On Flux Quantization in F-Theory

We study the problem of four-form flux quantization in F-theory compactifications. We prove that for smooth, elliptically fibered Calabi-Yau fourfolds with a Weierstrass representation, the flux is always integrally quantized. This implies that any possible half-integral quantization effects must come from 7-branes, i.e. from singularities of the fourfold. We subsequently analyze the quantization rule on explicit fourfolds with Sp(N) singularities, and connect our findings via Sen's limit to IIB string theory. Via direct computations we find that the four-form is half-integrally quantized whenever the corresponding 7-brane stacks wrap non-spin complex surfaces, in accordance with the perturbative Freed-Witten anomaly. Our calculations on the fourfolds are done via toric techniques, whereas in IIB we rely on Sen's tachyon condensation picture to treat bound states of branes. Finally, we give general formulae for the curvature- and flux-induced D3 tadpoles for general fourfolds with Sp(N) singularities.Comment: 46 page

On Flux Quantization in F-Theory II: Unitary and Symplectic Gauge Groups

We study the quantization of the M-theory G-flux on elliptically fibered Calabi-Yau fourfolds with singularities giving rise to unitary and symplectic gauge groups. We seek and find its relation to the Freed-Witten quantization of worldvolume fluxes on 7-branes in type IIB orientifold compactifications on Calabi-Yau threefolds. By explicitly constructing the appropriate four-cycles on which to calculate the periods of the second Chern class of the fourfolds, we find that there is a half-integral shift in the quantization of G-flux whenever the corresponding dual 7-brane is wrapped on a non-spin submanifold. This correspondence of quantizations holds for all unitary and symplectic gauge groups, except for SU(3), which behaves mysteriously. We also perform our analysis in the case where, in addition to the aforementioned gauge groups, there is also a 'flavor' U(1)-gauge group.Comment: 33 pages, 4 figure

Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis group

BACKGROUND: Accurate methods to preoperatively characterize adnexal tumors are pivotal for optimal patient management. A recent metaanalysis concluded that the International Ovarian Tumor Analysis algorithms such as the Simple Rules are the best approaches to preoperatively classify adnexal masses as benign or malignant. OBJECTIVE: We sought to develop and validate a model to predict the risk of malignancy in adnexal masses using the ultrasound features in the Simple Rules. STUDY DESIGN: This was an international cross-sectional cohort study involving 22 oncology centers, referral centers for ultrasonography, and general hospitals. We included consecutive patients with an adnexal tumor who underwent a standardized transvaginal ultrasound examination and were selected for surgery. Data on 5020 patients were recorded in 3 phases from 2002 through 2012. The 5 Simple Rules features indicative of a benign tumor (B-features) and the 5 features indicative of malignancy (M-features) are based on the presence of ascites, tumor morphology, and degree of vascularity at ultrasonography. Gold standard was the histopathologic diagnosis of the adnexal mass (pathologist blinded to ultrasound findings). Logistic regression analysis was used to estimate the risk of malignancy based on the 10 ultrasound features and type of center. The diagnostic performance was evaluated by area under the receiver operating characteristic curve, sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), positive predictive value (PPV), negative predictive value (NPV), and calibration curves. RESULTS: Data on 4848 patients were analyzed. The malignancy rate was 43% (1402/3263) in oncology centers and 17% (263/1585) in other centers. The area under the receiver operating characteristic curve on validation data was very similar in oncology centers (0.917; 95% confidence interval, 0.901-0.931) and other centers (0.916; 95% confidence interval, 0.873-0.945). Risk estimates showed good calibration. In all, 23% of patients in the validation data set had a very low estimated risk (<1%) and 48% had a high estimated risk (≥30%). For the 1% risk cutoff, sensitivity was 99.7%, specificity 33.7%, LR+ 1.5, LR- 0.010, PPV 44.8%, and NPV 98.9%. For the 30% risk cutoff, sensitivity was 89.0%, specificity 84.7%, LR+ 5.8, LR- 0.13, PPV 75.4%, and NPV 93.9%. CONCLUSION: Quantification of the risk of malignancy based on the Simple Rules has good diagnostic performance both in oncology centers and other centers. A simple classification based on these risk estimates may form the basis of a clinical management system. Patients with a high risk may benefit from surgery by a gynecological oncologist, while patients with a lower risk may be managed locally

Arginine-gingipain-specific IgG in the sera of human patients with periodontal disease is required for opsonophagocytosis of Porphyromonas gingivalis

Thesis (M.S.D)--Boston University, Goldman School of Dental Medicine, 2003 (Oral Biology).Includes bibliographical references (leaves 48-59).Porphyromonas gingivalis is a primary etiologic agent of generalized aggressive periodontal disease (GAP), and gingipains, a group of cysteine proteinases, are critical virulence factors expressed by this organism. Gingipains are classified into two groups based on substrate specificity for arginine (Rgp A and RgpB) or lysine (Kgp) residues. In this study we characterized the levels of P. gingivalis-, and gingipain-specific IgG in sera of GAP patients, and examined the ability of gingipain-specific antibodies to facilitate opsonophagocytosis of P. gingivalis by human PMNs using a fluorescent phagocytosis assay. GAP patient sera possessed elevated levels of P. gingivalis-, arginine-gingipain (Rgp)A-, RgpB-, and lysine-gingipain (Kgp)-specific lgG (Kgp>RgpA>P. gingivalis>RgpB). Adsorption of GAP sera with P. gingivalis whole organisms, RgpA-, or RgpB-, but not Kgp-conjugated to sepharose beads significantly reduced opsonophagocytosis of P. gingivalis by PMNs. Our studies demonstrate that GAP patients possess elevated levels of P. gingivalis, and gingipain-specific IgG, demonstrate that arginine-gingipa. in antibodies promote uptake of P. gingivalis by PMNs, and establish that arginine gingipain-specific antibodies are important for control of P. gingivalis infections

Le dimensioni dell’entertainment nei Centri Commerciali: ipotesi di ricerca e prime riflessioni empiriche

The paper addresses the issue of entertainment in the context of Shopping Centers. Starting from the existing literature, the first part is aimed at clarifying the concept of entertainment and at analyzing the most popular entertainment activities. Three main categories are discussed: atmospheric-based entertainment, recreational service-based entertainment and special event-based entertainment. A distinction between hyper-realistic events and mediterranean events is also proposed. In the second part of the paper, we describe and discuss the results of an exploratory and qualitative survey, carried out through direct interviews with the management of ten Italian Shopping Centers, in order to investigate the features of entertainment activities managed within them and to evaluate, in a preliminary way, the significance of the research hypotheses identified in the work. Findings suggest the decreasing effectiveness of entertainment strategies related to the exclusive use of atmospherics and recreational services (which tend to characterize the basic tenat-mix of many Shopping Center) as well as the lower effectiveness of those forms of entertainment based on spectacular and impersonal events, in favor of less standardized events characterized by higher level of customer engagement, socialization and active participation of customers in the value creation process. Final results of this research will provide useful knowledge to support the managers of Shopping Centers in identifying and managing entertainment strategies more consistent with the specific context where they operate

Strategies to diagnose ovarian cancer: new evidence from phase 3 of the multicentre international IOTA study

Background: To compare different ultrasound-based international ovarian tumour analysis (IOTA) strategies and risk of malignancy index (RMI) for ovarian cancer diagnosis using a meta-analysis approach of centre-specific data from IOTA3. Methods: This prospective multicentre diagnostic accuracy study included 2403 patients with 1423 benign and 980 malignant adnexal masses from 2009 until 2012. All patients underwent standardised transvaginal ultrasonography. Test performance of RMI, subjective assessment (SA) of ultrasound findings, two IOTA risk models (LR1 and LR2), and strategies involving combinations of IOTA simple rules (SRs), simple descriptors (SDs) and LR2 with and without SA was estimated using a meta-analysis approach. Reference standard was histology after surgery. Results: The areas under the receiver operator characteristic curves of LR1, LR2, SA and RMI were 0.930 (0.917–0.942), 0.918 (0.905–0.930), 0.914 (0.886–0.936) and 0.875 (0.853–0.894). Diagnostic one-step and two-step strategies using LR1, LR2, SR and SD achieved summary estimates for sensitivity 90–96%, specificity 74–79% and diagnostic odds ratio (DOR) 32.8–50.5. Adding SA when IOTA methods yielded equivocal results improved performance (DOR 57.6–75.7). Risk of Malignancy Index had sensitivity 67%, specificity 91% and DOR 17.5. Conclusions: This study shows all IOTA strategies had excellent diagnostic performance in comparison with RMI. The IOTA strategy chosen may be determined by clinical preference

Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU.

OBJECTIVES: To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN: Prospective cohort study. SETTING: A total of 306 ICUs from 24 European countries. PARTICIPANTS: Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81-87 y]; 51.8% male). MEASUREMENTS: Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30-day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves. RESULTS: The 30-day-mortality was 1562 (41.9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis, Clinical Frailty Scale, Sequential Organ Failure Score, invasive mechanical ventilation, and renal replacement therapy. The discrimination, accuracy, and calibration of the model were good: the area under the curve for a score of 10 or higher was .80, and the Brier score was .18. At a cut point of 10 or higher (75% of all patients), the model predicts 30-day mortality in 91.1% of all patients who die. CONCLUSION: A predictive model of cumulative events predicts 30-day mortality in patients older than 80 years admitted to ICUs. Future studies should include other potential predictor variables including functional status, presence of advance care plans, and assessment of each patient's decision-making capacity

One-Step Laparoscopic Management of a Female Adnexal Tumor of Wolffian Origin

We report a case of female adnexal tumor of Wolffian origin (FATWO), a rare neoplasm arising from the mesonephric ducts. A 48-year-old woman came first to our center for a recent discovery of a pelvic mass. Transvaginal ultrasonographic findings suggested a solid right para-ovarian mass suspected to be malignant. After thorough counseling, the patient underwent operative laparoscopy for excision of the para-ovarian mass with frozen section (FS) examination resulting in the diagnosis of a poorly differentiated adenocarcinoma. In this case, FS results allowed performing a comprehensive oncological staging, through a totally laparoscopic extrafascial hysterectomy, bilateral adnexectomy, total omentectomy, pelvic wall peritonectomy, and pelvic, parasacral and para-aortic lymphadenectomy. Final pathological and immunohistochemical results confirmed the diagnosis of FATWO. To our knowledge, this is the first case of FATWO managed entirely by a minimally invasive laparoscopic approach in a single surgical session

Supplementations of industrial multichamber parenteral nutrition bags in critically ill children: safety of the practice

Parenteral nutrition (PN) is sometimes required in critically ill children because of contraindication or intolerance to full enteral nutrition. European guidelines recommend favoring multichamber bag PN (MCB PN), when possible, for quality purposes and ease of use. The prescribers may adjust the MCB PN through supplementations to better fulfill patient needs. The objective of this study is to investigate the use and supplementations of MCB PN. This observational, single-center, retrospective study was conducted in a pediatric intensive care unit (PICU). We collected prescriptions of MCB PNs and their supplementations added directly into PN bags. A descriptive analysis and a comparison of electrolyte supplementations with the manufacturer's recommendations were undertaken. One hundred thirty-five children (median age 39.2 months [7.0-118.8]) were included, 1449 MCB PNs were administered, and 1652 supplementations were carried out in 736 PN bags. Thirty-two percent of supplementations were vitamins, 32.2% were trace elements, and 35.8% were electrolytes. Around 10% of electrolyte supplementations in PN bags were outside the manufacturer's recommendations. These nonconformities primarily concerned phosphate. This study showed the real-world clinical use of MCB PN in the PICU. Proper attention should be paid to septic risks and physicochemical risks to ensure efficient practice and safety of MCB PN use. [Abstract copyright: © 2022 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.