Softly Broken A_4 Symmetry for Nearly Degenerate Neutrino Masses

The leptonic Higgs doublet model of neutrino masses is implemented with an A_4 discrete symmetry (the even permutation of 4 objects or equivalently the symmetry of the tetrahedron) which has 4 irreducible representations: 1, 1', 1'', and 3. The resulting spontaneous and soft breaking of A_4 provides a realistic model of charged-lepton masses as well as a nearly degenerate neutrino mass matrix. Phenomenological consequences at and below the TeV scale are discussed.Comment: 11 pages, no figur

Age-Related Disparities in Trauma Center Access for Severe Head Injuries Following the Release of the Updated Field Triage Guidelines

Objective: In 2006, the American College of Surgeons’ Committee on Trauma and the Center for Disease Control released field triage guidelines with special consideration for older adults. Additional considerations for direct transport to a Level I or II trauma center (TC) were added in 2011, reflecting perceived undertriage to TCs for older adults. We examined whether age-based disparities in TC care for severe head injury decreased following introduction of the 2011 revisions. Methods: A pre-post design analyzing the 2009 and 2012 Healthcare Cost and Utilization Project State Emergency Department Databases (SEDD) and State Inpatient Databases (SID) with multivariable logistic regressions considered changes in (1) the trauma designation of the emergency department where treatment was initiated and (2) transfer to a TC following initial treatment at a non-TC. Results: Compared with adults aged 18–44 years, after multivariable adjustment, in both years TC care was less likely for adults aged 45–64 years (OR: 0.76 in 2009 and 0.74 in 2012), aged 65–84 years (OR: 0.61 and 0.59), and aged 85+ years (OR: 0.53 and 0.56). Between 2009 and 2012, the likelihood of TC care increased for all age groups, with the largest increase among those aged 85+ years (OR = 1.18), which was statistically different (p = .02) from the increase among adults aged 18–44 years (OR = 1.12). The analysis of transfers yielded similar results. Conclusions: Although patterns of increased TC treatment for all groups with severe head trauma indicate improvements, age-based disparities persisted

New "Square Root" Model of Lepton Family Cyclic Symmetry

Following the newly formulated notion of form invariance of the neutrino mass matrix, a complete model of leptons is constructed. It is based on a specific unitary 3 X 3 matrix U in family space, such that U^2 is the simple discrete symmetry nu_e to -nu_e, nu_mu to nu_tau. Thus U also generates the cyclic group Z_4. The charged-lepton mass matrix is nearly diagonal while the neutrino mass matrix is of the form suitable for explaining maximal (large) mixing in atmospheric (solar) neutrino oscillations in the context of three nearly degenerate neutrino masses. Observable lepton flavor violation is predicted. Quarks may be treated in the same way as the charged leptons.Comment: 10 pages, no figur

Supersymmetric Model of Muon Anomalous Magnetic Moment and Neutrino Masses

We propose the novel lepton-number relationship $L_\tau = L_e + L_\mu$, which is uniquely realized by the interaction $(\hat \nu_e \hat \mu - \hat e \hat \nu_\mu) \hat \tau^c$ in supersymmetry and may account for a possibly large muon anomalous magnetic moment. Neutrino masses (with bimaximal mixing) may be generated from the spontaneous and soft breaking of this lepton symmetry.Comment: 10 pages, including 2 figure

Appendicitis and its associated mortality and morbidity in infants up to 3 months of age:A systematic review

Background and Aims: Although appendicitis is rare in young infants, the reported mortality is high. Primary aim of this systematic review was to provide updated insights in the mortality and morbidity (postoperative complications, Clavien-Dindo grades I–IV) of appendicitis in infants ≤3 months of age. Secondary aims comprised the evaluation of patient characteristics, diagnostic work-up, treatment strategies, comorbidity, and factors associated with poor outcome. Methods: This systematic review was reported according to the PRISMA statement with a search performed in Pubmed, Embase and Web of Science (up to September 5th 2022). Original articles (published in English ≥1980) reporting on infants ≤3 months of age with appendicitis were included. Both patients with abdominal appendicitis and herniated appendicitis (such as Amyand's hernia) were considered. Data were provided descriptively. Results: In total, 131 articles were included encompassing 242 cases after identification of 4294 records. Overall, 184 (76%) of the 242 patients had abdominal and 58 (24%) had herniated appendicitis. Two-hundred (83%) of the patients were newborns (≤28 days) and 42 (17%) were infants between 29 days and ≤3 months of age. Either immediate, or after initial conservative treatment, 236 (98%) patients underwent surgical treatment. Some 168 (69%) patients had perforated appendicitis. Mortality was reported in 20 (8%) patients and morbidity in an additional 18 (8%). All fatal cases had abdominal appendicitis and fatal outcome was relatively more often reported in newborns, term patients, patients with relevant comorbidity, nonperforated appendicitis and those presented from home. Conclusion: Mortality was reported in 20 (8%) infants ≤3 months of age and additional morbidity in 18 (8%). All patients with fatal outcome had abdominal appendicitis. Several patient characteristics were relatively more often reported in infants with poor outcome and adequate monitoring, early recognition and prompt treatment may favour the outcome.</p

Social networks and political participation in a Sicilian community context

AbstractThis study shows the linkage between political and social participation, underlining the relevance of the motivational sphere. The aim is to evaluate politically relevant social capital by adopting a relational perspective and ego-network measures, so that we can understand the interdependence between cognitive maps, motivational factors and relational dimension, both in qualitative and quantitative dimensions

Lepton Flavour Violation in a Class of Lopsided SO(10) Models

A class of predictive SO(10) grand unified theories with highly asymmetric mass matrices, known as lopsided textures, has been developed to accommodate the observed mixing in the neutrino sector. The model class effectively determines the rate for charged lepton flavour violation, and in particular the branching ratio for $\mu -> e \gamma$, assuming that the supersymmetric GUT breaks directly to the constrained minimal supersymmetric standard model (CMSSM). We find that in light of the combined constraints on the CMSSM parameters from direct searches and from the WMAP satellite observations, the resulting predicted rate for $\mu -> e \gamma$ in this model class can be within the current experimental bounds for low $\tan \beta$, but that the next generation of $\mu -> e \gamma$ experiments would effectively rule out this model class if LFV is not detected.Comment: 23 page

Evolution of mitral regurgitation in patients with heart failure referred to a tertiary heart failure clinic

Aims: Significant mitral regurgitation (MR) is an important predictor for all-cause mortality and heart failure (HF) hospitalizations independent of left ventricular ejection fraction (LVEF). The aims of this study were to investigate (i) in how many patients referred to a tertiary outpatient HF clinic HF therapy could be optimized, (ii) the effect of optimized treatment on MR severity, and (iii) whether a reduction in MR resulted in improvement of symptoms. Methods and results: Forty-seven referred patients with therapy-resistant symptomatic chronic HF with an LVEF <40% and at least moderate MR were analysed on admission and after optimization of HF treatment after 6–18 months. The patients were classified as a volume responder when LV end-systolic volume (LVESV) decreased ≥15%, as LVEF responder when LVEF increased by ≥5% points, as clinical responder when New York Heart Association (NYHA) class improved at least one category, and as MR responder when MR severity improved at least one category to maximally moderate. After 14 ± 4 months of treatment optimization, optimal doses of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker were seen in 18 (38%) patients compared with three (6%) at baseline (P < 0.001), and optimal doses of beta-blockers were seen in 14 (30%) patients compared with four (9%) at baseline (P < 0.001). In total, 68% of the patients were clinical responders, 57% MR responders, 34% volumetric responders, and 49% LVEF responders. NYHA class improved from 2.9 ± 0.6 to 2.0 ± 0.9 (P < 0.001), MR class from 5.2 ± 0.8 to 3.6 ± 1.5 (P < 0.001), LVEF from 24% ± 9% to 31% ± 12% (P < 0.01), and LVESV non-significantly improved. The positive predictive value of MR response to NYHA response was 88%; the negative predictive value was 53%, agreement 69%, and kappa 0.39. The positive predictive value of LVEF response to NYHA response was 76%; the negative predictive value was 44%, agreement 60%, and kappa 0.21. The positive predictive value of LVESV volume response to NYHA response was 75%; the negative predictive value was 39%, agreement 51%, and kappa 0.12. Conclusions: Although this study was limited by a small number of patients, initiation and up-titration of recommended HF therapy in patients referred to our tertiary HF outpatient clinic resulted in significant MR reduction in over half of the patients, emphasizing the importance of optimal medical treatment in these very sick cardiac patients with otherwise grave prognosis. MR reduction was best correlated to NYHA improvement

Electromagnetic suppression of the decay mu --> e+gamma

Due to large QED anomalous dimensions of the electric and magnetic dipole operators, the rate of the rare muon decay mu --> e+gamma is suppressed by the factor [ 1- 8 alpha/pi ln(Lambda/m_mu) ], independent of the physics responsible for the lepton-flavor violation, except for the scale Lambda at which it occurs. For Lambda = 100 -- 1000 GeV, the resulting decrease of the rate amounts to about 12 -- 17 %.Comment: Added analysis of four-fermion operators. Journal versio

Excision of both pretreatment marked positive nodes and sentinel nodes improves axillary staging after neoadjuvant systemic therapy in breast cancer

Background: Marking the axilla with radioactive iodine seed and sentinel lymph node (SLN) biopsy have been proposed for axillary staging after neoadjuvant systemic therapy in clinically node-positive breast cancer. This study evaluated the identification rate and detection of residual disease with combined excision of pretreatment-positive marked lymph nodes (MLNs) together with SLNs. Methods: This was a multicentre retrospective analysis of patients with clinically node-positive breast cancer undergoing neoadjuvant systemic therapy and the combination procedure (with or without axillary lymph node dissection). The identification rate and detection of axillary residual disease were calculated for the combination procedure, and for MLNs and SLNs separately. Results: At least one MLN and/or SLN(s) were identified by the combination procedure in 138 of 139 patients (identification rate 99·3 per cent). The identification rate was 92·8 per cent for MLNs alone and 87·8 per cent for SLNs alone. In 88 of 139 patients (63·3 per cent) residual axillary disease was detected by the combination procedure. Residual disease was shown only in the MLN in 20 of 88 patients (23 per cent) and only in the SLN in ten of 88 (11 per cent), whereas both the MLN and SLN contained residual disease in the remainder (58 of 88, 66 per cent). Conclusion: Excision of the pretreatment-positive MLN together with SLNs after neoadjuvant systemic therapy in patients with clinically node-positive disease resulted in a higher identification rate and improved detection of residual axillary disease