Search

The main result in this paper is the failure of the finitely generated intersection property (FGIP) of ascending HNN extensions of non-cyclic finite rank free groups. This class of groups consists of free-by-cyclic groups and properly ascending HNN extensions of free groups. We also give a sufficient condition for the failure of the FGIP in the context of relative hyperbolicity, we apply this to free-by-cyclic groups of exponential growth.

Despite advances in the treatment of high energy proximal tibia fractures, including the utilization of staged management with external fixation, the infection rate remains high. Overlap between external fixator pin sites and definitive internal fixation has been proposed as a risk factor for infection.This retrospective study reviews 244 patients with staged knee-spanning external fixation followed by delayed definitive internal fixation at two separate level one trauma centers. Presence of pin-plate overlap as well as several other known risk factors for infection were recorded and measured to include open fractures, compartment syndrome, operative time and number of incisions. Development of deep infection was the primary outcome. Both univariate and multivariate statistics were applied to determine differences in rates of infection.65 (26.6%) patients had presence of pin-plate overlap while 179 (73.4%) patients had no overlap. There were no differences between overlapping and non-overlapping groups with respect to other infectious risk factors. Deep infection occurred in 34 (13.9%) total patients, 18 (27.7%) were in patients with pin-plate overlap and 16 (8.9%) in those without overlap. (P = 0.003; RR 3.01, 95% CI 1.51-4.76).This large, multicenter study demonstrated a statistically significant association between pin-plate overlap and the development of deep infection in tibial plateau fractures. On multivariate analysis, pin-plate overlap was identified as an independent risk factor for infection. When treating these complex injuries, surgeons should consider the definitive fixation construct when placing external fixation pins.

Background In 2016, the Centers for Disease Control and Prevention (CDC) changed the time frame for their definition of deep surgical site infection (SSI) from within 1 year to within 90 days of surgery. We hypothesized that a substantial number of infections in patients who have undergone fracture fixation present beyond 90 days and that there are patient factors that can predict who is more likely to present with SSI after 90 days. Methods A retrospective review yielded 452 deep SSI after fracture fixation. These patients were divided into two groups—those infected within 90 days of surgery (308 patients) and those infected beyond 90 days (144 patients). Data were collected on risk factors for infection. Univariate and multiple logistic regression analyses were performed to compare the two groups. A randomly selected control group was used to build infection prediction models for both outcomes. The two outcomes were then modeled against each other to determine whether differences in predictors for early versus late infection exist. Results Of the 452 infections, 144 occurred beyond 90 days (32%). No statistically significant patient factors were found in univariate analysis between the early and late infection groups. The need for flap coverage was the only injury characteristic that differed significantly between groups, with patients in the late infection group more likely to have needed a flap. In models of early versus late infection, there are no statistically significant predictors. When modeled against the control group and directly comparing the two models, predictors for early infection include male sex and fractures of the pelvis, acetabulum, or hip, whereas predictors of late infection include hepatitis C and/or human immunodeficiency virus (HIV) and admission to the intensive care unit (ICU). Conclusion Use of the recent CDC definition will underestimate the rate of actual postoperative infections when applied to orthopaedic trauma patients. Hepatitis C and/or HIV and ICU admission are predictors of late infection, whereas male sex and pelvis, acetabulum, or hip fractures are predictors of early infection. Patients who receive flap coverage may be more likely to present with late infection.

We study a family of finitely generated residually finite groups. These groups are doubles $F_2*_H F_2$ of a rank-$2$ free group $F_2$ along an infinitely generated subgroup $H$. Varying $H$ yields uncountably many groups up to isomorphism., Comment: 10 pages, 2 figures

We show that if G G is of type F n \mathcal {F}_n , and G G splits as a finite graph of groups, then the vertex groups are of type F n \mathcal {F}_n if the edge groups are of type F n \mathcal {F}_n .

Failing to communicate a message in everyday settings can be a frustrating experience. However, miscommunication can lead to disaster in high-stakes situations. Yet in these contexts, under pressure to perform efficiently, speakers may also find themselves with limited resources to devote to message clarity. To understand how cognitive constraint affects communication and explore a possible low-cost solution, we investigated a method for moderating ambiguity production in the face of competing attentional demands: taking the perspective of the listener. Over two experiments, speakers labeled images (Experiment 1) or provided instructions (Experiment 2) to listeners in a non-interactive communication task. In both experiments, speakers were randomly assigned to cognitive constraint and perspective-taking conditions, such that some speakers were under higher cognitive constraint and some speakers received a simple perspective-taking directive. We replicated previous findings that additional cognitive constraint impairs speakers’ ability to avoid ambiguity. Additionally, we found that a simple directive can promote speaker clarity when labeling images, but not when providing instructions. These results suggest that a simple directive is likely insufficient to ensure speaker clarity in all cases.

To determine factors predictive of postoperative surgical site infection (SSI) after fracture fixation and create a prediction score for risk of infection at time of initial treatment.Retrospective cohort study.Level I trauma center.Study group, 311 patients with deep SSI; control group, 608 patients.We evaluated 27 factors theorized to be associated with postoperative infection. Bivariate and multiple logistic regression analyses were used to build a prediction model. A composite score reflecting risk of SSI was then created.Risk of postoperative infection.The final model consisted of 8 independent predictors: (1) male sex, (2) obesity (body mass index ≥ 30) (3) diabetes, (4) alcohol abuse, (5) fracture region, (6) Gustilo-Anderson type III open fracture, (7) methicillin-resistant Staphylococcus aureus nasal swab testing (not tested or positive result), and (8) American Society of Anesthesiologists classification. Risk strata were well correlated with observed proportion of SSI and resulted in a percent risk of infection of 1% for ≤3 points, 6% for 4-5 points, 11% for 6 to 8-9 points, and 41% for ≥10 points.The proposed postoperative infection prediction model might be able to determine which patients have fractures at higher risk of infection and provides an estimate of the percent risk of infection before fixation.Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

We show that certain right-angled Coxeter groups have finite index subgroups that quotient to $\mathbb Z$ with finitely generated kernels. The proof uses Bestvina-Brady Morse theory facilitated by combinatorial arguments. We describe a variety of examples where the plan succeeds or fails. Among the successful examples are the right-angled reflection groups in $\mathbb H^4$ with fundamental domain the $120$-cell or the $24$-cell., 30 pages, to appear in J. Inst. Math. Jussieu

OBJECTIVES To evaluate the association of admission blood glucose ≥200 mg/dL and surgical site infection in orthopaedic trauma surgery. DESIGN Retrospective, case control study. SETTING Academic trauma center. PATIENTS Four hundred sixty-five nondiabetic, noncritically ill orthopaedic trauma patients with an extremity, pelvic, or acetabular fracture and requiring open reduction and internal fixation or intramedullary nailing. INTERVENTION None. MAIN OUTCOME MEASUREMENTS Ninety-day deep surgical site infection. RESULTS Admission blood glucose ≥200 mg/dL was significantly associated with the primary outcome (8/128, 6.3% vs. 35/337, 1.8%; P = 0.01). Multivariable logistic regression modeling demonstrated that admission blood glucose ≥200 mg/dL was a significant risk factor for deep surgical site infections [odds ratio (OR): 4.7, 95% confidence interval (CI) 1.4-15.7], after controlling for male gender (OR: 1.8, 95% CI: 1.1-3.1), prior drug or alcohol abuse (OR: 1.9, 95% CI 0.9-4.0), open fracture (OR: 6.4, 95% CI 3.7-11.0), and fracture region (upper extremity OR: reference; pelvis/hip OR: 3.9, 95% CI 1.6-9.7; femur OR: 2.0, 95% CI 0.88-4.8; tibia/ankle OR: 3.3, 95% CI 1.7-6.2; and foot OR: 2.7, 95% CI 1.2-6.3). CONCLUSIONS Admission glucose ≥200 mg/dL was a significant independent risk factor for 90-day deep surgical site infections in orthopaedic trauma patients and may serve as an important marker for infection risk. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

The purpose of this study is to compare biomechanical properties of fully and partially threaded iliosacral screws. We hypothesise that fully threaded screws will have a higher yield force, and less deformation than partially threaded screws following axial loading. Twenty sawbone blocks were uniformly divided to simulate vertical sacral fractures. Ten blocks were affixed with fully threaded iliosacral screws in an over-drilled, lag-by-technique fashion whilst the remaining ten were fixed with partially threaded lag-by-design screws. All screws measured 7.3-mm x 145 mm, and were inserted to a 70% of calculated maximal insertional torque, ensuring uniform screw placement throughout across models. Continuous axial loads were applied to 3 constructs of each type to failure to determine baseline characteristics. Five hundred loading cycles of 500 N at 1 Hz were applied to 4 constructs of each type, and then axially loaded to failure. Force displacement curves, elastic, and plastic deformation of each construct was recorded. Fully threaded constructs had a 428% higher yield force, 61% higher stiffness, 125% higher ultimate force, and 66% lower yield deformation (p

Background The area under the concentration-time curve over 24 hours (AUC24 ) is frequently utilized to monitor tobramycin exposure in children with cystic fibrosis (CF). An understanding of exposure target achievement during clinical implementation of an AUC24 based approach in children is limited. Methods A retrospective chart review was performed in children with CF treated with once daily tobramycin and drug concentration monitoring at a pediatric CF center. During clinical care AUC24 was estimated using a traditional log-linear regression approach (LLR). AUC24 was also estimated retrospectively using a pharmacokinetic model-based Bayesian forecasting approach (BF). AUC24 achievement after both approaches were compared. Results In 77 treatment courses (mean age, 12.7 ± 5.0 years), a target AUC24 100 to 125 mg h/L was achieved after starting dose in 21 (27%) and after initial dose adjustment in 35 (45%). In the first 7 days of treatment, 24 (32%) required ≥3 dose adjustments, and the mean number of drug concentrations measured was 7.1 ± 3.2. Examination of a BF approach demonstrated adequate prediction of measured tobramycin concentrations (median bias -2.1% [95% CI -3.1 to -1.4]; median precision 7.6% [95% CI, 7.1%-8.2%]). AUC24 estimates utilizing the BF approach were higher than the LLR approach with a mean difference of 6.4 mg h/L (95% CI, 4.8 to 8.0 mg h/L). Conclusions Achievement of a narrow AUC24 target is challenging during clinical care, and dose individualization is needed in most children with CF. Implementing a BF approach for estimating AUC24 in children with CF is supported.

Author(s): Dompe, V; Adams, DQ; Alduino, C; Alfonso, K; Avignone, FT; Azzolini, O; Bari, G; Bellini, F; Benato, G; Bersani, A; Biassoni, M; Branca, A; Brofferio, C; Bucci, C; Caminata, A; Campani, A; Canonica, L; Cao, XG; Capelli, S; Cappelli, L; Cardani, L; Carniti, P; Casali, N; Chiesa, D; Chott, N; Clemenza, M; Copello, S; Cosmelli, C; Cremonesi, O; Creswick, RJ; Cushman, JS; D'Addabbo, A; D'Aguanno, D; Dafinei, I; Davis, CJ; Dell'Oro, S; Domizio, SD; Drobizhev, A; Fang, DQ; Fantini, G; Faverzani, M; Ferri, E; Ferroni, F; Fiorini, E; Franceschi, MA; Freedman, SJ; Fujikawa, BK; Giachero, A; Gironi, L; Giuliani, A; Gorla, P; Gotti, C; Gutierrez, TD; Han, K; Heeger, KM; Huang, RG; Huang, HZ; Johnston, J; Keppel, G; Kolomensky, YG; Leder, A; Ligi, C; Ma, YG; Marini, L; Martinez, M; Maruyama, RH; Mei, Y; Moggi, N; Morganti, S; Napolitano, T; Nastasi, M; Nones, C; Norman, EB; Novati, V; Nucciotti, A; Nutini, I; O'Donnell, T; Ouellet, JL; Pagliarone, CE; Pallavicini, M; Pattavina, L; Pavan, M; Pessina, G; Pettinacci, V; Pira, C | Abstract: CUORE is a cryogenic experiment that focuses on the search of neutrinoless double beta decay in 130Te and it is located at the Gran Sasso National Laboratories. Its detector consists of 988 TeO2 crystals operating at a base temperature of ∼10 mK. It is the first ton-scale bolometric experiment ever realized for this purpose. Thanks to its large target mass and ultra-low background, the CUORE detector is also suitable for the search of other rare phenomena. In particular the low energy part of the spectra is interesting for the detection of WIMP-nuclei scattering reactions. One of the most important requirements to perform these studies is represented by the achievement of a stable energy threshold lower than 10 keV. Here, the CUORE capability to accomplish this purpose using a low energy software trigger will be presented and described.

OBJECTIVE To determine the risk factors for knee stiffness surgery after tibial plateau fixation. DESIGN Retrospective observational cohort study. SETTING Academic Level I trauma center. PATIENTS/PARTICIPANTS A study group of 110 patients who underwent knee stiffness surgery (manipulation while under anesthesia, arthroscopic lysis of adhesion, or quadricepsplasty) at a time remote from open reduction and internal fixation of tibial plateau fractures and a control group of 319 patients with tibial plateau fractures treated with open reduction and internal fixation who did not undergo knee stiffness surgery and who had either a minimum of 1 year of follow-up or clearly documented range of motion ≥110 degrees with a minimum of 90 days of follow-up. INTERVENTION Each case was assessed from the time of index admission through study event, end of minimum follow-up, or achievement of ≥110 degrees range of motion. MAIN OUTCOME MEASUREMENTS Knee stiffness surgery. RESULTS Total number of weeks in an external fixator (odds ratio, 1.5 per week; 95% confidence interval, 1.3-1.7; P < 0.001) and the presence of bilateral tibial plateau fractures (odds ratio, 3.3; 95% confidence interval, 1.2-9.1; P = 0.02) were significant predictors of knee stiffness intervention. CONCLUSION Clinicians should be aware that the time spent in external fixation and the presence of bilateral tibial plateau injuries are strong risk factors for requiring subsequent surgery to treat knee stiffness. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Let M be a compact oriented irreducible 3-manifold which is neither a graph manifold nor a hyperbolic manifold. We prove that the fundamental group of M is virtually special., 29 pages, 4 figures

OBJECTIVE To develop a clinically useful prediction model of success at the time of surgery to promote bone healing for established tibial nonunion or traumatic bone defects. DESIGN Retrospective case controlled. SETTING Level 1 trauma center. PATIENTS Adult patients treated with surgery for established tibia fracture nonunion or traumatic bone defects from 2007 to 2016. Two hundred three patients met the inclusion criteria and were available for final analysis. INTERVENTION Surgery to promote bone healing of established tibia fracture nonunion or segmental defect with plate and screw construct, intramedullary nail fixation, or multiplanar external fixation. MAIN OUTCOME MEASURES Failure of the surgery to promote bone healing that was defined as unplanned revision surgery for lack of bone healing or deep infection. No patients were excluded who had a primary outcome event. RESULTS Multivariate logistic modeling identified 5 significant (P < 0.05) risk factors for failure of the surgery to promote bone healing: (1) mechanism of injury, (2) Increasing body mass index, (3) cortical defect size (mm), (4) flap size (cm), and (5) insurance status. A prediction model was created based on these factors and awarded 0 points for fall, 17 points for high energy blunt trauma (OR = 17; 95% CI, 1-286, P = 0.05), 22 points for industrial/other (OR = 22; 95% CI, 1-4, P = 0.04), and 28 points for ballistic injuries (OR = 28; 95% CI, 1-605, P = 0.04). One point is given for every 10 cm of flap size (OR = 1; 95% CI, 1-1.1, P < 0.001), 10 mm of mean cortical gap distance (OR = 1; 95% CI, 1-2, P = 0.004), and 10 units BMI, respectively (OR = 1.5; 95% CI, 1-3, P = 0.16). Two points are awarded for Medicaid or no insurance (OR = 2; 95% CI, 1-5, P = 0.035) and 3 points for Medicare (3; 95% CI, 1-9, P = 0.033). Each 1-point increase in risk score was associated with a 6% increased chance of requiring at least 1 revision surgery (P < 0.001). CONCLUSIONS This study presents a clinical score that predicts the likelihood of success after surgery for tibia fracture nonunions or traumatic bone defects and may help clinicians better determine which patients are likely to fail these procedures and require further surgery.

This Letter reports the first measurement of the ^{235}U ν[over ¯]_{e} energy spectrum by PROSPECT, the Precision Reactor Oscillation and Spectrum experiment, operating 7.9 m from the 85 MW_{th} highly enriched uranium (HEU) High Flux Isotope Reactor. With a surface-based, segmented detector, PROSPECT has observed 31678±304(stat) ν[over ¯]_{e}-induced inverse beta decays, the largest sample from HEU fission to date, 99% of which are attributed to ^{235}U. Despite broad agreement, comparison of the Huber ^{235}U model to the measured spectrum produces a χ^{2}/ndf=51.4/31, driven primarily by deviations in two localized energy regions. The measured ^{235}U spectrum shape is consistent with a deviation relative to prediction equal in size to that observed at low-enriched uranium power reactors in the ν[over ¯]_{e} energy region of 5-7 MeV.

This Letter reports the first measurement of the ^{235}U ν[over ¯]_{e} energy spectrum by PROSPECT, the Precision Reactor Oscillation and Spectrum experiment, operating 7.9 m from the 85 MW_{th} highly enriched uranium (HEU) High Flux Isotope Reactor. With a surface-based, segmented detector, PROSPECT has observed 31678±304(stat) ν[over ¯]_{e}-induced inverse beta decays, the largest sample from HEU fission to date, 99% of which are attributed to ^{235}U. Despite broad agreement, comparison of the Huber ^{235}U model to the measured spectrum produces a χ^{2}/ndf=51.4/31, driven primarily by deviations in two localized energy regions. The measured ^{235}U spectrum shape is consistent with a deviation relative to prediction equal in size to that observed at low-enriched uranium power reactors in the ν[over ¯]_{e} energy region of 5-7 MeV.

Epithelial cells acquire migratory/invasive and stemness traits upon conversion to the mesenchymal phenotype. The expression of E-cadherin is a key to this transition; yet precise understanding of the pathways involved in integrating E-cadherin loss to the gain of mesenchymal traits remains poorly understood. Here, we show that phosphoinositide-generating enzyme, PIPKIγ, expression is upregulated upon epithelial-mesenchymal transition (EMT) and together with the cytoskeletal protein talin assemble into a signaling complex upon E-cadherin loss. PIPKIγ and talin together control the adhesion and phosphoinositide signaling that regulates conversion to the mesenchymal phenotypes. PIPKIγ and talin regulate the stability of E-cadherin transcriptional repressors, snail and slug, induced by transforming growth factor-β1 or extracellular matrix protein. Loss of PIPKIγ or talin or their interaction impaired EMT and the acquisition of cell motility and stemness. This demonstrates a mechanism where a phosphoinositide-generating enzyme PIPKIγ couples with a cytoskeletal protein talin to control the acquisition of mesenchymal phenotypes.

The CUORE experiment, a ton-scale cryogenic bolometer array, recently began operation at the Laboratori Nazionali del Gran Sasso in Italy. The array represents a significant advancement in this technology, and in this work we apply it for the first time to a high-sensitivity search for a lepton-number-violating process: ^{130}Te neutrinoless double-beta decay. Examining a total TeO_{2} exposure of 86.3 kg yr, characterized by an effective energy resolution of (7.7±0.5) keV FWHM and a background in the region of interest of (0.014±0.002) counts/(keV kg yr), we find no evidence for neutrinoless double-beta decay. Including systematic uncertainties, we place a lower limit on the decay half-life of T_{1/2}^{0ν}(^{130}Te)>1.3×10^{25} yr (90% C.L.); the median statistical sensitivity of this search is 7.0×10^{24} yr. Combining this result with those of two earlier experiments, Cuoricino and CUORE-0, we find T_{1/2}^{0ν}(^{130}Te)>1.5×10^{25} yr (90% C.L.), which is the most stringent limit to date on this decay. Interpreting this result as a limit on the effective Majorana neutrino mass, we find m_{ββ}

This study sought to determine (1) whether surgeons can accurately predict functional outcomes of operative fixation of pilon fractures based on injury and initial postoperative radiographs, (2) whether the surgeon's level of experience is associated with the ability to successfully predict outcome, and (3) the association between patients' demographic and clinical characteristics and surgeons' prediction scores. A blinded, randomized provider survey was conducted at a level I trauma center. Seven fellowship-trained orthopedic traumatologists and 4 orthopedic trauma fellows who were blinded to outcome reviewed data regarding 95 pilon fractures in random order. Injury ankle radiographs, initial postoperative fixation radiographs, and brief patient histories were assessed. Midterm follow-up functional outcome scores obtained a mean 4.9 years after surgery were available for all patients. Main outcome measures were Pearson correlation coefficient-assessed functional outcomes and surgeon-predicted outcomes. A mixed-effect model determined the association between patients' characteristics and surgeons' prediction scores. Minimal positive correlation was observed between functional outcomes and prediction scores. No difference was noted between the attending and fellow groups in prediction ability. When surgeons' prediction confidence level was greater than 1 SD above the mean confidence level, correlation between functional outcome and prediction improved, although poor correlation was still observed. AO/OTA type 43C fractures, high-energy mechanisms, and older patient age were characteristics associated with lower prediction scores. Surgeons had poor ability to predict functional outcomes of patients with pilon fractures based on injury and initial postoperative radiographs, and level of experience was not associated with ability to predict outcome. [ Orthopedics . 2020; 43(1): e43–e46.]

This paper describes the design and performance of a 50 liter, two-segment $^{6}$Li-loaded liquid scintillator detector that was designed and operated as prototype for the PROSPECT (Precision Reactor Oscillation and Spectrum) Experiment. The two-segment detector was constructed according to the design specifications of the experiment. It features low-mass optical separators, an integrated source and optical calibration system, and materials that are compatible with the $^{6}$Li-doped scintillator developed by PROSPECT. We demonstrate a high light collection of 850$\pm$20 PE/MeV, an energy resolution of $\sigma$ = 4.0$\pm$0.2% at 1 MeV, and efficient pulse-shape discrimination of low $dE/dx$ (electronic recoil) and high $dE/dx$ (nuclear recoil) energy depositions. An effective scintillation attenuation length of 85$\pm$3 cm is measured in each segment. The 0.1% by mass concentration of $^{6}$Li in the scintillator results in a measured neutron capture time of $\tau$ = 42.8$\pm$0.2 $\mu s$. The long-term stability of the scintillator is also discussed. The detector response meets the criteria necessary for achieving the PROSPECT physics goals and demonstrates features that may find application in fast neutron detection., Comment: 16 pages, 13 figures; minor edits to design detail and references

This Letter reports the first scientific results from the observation of antineutrinos emitted by fission products of $^{235}$U at the High Flux Isotope Reactor. PROSPECT, the Precision Reactor Oscillation and Spectrum Experiment, consists of a segmented 4 ton $^6$Li-doped liquid scintillator detector covering a baseline range of 7-9 m from the reactor and operating under less than 1 meter water equivalent overburden. Data collected during 33 live-days of reactor operation at a nominal power of 85 MW yields a detection of 25461 $\pm$ 283 (stat.) inverse beta decays. Observation of reactor antineutrinos can be achieved in PROSPECT at 5$\sigma$ statistical significance within two hours of on-surface reactor-on data-taking. A reactor-model independent analysis of the inverse beta decay prompt energy spectrum as a function of baseline constrains significant portions of the previously allowed sterile neutrino oscillation parameter space at 95% confidence level and disfavors the best fit of the Reactor Antineutrino Anomaly at 2.2$\sigma$ confidence level., Comment: 7 pages, 5 figures; v3: Added additional supplemental files

The Precision Reactor Oscillation and Spectrum Experiment, PROSPECT, is designed to make both a precise measurement of the antineutrino spectrum from a highly-enriched uranium reactor and to probe eV-scale sterile neutrinos by searching for neutrino oscillations over meter-long baselines. PROSPECT utilizes a segmented $^6$Li-doped liquid scintillator detector for both efficient detection of reactor antineutrinos through the inverse beta decay reaction and excellent background discrimination. PROSPECT is a movable 4-ton antineutrino detector covering distances of 7m to 13m from the High Flux Isotope Reactor core. It will probe the best-fit point of the $\bar\nu_e$ disappearance experiments at 4$\sigma$ in 1 year and the favored regions of the sterile neutrino parameter space at more than 3$\sigma$ in 3 years. PROSPECT will test the origin of spectral deviations observed in recent $\theta_{13}$ experiments, search for sterile neutrinos, and address the hypothesis of sterile neutrinos as an explanation of the reactor anomaly. This paper describes the design, construction, and commissioning of PROSPECT and reports first data characterizing the performance of the PROSPECT antineutrino detector., Comment: 30 pages, 33 figures; updated with journal revision and reference

The assembly of signaling complexes at the plasma membrane is required for the initiation and propagation of cellular signaling upon cell activation. The class I PI3K and the serine/threonine-specific protein kinase Akt signaling pathways (PI3K/Akt) are often activated in tumors. These pathways are initiated by the generation of phosphatidylinositol 3,4,5-triphosphate (PIP3) by PI3K-mediated phosphorylation of phosphatidylinositol 4,5-biphosphate (PIP2), synthesized by phosphatidylinositol 4-phosphate 5-kinase (PIPKI) enzymes. The mechanism of how tumor cells recruit and organize the PIP2-synthesizing enzymes with PI3K in the plasma membrane for activation of PI3K/Akt signaling is not defined. Here, we demonstrated a role for the phosphatidylinositol 4-phosphate 5-kinase Iγ (PIPKIγ) in PI3K/Akt signaling. PIPKIγ is overexpressed in triple-negative breast cancers. Loss of PIPKIγ or its focal adhesion-targeting variant, PIPKIγi2, impaired PI3K/Akt activation upon stimulation with growth factors or extracellular matrix proteins in different tumor cells. PIPKIγi2 assembles into a complex containing Src and PI3K; Src was required for the recruitment of PI3K enzyme into the complex. PIPKIγi2 interaction with Src and its lipid kinase activity were required for promoting PI3K/Akt signaling. These results define a mechanism by which PIPKIγi2 and PI3K are integrated into a complex regulated by Src, resulting in the spatial generation of PIP2, which is the substrate PI3K required for PIP3 generation and subsequent Akt activation. This study elucidates the mechanism by which PIP2-generating enzyme controls Akt activation upstream of a PI3K enzyme. This pathway may represent a signaling nexus required for the survival and growth of metastasizing and circulating tumor cells in vivo.

Neutrinoless double-beta ($0\nu\beta\beta$) decay is a hypothesized lepton-number-violating process that offers the only known means of asserting the possible Majorana nature of neutrino mass. The Cryogenic Underground Observatory for Rare Events (CUORE) is an upcoming experiment designed to search for $0\nu\beta\beta$ decay of $^{130}$Te using an array of 988 TeO$_2$ crystal bolometers operated at 10 mK. The detector will contain 206 kg of $^{130}$Te and have an average energy resolution of 5 keV; the projected $0\nu\beta\beta$ decay half-life sensitivity after five years of live time is $1.6\times 10^{26}$ y at $1\sigma$ ($9.5\times10^{25}$ y at the 90% confidence level), which corresponds to an upper limit on the effective Majorana mass in the range 40--100 meV (50--130 meV). In this paper we review the experimental techniques used in CUORE as well as its current status and anticipated physics reach., Comment: 20 pages, 8 figures. Published in Advances in High Energy Physics, Volume 2015 (2015), Article ID 879871

This case study discusses a 13-year-old girl diagnosed with a displaced Salter Harris II fracture of the proximal femoral epiphysis post reduction of a dislocated hip. Radiographs before reduction revealed a small fracture of the inferomedial femoral head. This, however, did not induce concern before reduction. The patient underwent reparative surgery of the epiphysis only to develop a collapsed femoral head, which was remedied through total hip arthroplasty. A decrease in blood flow, the delicacy in reduction, and unknown predispositions might have been contributing factors toward the unique development in this case.

The CUORE Crystal Validation Runs (CCVRs) have been carried out since the end of 2008 at the Gran Sasso National Laboratories, in order to test the performances and the radiopurity of the TeO$_2$ crystals produced at SICCAS (Shanghai Institute of Ceramics, Chinese Academy of Sciences) for the CUORE experiment. In this work the results of the first 5 validation runs are presented. Results have been obtained for bulk contaminations and surface contaminations from several nuclides. An extrapolation to the CUORE background has been performed., 11 pages, 8 figures

BackgroundFew data are available regarding the use of metolazone in infants in cardiac intensive care. Researchers need to carry out further evaluation to characterise the effects of this treatment in this population.MethodsThis is a descriptive, retrospective study carried out in patients less than a year old. These infants had received metolazone over a 2-year period in the paediatric cardiac intensive care unit at our institution. The primary goal was to measure the change in urine output from 24 hours before the start of metolazone therapy to 24 hours after. Patient demographic variables, laboratory data, and fluid-balance data were analysed.ResultsThe study identified 97 infants with a mean age of 0.32±0.25 years. Their mean weight was 4.9±1.5 kg, and 58% of the participants were male. An overall 63% of them had undergone cardiovascular surgery. The baseline estimated creatinine clearance was 93±37 ml/minute/1.73 m2. Initially, the participants had received a metolazone dose of 0.27±0.10 mg/kg/day, the maximum dose being 0.43 mg/kg/day. They had also received other diuretics during metolazone initiation, such as furosemide (87.6%), spironolactone (58.8%), acetazolamide (11.3%), bumetanide (7.2%), and ethacrynic acid (1%). The median change in urine output after metolazone was 0.9 ml/kg/hour (interquartile range 0.15–1.9). The study categorised a total of 66 patients (68.0%) as responders. Multivariable analysis identified acetazolamide use (p=0.002) and increased fluid input in the 24 hours after metolazone initiation (p0.05).ConclusionsMetolazone increased urine output in a select group of patients. Efficacy can be maximised by strategic selection of patients.

Disruption of the extensor mechanism after total knee arthroplasty (TKA) is an infrequent but devastating complication. Presently, limited data exists regarding the optimal treatment and long-term outcomes. Patients who underwent reconstruction of their knee extensor mechanism using Achilles tendon allograft following TKA between January 2003 and January 2012 were identified. Sixteen patients with 17 reconstructions (10 patellar tendons, 7 quadriceps tendons) were studied. All patients underwent evaluation at an average of 45.7 months. Ten of the patients were followed to an average of 65.4 months. After reconstruction, the average extensor lag was 6.6° and average knee flexion was 105.1°. Of the patients with a minimum follow-up of two years and an average follow-up of 65.4 months, the average extensor lag and knee flexion was 8.4° and 107.9°, respectively, with quadriceps strength maintained at an average of 4/5. The quadriceps tendon reconstructions had an average extensor lag and flexion of 2.9° and 103°, respectively. The patellar tendon reconstructions, excluding one re-rupture, had an average extensor lag and flexion of 9.6° and 105.1°, respectively. Four patients died during the follow-up period. All but one of the patients were below the mean for age-matched controls on the SF-36. Achilles tendon allograft reconstruction is a reliable and durable treatment for patients who sustain not only patellar tendon ruptures, but also quadriceps tendon ruptures following TKA. Despite the success of this technique, the injury and procedure have a profound impact on overall function.

We prove that if S is a properly embedded incompressible surface in a compact 3-manifold M, then the fundamental group of S is separable in the fundamental group of M., 8 pages