Search

Abstract Background Prescribing physical exercise as part of the clinical treatment of cancer patients has become an important strategy in the therapeutic arsenal available in the main health centers specialized in neoplastic diseases, but there is still uncertainty regarding the role of regular physical activity in modifying oxidative stress markers and antioxidants, as high levels of oxidative stress can lead to the development of carcinogens. Therefore, we assessed the effect of physical activity versus absence of physical activity on markers of oxidative stress and antioxidants in cancer patients. Methods We looked for randomized controlled trials that included adult with any type of cancer performing some physical activity and compared them to a control group of cancer patients with no physical activity. The outcomes of interest collected were markers of oxidative stress and antioxidants. Six databases were used for the search (EMBASE, The Cochrane Library (CENTRAL), US National Library of Medicine (PubMed), Physiotherapy Evidence Database (PEDro), Cumulative Index of Nursing and Allied Health (CINAHL) and SPORTDiscus via EBSCO) until January 31st, 2024. Results In the end, 7 randomized controlled clinical trials were included, totaling 573 participants. It was possible to conduct a meta-analysis with demonstrated that physical activity potentially increases the antioxidant marker Trolox, Taoc, Gpx, (SMD = 1.23, CI: 0.13 to 2.34). However, these findings were classified as having very low to moderate GRADE evidence. Conclusion Cancer patients who participated in physical activity programs may have exhibited an increased concentration of antioxidants. Although the overall quality of the evidence in the studies was very low, these findings represent an important field of research that should be guided by studies with more participants and homogeneous methods of analysis of oxidant stress and antioxidant markers. Trial registration PROSPERO CRD42021257815.

Abstract Discrete flavor symmetries have been an appealing approach for explaining the observed flavor structure, which is not justified in the Standard Model (SM). Typically, these models require a so-called flavon field in order to give rise to the flavor structure upon the breaking of the flavor symmetry by the vacuum expectation value (VEV) of the flavon. Generally, in order to obtain the desired vacuum alignment, a flavon potential that includes additional so-called driving fields is required. On the other hand, allowing the flavor symmetry to be modular leads to a structure where the couplings are all holomorphic functions that depend only on a complex modulus, thus greatly reducing the number of parameters in the model. We show that these elements can be combined to simultaneously explain the flavor structure and dark matter (DM) relic abundance. We present a modular model with flavon vacuum alignment that allows for realistic flavor predictions while providing a successful fermionic DM candidate.

Abstract Only four T 2 / ℤ K $$ {\mathbbm{T}}^2/{\mathbb{Z}}_K $$ orbifold building blocks are admissible in heterotic string compactifications. We investigate the flavor properties of all of these building blocks. In each case, we identify the traditional and modular flavor symmetries, and determine the corresponding representations and (fractional) modular weights of the available massless matter states. The resulting finite flavor symmetries include Abelian and non-Abelian traditional symmetries, discrete R symmetries, as well as the double-covered finite modular groups (S 3 × S 3) ⋊ ℤ 4, T ′, 2D 3 and S 3 × T ′. Our findings provide restrictions for bottom-up model building with consistent ultraviolet embeddings.

Abstract Introduction To date, there are no sufficient studies aimed to determine a correlation between personal, academic, and psychological variables with academic achievement, measured with the grade point average (GPA) and intelligence in university students according to each sex. Study aim To determine the correlation between studying strategies, personal and psychological factors with GPA and intelligence in a sample of health sciences university students. Methods Health Sciences university students, were invited to participate, those who accepted were cited in a computer room where they signed an informed consent and filled an electronic questionnaire with sociodemographic, behavioral, psychological variables and studying strategies (from the MLSQ instrument) afterwards they performed a verbal and non-verbal intelligence test (Shipley-2). Results A total of 439 students were included, from which 297 (67.7%) were women. The mean of age was 20.34 ± 2.61 years old. We found that no differences in GPA where observed between sexes. We detected a higher correlation between combined intelligence and GPA in women than in men. In addition, most studying strategies showed a higher correlation with GPA than intelligence scores in men´s sample. All these findings coincide with the fact that preparatory GPA was the most correlated variable with university GPA in both sexes. Finally, women showed higher levels of the sum of diseases, somatization, anxiety, depression and academic stress than men, and all these variables showed low significant correlations with the combined intelligence score only in women´s sample. Conclusion Verbal and non-verbal intelligence scores show a lower association to GPA in men than in women, while studying strategies showed a higher association with GPA in men than in women.

Abstract Inspired by the structure of top-down derived models endowed with modular flavor symmetries, we investigate the yet phenomenologically unexplored binary dihedral group 2D 3. After building the vector-valued modular forms in the representations of 2D 3 with small modular weights, we systematically classify all (Dirac and Majorana) mass textures of fermions with fractional modular weights and all possible 2 + 1-family structures. This allows us to explore the parameter space of fermion models based on 2D 3, aiming at a description of both quarks and leptons with a minimal number of parameters and best compatibility with observed data. We consider the separate possibilities of neutrino masses generated by either a type-I seesaw mechanism or the Weinberg operator. We identify a model that, besides fitting all known flavor observables, delivers predictions for six not-yet measured parameters and favors normal-ordered neutrino masses generated by the Weinberg operator. It would be interesting to figure out whether it is possible to embed our model within a top-down scheme, such as $${\mathbb{T}}^{2}/{\mathbb{Z}}_{4}$$ heterotic orbifold compactifications.

Objective: To compare the effects between telerehabilitation and in-person rehabilitation on physical function, pain and quality of life in patients with breast cancer after surgery. Design: Randomized, controlled, and parallel study that involved post-surgical oncological breast surgery patients who were female and aged between 18 and 70 years. The study was conducted in an outpatient environment, and the participants were randomized using a computer system. Population was divided into 2 groups: G1 (n = 20), who received face-to-face care, and G2 (n = 24), who received telerehabilitation. Participants were followed for 15 and 45 days postoperatively. The study’s primary outcomes were based on 44 patients (n = 44). Values of changes in quality of life, range of motion (ROM), muscle strength, and upper limb functionality were compared for both groups during the 15 to 45 day postoperative. Results: Both groups exhibited progressive improvements in range of motion, muscle strength, functionality, and quality of life over time (15- and 45-days post-operatively [PO]), indicating a positive response to treatment. Patients in G2 demonstrated more significant improvements in range of motion and muscle strength, as well as better functionality and quality of life compared to G1, particularly after 45 days PO. Additionally, G2 exhibited a more significant reduction in fatigue after 45 days PO. Conclusions: Telerehabilitation is a viable option with good usability, and has been shown to produce results similar to in-person physiotherapy in most cases, and even superior in some. Long-term intervention studies are needed for the development of telerehabilitation.

Background Chemotherapy results in toxic effects, causing damage to various systems, such as the human motor system. Objective To investigate the prevalence of lesions in the human motor system presented by patients undergoing chemotherapy treatment. Method Systematic Review with Meta-Analysis. Databases: PubMed, EMBASE and LILACS, in December 2022. Randomized controlled trials were included, with no restriction on publication period or language. Evaluation of the methodological quality using the RoB 2 tool and the GRADE system for the assessment of the quality of the evidence. The meta-analysis was performed using the R software. Registered in the PROSPERO database with ID: CRD42022384265. Results Ten studies were incorporated into the systematic review and for meta- analysis of proportion of fatigue, arthralgia, sensory neuropathy, motor neuropathy, myalgia, muscle weakness, weight loss, a variable number of studies was used. There were a total of 6672 patients and the proportion of occurrence consisted of 31% (0.30; 0.32), 20% (0.19; 0.22), 18% (0.17; 0.19), 10% (0.09; 0.12), 11% (0.10; 0.11), 12% (0.10; 0,13) and 13% (0.12; 0.15), respectively. There was a high risk of bias, according to Rob 2, in all included studies. In the analysis of the level of evidence by GRADE, five studies showed a very low level of evidence, with heterogeneity above 50%. Conclusions Different types of chemotherapy cause various damages to the motor system and possibly worsen patients' functionality.

Stars in close binaries are tidally distorted, and this has a strong effect on their pulsation modes. We compute the mode frequencies and geometries of tidally distorted stars using perturbation theory, accounting for the effects of the Coriolis force and the coupling between different azimuthal orders m of a multiplet induced by the tidal distortion. For tidally coupled dipole pressure modes, the tidal coupling dominates over the Coriolis force and the resulting pulsations are “triaxial,” with each of the three modes in a multiplet “tidally tilted,” to be aligned with one of the three principal axes of the star. The observed amplitudes and phases of the dipole modes aligned orthogonal to the spin axis are modulated throughout the orbit, producing doublets in the power spectrum that are spaced by exactly twice the orbital frequency. Quadrupole modes have similar but slightly more complex behavior. This amplitude modulation allows for mode identification, which can potentially enable detailed asteroseismic analyses of tidally tilted pulsators. Pressure modes should exhibit this behavior in stellar binaries close enough to be tidally synchronized, while gravity modes should remain aligned with the star's spin axis. We discuss applications to various types of pulsating stars and the relationship between the tidal tilting of pulsations and the “single-sided” pulsations sometimes observed in very tidally distorted stars.

Background: Frailty is associated with an increased susceptibility to functional decline, impairment, hospitalization, and mortality among the older adults. However, the potential reversibility of frailty lies in identifying modifiable factors that could prevent, mitigate, or interrupt its progression. While there is a suggestion that sleep disorders may increase the risk of frailty and impairment, the risk stratification of this relationship remains inconclusive. Objective: Stratify the risk of frailty and impairment and investigate potential connections with sleep quality, excessive daytime sleepiness, and the risk of obstructive sleep apnea in older adults dwelling in the community. Methods: This was a quantitative cross-sectional investigation. Frailty risk and impairment were stratified using the Frail Non-disabled Questionnaire (for impairment) and the FRAIL Scale (for Frailty). The assessment of excessive daytime sleepiness, sleep quality, and the risk of obstructive sleep apnea involved the employment of the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and the STOP-BANG questionnaire, respectively. Results: A total of 109 older adults living in the urban area (86 %, p = 0.010), females (61 %; p = 0.030), median age 68 (64–75) years, with overweight (36 %, p

While the COVID-19 pandemic is known to have caused widespread mental health challenges, it remains unknown how the prevalence, presentation, and predictors of mental health adversity during the pandemic compare to other mass crises. We shed light on this question using longitudinal survey data (2003–2021) from 424 low-income mothers who were affected by both the pandemic and Hurricane Katrina, which struck the U.S. Gulf Coast in 2005. The prevalence of elevated posttraumatic stress symptoms was similar 1-year into the pandemic (41.6%) as 1-year post-Katrina (41.9%), while elevated psychological distress was more prevalent 1-year into the pandemic (48.3%) than 1-year post-Katrina (37.2%). Adjusted logistic regression models showed that pandemic-related bereavement, fear or worry, lapsed medical care, and economic stressors predicted mental health adversity during the pandemic. Similar exposures were associated with mental health adversity post-Katrina. Findings underscore the continued need for pandemic-related mental health services and suggest that preventing traumatic or stressful exposures may reduce the mental health impacts of future mass crises.

Modular flavor symmetries provide us with a very compelling approach to the flavor problem. It has been argued that moduli values close to some special values like τ=i or τ=ω provide us with the best fits to data. We point out that the presence of hidden “matter” fields, needed to uplift symmetric AdS vacua, gives rise to a dynamical mechanism that leads to such values of τ.

Discrete flavor symmetries provide a promising approach to understand the flavor sector of the standard model of particle physics. Top-down (TD) explanations from string theory reveal two different types of such flavor symmetries: traditional and modular flavor symmetries that combine to the eclectic flavor group. There have been many bottom-up (BU) constructions to fit experimental data within this scheme. We compare TD and BU constructions to identify the most promising groups and try to give a unified description. Although there is some progress in joining BU and TD approaches, we point out some gaps that have to be closed with future model building.

Abstract Eclectic flavor groups arising from string compactifications combine the power of modular and traditional flavor symmetries to address the flavor puzzle. This top-down scheme determines the representations and modular weights of all matter fields, imposing strict constraints on the structure of the effective potential, which result in controlled corrections. We study the lepton and quark flavor phenomenology of an explicit, potentially realistic example model based on a 𝕋6/ℤ3 × ℤ3 orbifold compactification of the heterotic string that gives rise to an Ω(2) eclectic flavor symmetry. We find that the interplay of flavon alignment and the localization of the modulus in the vicinity of a symmetry-enhanced point leads to naturally protected fermion mass hierarchies, favoring normal-ordered neutrino masses arising from a see-saw mechanism. We show that our model can reproduce all observables in the lepton sector with a small number of parameters and deliver predictions for so far undetermined neutrino observables. Furthermore, we extend the fit to quarks and find that Kähler corrections are instrumental in obtaining a successful simultaneous fit to the quark and lepton sectors.

Introdução: O câncer de mama é o mais incidente nas mulheres e a cirurgia é o principal tratamento de escolha. A síndrome da rede axilar (SRA) é uma condição recorrente que ocorre em até 86% das pacientes após cirurgia, se apresenta como um único cordão ou múltiplos cordões nos tecidos subcutâneos da axila ipsilateral e gera dor e limitação do movimento. Objetivo: Investigar estudos sobre a ocorrência e fatores associados à SRA após tratamento do câncer de mama. Método: Revisão sistemática com metanálise, nas bases de dados PubMed, LILACS e EMBASE, com a metodologia PECOS, seguindo a diretriz PRISMA. Resultados: Cinco artigos foram selecionados, com taxa de ocorrência da SRA de 35%. Os fatores associados encontrados apresentaram um menor risco relativo (RR) de recorrência para quem realizou biópsia de linfonodo sentinela em comparação aos que se submeteram à dissecção axilar (RR 0,49; IC 95% [0,42; 0,57] I²=95%, p=0,01). Houve uma variação de 35% a 39% de desenvolvimento para a SRA em pacientes que se submeteram à quimioterapia e radioterapia, porém o tipo de cirurgia não teve resultado estatisticamente significativo para o desencadeamento da síndrome. Conclusão: Indivíduos que realizaram biópsia de linfonodo sentinela têm menos chance de desenvolver a SRA quando comparados aos que fizeram dissecção axilar. As terapias oncológicas apresentaram proporções parecidas de aparecimento da SRA e o tipo de cirurgia não interferiu na evolução da patologia.

Artificial neural networks can be an important tool to improve the search for admissible string compactifications and characterize them. In this paper we construct the heterotic orbiencoder , a general deep autoencoder to study heterotic orbifold models arising from various Abelian orbifold geometries. Our neural network can be easily trained to successfully encode the large parameter space of many orbifold geometries simultaneously, independently of the statistical dissimilarities of their training features. In particular, we show that our autoencoder is capable of compressing with good accuracy the large parameter space of two promising orbifold geometries in just three parameters. Further, most orbifold models with phenomenologically appealing features appear in bounded regions of this small space. Our results hint towards a possible simplification of the classification of (promising) heterotic orbifold models.

The neutrino sector offers one of the most sensitive probes of new physics beyond the Standard Model of Particle Physics (SM). The mechanism of neutrino mass generation is still unknown. The observed suppression of neutrino masses hints at a large scale, conceivably of the order of the scale of a rand unified theory (GUT), which is a unique feature of neutrinos that is not shared by the charged fermions. The origin of neutrino masses and mixing is part of the outstanding puzzle of fermion masses and mixings, which is not explained ab initio in the SM. Flavor model building for both quark and lepton sectors is important in order to gain a better understanding of the origin of the structure of mass hierarchy and flavor mixing, which constitute the dominant fraction of the SM parameters. Recent activities in neutrino flavor model building based on non-Abelian discrete flavor symmetries and modular flavor symmetries have been shown to be a promising direction to explore. The emerging models provide a framework that has a significantly reduced number of undetermined parameters in the flavor sector. In addition, such a framework affords a novel origin of CP violation from group theory due to the intimate connection between physical CP transformation and group theoretical properties of non-Abelian discrete groups. Model building based on non-Abelian discrete flavor symmetries and their modular variants enables the particle physics community to interpret the current and anticipated upcoming data from neutrino experiments. Non-Abelian discrete flavor symmetries and their modular variants can result from compactification of a higher-dimensional theory. Pursuit of flavor model building based on such frameworks thus also provides the connection to possible UV completions: in particular, to string theory. We emphasize the importance of constructing models in which the uncertainties of theoretical predictions are smaller than, or at most compatible with, the error bars of measurements in neutrino experiments. While there exist proof-of-principle versions of bottom-up models in which the theoretical uncertainties are under control, it is remarkable that the key ingredients of such constructions were discovered first in top-down model building. We outline how a successful unification of bottom-up and top-down ideas and techniques may guide us towards a new era of precision flavor model building in which future experimental results can give us crucial insights into the UV completion of the SM.

Abstract The anatomy and even existence of a common tendinous origin of the extraocular eye muscles, or annulus of Zinn, has widely been debated in anatomical literature. This study explored the anatomical origins of the recti muscles, their course into the orbit and the dural connections of the common tendinous origin with the skull base. Twenty orbits of ten adult human cadavers were dissected. The orbital apex and its dural connections were photographed. Histological examination of apical specimens was performed. In all cadavers, extraocular muscles were observed to have a common tendinous origin at the orbital apex, continuous with dural connections extending into the skull base. Accessory slips of the medial rectus were observed across all cadavers. Dual heads of the lateral rectus were observed in fourteen orbits of seven cadavers. The origin of the levator palpebrae superioris appeared to be contiguous with the superior rectus at the common tendinous origin in all but one cadaver. These results support the existence of a common tendinous origin of the extraocular muscles, that is continuous with the skull base dura. In addition, they support the existence of variations in orbital anatomy including dual or accessory muscle slips of the extraocular muscles.

We report the discovery of ZTF J0127+5258, a compact mass-transferring binary with an orbital period of 13.7 minutes. The system contains a white dwarf accretor, which likely originated as a post–common envelope carbon–oxygen (CO) white dwarf, and a warm donor ( T _eff,donor = 16,400 ± 1000 K). The donor probably formed during a common envelope phase between the CO white dwarf and an evolving giant that left behind a helium star or white dwarf in a close orbit with the CO white dwarf. We measure gravitational wave–driven orbital inspiral with ∼51 σ significance, which yields a joint constraint on the component masses and mass transfer rate. While the accretion disk in the system is dominated by ionized helium emission, the donor exhibits a mixture of hydrogen and helium absorption lines. Phase-resolved spectroscopy yields a donor radial velocity semiamplitude of 771 ± 27 km s ^−1 , and high-speed photometry reveals that the system is eclipsing. We detect a Chandra X-ray counterpart with L _X ∼ 3 × 10 ^31 erg s ^−1 . Depending on the mass transfer rate, the system will likely either evolve into a stably mass-transferring helium cataclysmic variable, merge to become an R CrB star, or explode as a Type Ia supernova in the next million years. We predict that the Laser Space Interferometer Antenna (LISA) will detect the source with a signal-to-noise ratio of 24 ± 6 after 4 yr of observations. The system is the first LISA-loud mass-transferring binary with an intrinsically luminous donor, a class of sources that provide the opportunity to leverage the synergy between optical and infrared time domain surveys, X-ray facilities, and gravitational-wave observatories to probe general relativity, accretion physics, and binary evolution.

Abstract Nontrivial strong dynamics often leads to the appearance of chiral composites. In phenomenological applications, these can either play the role of Standard Model particles or lift chiral exotics by partnering with them in mass terms. As a consequence, the RG flow may change the effective number of chiral generations, a phenomenon we call generation flow. We provide explicit constructions of globally consistent string models exhibiting generation flow. Since such constructions were misclassified in the traditional model searches, our results imply that more care than usually appreciated has to be taken when scanning string compactifications for realistic models.

Abstract We present a detailed analysis of the eclectic flavor structure of the two-dimensional ℤ2 orbifold with its two unconstrained moduli T and U as well as SL(2, ℤ) T × SL(2, ℤ) U modular symmetry. This provides a thorough understanding of mirror symmetry as well as the R-symmetries that appear as a consequence of the automorphy factors of modular transformations. It leads to a complete picture of local flavor unification in the (T, U) modulus landscape. In view of applications towards the flavor structure of particle physics models, we are led to top-down constructions with high predictive power. The first reason is the very limited availability of flavor representations of twisted matter fields as well as their (fixed) modular weights. This is followed by severe restrictions from traditional and (finite) modular flavor symmetries, mirror symmetry, CP $$ \mathcal{CP} $$ and R-symmetries on the superpotential and Kähler potential of the theory.

Abstract We revisit the flavor symmetries arising from compactifications on tori with magnetic background fluxes. Using Euler’s Theorem, we derive closed form analytic expressions for the Yukawa couplings that are valid for arbitrary flux parameters. We discuss the modular transformations for even and odd units of magnetic flux, M, and show that they give rise to finite metaplectic groups the order of which is determined by the least common multiple of the number of zero-mode flavors involved. Unlike in models in which modular flavor symmetries are postulated, in this approach they derive from an underlying torus. This allows us to retain control over parameters, such as those governing the kinetic terms, that are free in the bottom-up approach, thus leading to an increased predictivity. In addition, the geometric picture allows us to understand the relative suppression of Yukawa couplings from their localization properties in the compact space. We also comment on the role supersymmetry plays in these constructions, and outline a path towards non-supersymmetric models with modular flavor symmetries.

Abstract Modular symmetries naturally combine with traditional flavor symmetries and CP $$ \mathcal{CP} $$ , giving rise to the so-called eclectic flavor symmetry. We apply this scheme to the two-dimensional ℤ2 orbifold, which is equipped with two modular symmetries SL(2, ℤ) T and SL(2, ℤ) U associated with two moduli: the Kähler modulus T and the complex structure modulus U. The resulting finite modular group is ((S 3 × S 3) ⋊ ℤ4) × ℤ2 including mirror symmetry (that exchanges T and U) and a generalized CP $$ \mathcal{CP} $$ -transformation. Together with the traditional flavor symmetry (D 8 × D 8)/ℤ2, this leads to a huge eclectic flavor group with 4608 elements. At specific regions in moduli space we observe enhanced unified flavor symmetries with as many as 1152 elements for the tetrahedral shaped orbifold and T = U = exp π i 3 $$ \left\langle T\right\rangle =\left\langle U\right\rangle =\exp \left(\frac{\pi \mathrm{i}}{3}\right) $$ . This rich eclectic structure implies interesting (modular) flavor groups for particle physics models derived form string theory.

Abstract Background This study aimed to determine the epidemiological, microbiological, and molecular characteristics of an outbreak of carbapenem-resistant Leclercia adecarboxylata in three hospitals associated with the unintended use of contaminated total parental nutrition (TPN). Methods For 10 days, 25 patients who received intravenous TPN from the same batch of a formula developed sepsis and had blood cultures positive for L. adecarboxylata. Antimicrobial susceptibility and carbapenemase production were performed in 31 isolates, including one from an unopened bottle of TPN. Carbapenemase-encoding genes, extended-spectrum β-lactamase–encoding genes were screened by PCR, and plasmid profiles were determined. Horizontal transfer of carbapenem resistance was performed by solid mating. Clonal diversity was performed by pulsed-field gel electrophoresis. The resistome was explored by whole-genome sequencing on two selected strains, and comparative genomics was performed using Roary. Results All 31 isolates were resistant to aztreonam, cephalosporins, carbapenems, trimethoprim/sulfamethoxazole, and susceptible to gentamicin, tetracycline, and colistin. Lower susceptibility to levofloxacin (51.6%) and ciprofloxacin (22.6%) was observed. All the isolates were carbapenemase producers and positive for bla NDM-1, bla TEM-1B, and bla SHV-12 genes. One main lineage was detected (clone A, 83.9%; A1, 12.9%; A2, 3.2%). The bla NDM-1 gene is embedded in a Tn125-like element. Genome analysis showed genes encoding resistance for aminoglycosides, quinolones, trimethoprim, colistin, phenicols, and sulphonamides and the presence of IncFII (Yp), IncHI2, and IncHI2A incompatibility groups. Comparative genomics showed a major phylogenetic relationship among L. adecarboxylata I1 and USDA-ARS-USMARC-60222 genomes, followed by our two selected strains. Conclusion We present epidemiological, microbiological, and molecular evidence of an outbreak of carbapenem-resistant L. adecarboxylata in three hospitals in western Mexico associated with the use of contaminated TPN.

Abstract The simultaneous study of top-down and bottom-up approaches to modular flavor symmetry leads necessarily to the concept of eclectic flavor groups. These are non-trivial products of modular and traditional flavor symmetries that exhibit the phenomenon of local flavor enhancement in moduli space. We develop methods to determine the eclectic flavor groups that can be consistently associated with a given traditional flavor symmetry. Applying these methods to a large family of prominent traditional flavor symmetries, we try to identify potential candidates for realistic eclectic flavor groups and show that they are relatively rare. Model building with finite modular flavor symmetries thus appears to be much more restrictive than previously thought.

Objectives Considering the expansion of primary care in areas of difficult access in the Brazilian territory in recent decades, the aim of this study to evaluate the effect of the Family Health Strategy (FHS) expansion on hospitalisations due to ambulatory care-sensitive conditions (ACSCs) and mortality in children under 5 years of age in the state of Pará, Brazilian Amazon.Methods A longitudinal analysis from 2008 to 2017 was conducted for data collected from the SUS’s database (DATASUS) using panel regression methods to determine the association between the expansion FHS coverage, ACSC rate, under 5 mortality rate and child mortality rate in municipalities of the state of Pará.Results There was an expansion of 40% of the population coverage of the FHS, in the same period there were 347 468.55 hospitalisations due to ASCSs of children under 5 years of age in the public health network in the state of Pará, which represented a reduction of almost 28% (p value

Modular flavor symmetries provide us with a new, promising approach to the flavor problem. However, in their original formulation the kinetic terms of the standard model fields do not have a preferred form, thus introducing additional parameters, which limit the predictive power of this scheme. In this work, we introduce the scheme of quasi–eclectic flavor symmetries as a simple fix. These symmetries are the direct product of a modular and a traditional flavor symmetry, which are spontaneously broken to a diagonal modular flavor subgroup. This allows us to construct a version of Feruglio's model with the Kähler terms under control. At the same time, the starting point is reminiscent of what one obtains from explicit string models.

Breast cancer is the most prevalent malignant neoplasm and the leading cause cancer of death among women globally. In Brazil, survival rates vary according to the region and few studies have been conducted on breast cancer survival in less developed areas, such as the Amazon region. The aim of this study was to analyze the five-year survival rate and prognostic factors in women treated for breast cancer in the city of Belém in northern Brazil. A retrospective hospital-based cohort study was conducted (2007-2013). Sociodemographic, clinical/tumor, and treatment variables were obtained from the records at the Ophir Loyola Hospital. Survival analysis involved the Kaplan-Meier statistical method and Cox regression analysis was performed. The significance level was 5% (p

Complex periodic variables (CPVs) are stars that exhibit highly structured and periodic optical light curves. Previous studies have indicated that these stars are typically disk-free pre-main-sequence M dwarfs with rotation periods ranging from 0.2 to 2 days. To advance our understanding of these enigmatic objects, we conducted a blind search using TESS 2 minute data of 65,760 K and M dwarfs with T

The incorporation of Wilson lines leads to an extension of the modular symmetries of string compactification beyond SL(2,Z). In the simplest case with one Wilson line Z, Kähler modulus T and complex structure modulus U, we are led to the Siegel modular group Sp(4,Z). It includes SL(2,Z)T×SL(2,Z)U as well as Z2 mirror symmetry, which interchanges T and U. Possible applications to flavor physics of the Standard Model require the study of orbifolds of Sp(4,Z) to obtain chiral fermions. We identify the 13 possible orbifolds and determine their modular flavor symmetries as subgroups of Sp(4,Z). Some cases correspond to symmetric orbifolds that extend previously discussed cases of SL(2,Z). Others are based on asymmetric orbifold twists (including mirror symmetry) that do no longer allow for a simple intuitive geometrical interpretation and require further study. Sometimes they can be mapped back to symmetric orbifolds with quantized Wilson lines. The symmetries of Sp(4,Z) reveal exciting new aspects of modular symmetries with promising applications to flavor model building.

Highly active antiretroviral therapy (HAART) for Human Immunodeficiency Virus (HIV) is important for suppressing HIV replication; however, adverse effects from prolonged use cause concern. With an increasing incidence of infection in children, the analysis of the maximum respiratory pressures of children exposed to HAART aims to observe possible changes related to continued use, such as: metabolic disorders, cardiovascular disorders, fat redistribution abnormalities and respiratory musculature. Thus, the aim of this study was to evaluate the influence of body composition on the respiratory muscle strength of Amazonian children exposed to HIV therapy. It is believed that these children may have some degree of malnutrition and difficulties in accessing health services. The sample was composed of 60 volunteers, both genders, mean age of 7.85 years, in two groups: experimental (EG) (n=29) - exposed to HIV and therapy, and control (CG) (n=31) - not exposed to HIV or to therapy. The subjects were submitted to respiratory muscle strength (RMS) measurement by manovacuometry and body composition: Body Mass Index (BMI) calculation; measurement of tricipital skinfolds (TS), subscapular skinfolds (SS) and waist circumference (WC), to subsequently calculate the WC to height ratio. Data were analyzed by Fisher's exact test which identified a statistical significance between genders on maximum inspiratory (p = 0.01) and expiratory (p = 0.0008) pressures, and SS (p=0.04), TS (p=0.05) and WC (p=0.05) on Maximum Inspiratory Pressure. There was an influence of body fat distribution on respiratory muscle strength of female Amazonian children exposed to antiretroviral therapy of human immunodeficiency virus.

Additional Abelian gauge interactions are generic to string compactifications. In heterotic string models, gauge coupling unification of such forces and other gauge interactions is natural due to their common origin. In this letter we study systematically the 1-loop running of the coupling constants in effective vacua emerging from Z8 heterotic orbifold compactifications that provide the matter spectrum of the MSSM plus some vectorlike exotics, restricting to vacua that yield a non-anomalous U(1)′ symmetry, gauge coupling unification and the observed values of known gauge couplings. We determine the low-energy value of the U(1)′ coupling constant for different scales of supersymmetry breakdown. We find that the U(1)′ coupling constant is quite restricted in string models to lie in the range 0.46–0.7 for low-scale supersymmetry or 0.44–0.6 in other cases. We argue that the phenomenology of these string vacua should be further explored to solve some extant issues, such as the stability of the Higgs vacuum.

String theory leads to a flavor scheme where modular symmetries play a crucial role. Together with the traditional flavor symmetries they combine to an eclectic flavor group, which we determine via outer automorphisms of the Narain space group. Unbroken flavor symmetries are subgroups of this eclectic group and their size depends on the location in moduli space. This mechanism of local flavor unification allows a different flavor structure for different sectors of the theory (such as quarks and leptons) and also explains the spontaneous breakdown of flavor- and CP-symmetries (via a motion in moduli space). We derive the modular groups, including CP and R-symmetries, for different sub-sectors of six-dimensional string compactifications and determine the general properties of the allowed flavor groups from this top-down perspective. It leads to a very predictive flavor scheme that should be confronted with the variety of existing bottom-up constructions of flavor symmetry in order to clarify which of them could have a consistent top-down completion.

We derive the potential modular symmetries of heterotic string theory. For a toroidal compactification with Wilson line modulus, we obtain the Siegel modular group Sp(4,Z) that includes the modular symmetries SL(2,Z)T and SL(2,Z)U (of the “geometric” moduli T and U) as well as mirror symmetry. In addition, string theory provides a candidate for a CP -like symmetry that enhances the Siegel modular group to GSp(4,Z).

BackgroundThe Family Health Strategy (FHS) became consolidated as a primary care model and gatekeeper for the Unified Health System (Sistema Único de Saúde, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expansion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities.MethodsIn the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the association between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Pará, in the Brazilian Amazon, from 2008 to 2017.ResultsThe results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory.ConclusionsThe findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon.

In a consistent top-down approach based on orbifold compactifications, modular and traditional flavor symmetries combine nontrivially to the so-called eclectic flavor symmetry. We extend this scheme from two extra dimensions, discussed previously, to the six extra dimensions of string theory. By doing so, new insights on the nature of CP and its spontaneous breaking emerge. Moreover, we identify a new interpretation of R-symmetries as unbroken remnants from modular symmetries that are associated with geometrically stabilized complex structure moduli. Hence, all symmetries (i.e. modular, traditional flavor, CP and R) share a common origin in string theory: on a technical level, they are given by outer automorphisms of the Narain space group. The eclectic top-down approach leads to a very restrictive scheme with high predictive power. It remains a challenge to connect this with existing bottom-up constructions of modular flavor symmetry.

A top-down approach to the flavor problem motivated from string theory leads to the concept of eclectic flavor groups that combine traditional and modular flavor symmetries. To make contact with models constructed in the bottom-up approach, we analyze a specific example based on the eclectic flavor group Ω(1) (a nontrivial combination of the traditional flavor group Δ(54) and the finite modular group T′) in order to extract general lessons from the eclectic scheme. We observe that this scheme is highly predictive since it severely restricts the possible group representations and modular weights of matter fields. Thereby, it controls the structure of the Kähler potential and the superpotential, which we discuss explicitly. In particular, both Kähler potential and superpotential are shown to transform nontrivially, but combine to an invariant action. Finally, we find that discrete R-symmetries are intrinsic to eclectic flavor groups.

Abstract It is well-known that the space group selection rule constrains the interactions of closed strings on orbifolds. For some examples, this rule has been described by an effective Abelian symmetry that combines with a permutation symmetry to a non-Abelian flavor symmetry like D 4 or Δ(54). However, the general case of the effective Abelian symmetries was not yet fully understood. In this work, we formalize the computation of the Abelian symmetry that results from the space group selection rule by imposing two conditions only: (i) well-defined discrete charges and (ii) their conservation. The resulting symmetry, which we call the space group flavor symmetry D S , is uniquely specified by the Abelianization of the space group. For all Abelian orbifolds with N = 1 $$ \mathcal{N}=1 $$ supersymmetry we compute D S and identify new cases, for example, where D S contains a ℤ 2 dark matter-parity with charges 0 and 1 for massless and massive strings, respectively.

Models with modular flavor symmetries have been thought to be highly predictive. We point out that these predictions are subject to corrections from non–holomorphic terms in the Lagrangean. Specifically, in the models discussed in the literature, the Kähler potential is not fixed by the symmetries, for instance. The most general Kähler potential consistent with the symmetries of the model contains additional terms with additional parameters, which reduce the predictive power of these constructions. We also comment on potential ways of how one may conceivably retain the predictivity.

ImportanceTrichiasis surgery programs globally have faced high rates of poor surgical outcomes. Identifying correctable risk factors for improving long-term outcomes is essential for countries targeting elimination of trachoma as a public health problem.ObjectiveTo determine whether the location of trichiatic eyelashes prior to surgery influences development of post-operative trichiasis (PTT) within two years after surgery.DesignSecondary data analysis of four randomized clinical trials evaluating methods to improve trichiasis surgery outcomes. These include the Surgery for Trichiasis, Antibiotics for Recurrence (STAR) trial, Partnership for Rapid Elimination of Trachoma (PRET-Surgery), absorbable versus silk sutures trial, and epilation versus surgery for minor trichiasis trial.SettingPrimary trials were conducted in rural areas of Ethiopia and Tanzania.Interventions or exposuresTrichiasis surgery performed with either the bilamellar tarsal rotation procedure or posterior lamellar rotation procedure.Main outcomesPrevalence of PTT within two years after surgery, location of trichiatic eyelashes pre-operatively and post-operatively.Results6,747 eyelids that underwent first-time trichiasis surgery were included. PTT rates varied by study, ranging from 10-40%. PTT was less severe (based on number of trichiatic eyelashes) than initial trichiasis for 72% of those developing PTT, and only 2% of eyelids were worse at follow up than pre-operatively. Eyelids with central only-trichiasis pre-operatively had lower rates of PTT than eyelids with peripheral only trichiasis in each of the three trials that included severe TT cases. 10% of eyelids with peripheral trichiasis pre-operatively that develop PTT have central TT post-operatively.Conclusions and relevancePre-operative central trichiasis is less likely than peripheral trichiasis to be associated with subsequent PTT. Regardless of type of surgery, surgeon skill levels, or pre-operative trichiasis severity, the presence of peripheral trichiasis pre-operatively is associated with higher rates of PTT. Making an incision that extends the length of the eyelid and adequately rotating the nasal and temporal aspects of the eyelid when suturing may help to minimize the chance of developing peripheral PTT.Trial registrationClinicalTrials.gov PRET: NCT00886015; Suture: NCT005228560; Epilation: NCT00522912.

La integración de los inmigrantes a la sociedad estadounidense ha sido abordada desde diversos ámbitos (social, cultural, político y económico) y a la luz de las perspectivas de la asimilación o el multiculturalismo, concibiendo el proceso de incorporación como unidireccional, donde los recién llegados tienen la responsabilidad de incorporarse a la sociedad receptora adaptándose a la cultura dominante. Por el contrario, la integración jurídica debe entenderse como un proceso bidireccional en donde el Estado implementa políticas para que los inmigrantes se incorporen a la sociedad, así como los recién llegados hagan lo propio para formar parte de la vida del lugar de establecimiento. En el fondo de esta noción está el que los inmigrantes indígenas tengan derecho a tener derechos. Para ello, se propone un modelo de análisis sobre los niveles de incorporación de estos sujetos, a través de dos unidades: la cultura jurídica y el acceso a la justicia como política jurídica.

Caatinga is one of the Brazilian biomes where the highest degradation rates are recorded. It is associated mainly to the removal of vegetation for energy production and practice of subsistence agriculture, causing interference in nutrient cycling. The aim of the study was to quantify and chemically analyze litter deposition in a fragment of Caatinga, located in the municipality of Pombal, Paraíba (PB) state. It was collected monthly for 12 months, and separated into different fractions (leaves, reproductive structures, branches and miscellaneous), all litter deposited on collectors of 1.0 m2, distributed systematically. The nutrients analyzed were N, P, K, Ca and Mg. The annual litter was of 3785.67 kg ha -1 , predominantly composed of leaf fraction with 70.2%, followed by the fraction reproductive structures with 18.3%. The nutrient content in the leaf litter followed the order Ca> N> K> Mg> P. The nutrient content in the fractions vary according to time and there is evidence of their relationship with the rainfall. The deposition of litter coincided with the seasonal period of Caatinga.

OBJECTIVE To analyze the prevalence and factors associated with smoking abstinence among patients who were treated in a reference unit for smoking cessation. METHODS This cross-sectional study examined the medical records of 532 patients treated in a reference unit for smoking cessation in Belém, PA, Northern Brazil, between January 2010 and June 2012. Sociodemographic variables and those related to smoking history and treatment were analyzed. Statistical significance was set at p < 0.05. RESULTS The mean age of the participants was 50 years; 57.0% of the patients were women. The mean tobacco load was 30 packs/year, and the mean smoking duration was approximately 32 years. Most patients remained in treatment for four months. The rate of smoking abstinence was 75.0%. Regression analysis indicated that maintenance therapy, absence of relapse triggers, and lower chemical dependence were significantly associated with smoking cessation. CONCLUSIONS The smoking abstinence rate observed was 75.0%. The cessation process was associated with several aspects, including the degree of chemical dependence, symptoms of withdrawal, and period of patient follow-up in a multidisciplinary treatment program. Studies of this nature contribute to the collection of consistent epidemiological data and are essential for the implementation of effective smoking prevention and cessation strategies.

BACKGROUND:Rural populations in low-income countries commonly suffer from the co-morbidity of neglected tropical diseases (NTDs). Podoconiosis, trachomatous trichiasis (both NTDs) and cataract are common causes of morbidity among subsistence farmers in the highlands of northern Ethiopia. We explored whether podoconiosis was associated with cataract or trachomatous trichiasis (TT) among this population. METHODS:A comparative cross-sectional study was conducted in East Gojam region, Amhara, Ethiopia in May 2016. Data were collected from patients previously identified as having podoconiosis and from matched healthy neighbourhood controls. Information on socio-demographic factors, clinical factors and past medical history were collected by an interview-administered questionnaire. Clinical examination involved grading of podoconiosis by examination of both legs, measurement of visual acuity, direct ophthalmoscopy of dilated pupils to grade cataract, and eyelid and corneal examination to grade trachoma. Multiple logistic regression was conducted to estimate independent association and correlates of podoconiosis, TT and cataract. FINDINGS:A total of 700 participants were included in this study; 350 podoconiosis patients and 350 healthy neighbourhood controls. The prevalence of TT was higher among podoconiosis patients than controls (65 (18.6%) vs 43 (12.3%)) with an adjusted odds ratio OR 1.57 (95% CI 1.02-2.40), p = 0.04. There was no significant difference in prevalence of cataract between the two populations with an adjusted OR 0.83 (95% CI 0.55-1.25), p = 0.36. Mean best visual acuity was 0.59 (SD 0.06) in podoconiosis cases compared to 0.44 (SD 0.04) in controls, p

Cervical cancer (CC) is the most common type of cancer in women and is the third leading cause of death in most developing countries, causing more than 288,000 deaths in women worldwide each year. The most favourable survival rate is in developed countries, since CC mortality has recently declined in those countries. The purpose of this study was to determine the survival rate and associated factors of CC patients at a reference hospital in the Amazon region. The patient sample included records of 339 patients with cervical cancer who had been hospitalized in Belém, Pará, Brazil from January 2005 to December 2010; the socioeconomic and clinical data were collected between June and September 2016. A survival rate of approximately 84% was observed, and it was found that disease stage (p