Seroprevalence of Chikungunya Virus after Its Emergence in Brazil.

Chikungunya has had a substantial impact on public health because of the magnitude of its epidemics and its highly debilitating symptoms. We estimated the seroprevalence, proportion of symptomatic cases, and proportion of chronic form of disease after introduction of chikungunya virus (CHIKV) in 2 cities in Brazil. We conducted the population-based study through household interviews and serologic surveys during October-December 2015. In Feira de Santana, we conducted a serologic survey of 385 persons; 57.1% were CHIKV-positive. Among them, 32.7% reported symptoms, and 68.1% contracted chronic chikungunya disease. A similar survey in Riachão do Jacuípe included 446 persons; 45.7% were CHIKV-positive, 41.2% reported symptoms, and 75.0% contracted the chronic form. Our data confirm intense CHIKV transmission during the continuing epidemic. Chronic pain developed in a high proportion of patients. We recommend training health professionals in management of chronic pain, which will improve the quality of life of chikungunya-affected persons

DESARROLLO DE UN PROTOCOLO DE MULTIPLICACIÓN DE BAMBÚ GUADUA ANGUSTIFOLIA USANDO BIORREACTORES DE INMERSIÓN TEMPORAL BITS, CON FINES DE REFORESTACIÓN

The Bamboo Guadua angustifolia has great economic and environmental importance, but its traditional methods of propagation are inefficient. The objective of the study was to develop an efficient micropropagation protocol for Guadua, using Temporary Immersion Bioreactors BITs. For the establishment, disinfected nodal segments and Murashige & Skoog MS medium + 2 mg L-1 of benzylaminopurine BAP were used. For micropropagation, 5 doses of BAP 2, 3, 4, 5 and 6 mg L-1 were tested. In the multiplication phase in BITs, MS was used with 3 doses of BAP 3, 4, 5 mg L-1 and immersion frequencies every 3, 6 and 8 hours. For rooting in BITs, MS + 2.5 mg L-1 of adenine sulfate was used. The results showed that using 2 mg L-1 of BAP, one shoot per explant was obtained, while with 3, 4, 5 and 6 mg L-1 of BAP, 2 shoots were obtained. In BIT multiplication, 3.5, 7.5 and 10.4 shoots per explant were obtained with doses of 3, 4 and 5 mg L-1 of BAP, respectively. Using immersion frequencies every 3, 6, and 8 hours, 7.5, 8.7, and 13.6 shoots per plant were obtained, respectively. The number of roots was 11.3, 4.0 and 4.3 with immersion frequencies of 3, 6 and 8 hours. The best results in BITs were obtained using 3 mg L-1 of BAP and immersion frequency every 3 hours The results show significant advances in bamboo micropropagation and applicable to other species.El Bambú Guadua angustifolia posee gran importancia económica y ambiental, pero sus métodos tradicionales de propagación son ineficientes. El objetivo del estudio fue desarrollar un eficiente protocolo de micropropagación para Guadua, utilizando Biorreactores de Inmersión Temporal BITs. Para el establecimiento se utilizaron segmentos nodales desinfectados y medio Murashige & Skoog MS + 2 mg L-1 de bencilaminopurina BAP. Para la micropropagación se ensayaron 5 dosis de BAP 2, 3, 4, 5 y 6 mg L-1. En fase de multiplicación en BITS se utilizó MS con 3 dosis de BAP 3, 4, 5 mg L-1 y frecuencias de inmersión cada 3, 6 y 8 horas. Para enraizamiento en BITs se utilizó MS + 2.5 mg L-1 de sulfato de adenina. Los resultados mostraron que usando 2 mg L-1 de BAP, se obtuvo un brote por explante, mientras que con 3, 4, 5 y 6 mg L-1 de BAP se obtuvieron 2 brotes. En multiplicación BIT se obtuvieron 3.5, 7.5 y 10.4 brotes por explante con dosis de 3, 4 y 5 mg L-1 de BAP, respectivamente. Usando frecuencias de inmersión cada 3, 6 y 8 horas, se obtuvieron 7.5, 8.7 y 13.6 brotes por plantas, respectivamente. El número de raíces fue de 11.3, 4.0 y 4.3 con frecuencias de inmersiones de 3, 6 y 8 horas. Los mejores resultados en BITs se obtuvieron usando 3 mg L-1 de BAP y frecuencia de inmersión cada 3 horas. Los resultados muestran avances significativos en micropropagación de bambú y aplicable a otras especies

Measurements of the charge asymmetry in top-quark pair production in the dilepton final state at s √ =8 TeV with the ATLAS detector

Measurements of the top-antitop quark pair production charge asymmetry in the dilepton channel, characterized by two high-pT leptons (electrons or muons), are presented using data corresponding to an integrated luminosity of 20.3  fb−1 from pp collisions at a center-of-mass energy s√=8  TeV collected with the ATLAS detector at the Large Hadron Collider at CERN. Inclusive and differential measurements as a function of the invariant mass, transverse momentum, and longitudinal boost of the tt¯ system are performed both in the full phase space and in a fiducial phase space closely matching the detector acceptance. Two observables are studied: AℓℓC based on the selected leptons and Att¯C based on the reconstructed tt¯ final state. The inclusive asymmetries are measured in the full phase space to be AℓℓC=0.008±0.006 and Att¯C=0.021±0.016, which are in agreement with the Standard Model predictions of AℓℓC=0.0064±0.0003 and Att¯C=0.0111±0.0004

Study of the B-c(+) -> J/psi D-s(+) and Bc(+) -> J/psi D-s*(+) decays with the ATLAS detector

The decays B-c(+) -> J/psi D-s(+) and B-c(+) -> J/psi D-s*(+) are studied with the ATLAS detector at the LHC using a dataset corresponding to integrated luminosities of 4.9 and 20.6 fb(-1) of pp collisions collected at centre-of-mass energies root s = 7 TeV and 8 TeV, respectively. Signal candidates are identified through J/psi -> mu(+)mu(-) and D-s(()*()+) -> phi pi(+)(gamma/pi(0)) decays. With a two-dimensional likelihood fit involving the B-c(+) reconstructed invariant mass and an angle between the mu(+) and D-s(+) candidate momenta in the muon pair rest frame, the yields of B-c(+) -> J/psi D-s(+) and B-c(+) -> J/psi D-s*(+), and the transverse polarisation fraction in B-c(+) -> J/psi D-s*(+) decay are measured. The transverse polarisation fraction is determined to be Gamma +/-+/-(B-c(+) -> J/psi D-s*(+))/Gamma(B-c(+) -> J/psi D-s*(+)) = 0.38 +/- 0.23 +/- 0.07, and the derived ratio of the branching fractions of the two modes is B-Bc+ -> J/psi D-s*+/B-Bc+ -> J/psi D-s(+) = 2.8(-0.8)(+1.2) +/- 0.3, where the first error is statistical and the second is systematic. Finally, a sample of B-c(+) -> J/psi pi(+) decays is used to derive the ratios of branching fractions B-Bc+ -> J/psi D-s*+/B-Bc+ -> J/psi pi(+) = 3.8 +/- 1.1 +/- 0.4 +/- 0.2 and B-Bc+ -> J/psi D-s*+/B-Bc+ -> J/psi pi(+) = 10.4 +/- 3.1 +/- 1.5 +/- 0.6, where the third error corresponds to the uncertainty of the branching fraction of D-s(+) -> phi(K+ K-)pi(+) decay. The available theoretical predictions are generally consistent with the measurement

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

A search for an excited muon decaying to a muon and two jets in pp collisions at √s = 8 TeV with the ATLAS detector

A new search signature for excited leptons is explored. Excited muons are sought in the channel $pp \to \mu\mu^* \to \mu \mu\textrm{ jet jet}$, assuming both the production and decay occur via a contact interaction. The analysis is based on 20.3 fb$^{-1}$ of $pp$ collision data at a centre-of-mass energy of $\sqrt{s}$ = 8 TeV taken with the ATLAS detector at the Large Hadron Collider. No evidence of excited muons is found, and limits are set at the 95% confidence level on the cross section times branching ratio as a function of the excited-muon mass $m_{\mu^*}$. For $m_{\mu^*}$ between 1.3 TeV and 3.0 TeV, the upper limit on $\sigma B(\mu^* \to \mu q \bar{q}$) is between 0.6 and 1 fb. Limits on $\sigma B$ are converted to lower bounds on the compositeness scale $\Lambda$. In the limiting case $\Lambda = m_{\mu^*}$, excited muons with a mass below 2.9 TeV are excluded. With the same model assumptions, these limits at larger $\mu^*$ masses improve upon previous limits from traditional searches based on the gauge-mediated decay $\mu^* \to \mu \gamma$.Comment: 33 pages in total, author list starting page 16, 4 figures, 5 tables, final version published by New Journal of Physics including corrections in Erratum https://dx.doi.org/10.1088/1367-2630/ab46ed. All figures including auxiliary are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/EXOT-2015-0

Search for anomalous electroweak production of WW/WZ in association with a high-mass dijet system in pp collisions at √s=8 TeV with the ATLAS detector

A search is presented for anomalous quartic gauge boson couplings in vector-boson scattering. The data for the analysis correspond to $20.2$ fb$^{-1}$ of $\sqrt{s}=8$ TeV $pp$ collisions, and were collected in 2012 by the ATLAS experiment at the Large Hadron Collider. The search looks for the production of $WW$ or $WZ$ boson pairs accompanied by a high-mass dijet system, with one $W$ decaying leptonically, and a $W$ or $Z$ decaying hadronically. The hadronically decaying $W/Z$ is reconstructed as either two small-radius jets or one large-radius jet using jet substructure techniques. Constraints on the anomalous quartic gauge boson coupling parameters $\alpha_4$ and $\alpha_5$ are set by fitting the transverse mass of the diboson system, and the resulting 95% confidence intervals are $-0.024<\alpha_4<0.030$ and $-0.028<\alpha_5<0.033$.Comment: 38 pages in total, author list starting page 22, 5 figures, 2 tables, published in Phys. Rev. D. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2015-09

Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.

Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch