Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk.

OBJECTIVE: Radiotherapy (RT) is effective in preventing heterotopic ossification (HO) around acetabular fractures requiring surgical reconstruction. We audited outcomes and estimated risks from RT prophylaxis, and alternatives of indometacin or no prophylaxis. METHODS: 34 patients underwent reconstruction of acetabular fractures through a posterior approach, followed by a 8-Gy single fraction. The mean age was 44 years. The mean time from surgery to RT was 1.1 days. The major RT risk is radiation-induced fatal cancer. The International Commission on Radiological Protection (ICRP) method was used to estimate risk, and compared with a method (Trott and Kemprad) specifically for estimating RT risk for benign disease. These were compared with risks associated with indometacin and no prophylaxis. RESULTS: 28 patients (82%) developed no HO; 6 developed Brooker Class I; and none developed Class II-IV HO. The ICRP method suggests a risk of fatal cancer in the range of 1 in 1000 to 1 in 10,000; the Trott and Kemprad method suggests 1 in 3000. For younger patients, this may rise to 1 in 2000; and for elderly patients, it may fall to 1 in 6000. The risk of death from gastric bleeding or perforation from indometacin is 1 in 180 to 1 in 900 in older patients. Without prophylaxis risk of death from reoperation to remove HO is 1 in 4000 to 1 in 30,000. CONCLUSION: These results are encouraging, consistent with much larger series and endorse our multidisciplinary management. Risk estimates can be used in discussion with patients. ADVANCES IN KNOWLEDGE: The risk from RT prophylaxis is small, it is safer than indometacin and substantially overlaps with the range for no prophylaxis.NGB is supported by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre. JES is supported by Cancer Research UK through the Cambridge Cancer Centre.This is the accepted manuscript version. The final version is available from the BIR at http://www.birpublications.org/doi/abs/10.1259/bjr.20140398?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed&

Scherk-Schwarz reduction of M-theory on G2-manifolds with fluxes

We analyse the 4-dimensional effective supergravity theories obtained from the Scherk--Schwarz reduction of M-theory on twisted 7-tori in the presence of 4-form fluxes. We implement the appropriate orbifold projection that preserves a G2-structure on the internal 7-manifold and truncates the effective field theory to an N=1, D=4 supergravity. We provide a detailed account of the effective supergravity with explicit expressions for the Kaehler potential and the superpotential in terms of the fluxes and of the geometrical data of the internal manifold. Subsequently, we explore the landscape of vacua of M-theory compactifications on twisted tori, where we emphasize the role of geometric fluxes and discuss the validity of the bottom-up approach. Finally, by reducing along isometries of the internal 7-manifold, we obtain superpotentials for the corresponding type IIA backgrounds.Comment: 43 pages, Latex; v3 typos corrected, one reference added, JHEP versio

Generalized Geometry and Partial Supersymmetry Breaking

This review article consists of two parts. In the first part we use the formalism of (exceptional) generalized geometry to derive the scalar field space of SU(2)xSU(2)-structure compactifications. We show that in contrast to SU(3)xSU(3) structures, there is no dynamical SU(2)xSU(2) structure interpolating between an SU(2) structure and an identity structure. Furthermore, we derive the scalar manifold of the low-energy effective action for consistent Kaluza-Klein truncations as expected from N=4 supergravity. In the second part we then determine the general conditions for the existence of stable Minkowski and AdS N=1 vacua in spontaneously broken gauged N=2 supergravities and construct the general solution under the assumption that two appropriate commuting isometries exist in the hypermultiplet sector. Furthermore, we derive the low-energy effective action below the scale of partial supersymmetry breaking and show that it satisfies the constraints of N=1 supergravity. We then apply the discussion to special quaternionic-Kahler geometries which appear in the low-energy limit of SU(3)xSU(3)-structure compactifications and construct Killing vectors with the right properties. Finally we discuss the string theory realizations for these solutions.Comment: 117 pages, Ph.D. thesis (Advisor: Jan Louis); v2: references adde

Generalized N=1 Orientifold Compactifications and the Hitchin functionals

The four-dimensional N=1 supergravity theories arising in compactifications of type IIA and type IIB on generalized orientifold backgrounds with background fluxes are discussed. The Kahler potentials are derived for reductions on SU(3) structure orientifolds and shown to consist of the logarithm of the two Hitchin functionals. These are functions of even and odd forms parameterizing the geometry of the internal manifold, the B-field and the dilaton. The superpotentials induced by background fluxes and the non-Calabi-Yau geometry are determined by a reduction of the type IIA and type IIB fermionic actions on SU(3) and generalized SU(3) x SU(3) manifolds. Mirror spaces of Calabi-Yau orientifolds with electric and part of the magnetic NS-NS fluxes are conjectured to be certain SU(3) x SU(3) structure manifolds. Evidence for this identification is provided by comparing the generalized type IIA and type IIB superpotentials.Comment: 57 pages, references adde

Lectures on Generalized Complex Geometry for Physicists

In these lectures we review Generalized Complex Geometry and discuss two main applications to string theory: the description of supersymmetric flux compactifications and the supersymmetric embedding of D-branes. We start by reviewing G-structures, and in particular SU(3)-structure and its torsion classes, before extending to Generalized Complex Geometry. We then discuss the supersymmetry conditions of type II supergravity in terms of differential conditions on pure spinors, and finally introduce generalized calibrations to describe D-branes. As examples we discuss in some detail AdS4 compactifications, which play a role as the geometric duals in the AdS4/CFT3-correspondence.Comment: 94 pages, 4 figures, 5 tables, lectures Sogang University August 2007 and Modave Summer School September 2008, v2: references adde

Moduli Stabilization and Cosmology of Type IIB on SU(2)-Structure Orientifolds

We consider type IIB flux compactifications on six-dimensional SU(2)-structure manifolds with O5- and O7-planes. These six-dimensional spaces allow not only for F_3 and H_3 fluxes but also for F_1 and F_5 fluxes. We derive the four-dimensional N=1 scalar potential for such compactifications and present one explicit example of a fully stabilized AdS vacuum with large volume and small string coupling. We then discuss cosmological aspects of these compactifications and derive several no-go theorems that forbid dS vacua and slow-roll inflation under certain conditions. We also study concrete examples of cosets and twisted tori and find that our no-go theorems forbid dS vacua and slow-roll inflation in all but one of them. For the latter we find a dS critical point with \epsilon numerically zero. However, the point has two tachyons and eta-parameter \eta \approx -3.1.Comment: 35 pages + appendices, LaTeX2e; v2: numerical dS extremum added, typos corrected, references adde

Gaugino Condensates and Fluxes in N = 1 Effective Superpotentials

In the framework of orbifold compactifications of heterotic and type II orientifolds, we study effective N = 1 supergravity potentials arising from fluxes and gaugino condensates. These string solutions display a broad phenomenology which we analyze using the method of N = 4 supergravity gaugings. We give examples in type II and heterotic compactifications of combined fluxes and condensates leading to vacua with naturally small supersymmetry breaking scale controlled by the condensate, cases where the supersymmetry breaking scale is specified by the fluxes even in the presence of a condensate and also examples where fluxes and condensates conspire to preserve supersymmetry.Comment: 31 page

BPS-like potential for compactifications of heterotic M-theory?

We analyze the possibility to rewrite the action of Horava-Witten theory in a BPS-like form, which means that it is given as a sum of squares of the supersymmetry conditions. To this end we compactify the theory on a seven dimensional manifold of SU(3) structure and rewrite the scalar curvature of the compactification manifold in terms of the SU(3) structure forms. This shows that a BPS-like form cannot be obtained in general, but only for certain types of compactifications.Comment: 31 pages, no figures, references added, typos correcte

Exploiting N=2 in consistent coset reductions of type IIA

We study compactifications of type IIA supergravity on cosets exhibiting SU(3) structure. We establish the consistency of the truncation based on left-invariance, providing a justification for the choice of expansion forms which yields gauged N=2 supergravity in 4 dimensions. We explore N=1 solutions of these theories, emphasizing the requirements of flux quantization, as well as their non-supersymmetric companions. In particular, we obtain a no-go result for de Sitter solutions at string tree level, and, exploiting the enhanced leverage of the N=2 setup, provide a preliminary analysis of the existence of de Sitter vacua at all string loop order.Comment: 38 pages, 1 figure; v2: appendix on solving string loop corrected susy equations added, references added, typos corrected; v3: minor modification