocardial infarction and hospitalization for cardiovascular causes. Quality of life and costs will also be assessed.</p> <p>Discussion</p> <p>The C.E.DOSE study will help inform the optimal therapeutic strategy for the management of anemia of hemodialysis patients, improving clinical outcomes, quality of life and costs, by ascertaining the potential benefits and harms of different fixed ESA doses.</p> <p>Trial registration</p> <p>Clinicaltrials.gov NCT00827021</p

Relative importance of climatic variables, soil properties and plant traits to spatial variability in net CO2 exchange across global forests and grasslands

Compared to the well-known drivers of spatial variability in gross primary productivity (GPP), the relative importance of climatic variables, soil properties and plant traits to the spatial variability in net ecosystem exchange of CO2 between terrestrial ecosystem and atmosphere (NEE) is poorly understood. We used principal component regression to analyze data from 147 eddy flux sites to disentangle effects of climatic variables, soil properties and plant traits on the spatial variation in annual NEE and its components (GPP and ecosystem respiration (RE)) across global forests and grasslands. Our results showed that the largest unique contribution (proportion of variance only explained by one class of variables) to NEE variance came from climatic variables for forests (24%-30%) and soil properties for grasslands (41%-54%). Specifically, mean annual precipitation and potential evapotranspiration were the most important climatic variables driving forest NEE, whereas available soil water capacity, clay content and cation exchange capacity mainly influenced grassland NEE. Plant traits showed a small unique contribution to NEE in both forests and grasslands. However, leaf phosphorus content strongly interacted with soil total nitrogen density and clay content, and these combined factors represented a major contribution for grassland NEE. For GPP and RE, the majority of spatial variance was attributed to the common contribution of climate, soil and plant traits (50% - 62%, proportion of variance explained by more than one class of variables), rather than their unique contributions. Interestingly, those factors with only minor influences on GPP and RE variability (e.g., soil properties) have significant contributions to the spatial variability in NEE. Such emerging factors and the interactions between climatic variables, soil properties and plant traits are not well represented in current terrestrial biosphere models, which should be considered in future model improvement to accurately predict the spatial pattern of carbon cycling across forests and grasslands globally.Peer reviewe

Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients' insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet's agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients' and informants' ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative