2,482 research outputs found
Cosmic Strings, Zero Modes and SUSY breaking in Nonabelian N=1 Gauge Theories
We investigate the microphysics of cosmic strings in Nonabelian gauge
theories with N=1 supersymmetry. We give the vortex solutions in a specific
example and demonstrate that fermionic superconductivity arises because of the
couplings and interactions dictated by supersymmetry. We then use supersymmetry
transformations to obtain the relevant fermionic zero modes and investigate the
role of soft supersymmetry breaking on the existence and properties of the
superconducting strings.Comment: 12 pages, RevTex, submitted to Phys. Rev.
Chiral Vortons and Cosmological Constraints on Particle Physics
We investigate the cosmological consequences of particle physics theories
that admit stable loops of current-carrying string - vortons. In particular, we
consider chiral theories where a single fermion zero mode is excited in the
string core, such as those arising in supersymmetric theories with a D-term.
The resulting vortons formed in such theories are expected to be more stable
than their non-chiral cousins. General symmetry breaking schemes are considered
in which strings formed at one symmetry breaking scale become current-carrying
at a subsequent phase transition. The vorton abundance is estimated and
constraints placed on the underlying particle physics theories from
cosmological observations. Our constraints on the chiral theory are
considerably more stringent than the previous estimates for more general
theories.Comment: minor corrections made. This version will appear in PR
A Roadmap to Health Insurance for All: Principles for Reform
Presents principles for health insurance reform and compares the potential of three approaches -- tax incentives for the individual insurance market; mixed private-public group insurance with shared financing responsibility; and public insurance
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Location, Location, Location: Where You Live Determines Your Access to Abortion
Through the hypothetical, but very plausible case of Julia, we illustrate that where a woman lives in the United States impacts her access to the best abortion care. Widespread state-level restrictions on abortion care have increased in recent years and negatively impact a woman’s ability to access quality, unbiased, evidence-based care. Poor women and women of color are disproportionately affected by these restrictions. It is important as medical professionals to understand the political, not medical, motivations behind these laws so we can speak out against them
Managing menopausal symptoms and associated clinical issues in breast cancer survivors
Objective:
Review evidence to guide management of menopausal signs and symptoms in women after breast cancer and make recommendations accordingly.
Evidence:
Randomized controlled clinical trials, observational studies, evidence-based guidelines, and expert opinion from professional societies.
Background:
Symptoms and clinical problems associated with estrogen depletion—sleep disorders, vulvovaginal atrophy (VVA), vasomotor symptoms (VMS), mood changes, depressive symptoms, cardiovascular disease, osteopenia, and osteoporosis—confront the estimated 9.3 million breast cancer survivors globally.
Recommendations:
Following breast cancer, women should not generally be treated with menopausal hormone therapy or tibolone but should optimize lifestyle. Women with moderate to severe symptoms may benefit from mind–brain behavior or nonhormone, pharmacologic therapy. The selective serotonin/noradrenaline reuptake inhibitors and gabapentenoid agents improve VMS and quality of life. For osteoporosis, nonhormonal agents are available. Treatment of VVA remains an area of unmet need. Low-dose vaginal estrogen is absorbed in small amounts with blood levels remaining within the normal postmenopausal range but could potentially stimulate occult breast cancer cells, and although poorly studied, is not generally advised, particularly for those on aromatase inhibitors. Intravaginal dehydroepiandrosterone and oral ospemiphene have been approved to treat dyspareunia, but safety after breast cancer has not been established. Vaginal laser therapy is being used for VVA but efficacy from sham-controlled studies is lacking. Therapies undergoing development include lasofoxifene, neurokinin B inhibitors, stellate ganglion blockade, vaginal testosterone, and estetrol.
Conclusions:
Nonhormone options and therapies are available for treatment of estrogen depletion symptoms and clinical problems after a diagnosis of breast cancer. Individualization of treatment is essential
Spillover adherence effects of fixed-dose combination HIV therapy
The impact of fixed-dose combination (FDC) products on adherence to other, non-fixed regimen components has not been examined. We compared adherence to a third antiretroviral (ART) component among patients receiving a nucleoside reverse transcriptase inhibitor (NRTI) backbone consisting of the FDC Epzicom®, GlaxoSmithKline Inc, Research Triangle Park, NC (abacavir sulfate 600 mg + lamivudine 300 mg; FDC group) versus NRTI combinations taken as two separate pills (NRTI Combo group) using data from a national sample of 30 health plans covering approximately 38 million lives from 1997 to 2005. Adherence was measured as the medication possession ratio (MPR). Multivariate logistic regression compared treatment groups based on the likelihood of achieving ≥95% adherence, with sensitivity analyses using alternative thresholds. MPR was assessed as a continuous variable using multivariate linear regression. Covariates included age, gender, insurance payer type, year of study drug initiation, presence of mental health and substance abuse disorders, and third agent class. The study sample consisted of 650 FDC and 1947 NRTI Combo patients. Unadjusted mean adherence to the third agent was higher in the FDC group than the NRTI Combo group (0.92 vs 0.85; P < 0.0001). In regression analyses, FDC patients were 48% and 39% more likely to achieve 95% and 90% third agent adherence, respectively (P ≤ 0.03). None of the other MPR specifications achieved comparable results. Among managed care patients, use of an FDC appears to substantially improve adherence to a third regimen component and thus the likelihood of achieving the accepted standard for adherence to HIV therapy of 95%
Fermionic Zero Modes of Supergravity Cosmic Strings
Recent developments in string theory suggest that cosmic strings could be
formed at the end of brane inflation. Supergravity provides a realistic model
to study the properties of strings arising in brane inflation. Whilst the
properties of cosmic strings in flat space-time have been extensively studied
there are significant complications in the presence of gravity. We study the
effects of gravitation on cosmic strings arising in supergravity. Fermion zero
modes are a common feature of cosmic strings, and generically occur in
supersymmetric models. The corresponding massless currents can give rise to
stable string loops (vortons). The vorton density in our universe is strongly
constrained, allowing many theories with cosmic strings to be ruled out. We
investigate the existence of fermion zero modes on cosmic strings in
supergravity theories. A general index theorem for the number of zero modes is
derived. We show that by including the gravitino, some (but not all) zero modes
disappear. This weakens the constraints on cosmic string models. In particular,
winding number one cosmic D-strings in models of brane inflation are not
subject to vorton constraints. We also discuss the effects of supersymmetry
breaking on cosmic D-strings.Comment: 33 page
Branes on the Horizon
Models with extra dimensions are often invoked to resolve cosmological problems. We investigate the possibility of apparent acausality as seen by a brane-based observer resulting from signal propagation through the extra dimensions. Null geodesics are first computed in static and cosmological single-brane models, following which we derive the equations of motion for the inter-brane distance in a two-brane scenario, which we use to examine possible acausality in this more complex setup. Despite observing significant effective acausality in some situations there is no a priori solution to the horizon problem using this mechanism. In the two-brane scenario there can be significant late time violation of gravitational Lorentz invariance, resulting in the gravitational horizon being larger than the particle horizon, leading to potential signals in gravitational wave detectors
Treatment of symptoms of the menopause: an endocrine society clinical practice guideline
Objective:
The objective of this document is to generate a practice guideline for the management and treatment of symptoms of the menopause.
Participants:
The Treatment of Symptoms of the Menopause Task Force included six experts, a methodologist, and a medical writer, all appointed by The Endocrine Society.
Evidence:
The Task Force developed this evidenced-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews of published data and considered several other existing meta-analyses and trials.
Consensus Process:
Multiple e-mail communications, conference calls, and one face-to-face meeting determined consensus. Committees of The Endocrine Society, representatives from endorsing societies, and members of The Endocrine Society reviewed and commented on the drafts of the guidelines. The Australasian Menopause Society, the British Menopause Society, European Menopause and Andropause Society, the European Society of Endocrinology, and the International Menopause Society (co-sponsors of the guideline) reviewed and commented on the draft.
Conclusions:
Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and other symptoms of the climacteric. Benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or under 10 years since the onset of menopause. Health care professionals should individualize therapy based on clinical factors and patient preference. They should screen women before initiating MHT for cardiovascular and breast cancer risk and recommend the most appropriate therapy depending on risk/benefit considerations. Current evidence does not justify the use of MHT to prevent coronary heart disease, breast cancer, or dementia. Other options are available for those with vasomotor symptoms who prefer not to use MHT or who have contraindications because these patients should not use MHT. Low-dose vaginal estrogen and ospemifene provide effective therapy for the genitourinary syndrome of menopause, and vaginal moisturizers and lubricants are available for those not choosing hormonal therapy. All postmenopausal women should embrace appropriate lifestyle measures
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