Late-Time Tails of Wave Propagation in Higher Dimensional Spacetimes

We study the late-time tails appearing in the propagation of massless fields (scalar, electromagnetic and gravitational) in the vicinities of a D-dimensional Schwarzschild black hole. We find that at late times the fields always exhibit a power-law falloff, but the power-law is highly sensitive to the dimensionality of the spacetime. Accordingly, for odd D>3 we find that the field behaves as t^[-(2l+D-2)] at late times, where l is the angular index determining the angular dependence of the field. This behavior is entirely due to D being odd, it does not depend on the presence of a black hole in the spacetime. Indeed this tails is already present in the flat space Green's function. On the other hand, for even D>4 the field decays as t^[-(2l+3D-8)], and this time there is no contribution from the flat background. This power-law is entirely due to the presence of the black hole. The D=4 case is special and exhibits, as is well known, the t^[-(2l+3)] behavior. In the extra dimensional scenario for our Universe, our results are strictly correct if the extra dimensions are infinite, but also give a good description of the late time behaviour of any field if the large extra dimensions are large enough.Comment: 6 pages, 3 figures, RevTeX4. Version to appear in Rapid Communications of Physical Review

Dirty black holes: Quasinormal modes for "squeezed" horizons

We consider the quasinormal modes for a class of black hole spacetimes that, informally speaking, contain a closely ``squeezed'' pair of horizons. (This scenario, where the relevant observer is presumed to be ``trapped'' between the horizons, is operationally distinct from near-extremal black holes with an external observer.) It is shown, by analytical means, that the spacing of the quasinormal frequencies equals the surface gravity at the squeezed horizons. Moreover, we can calculate the real part of these frequencies provided that the horizons are sufficiently close together (but not necessarily degenerate or even ``nearly degenerate''). The novelty of our analysis (which extends a model-specific treatment by Cardoso and Lemos) is that we consider ``dirty'' black holes; that is, the observable portion of the (static and spherically symmetric) spacetime is allowed to contain an arbitrary distribution of matter.Comment: 15 pages, uses iopart.cls and setstack.sty V2: Two references added. Also, the appendix now relates our computation of the Regge-Wheeler potential for gravity in a generic "dirty" black hole to the results of Karlovini [gr-qc/0111066

Quasinormal modes of Schwarzschild black holes in four and higher dimensions

We make a thorough investigation of the asymptotic quasinormal modes of the four and five-dimensional Schwarzschild black hole for scalar, electromagnetic and gravitational perturbations. Our numerical results give full support to all the analytical predictions by Motl and Neitzke, for the leading term. We also compute the first order corrections analytically, by extending to higher dimensions, previous work of Musiri and Siopsis, and find excellent agreement with the numerical results. For generic spacetime dimension number D the first-order corrections go as $\frac{1}{n^{(D-3)/(D-2)}}$. This means that there is a more rapid convergence to the asymptotic value for the five dimensional case than for the four dimensional case, as we also show numerically.Comment: 12 pages, 5 figures, RevTeX4. v2. Typos corrected, references adde

Dirty black holes: Quasinormal modes

In this paper, we investigate the asymptotic nature of the quasinormal modes for "dirty" black holes -- generic static and spherically symmetric spacetimes for which a central black hole is surrounded by arbitrary "matter" fields. We demonstrate that, to the leading asymptotic order, the [imaginary] spacing between modes is precisely equal to the surface gravity, independent of the specifics of the black hole system. Our analytical method is based on locating the complex poles in the first Born approximation for the scattering amplitude. We first verify that our formalism agrees, asymptotically, with previous studies on the Schwarzschild black hole. The analysis is then generalized to more exotic black hole geometries. We also extend considerations to spacetimes with two horizons and briefly discuss the degenerate-horizon scenario.Comment: 15 pages; uses iopart.cls setstack.sty; V2: one additional reference added, no physics changes; V3: two extra references, minor changes in response to referee comment

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

The black hole bomb and superradiant instabilities

A wave impinging on a Kerr black hole can be amplified as it scatters off the hole if certain conditions are satisfied giving rise to superradiant scattering. By placing a mirror around the black hole one can make the system unstable. This is the black hole bomb of Press and Teukolsky. We investigate in detail this process and compute the growing timescales and oscillation frequencies as a function of the mirror's location. It is found that in order for the system black hole plus mirror to become unstable there is a minimum distance at which the mirror must be located. We also give an explicit example showing that such a bomb can be built. In addition, our arguments enable us to justify why large Kerr-AdS black holes are stable and small Kerr-AdS black holes should be unstable