Patients' perspective and lung function correlation:the importance of questionnaires in home mechanical ventilation

Classical physiological variables used to monitor respiratory function in patients under non-invasive ventilation (NIV), such as FEV1 or FVC, correlate poorly with reported impairment of physical function or overall health status and hence provide an incomplete picture of impaired health. Aim: to investigate the association between the Portuguese S3-non-invasive ventilation (S3-NIV) questionnaire score and objective measures of lung function. Consecutive adult patients with chronic respiratory failure, established on home NIV for at least 30 days were recruited in one outpatient clinic. Correlations between physiological variables and S3-NIV score were computed with Spearman rank coefficient. We studied 230 stable patients (126 male, 54.8%) with a mean age of 69.2 (± 11,0) years. Demographic and spirometry characteristics, and S3-NIV respiratory and total scores are presented on the table, according to disease groups. Spearman coefficient values are also presented. Neither the S3-NIV total score nor the respiratory symptoms subscore correlate with lung function impairment in any of the disease groups. This reinforces the notion that symptoms questionnaires and patient reported outcome measures must always be obtained directly from the patient and should be included in regular treatment monitoring

First report of multiple lineages of dengue viruses type 1 in Rio de Janeiro, Brazil

<p>Abstract</p> <p>Background</p> <p>In Brazil dengue has been a major public health problem since DENV-1 introduction and spread in 1986. After a low or silent co-circulation, DENV-1 re-emerged in 2009 causing a major epidemic in the country in 2010 and 2011. In this study, the phylogeny of DENV-1 strains isolated in RJ after its first introduction in 1986 and after its emergence in 2009 and 2010 was performed in order to document possible evolutionary patterns or introductions in a re-emergent virus.</p> <p>Findings</p> <p>The analysis of the E gene sequences demonstrated that DENV-1 isolated during 2009/2010 still belong to genotype V (Americas/Africa) but grouping in a distinct clade (lineage II) of that represented by earlier DENV-1 (lineage I). However, strains isolated in 2011 grouped together forming another distinct clade (lineage III).</p> <p>Conclusions</p> <p>The monitoring of DENV is important to observe the spread of potentially virulent strains as well to evaluate its impact over the population during an outbreak. Whether explosive epidemics reported in Brazil caused mainly by DENV-1 was due to lineage replacement, or due the population susceptibility to this serotype which has not circulated for almost a decade or even due to the occurrence of secondary infections in a hyperendemic country, is not clear. This is the first report of multiple lineages of DENV-1 detected in Brazil.</p

Light MSSM Higgs boson mass to three-loop accuracy

The light CP even Higgs boson mass, Mh, is calculated to three-loop accuracy within the Minimal Supersymmetric Standard Model (MSSM). The result is expressed in terms of DRbar parameters and implemented in the computer program H3m. The calculation is based on the proper approximations and their combination in various regions of the parameter space. The three-loop effects to Mh are typically of the order of a few hundred MeV and opposite in sign to the two-loop corrections. The remaining theory uncertainty due to higher order perturbative corrections is estimated to be less than 1 GeV.Comment: 39 pages, 13 figures. v2: minor changes, typos fixe

Slepton pair production in the POWHEG BOX

We present an implementation for slepton pair production at hadron colliders in the POWHEG BOX, a framework for combining next-to-leading order QCD calculations with parton-shower Monte-Carlo programs. Our code provides a SUSY Les Houches Accord interface for setting the supersymmetric input parameters. Decays of the sleptons and parton-shower effects are simulated with PYTHIA. Focussing on a representative point in the supersymmetric parameter space we show results for kinematic distributions that can be observed experimentally. While next-to-leading order QCD corrections are sizable for all distributions, the parton shower affects the color-neutral particles only marginally. Pronounced parton-shower effects are found for jet distributions.Comment: 10 pages, 4 figure

Effects of apparent temperature on daily mortality in Lisbon and Oporto, Portugal

<p>Abstract</p> <p>Background</p> <p>Evidence that elevated temperatures can lead to increased mortality is well documented, with population vulnerability being location specific. However, very few studies have been conducted that assess the effects of temperature on daily mortality in urban areas in Portugal.</p> <p>Methods</p> <p>In this paper time-series analysis was used to model the relationship between mean apparent temperature and daily mortality during the warm season (April to September) in the two largest urban areas in Portugal: Lisbon and Oporto. We used generalized additive Poisson regression models, adjusted for day of week and season.</p> <p>Results</p> <p>Our results show that in Lisbon, a 1°C increase in mean apparent temperature is associated with a 2.1% (95%CI: 1.6, 2.5), 2.4% (95%CI: 1.7, 3.1) and 1.7% (95%CI: 0.1, 3.4) increase in all-causes, cardiovascular, and respiratory mortality, respectively. In Oporto the increase was 1.5% (95%CI: 1.0, 1.9), 2.1% (95%CI: 1.3, 2.9) and 2.7% (95%CI: 1.2, 4.3) respectively. In both cities, this increase was greater for the group >65 years.</p> <p>Conclusion</p> <p>Even without extremes in apparent temperature, we observed an association between temperature and daily mortality in Portugal. Additional research is needed to allow for better assessment of vulnerability within populations in Portugal in order to develop more effective heat-related morbidity and mortality public health programs.</p

O(alpha_s^2) corrections to fermionic Higgs decays in the MSSM

We compute the two-loop corrections of O(alpha_s^2) to the Yukawa couplings in the framework of the Minimal Supersymmetric Standard Model (MSSM). The calculation is performed using the effective Lagrangian approach under the approximation of neglecting the Higgs boson mass with respect to the top quark, gluino and all squark flavour masses. As an application we derive the O(alpha_s^2) corrections to the partial decay width of the lightest Higgs boson to a bottom quark pair. We find that the two-loop corrections are sizable for large values of tan_beta and low CP-odd Higgs boson mass. With our calculation of the O(alpha_s^2) corrections the remaining theoretical uncertainties reduce below a few percent.Comment: 22 pages, 10 figure

Proliferation of Hydroelectric Dams in the Andean Amazon and Implications for Andes-Amazon Connectivity

Due to rising energy demands and abundant untapped potential, hydropower projects are rapidly increasing in the Neotropics. This is especially true in the wet and rugged Andean Amazon, where regional governments are prioritizing new hydroelectric dams as the centerpiece of long-term energy plans. However, the current planning for hydropower lacks adequate regional and basin-scale assessment of potential ecological impacts. This lack of strategic planning is particularly problematic given the intimate link between the Andes and Amazonian flood plain, together one of the most species rich zones on Earth. We examined the potential ecological impacts, in terms of river connectivity and forest loss, of the planned proliferation of hydroelectric dams across all Andean tributaries of the Amazon River. Considering data on the full portfolios of existing and planned dams, along with data on roads and transmission line systems, we developed a new conceptual framework to estimate the relative impacts of all planned dams. There are plans for 151 new dams greater than 2 MW over the next 20 years, more than a 300% increase. These dams would include five of the six major Andean tributaries of the Amazon. Our ecological impact analysis classified 47% of the potential new dams as high impact and just 19% as low impact. Sixty percent of the dams would cause the first major break in connectivity between protected Andean headwaters and the lowland Amazon. More than 80% would drive deforestation due to new roads, transmission lines, or inundation. We conclude with a discussion of three major policy implications of these findings. 1) There is a critical need for further strategic regional and basin scale evaluation of dams. 2) There is an urgent need for a strategic plan to maintain Andes-Amazon connectivity. 3) Reconsideration of hydropower as a low-impact energy source in the Neotropics