The medical elective: A unique educational opportunity

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Asymptotic behavior of w in general quintom model

For the quintom models with arbitrary potential $V=V(\phi,\sigma)$, the asymptotic value of equation of state parameter w is obtained by a new method. In this method, w of stable attractors are calculated by using the ratio (d ln V)/(d ln a) in asymptotic region. All the known results, have been obtained by other methods, are reproduced by this method as specific examples.Comment: 8 pages, one example is added, accepted for publication in Gen. Rel. Gra

Does hepatocellular carcinoma in non-alcoholic steatohepatitis exist in cirrhotic and non-cirrhotic patients?

Non-alcoholic steatohepatitis (NASH) has been associated with hepatocellular carcinoma (HCC) often arising in histologically advanced disease when steatohepatitis is not active (cryptogenic cirrhosis). Our objective was to characterize patients with HCC and active, histologically defined steatohepatitis. Among 394 patients with HCC detected by ultrasound imaging over 8 years and staged by the Barcelona Clinic Liver Cancer (BCLC) criteria, we identified 7 cases (1.7%) with HCC occurring in the setting of active biopsy-proven NASH. All were negative for other liver diseases such as hepatitis C, hepatitis B, autoimmune hepatitis, Wilson disease, and hemochromatosis. The patients (4 males and 3 females, age 63 ± 13 years) were either overweight (4) or obese (3); 57% were diabetic and 28.5% had dyslipidemia. Cirrhosis was present in 6 of 7 patients, but 1 patient had well-differentiated HCC in the setting of NASH without cirrhosis (fibrosis stage 1) based on repeated liver biopsies, the absence of portal hypertension by clinical and radiographic evaluations and by direct surgical inspection. Among the cirrhotic patients, 71.4% were clinically staged as Child A and 14.2% as Child B. Tumor size ranged from 1.0 to 5.2 cm and 5 of 7 patients were classified as early stage; 46% of all nodules were hyper-echoic and 57% were <3 cm. HCC was well differentiated in 1/6 and moderately differentiated in 5/6. Alpha-fetoprotein was <100 ng/mL in all patients. HCC in patients with active steatohepatitis is often multifocal, may precede clinically advanced disease and occurs without diagnostic levels of alpha-fetoprotein. Importantly, HCC may occur in NASH in the absence of cirrhosis. More aggressive screening of NASH patients may be warranted

Dynamics of the self-interacting chameleon cosmology

In this article we study the properties of the flat FRW chameleon cosmology in which the cosmic expansion of the Universe is affected by the chameleon field and dark energy. In particular, we perform a detailed examination of the model in the light of numerical analysis. The results illustrate that the interacting chameleon filed plays an important role in late time universe acceleration and phantom crossing.Comment: 13 pages, 8 figures, to appear in Astrophysics and Space Sc

Wormholes and Ringholes in a Dark-Energy Universe

The effects that the present accelerating expansion of the universe has on the size and shape of Lorentzian wormholes and ringholes are considered. It is shown that, quite similarly to how it occurs for inflating wormholes, relative to the initial embedding-space coordinate system, whereas the shape of the considered holes is always preserved with time, their size is driven by the expansion to increase by a factor which is proportional to the scale factor of the universe. In the case that dark energy is phantom energy, which is not excluded by present constraints on the dark-energy equation of state, that size increase with time becomes quite more remarkable, and a rather speculative scenario is here presented where the big rip can be circumvented by future advanced civilizations by utilizing sufficiently grown up wormholes and ringholes as time machines that shortcut the big-rip singularity.Comment: 11 pages, RevTex, to appear in Phys. Rev.

Geometric Scaling in a Symmetric Saturation Model

We illustrate geometric scaling for the photon-proton cross section with a very simple saturation model. We describe the proton structure function F2 at small x in a wide kinematical range with an elementary functional form and a small number of free parameters. We speculate that the symmetry between low and high Q2 recently discovered in the data could be related to a well-known symmetry of the two-gluon- exchange dipole-dipole cross section.Comment: 15 pages, 4 figure

The dS/CFT Correspondence and the Big Smash

Recent observations suggest that the cosmological equation-of-state parameter w is close to -1. To say this is to imply that w could be slightly less than -1, which leads to R.Caldwell's "Phantom cosmologies". These often have the property that they end in a "Big Smash", a final singularity in which the Universe is destroyed in a finite proper time by excessive *expansion*. We show that, classically, this fate is not inevitable: there exist Smash-free Phantom cosmologies, obtained by a suitable perturbation of the deSitter equation of state, in which the spacetime is in fact asymptotically deSitter. [Contrary to popular belief, such cosmologies, which violate the Dominant Energy Condition, do not necessarily violate causality.] We also argue, however, that the physical interpretation of these classically acceptable spacetimes is radically altered by ``holography'', as manifested in the dS/CFT correspondence. It is shown that, if the boundary CFTs have conventional properties, then recent ideas on "time as an inverse renormalization group flow" can be used to rule out these cosmologies. Very recently, however, it has been argued that the CFTs in dS/CFT are of a radically unconventional form, and this opens up the possibility that Smash-free Phantom spacetimes offer a simple model of a "bouncing" cosmology in which the quantum-mechanical entanglement of the field theories in the infinite past and future plays an essential role.Comment: 22 pages, clarification of triple analytic continuation, additional Comments added in the light of hep-th/020724

Which treatment is most effective for patients with Achilles tendinopathy?:A living systematic review with network meta-analysis of 29 randomised controlled trials

Objective: To provide a consistently updated overview of the comparative effectiveness of treatments for Achilles tendinopathy. Design: Living systematic review and network meta-analysis. Data sources: Multiple databases including grey literature sources were searched up to February 2019. Study eligibility criteria: Randomised controlled trials examining the effectiveness of any treatment in patients wit

Constraints on accelerating universe using ESSENCE and Gold supernovae data combined with other cosmological probes

We use recently observed data: the 192 ESSENCE type Ia supernovae (SNe Ia), the 182 Gold SNe Ia, the 3-year WMAP, the SDSS baryon acoustic peak, the X-ray gas mass fraction in clusters and the observational $H(z)$ data to constrain models of the accelerating universe. Combining the 192 ESSENCE data with the observational $H(z)$ data to constrain a parameterized deceleration parameter, we obtain the best fit values of transition redshift and current deceleration parameter $z_{T}=0.632^{+0.256}_{-0.127}$, $q_{0}=-0.788^{+0.182}_{-0.182}$. Furthermore, using $\Lambda$CDM model and two model-independent equation of state of dark energy, we find that the combined constraint from the 192 ESSENCE data and other four cosmological observations gives smaller values of $\Omega_{0m}$ and $q_{0}$, but a larger value of $z_{T}$ than the combined constraint from the 182 Gold data with other four observations. Finally, according to the Akaike information criterion it is shown that the recently observed data equally supports three dark energy models: $\Lambda$CDM, $w_{de}(z)=w_{0}$ and $w_{de}(z)=w_{0}+w_{1}\ln(1+z)$.Comment: 18 pages, 8 figure

Small Scale Structure Formation in Chameleon Cosmology

Chameleon fields are scalar fields whose mass depends on the ambient matter density. We investigate the effects of these fields on the growth of density perturbations on sub-galactic scales and the formation of the first dark matter halos. Density perturbations on comoving scales $R < 1 {\rm pc}$ go non--linear and collapse to form structure much earlier than in standard $\Lambda$CDM cosmology. The resulting mini-halos are hence more dense and resilient to disruption. We therefore expect (provided that the density perturbations on these scales have not been erased by damping processes) that the dark matter distribution on small scales would be more clumpy in chameleon cosmology than in the $\Lambda$CDM model.Comment: 13 pages, 4 figure