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Abstract Background Despite recent advances, optimal therapeutic approaches applicable to subpopulations with primary central nervous system (CNS) lymphoma outside of clinical trials remain to be determined. Methods We performed a retrospective study of immunocompetent, adult patients with histologically confirmed diffuse large B‐cell lymphoma of the CNS (PCNSL). 190/204 (93%) patients (median age: 65) received one of five high‐dose methotrexate (HD‐MTX) containing chemotherapy regimens: MPV/Ara‐C (HD‐MTX, procarbazine, and vincristine, followed by cytarabine [Ara‐C]) (n = 94, 50%), MATRix (HD‐MTX, Ara‐C, thiotepa, and rituximab) (n = 19, 10%), HD‐MTX/Ara‐C (n = 31, 16%), HD‐MTX monotherapy (n = 35, 18%) and MBVP (HD‐MTX, carmustine, teniposide, prednisolone) (n = 11, 6%). Results Cumulative median HD‐MTX and Ara‐C doses were 17 g/m2 (range: 1–64 g/m2) and 12 g/m2 (0–32 g/m2) respectively. Using 14 g/m2 as the reference dose, the median HD‐MTX relative dose intensity (HD‐MTX‐RDI) was 1.25 (0.27‐4.57) with 84% receiving > 0.75. The overall response rate (ORR) was 72% (complete response: 50%) after completing HD‐MTX. At a median follow‐up of 3.41 years (0.06–9.42), progression‐free survival (PFS) and overall survival (OS) were different between chemotherapy cohorts, with the best outcomes achieved in the MPV/Ara‐C cohort (2‐year PFS 74%, 2‐year OS 82%; p = 0.0001 and p = 0.0024 respectively). On multivariate analysis, MPV/Ara‐C administration and HD‐MTX‐RDI > 0.75 were associated with longer PFS and OS. Conclusion Sequential, response‐adapted approaches can improve outcomes, even in older patients who are ineligible for a high‐intensity concurrent chemotherapy approach and do not undergo traditional consolidative strategies.

Jingjing Mu,1,2,* Shiyi Xiong,2,* Guixiang Yang,2 Fengfeng Wang,3 Xuanying Li,2 Qiong Gao,2 Qiang Niu,2 Stanley Sau Ching Wong,3 Xuebing Xu,2 Yauwai Chan,2,* Yalan Li1,* 1Department of Anesthesiology, the First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, People’s Republic of China; 2Department of Anaesthesiology, the University of Hong Kong Shenzhen Hospital, Shenzhen, People’s Republic of China; 3Department of Anaesthesiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong*These authors contributed equally to this workCorrespondence: Yalan Li, Department of Anesthesiology, the First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, People’s Republic of China, Tel +8613500013993, Email tyalan@jnu.edu.cn Yauwai Chan, Department of Anesthesiology, the University of Hong Kong Shenzhen Hospital, Shenzhen, People’s Republic of China, Tel +86 150 0204 8972, Email cywz01@hku.hkPurpose: Although pediatric epidural analgesia is a well-established technique used perioperatively. It is unclear whether a lumbar or caudal epidural is suitable for osteogenesis imperfecta (OI) patients, which may be associated with brittle bones and spine deformity. We conducted a retrospective study to investigate and compare the efficacy of the two continuous epidural techniques in pediatric patients undergoing lower extremity osteotomy surgery using a propensity score-matched analysis (PSMA).Patients and Methods: A total of 274 patients were included. Patients’ age, weight, and height were adjusted using PSMA. 90 patients were matched for further analysis, with 45 patients in the lumbar epidural group (Group L) and 45 patients in the caudal epidural group (Group C). Pain scores were categorized into three grades: mild (0– 3), moderate (4– 6), and severe (7– 10), and compared between the two groups. Additionally, operation time, operation site, blood loss, scoliosis, oral analgesic medications, and catheter or nerve-related complications were compared.Results: There were no significant differences in operation time, operation site, scoliosis, and blood loss between the two groups. The percentage of moderate to severe pain during movement was significantly higher in Group L than in Group C, with 37.5% versus 17.5% on the second-day post-operation (P=0.039). However, no statistically significant difference was observed on other days. Additionally, there was no significant difference in oral medication consumption and complications between the two groups.Conclusion: Both lumbar and caudal epidural analgesia can be effectively used postoperatively, and a caudal epidural should be considered where performing a lumbar epidural is challenging in OI pediatric patients.Plain Language Summary: Osteogenesis imperfecta (OI) is a rare genetic disorder that affects the body’s connective tissues, particularly the bones and ligaments. It is caused by abnormalities in type I collagen, which leads to skeletal fragility known as “brittle bones”. This fragility can cause various issues, including an increased risk of fractures from minor trauma, limb deformities, and unusual fractures such as vertebral compressions. OI patients may also experience spinal manifestations such as scoliosis and kyphosis.Lumbar epidural analgesia has been found to be effective in providing pain relief for surgeries that involve the lower extremities. Additionally, caudal epidural analgesia has also demonstrated its effectiveness in providing postoperative analgesia for surgeries that affect the lower limbs. However, there is still debate about the safety of epidural analgesia in patients with skeletal dysplasias, especially those with OI. Despite this uncertainty, our center, which was supported by the Rare Diseases Public Welfare Organization, has successfully used epidural analgesia since 2015 in the southern part of China for OI surgeries.We conducted a retrospective study to share our experiences of nine years of practice and compare lumbar epidural with caudal epidural using a propensity score matching to balance basic demographics. We also compared the presence of scoliosis. Our findings suggest that both lumbar and caudal epidural analgesia can be safely used in OI patients. In cases where lumbar punctures may pose challenges due to potential spine deformities, the caudal route can be an alternative.Keywords: Lumbar epidural, caudal epidural, osteotomy surgery, osteogenesis imperfecta, cohort analysis, pain management

Bruton tyrosine kinase inhibitors (BTKi) have transformed the treatment of B-cell malignancies, but intolerance has often led to their discontinuation. The phase 1/2 BRUIN study evaluated pirtobrutinib, a highly selective non-covalent (reversible) BTKi, in patients with R/R B-cell malignancies (NCT03740529). Pirtobrutinib was investigated in 127 patients with intolerance to at least one prior BTKi therapy in the absence of progressive disease. The most common adverse event (AE) leading to BTKi discontinuation was cardiac disorders (n=40, 31.5%), specifically atrial fibrillation (n=30, 23.6%). The median follow-up was 17.4 months and the median time on pirtobrutinib was 15.3 months. The most common reasons for pirtobrutinib discontinuation were progressive disease (26.8%), AE (10.2%), or death (5.5%). The most frequent treatment-emergent AEs were fatigue (39.4%) and neutropenia (37.0%). Among patients who discontinued a prior BTKi for a cardiac issue, 75% had no recurrence of their cardiac AE. No patient discontinued pirtobrutinib for the same AE that led to discontinuation of the prior BTKi. In 78 CLL/SLL and 21 MCL patients intolerant to prior BTKi, ORR to pirtobrutinib was 76.9% and 81.0%, respectively. Median PFS for CLL/SLL was 28.4 months and was not estimable for MCL. These results suggest that pirtobrutinib was safe, well-tolerated, and an efficacious option in patients with prior BTKi-intolerance.

Abstract Polatuzumab vedotin (Pola) is an approved therapy in combination with rituximab and bendamustine for relapsed or refractory diffuse large B‐cell lymphoma (RR‐DLBCL) based on positive results of the landmark phase II randomised G029365 trial. However, trial results for many approved novel therapies in RR‐DLBCL have not been replicated in routine care cohorts, as RR‐DLBCL patient populations are heterogeneous and trial eligibility is increasingly restrictive. We evaluated outcomes from pola ± bendamustine and rituximab in patients with RR‐DLBCL enrolled in a compassionate access program with no alternative treatment options identified via the Australasian Lymphoma and Related Diseases Registry according to their eligibility for the original phase II published study. Of 58 eligible patients, 74% met the criteria deeming them ineligible for the G029365 original study at the time of pola's commencement. Median progression‐free survival and overall survival in our cohort were 2.3 and 3.5 months, respectively. In contrast to the landmark trial cohort, more of our patients ceased therapy prior to completion, the majority due to progressive disease and only 8/58 received any subsequent treatment. Dismal outcomes in this Australian real‐world population demonstrate trial eligibility is challenging to meet, and newer treatments can be difficult to deliver in routine care. Clinically applicable results from therapeutic studies require trial cohorts to reflect representative clinical populations wherever possible, and more research is required to address the benefit of novel agents in the increasing majority who are ineligible for modern studies.

Follicular Lymphoma (FL) treatment initiation is largely determined by tumor burden and symptoms. In the pre-rituximab era, the Group d’Etude des Lymphomes Folliculaires (GELF) developed widely adopted criteria to identify high tumor burden FL patients to harmonize clinical trial populations. The utilization of GELF criteria (GELFc) in routine therapeutic decision-making is poorly described. This multicenter retrospective study evaluated patterns of GELFc at presentation and GELFc utilization in therapeutic decision-making in newly diagnosed, advanced stage rituximab-era FL. Associations between GELFc, treatment given, and patient survival were analyzed in 300 eligible cases identified between 2002-2019. 163 (54%) had ≥1 GELFc at diagnosis. The presence or cumulative number of GELFc did not predict PFS in patients undergoing watch-and-wait (WW) or those receiving systemic treatment. Of interest, in patients with ≥1 GELFc, 16/163 (10%) underwent initial watch-and-wait (comprising 22% of the watchand- wait cohort). In those receiving systemic therapy +/- radiotherapy, 74/215 (34%) met no GELFc. Our data suggest clinicians are using adjunctive measures to make decisions regarding treatment initiation in a significant proportion of patients. By restricting FL clinical trial eligibility only to those meeting GELFc, reported outcomes may not be applicable to a significant proportion of patients treated in routine care settings.

الملخص: على عكس الأوبئة في الماضي، شهد تفشي مرض كوفيد-19 الذي ينتقل بسرعة في جميع أنحاء العالم نهجا مختلفا تماما للضوابط والتدابير التي تم تنفيذها في جميع البلدان المتضررة. لا يزال عدم فهم الطبيعة الأساسية لتفشي المرض يجعل من كوفيد-19 تحديا لكل من ممارسي الرعاية الصحية والمجتمع العلمي. لا تزال التحديات التي تواجه تطوير اللقاح وتقييمه، والخيارات العلاجية الحصرية، وعلاج البلازما في فترة النقاهة، ومناعة القطيع، فضلا عن ظهور العدوى مرة أخرى والمتغيرات الجديدة، هي العقبات الرئيسية أمام مكافحة كوفيد-19. تناقش هذه المراجعة هذه التحديات في إدارة كوفيد-19 بشكل مفصل وتسلط الضوء على الآليات اللازمة لمساعدتنا على فهم هذا الوباء بشكل أفضل. Abstract: Unlike pandemics in the past, the outbreak of coronavirus disease 2019 (COVID-19), which rapidly spread worldwide, was met with a different approach to control and measures implemented across affected countries. The lack of understanding of the fundamental nature of the outbreak continues to make COVID-19 challenging to manage for both healthcare practitioners and the scientific community. Challenges to vaccine development and evaluation, current therapeutic options, convalescent plasma therapy, herd immunity, and the emergence of reinfection and new variants remain the major obstacles to combating COVID-19. This review discusses these challenges in the management of COVID-19 at length and highlights the mechanisms needed to provide better understanding of this pandemic.

Abstract Background N-methyl-2-pyrrolidone (NMP) is an epigenetically active chemical fragment and organic solvent with numerous applications including use as a drug-delivery vehicle. Previously considered biologically inert, NMP demonstrates immunomodulatory and anti-myeloma properties that are partly explained by acetyllysine mimetic properties and non-specific bromodomain inhibition. We therefore evaluated orally administered NMP in a phase 1 dose-escalation trial to establish its maximum tolerated dose (MTD) in patients with relapsed/refractory multiple myeloma (RR–MM). Secondary endpoints were safety, pharmacokinetics (PK), overall response rate and immunological biomarkers of activity. Results Thirteen patients received NMP at starting doses between 50 and 400 mg daily. Intra-patient dose escalation occurred in five patients, with one attaining the ceiling protocolised dose of 1 g daily. Median number of monthly cycles commenced was three (range 1–20). Grade 3–4 adverse events (AEs) were reported in seven (54%; 95% CI 25–81%) patients. Most common AEs (> 30% of patients) of any grade were nausea and musculoskeletal pain. The only dose limiting toxicity (DLT) was diarrhoea in a patient receiving 200 mg NMP (overall DLT rate 8%; 95% CI 0–36%). Hence, the MTD was not defined. Median progression-free and overall survival were 57 (range 29–539) days and 33 (95% CI 9.7– > 44) months, respectively. The best response of stable disease (SD) was achieved in nine patients (69%; 95% CI 39–91%). PK analysis demonstrated proportional dose–concentrations up to 400 mg daily, with a more linear relationship above 500 mg. Maximum plasma concentrations (Cmax) of 16.7 mg/L at the 800 mg dose were below those predicted to inhibit BET-bromodomains. Peripheral blood immune-profiling demonstrated maintenance of natural killer (NK) cells, and a gene expression signature suggestive of enhanced T, B and NK cell functions; a subject with prolonged exposure manifested sustained recovery of B and NK cells at 12 months. Conclusions NMP demonstrated potential disease stabilising and immunomodulatory activity at sub-BET inhibitory plasma concentrations and was well tolerated in RR–MM; an MTD was not determined up to a maximum dose of 1 g daily. Further dose-finding studies are required to optimise NMP dosing strategies for therapeutic intervention.

Grade (G) 3B follicular lymphoma (FL) is a rare FL subtype which exists on a histological continuum between ‘lowgrade’ (Grade 1, 2 and 3A FL) and diffuse large B-cell lymphoma (DLBCL) appearing to share features with each. Clinical characteristics and outcomes are poorly understood due to lack of adequate representation in prospective trials and large-scale analyses. We analyzed 157 G3BFL cases from 18 international centers, and two comparator groups; G3AFL (n=302) and DLBCL (n=548). Composite histology with DLBCL or low-grade FL occurred in approximately half of the G3BFL cases. With a median of 5 years follow-up, the overall survival and progression-free survival of G3BFL patients was better than that of DLBCL patients (P

ISFRA (Integrated SFR Analysis Program for PSA) computer program has been developed for simulating the response of the PGSFR pool design with metal fuel during a severe accident. This paper describes validation of the ISFRA aerosol model against the Aerosol Behavior Code Validation and Evaluation (ABCOVE) experiments undertaken in 1980s for radionuclide transport within a SFR containment. ABCOVE AB5, AB6, and AB7 tests are simulated using the ISFRA aerosol model and the results are compared against the measured data as well as with the simulation results of the MELCOR severe accident code. It is revealed that the ISFRA prediction of single-component aerosols inside a vessel (AB5) is in good agreement with the experimental data as well as with the results of the aerosol model in MELCOR. Moreover, the ISFRA aerosol model can predict the “washout” phenomenon due to the interaction between two aerosol species (AB6) and two-component aerosols without strong mutual interference (AB7). Based on the theory review of the aerosol correlation technique, it is concluded that the ISFRA aerosol model can provide fast, stable calculations with reasonable accuracy for most of the cases unless the aerosol size distribution is strongly deformed from log-normal distribution.

Yung Chan, Bik Sai Bessie Tong, Pui Yan Ngan, Chi Sum Au Apex Dermatology Institute, Kowloon, Hong KongCorrespondence: Yung Chan Room 1103-06, 11/F Hong Kong Pacific Centre, 28 Hankow Road, Tsim Sha Tsui, Kowloon, Hong KongTel + 852 3703 3580Fax + 852 3702 0018Email info@apexdermhk.comBackground: Interleukin-23 inhibitors are novel treatment options for psoriasis, and their efficacy and safety have been widely demonstrated in phase 3 clinical trials. Nonetheless, their real-world data remain limited, especially in Asia.Objective: To evaluate the real-world effectiveness of interleukin-23 inhibitor guselkumab in Chinese patients with psoriasis.Methods: In this retrospective single-center study, Chinese patients with psoriasis receiving a standard dose of guselkumab from November 2018 to May 2020 were included in the study cohort. Disease assessment was performed at baseline (Week 0), and at Week 4, 12, and 20 thereafter, using Psoriasis Area and Severity Index (PASI) score.Results: Data of 68 adult patients with psoriasis were retrieved for analysis. At Week 20, 72.1%/47.1% of the patients achieved PASI 90/100 response respectively, and 76.5% achieved a PASI score < 3. Baseline mean PASI score was 17.5, which significantly reduced to 2.0 at Week 20 (P=0.000). No previous use of biologics was a single significant factor associated with achieving PASI 90/100 and PASI score < 3 responses at Week 20 (all Ps< 0.05), while there were no statistically significant differences between males and females and body weight > 75 and ≤ 75 kg in achieving these responses (all Ps> 0.05). Adverse events were experienced by five patients (7.4%), and all were mild in severity.Conclusion: In this first real-world study on guselkumab among Chinese patients with psoriasis, this biologics was shown to be safe and effective in reaching an optimal clinical response up to 20 weeks.Keywords: Chinese, guselkumab, interleukin-23, psoriasis, real-world

No abstract available. Article truncated after 150 words. History of Present Illness A 75-year-old man presented with unsteady gait, difficulty concentrating and abdominal pain with loose stools. One day prior to admission, he experienced waxing and waning nausea, cramping abdominal pain, one episode of emesis and loose stools. He described acute gait disorder related to difficulty with balance. Due to concern for dehydration, he drank 10-12 cans of carbonated water without further emesis. He also experienced vague and alternating sensations of feeling “hot” in half of his body and “cold” in the other half of his body. Forty-eight hours prior to presentation, he had just returned from a five-day trip to New Orleans. PMH, SH, and FH: The patient has hypertension and hyperlipidemia that is well-controlled. Regular medicines include losartan, diltiazem, HCTZ and simvastatin. He is a professor of medicine. He had distant tobacco use with a 10 pk-yr history. He denies recreational drug use. He endorsed drinking …

Thermoplastic resin is infused into fabric layers to form rigid fiber-reinforced composites (FRCs), which are commonly used for ballistic resistance purposes. Here, we explore the use of patterned thermoplastic hot film as a rapid and straightforward method to laminate plain-weave UHMWPE and demonstrate that these composites have attractive ballistic and stiffness properties. Lamination of 25 layers of fabric using hot press compression lamination of each individual layer with hot film was able to confer the ability to stop 0.357 magnum ammunition shot at 435.9 ± 9 m/s. Patterning the hot film resulted in the composite panels retaining most of their flexibility without losing their ballistic performance compared to when they are laminated with plain (not patterned) hot film. Using the hot film for lamination results in an increase in energy absorption of the laminates with a smaller backface signature and backface volume. These laminates are lighter and more flexible than the commonly used hot resin-infused FRC.

Abstract: Management practices in early-stage (I/II) follicular lymphoma (FL) are variable and include radiation (RT), systemic therapy, or combined modality therapy (CMT). There is a paucity of data regarding maintenance rituximab in this cohort. We conducted an international retrospective study of patients with newly diagnosed early-stage FL staged with positron emission tomography (PET)–computed tomography and bone marrow biopsy. Three hundred sixty-five patients (stage I, n = 221), median age 63 years, treated from 2005-2017 were included, with a median follow-up of 45 months. Management included watchful waiting (WW; n = 85) and active treatment (n = 280). The latter consisted of RT alone (n = 171) or systemic therapy (immunochemotherapy [n = 63] or CMT [n = 46]). Forty-nine systemically treated patients received maintenance rituximab; 72.7% of stage I patients received RT alone, compared to 42.6% with stage II (P < .001). Active therapies yielded comparable overall response rates (P = .87). RT alone and systemic therapy without maintenance rituximab yielded similar progression-free survival (PFS) (hazard ratio [HR], 1.32; 95% confidence interval [CI], 0.77-2.34; P = .96). Maintenance rituximab improved PFS (HR, 0.24; 95% CI, 0.095-0.64; P = .017). The incidence of transformation was lower with systemic therapy compared to RT or WW (HR, 0.20; 95% CI, 0.070-0.61; P = .034). Overall survival was similar among all practices, including WW (P = .40). In the largest comparative assessment of management practices in the modern era, variable practices each resulted in similar excellent outcomes. Randomized studies are required to determine the optimal treatment in early-stage FL.

Charge conservation and the Pauli exclusion principle result from fundamental symmetries in the standard model of particle physics, and are typically taken as axiomatic. High-precision tests for small violations of these symmetries could point to new physics. Here we consider three models for violation of these processes, which would produce detectable ionization in the high-purity germanium detectors of the Majorana Demonstrator experiment. Using a 37.5 kg yr exposure, we report a lower limit on the electron mean lifetime, improving the previous best limit for the e→νeνe¯νe decay channel by more than an order of magnitude. We also present searches for two types of violation of the Pauli exclusion principle, setting limits on the probability of an electron to be found in a symmetric quantum state.

IntroductionPirtobrutinib, a highly selective, noncovalent (reversible) Bruton tyrosine kinase inhibitor, has demonstrated promising efficacy in B-cell malignancies and is associated with low rates of discontinuation and dose reduction. Pirtobrutinib is administered until disease progression or toxicity, necessitating an understanding of the safety profile in patients with extended treatment.MethodsHere we report the safety of pirtobrutinib in patients with relapsed/refractory B-cell malignancies with extended (≥12 months) drug exposure from the BRUIN trial. Assessments included median time-to-first-occurrence of adverse events (AEs), dose reductions, and discontinuations due to treatment-emergent AEs (TEAEs) and select AEs of interest (AESIs).ResultsOf 773 patients enrolled, 326 (42%) received treatment for ≥12 months. In the extended exposure cohort, the median time-on-treatment was 19 months. The most common all-cause TEAEs were fatigue (32%) and diarrhea (31%). TEAEs leading to dose reduction occurred in 23 (7%) and discontinuations in 11 (3%) extended exposure patients. One patient had a fatal treatment-related AE (COVID-19 pneumonia). Infections (73.0%) were the most common AESI with a median time-to-first-occurrence of 7.4 months. Majority of TEAEs and AESIs occurred during the first year of therapy.ConclusionsPirtobrutinib therapy continues to demonstrate an excellent safety profile amenable to long-term administration without evidence of new or worsening toxicity signals.

Databases such as PubMed, Scopus and Google Scholar were searched. Data extraction and assessment of study protocol was done by two independent reviewers and the results were reviewed by a third. OpenMeta analyst and comprehensive meta-analysis (CMA) were used for the meta-analysis. The random effect model was used, publication bias and between-study heterogeneity was assessed. Seventeen studies were added to the final meta-analysis. Studies were sampled from 2000–2018 and of the 8684 isolates tested, 2824 were VRE. The pooled prevalence of VRE among poultry in Malaysia was estimated at 24.0% (95% CI; 16.7–33.1%; I2 = 98.14%; p < 0.001). Between-study variability was high (t2 = 0.788; heterogeneity I2 = 98.14% with heterogeneity chi-square (Q) = 858.379, degrees of freedom (df) = 16, and p < 0.001). The funnel plot showed bias which was confirmed by Egger’s test and estimates from the leave-one-out forest plot did not affect the pooled prevalence. Pooled prevalence of VRE in chickens and ducks were 29.2% (CI = 18.8–42.5%) and 11.2%, CI = 9.0–14.0%) respectively. Enterococcus faecalis was reported most with more studies being reported in Peninsular Malaysia Central region and used antibiotic disc diffusion as detection method. Increased surveillance of VRE in poultry in Malaysia is required.

This research is a preliminary study on the preparation of wood plastic composites (WPC) from corn husk fiber (CHF) and recycled polystyrene foam (rPS). The effects of fiber content and alkaline treatment on tensile, thermal, water absorption and morphological properties of the composites were investigated. The rPS/CHF composites were prepared using melt compounding and compression moulding processes. The results showed that an increase of fiber content increased the tensile strength, modulus, and thermal stability (Td50%) of composites. However, the water absorption of composites increased vastly as the fiber content increases. The addition of more fiber also caused an earlier thermal degradation to composites. Alkaline treatment has improved the tensile strength, modulus, thermal stability (Td10%), and also reduced water absorption of rPS/CHF composites. The WPS prepared from rPS and treated CHF shows better tensile and thermal properties with lower water absorption.

Abstract We define “BPS graphs” on punctured Riemann surfaces associated with A N −1 theories of class S $$ \mathcal{S} $$ . BPS graphs provide a bridge between two powerful frameworks for studying the spectrum of BPS states: spectral networks and BPS quivers. They arise from degenerate spectral networks at maximal intersections of walls of marginal stability on the Coulomb branch. While the BPS spectrum is ill-defined at such intersections, a BPS graph captures a useful basis of elementary BPS states. The topology of a BPS graph encodes a BPS quiver, even for higher-rank theories and for theories with certain partial punctures. BPS graphs lead to a geometric realization of the combinatorics of Fock-Goncharov N - triangulations and generalize them in several ways.

Balance plays an important role in the daily lives of elderly people to prevent them from falls and injuries. A suitable exercise to improve balance is Tai Chi Chuan. The purpose of this study was to analyze balance control in Tai Chi Chuan practitioners and compare it with non-practisingactive elderly people.Ten Tai Chi Chuan practitioners, mean age 70.14, (5 womenand 5 men) were willing to participate in this study. Twelve elderly with amean age of 71.95 years, served as the control group. An oscillating suspended platform (Posturomed) was used to measure the horizontal movements in two orthogonal directions using a small ultrasonic marker (Microswing). The measured displacements in the two directions, anterior-posterior (AP) and medio-lateral (ML), were used to establish a balance index. The total sway line g can be divided into the x- and y-component (ML and AP sway). Four different stances were analyzed to evaluate balance ability: shoulder-wide stance with eyes open and closed, legs together, semitandem and tandem stance. An independent t-test was used to compare the groups. The Tai Chi Chuan group showed a significantly (p=0.04) better balance control in the ML direction in the shoulder-wide stance with eyes closed than the control group. In summary, practicing Tai Chi Chuan may have a positive influence on balance control when vision is obstructed and balance has to rely on the vestibular system. KEY WORDS: Postural Sway, Proprioception, Aging, Exercise

With excellent energy resolution and ultralow-level radiogenic backgrounds, the high-purity germanium detectors in the Majorana Demonstrator enable searches for several classes of exotic dark matter (DM) models. In this work, we report new experimental limits on keV-scale sterile neutrino DM via the transition magnetic moment from conversion to active neutrinos ν_{s}→ν_{a}. We report new limits on fermionic dark matter absorption (χ+A→ν+A) and sub-GeV DM-nucleus 3→2 scattering (χ+χ+A→ϕ+A), and new exclusion limits for bosonic dark matter (axionlike particles and dark photons). These searches utilize the (1-100)-keV low-energy region of a 37.5-kg y exposure collected by the Demonstrator between May 2016 and November 2019 using a set of ^{76}Ge-enriched detectors whose surface exposure time was carefully controlled, resulting in extremely low levels of cosmogenic activation.

The MAJORANA DEMONSTRATOR is a neutrinoless double-beta decay (0νββ) experiment containing ~30 kg of p-type point-contact germanium detectors enriched to 88% in 76Ge and ~14 kg of natural germanium detectors. The detectors are housed in two electroformed copper cryostats and surrounded by a graded passive shield with an active muon veto. An extensive radioassay campaign was performed prior to installation to insure the use of ultra-clean materials. The DEMONSTRATOR achieved one of the lowest background rates in the region of the 0νββ Q-value, 15.7±1.4 cts/(FWHM t y) from the low-background configuration spanning most of the 64.5 kg-yr active exposure. Nevertheless this background rate is a factor of five higher than the projected background rate. This discrepancy arises from an excess of events from the 232Th decay chain. Background-model fits aim to explain the deviation from assay-based projections, potentially determine the source(s) of observed backgrounds, and allow a precise measurement of the two-neutrino double-beta decay half-life. The fits agree with earlier simulation studies, which indicate the origin of the 232Th excess is not from a near-detector component and have informed design decisions for the next-generation LEGEND experiment. Recent findings have narrowed the suspected locations for the excess activity, motivating a final simulation and assay campaign to complete the background model.

The Majorana Demonstrator was a search for neutrinoless double-beta decay (0νββ) in the 76Ge isotope. It was staged at the 4850-foot level of the Sanford Underground Research Facility (SURF) in Lead, SD. The experiment consisted of 58 germanium detectors housed in a low background shield and was calibrated once per week by deploying a 228Th line source for 1 to 2 hours. The energy scale calibration determination for the detector array was automated using custom analysis tools. We describe the offline procedure for calibration of the Demonstrator germanium detectors, including the simultaneous fitting of multiple spectral peaks, estimation of energy scale uncertainties, and the automation of the calibration procedure.

Although considerable research has been directed at developing materials for ballistic protection, considerably less has been conducted to address non-firearm threats. Even fewer studies have examined the incorporation of particle-laden elastomers with textiles for spike, knife, and needle protection. We report on a new composite consisting of ultra-high-molecular-weight polyethylene (UHMWPE) fabric impregnated with nanoparticle-loaded elastomer, specifically designed for spike- and needle-resistant garments. Failure analysis and parametric studies of particle-loading and layer-count were conducted using a mixture of SiC and polyurethane at 0, 30, and 50 wt.%. The maximum penetration resistance force of a single-layer of uncoated fabric increased up to 218−229% due to nanoparticle loading. Multiple-layer stacks of coated fabric show up to 57% and 346% improvement in spike puncture and hypodermic needle resistance, respectively, and yet were more flexible and 21−55% thinner than a multiple-layer stack of neat fabric (of comparable areal density). We show that oxygen-plasma-treatment of UHMWPE is critical to enable effective coating.

Time-resolved, angle-resolved photoemission spectroscopy (TR-ARPES) is a one-particle spectroscopic technique that can probe excitons (two-particle excitations) in momentum space. We present an ab initio, time-domain GW approach to TR-ARPES and apply it to monolayer MoS2. We show that photoexcited excitons may be measured and quantified as satellite bands and lead to the renormalization of the quasiparticle bands. These features are explained in terms of an exciton-Floquet phenomenon induced by an exciton time-dependent bosonic field, which are orders of magnitude stronger than those of laser field-induced Floquet bands in low-dimensional semiconductors. Our findings imply a way to engineer Floquet matter through the coherent oscillation of excitons and open the new door for mechanisms for band structure engineering.

This corrects the article DOI: 10.1103/PhysRevLett.129.080401.

GT Chua, YC Chan, SW ChengDivision of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong KongBackground: Vitamin D deficiency has recently been implicated as a contributory factor in the development of peripheral arterial disease (PAD).Methods: A review of the published literature on PAD and vitamin D was undertaken using Medline, PubMed, and Embase, and cross-referenced. All relevant published papers on the subject were reviewed.Results: Published studies have shown that there is a significant association between vitamin D and PAD. Populations with lower vitamin D levels are more likely to develop PAD in a graded manner. Higher amputation rates are also observed among patients with PAD and lower vitamin D levels. In addition, vitamin D deficiency is significantly associated with increased risk of cardiovascular adverse events. This was also observed in the mouse model where low vitamin D led to the development of atherosclerosis.Conclusion: This study shows that vitamin D deficiency could be an independent risk factor for the development of PAD and that this risk factor is easily correctable. Further studies should look into the effects of vitamin D supplementation in patients with PAD.Keywords: peripheral arterial disease, claudication, gangrene, vitamin D deficiency, amputation, cardiovascular risk factors

The Majorana Collaboration is using an array of high-purity Ge detectors to search for neutrinoless double-beta decay in 76Ge. Searches for neutrinoless double-beta decay are understood to be the only viable experimental method for testing the Majorana nature of the neutrino. Observation of this decay would imply violation of lepton number, that neutrinos are Majorana in nature, and provide information on the neutrino mass. The Majorana Demonstrator comprises 44.1 kg of p-type point-contact Ge detectors (29.7 kg enriched in 76Ge) surrounded by a low-background shield system. The experiment achieved a high efficiency of converting raw Ge material to detectors and an unprecedented detector energy resolution of 2.5 keV FWHM at Qββ. The Majorana collaboration began taking physics data in 2016. This paper summarizes key construction aspects of the Demonstrator and shows preliminary results from initial data.

P-type point contact (PPC) high-purity germanium detectors are an important technology in astroparticle and nuclear physics due to their superb energy resolution, low noise, and pulse shape discrimination capabilities. Analysis of data from the Majorana Demonstrator, a neutrinoless double-β decay experiment deploying PPC detectors enriched in Ge76, has led to several novel improvements in the analysis of PPC signals. In this work we discuss charge trapping in PPC detectors and its effect on energy resolution. Small dislocations or impurities in the crystal lattice result in trapping of charge carriers from an ionization event of interest, attenuating the signal, and degrading the measured energy. We present a modified digital pole-zero correction to the signal energy estimation that counters the effects of charge trapping and improves the energy resolution of the Majorana Demonstrator by approximately 30% to around 2.4 keV full width at half-maximum at 2039 keV, the Ge76 Q value. An alternative approach achieving similar resolution enhancement is also presented.