Sintomas neuropsiquiátricos e declínio cognitivo

Introdução: Os sintomas Neuropsiquiátricos (SNP) são manifestações comuns que afectam quase todas as pessoas que sofrem da doença de Alzheimer. O objectivo principal deste trabalho passa por relatar a prevalência dos diferentes SNP, utilizando uma prova especifica para esse efeito, o Neuropsychiatric Inventory – Questionnaire (NPI-Q), numa amostra de idosos recolhida junto da população geral, em instituições que recebem idosos (em diferentes valências) do Concelho de Coimbra. É igualmente nosso objectivo verificar se existe uma associação significativa entre o declínio cognitivo, avaliado através de uma prova de rastreio cognitivo, o Mini Mental State Examination (MMSE) junto do idoso e a gravidade (atribuída) dos SNP e o grau de perturbação causado pelos mesmos aos cuidadores informais dos idosos. Ao explorar esta associação e eventual papel preditivo da gravidade e grau de perturbação dos SNP para o declínio cognitivo, consideramos potenciais associações entre os SNP e o declínio e diferentes variáveis sociodemográficas, a sintomatologia depressiva e ansiosa. Importará controlar estas variáveis nas análises preditivas, no caso de encontrarmos associações estatisticamente significativas. Pretendemos, igualmente, controlar o eventual papel da simulação (teste Rey-15 Item Test/Rey 15), caso se encontre presente neste estudo. Metodologia: A amostra incluiu 52 idosos (média de idades, M = 80,1; Desvio-padrão, DP = 6,89; variação = 66 - 93) sob resposta social em diferentes instituições do Concelho de Coimbra que aceitaram responder voluntariamente (ou cujos familiares/cuidadores concederam o respectivo consentimento) a uma bateria de testes (incluindo algumas questões sociodemográficas, o MMSE, o Geriatric Anxiety Inventory/GAI a Geriatric Depression Scale/GDS, o Rey-15 e o NPI-Q. Resultados: A maioria dos sujeitos não sofria de declínio cognitivo (65%; n = 34), verificando-se, em oposição a outros estudos, que as percentagens de sujeitos com SNP eram inferiores. Os SNP mais prevalentes foram a Ansiedade (34,6%; n = 18) e a Irritabilidade (34,6%; n = 18). Verificou-se não existirem associações estatisticamente significativas entre a gravidade dos sintomas (NPI-Q) e grau de perturbação dos mesmos (NPI-Q), de acordo com os cuidadores informais, e a presença de declínio cognitivo nos idosos (MMSE). Também não se verificaram associações estatisticamente significativas entre a gravidade dos sintomas (NPI-Q) e grau de perturbação dos mesmos (NPI-Q), de acordo com os cuidadores informais e as variáveis sociodemográficas. Não foram encontradas associações entre a sintomatologia depressiva e ansiosa avaliada junto dos idosos e a gravidade dos SNP e grau de perturbação associado de acordo com os seus cuidadores informais. Conclusão/Discussão: Ao contrário do que poderia ser esperado, não se encontrou uma associação entre o declínio cognitivo, avaliado junto dos idosos, e a presença de SNP de acordo com os cuidadores informais. Vários motivos se podem associar a este resultado não significativo, como o facto da nossa amostra apresentar uma percentagem reduzida de idosos com declínio cognitivo, o tamanho reduzido da nossa amostra ou até mesmo o facto dos SNP terem sido avaliados por auxiliares da instituição que podem não possuir a formação necessária para os avaliar. Um dado igualmente relevante foi a ausência de associações significativas entre as medidas dos SNP e a sintomatologia depressiva/ansiosa e algumas variáveis sociodemográficas. Importa, em estudos futuros, com uma amostra maior, verificar se este padrão de resultados se mantém e, eventualmente, comparar os resultados obtidos depois do NPI-Q ser respondido por clínicos, familiares e auxiliares dos idosos. / Introduction: Neuropsychiatric symptoms (NPS) are common manifestations that afflict almost all Alzheimer’s disease patients. The main goal of this work was to present the prevalence of different NPS, using a specific test, the Neuropsychiatric Inventory – Questionnaire (NPI-Q), in a sample of elderly from the general population, under social answer in different institutions from Coimbra Council. Moreover, we want to verify if there is a significant association between the cognitive decline, assessed with a cognitive screening test, the Mini Mental State Examination (MMSE) administered to the elderly and the (attributed) severity of the NPS and distress caused by the symptoms, assessed by the informal caregiver of the elderly. While exploring this association and the potential predictive role of the severity and distress caused by the NPS to the cognitive decline, we also considered the potential associations between the NPS and the decline, different sociodemographic variables and depressive/anxious symptoms. It will be important to control these variables, if significant associations are found. We also wish to control the potential role of simulation (assessed by the Rey-15 Item Test/Rey 15), if we found that it is present in our sample. Methodology: Our sample comprises 52 elderly (mean age, M = 80,1; Standard deviation, SD = 6,89; range = 66 - 93) under social answer in different institutions from Coimbra Council who accepted to fill in voluntarily a test battery or whose relatives/caregivers gave consent, including some sociodemographic questions, the MMSE, the Geriatric Anxiety Inventory/GAI, the Geriatric Depression Scale/GDS, the Rey-15 and NPI-Q. Results: It was possible to verify that most of the subjects did not suffer from cognitive decline (65%; n = 34). We also verified, in opposition to other studies, that the percentage of elderly with NPS was lower, with the most prevalent being anxiety (34,6%; n = 18) and irritability (34,6%; n = 18). There were no statistically significant associations between symptoms severity (NPI-Q) and distress caused by them (NPI-Q), according to the informal caregivers and the presence of cognitive decline in the elderly (MMSE). Moreover, there were no significant associations between symptoms severity and associated distress (NPI-Q) and the sociodemographic variables of the study. There were no associations between depressive and anxious symptoms in the elderly and the symptoms severity and associated distress (NPI-Q) assessed by the informal caregivers. Conclusion/Discussion: Contrary to what would be expected, we did not find an association between cognitive decline in the elderly and the presence of NPS according to the informal caregivers. Several reasons can explain this non significant result, like the fact that our sample presents a low percentage of elderly with cognitive decline, the reduced sample size our even the fact that NPS were assessed by the assistant workers of the institutions that might no possess the necessary knowledge to assess them. Other relevant result was the absence of significant associations between the NPS measures and depressive/anxious symptoms and some demographic variables. In future studies, with a larger sample it will be important to verify if these patterns of results are maintained and, eventually, it would be interesting to compare the results found after the NPI-Q has been answered by clinicians, family members and institution’s assistants

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

Integrated genomic characterization of oesophageal carcinoma

Oesophageal cancers are prominent worldwide; however, there are few targeted therapies and survival rates for these cancers remain dismal. Here we performed a comprehensive molecular analysis of 164 carcinomas of the oesophagus derived from Western and Eastern populations. Beyond known histopathological and epidemiologic distinctions, molecular features differentiated oesophageal squamous cell carcinomas from oesophageal adenocarcinomas. Oesophageal squamous cell carcinomas resembled squamous carcinomas of other organs more than they did oesophageal adenocarcinomas. Our analyses identified three molecular subclasses of oesophageal squamous cell carcinomas, but none showed evidence for an aetiological role of human papillomavirus. Squamous cell carcinomas showed frequent genomic amplifications of CCND1 and SOX2 and/or TP63, whereas ERBB2, VEGFA and GATA4 and GATA6 were more commonly amplified in adenocarcinomas. Oesophageal adenocarcinomas strongly resembled the chromosomally unstable variant of gastric adenocarcinoma, suggesting that these cancers could be considered a single disease entity. However, some molecular features, including DNA hypermethylation, occurred disproportionally in oesophageal adenocarcinomas. These data provide a framework to facilitate more rational categorization of these tumours and a foundation for new therapies

Study of the B−→Λc+Λˉc−K−B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-} decay

The decay $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ is studied in proton-proton collisions at a center-of-mass energy of $\sqrt{s}=13$ TeV using data corresponding to an integrated luminosity of 5 $\mathrm{fb}^{-1}$ collected by the LHCb experiment. In the $\Lambda_{c}^+ K^{-}$ system, the $\Xi_{c}(2930)^{0}$ state observed at the BaBar and Belle experiments is resolved into two narrower states, $\Xi_{c}(2923)^{0}$ and $\Xi_{c}(2939)^{0}$, whose masses and widths are measured to be $$m(\Xi_{c}(2923)^{0}) = 2924.5 \pm 0.4 \pm 1.1 \,\mathrm{MeV}, \\ m(\Xi_{c}(2939)^{0}) = 2938.5 \pm 0.9 \pm 2.3 \,\mathrm{MeV}, \\ \Gamma(\Xi_{c}(2923)^{0}) = \phantom{000}4.8 \pm 0.9 \pm 1.5 \,\mathrm{MeV},\\ \Gamma(\Xi_{c}(2939)^{0}) = \phantom{00}11.0 \pm 1.9 \pm 7.5 \,\mathrm{MeV},$$ where the first uncertainties are statistical and the second systematic. The results are consistent with a previous LHCb measurement using a prompt $\Lambda_{c}^{+} K^{-}$ sample. Evidence of a new $\Xi_{c}(2880)^{0}$ state is found with a local significance of $3.8\,\sigma$, whose mass and width are measured to be $2881.8 \pm 3.1 \pm 8.5\,\mathrm{MeV}$ and $12.4 \pm 5.3 \pm 5.8 \,\mathrm{MeV}$, respectively. In addition, evidence of a new decay mode $\Xi_{c}(2790)^{0} \to \Lambda_{c}^{+} K^{-}$ is found with a significance of $3.7\,\sigma$. The relative branching fraction of $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ with respect to the $B^{-} \to D^{+} D^{-} K^{-}$ decay is measured to be $2.36 \pm 0.11 \pm 0.22 \pm 0.25$, where the first uncertainty is statistical, the second systematic and the third originates from the branching fractions of charm hadron decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-028.html (LHCb public pages

Multidifferential study of identified charged hadron distributions in ZZ-tagged jets in proton-proton collisions at s=\sqrt{s}=13 TeV

Jet fragmentation functions are measured for the first time in proton-proton collisions for charged pions, kaons, and protons within jets recoiling against a $Z$ boson. The charged-hadron distributions are studied longitudinally and transversely to the jet direction for jets with transverse momentum 20 $< p_{\textrm{T}} < 100$ GeV and in the pseudorapidity range $2.5 < \eta < 4$. The data sample was collected with the LHCb experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 1.64 fb$^{-1}$. Triple differential distributions as a function of the hadron longitudinal momentum fraction, hadron transverse momentum, and jet transverse momentum are also measured for the first time. This helps constrain transverse-momentum-dependent fragmentation functions. Differences in the shapes and magnitudes of the measured distributions for the different hadron species provide insights into the hadronization process for jets predominantly initiated by light quarks.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-013.html (LHCb public pages

Measurement of the ratios of branching fractions R(D∗)\mathcal{R}(D^{*}) and R(D0)\mathcal{R}(D^{0})

The ratios of branching fractions $\mathcal{R}(D^{*})\equiv\mathcal{B}(\bar{B}\to D^{*}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(\bar{B}\to D^{*}\mu^{-}\bar{\nu}_{\mu})$ and $\mathcal{R}(D^{0})\equiv\mathcal{B}(B^{-}\to D^{0}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(B^{-}\to D^{0}\mu^{-}\bar{\nu}_{\mu})$ are measured, assuming isospin symmetry, using a sample of proton-proton collision data corresponding to 3.0 fb${ }^{-1}$ of integrated luminosity recorded by the LHCb experiment during 2011 and 2012. The tau lepton is identified in the decay mode $\tau^{-}\to\mu^{-}\nu_{\tau}\bar{\nu}_{\mu}$. The measured values are $\mathcal{R}(D^{*})=0.281\pm0.018\pm0.024$ and $\mathcal{R}(D^{0})=0.441\pm0.060\pm0.066$, where the first uncertainty is statistical and the second is systematic. The correlation between these measurements is $\rho=-0.43$. Results are consistent with the current average of these quantities and are at a combined 1.9 standard deviations from the predictions based on lepton flavor universality in the Standard Model.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-039.html (LHCb public pages

Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires

The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of $t\overline{t}$, $W+b\overline{b}$ and $W+c\overline{c}$ is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 $\pm$ 0.02 \mbox{fb}^{-1}. The $W$ bosons are reconstructed in the decays $W\rightarrow\ell\nu$, where $\ell$ denotes muon or electron, while the $b$ and $c$ quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions

Physics case for an LHCb Upgrade II - Opportunities in flavour physics, and beyond, in the HL-LHC era

The LHCb Upgrade II will fully exploit the flavour-physics opportunities of the HL-LHC, and study additional physics topics that take advantage of the forward acceptance of the LHCb spectrometer. The LHCb Upgrade I will begin operation in 2020. Consolidation will occur, and modest enhancements of the Upgrade I detector will be installed, in Long Shutdown 3 of the LHC (2025) and these are discussed here. The main Upgrade II detector will be installed in long shutdown 4 of the LHC (2030) and will build on the strengths of the current LHCb experiment and the Upgrade I. It will operate at a luminosity up to 2×1034 cm−2s−1, ten times that of the Upgrade I detector. New detector components will improve the intrinsic performance of the experiment in certain key areas. An Expression Of Interest proposing Upgrade II was submitted in February 2017. The physics case for the Upgrade II is presented here in more depth. CP-violating phases will be measured with precisions unattainable at any other envisaged facility. The experiment will probe b → sl+l−and b → dl+l− transitions in both muon and electron decays in modes not accessible at Upgrade I. Minimal flavour violation will be tested with a precision measurement of the ratio of B(B0 → μ+μ−)/B(Bs → μ+μ−). Probing charm CP violation at the 10−5 level may result in its long sought discovery. Major advances in hadron spectroscopy will be possible, which will be powerful probes of low energy QCD. Upgrade II potentially will have the highest sensitivity of all the LHC experiments on the Higgs to charm-quark couplings. Generically, the new physics mass scale probed, for fixed couplings, will almost double compared with the pre-HL-LHC era; this extended reach for flavour physics is similar to that which would be achieved by the HE-LHC proposal for the energy frontier

LHCb upgrade software and computing : technical design report

This document reports the Research and Development activities that are carried out in the software and computing domains in view of the upgrade of the LHCb experiment. The implementation of a full software trigger implies major changes in the core software framework, in the event data model, and in the reconstruction algorithms. The increase of the data volumes for both real and simulated datasets requires a corresponding scaling of the distributed computing infrastructure. An implementation plan in both domains is presented, together with a risk assessment analysis

Measurement of nuclear modification factors of gamma(1S)), gamma(2S), and gamma(3S) mesons in PbPb collisions at root s(NN)=5.02 TeV

The cross sections for ϒ(1S), ϒ(2S), and ϒ(3S) production in lead-lead (PbPb) and proton-proton (pp) collisions at √sNN = 5.02 TeV have been measured using the CMS detector at the LHC. The nuclear modification factors, RAA, derived from the PbPb-to-pp ratio of yields for each state, are studied as functions of meson rapidity and transverse momentum, as well as PbPb collision centrality. The yields of all three states are found to be significantly suppressed, and compatible with a sequential ordering of the suppression, RAA(ϒ(1S)) > RAA(ϒ(2S)) > RAA(ϒ(3S)). The suppression of ϒ(1S) is larger than that seen at √sNN = 2.76 TeV, although the two are compatible within uncertainties. The upper limit on the RAA of ϒ(3S) integrated over pT, rapidity and centrality is 0.096 at 95% confidence level, which is the strongest suppression observed for a quarkonium state in heavy ion collisions to date. © 2019 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funded by SCOAP3.Peer reviewe