Factors contributing to the time taken to consult with symptoms of lung cancer: a cross-sectional study

<b>Objectives</b>: To determine what factors are associated with the time people take to consult with symptoms of lung cancer, with a focus on those from rural and socially deprived areas. <b>Methods</b>: A cross-sectional quantitative interview survey was performed of 360 patients with newly diagnosed primary lung cancer in three Scottish hospitals (two in Glasgow, one in NE Scotland). Supplementary data were obtained from medical case notes. The main outcome measures were the number of days from (1) the date participant defined first symptom until date of presentation to a medical practitioner; and (2) the date of earliest symptom from a symptom checklist (derived from clinical guidelines) until date of presentation to a medical practitioner. <b>Results</b>: 179 participants (50%) had symptoms for more than 14 weeks before presenting to a medical practitioner (median 99 days; interquartile range 31–381). 270 participants (75%) had unrecognised symptoms of lung cancer. There were no significant differences in time taken to consult with symptoms of lung cancer between rural and/or deprived participants compared with urban and/or affluent participants. Factors independently associated with increased time before consulting about symptoms were living alone, a history of chronic obstructive pulmonary disease (COPD) and longer pack years of smoking. Haemoptysis, new onset of shortness of breath, cough and loss of appetite were significantly associated with earlier consulting, as were a history of chest infection and renal failure. <b>Conclusion</b>: For many people with lung cancer, regardless of location and socioeconomic status, the time between symptom onset and consultation was long enough to plausibly affect prognosis. Long-term smokers, those with COPD and/or those living alone are at particular risk of taking longer to consult with symptoms of lung cancer and practitioners should be alert to this

Relaxed super self-duality and effective action

A closed-form expression is obtained for a holomorphic sector of the two-loop Euler-Heisenberg type effective action for N = 2 supersymmetric QED derived in hep-th/0308136. In the framework of the background-field method, this sector is singled out by computing the effective action for a background N = 2 vector multiplet satisfying a relaxed super self-duality condition. The approach advocated in this letter can be applied, in particular, to the study of the N = 4 super Yang-Mills theory on its Coulomb branch.Comment: 8 pages, latex; V2: comments, references added, typos correcte

Logarithmic Corrections to N=2 Black Hole Entropy: An Infrared Window into the Microstates

Logarithmic corrections to the extremal black hole entropy can be computed purely in terms of the low energy data -- the spectrum of massless fields and their interaction. The demand of reproducing these corrections provides a strong constraint on any microscopic theory of quantum gravity that attempts to explain the black hole entropy. Using quantum entropy function formalism we compute logarithmic corrections to the entropy of half BPS black holes in N=2 supersymmetric string theories. Our results allow us to test various proposals for the measure in the OSV formula, and we find agreement with the measure proposed by Denef and Moore if we assume their result to be valid at weak topological string coupling. Our analysis also gives the logarithmic corrections to the entropy of extremal Reissner-Nordstrom black holes in ordinary Einstein-Maxwell theory.Comment: LaTeX file, 66 page

Logarithmic Corrections to Rotating Extremal Black Hole Entropy in Four and Five Dimensions

We compute logarithmic corrections to the entropy of rotating extremal black holes using quantum entropy function i.e. Euclidean quantum gravity approach. Our analysis includes five dimensional supersymmetric BMPV black holes in type IIB string theory on T^5 and K3 x S^1 as well as in the five dimensional CHL models, and also non-supersymmetric extremal Kerr black hole and slowly rotating extremal Kerr-Newmann black holes in four dimensions. For BMPV black holes our results are in perfect agreement with the microscopic results derived from string theory. In particular we reproduce correctly the dependence of the logarithmic corrections on the number of U(1) gauge fields in the theory, and on the angular momentum carried by the black hole in different scaling limits. We also explain the shortcomings of the Cardy limit in explaining the logarithmic corrections in the limit in which the (super)gravity description of these black holes becomes a valid approximation. For non-supersymmetric extremal black holes, e.g. for the extremal Kerr black hole in four dimensions, our result provides a stringent testing ground for any microscopic explanation of the black hole entropy, e.g. Kerr/CFT correspondence.Comment: LaTeX file, 50 pages; v2: added extensive discussion on the relation between boundary condition and choice of ensemble, modified analysis for slowly rotating black holes, all results remain unchanged, typos corrected; v3: minor additions and correction

Verbal working memory and functional large-scale networks in schizophrenia

The aim of this study was to test whether bilinear and nonlinear effective connectivity (EC) measures of working memory fMRI data can differentiate between patients with schizophrenia (SZ) and healthy controls (HC). We applied bilinear and nonlinear Dynamic Causal Modeling (DCM) for the analysis of verbal working memory in 16 SZ and 21 HC. The connection strengths with nonlinear modulation between the dorsolateral prefrontal cortex (DLPFC) and the ventral tegmental area/substantia nigra (VTA/SN) were evaluated. We used Bayesian Model Selection at the group and family levels to compare the optimal bilinear and nonlinear models. Bayesian Model Averaging was used to assess the connection strengths with nonlinear modulation. The DCM analyses revealed that SZ and HC used different bilinear networks despite comparable behavioral performance. In addition, the connection strengths with nonlinear modulation between the DLPFC and the VTA/SN area showed differences between SZ and HC. The adoption of different functional networks in SZ and HC indicated neurobiological alterations underlying working memory performance, including different connection strengths with nonlinear modulation between the DLPFC and the VTA/SN area. These novel findings may increase our understanding of connectivity in working memory in schizophrenia

Modified Gravity via Spontaneous Symmetry Breaking

We construct effective field theories in which gravity is modified via spontaneous breaking of local Lorentz invariance. This is a gravitational analogue of the Higgs mechanism. These theories possess additional graviton modes and modified dispersion relations. They are manifestly well-behaved in the UV and free of discontinuities of the van Dam-Veltman-Zakharov type, ensuring compatibility with standard tests of gravity. They may have important phenomenological effects on large distance scales, offering an alternative to dark energy. For the case in which the symmetry is broken by a vector field with the wrong sign mass term, we identify four massless graviton modes (all with positive-definite norm for a suitable choice of a parameter) and show the absence of the discontinuity.Comment: 5 pages; revised versio

Some general properties of the renormalized stress-energy tensor for static quantum states on (n+1)-dimensional spherically symmetric black holes

We study the renormalized stress-energy tensor (RSET) for static quantum states on (n+1)-dimensional, static, spherically symmetric black holes. By solving the conservation equations, we are able to write the stress-energy tensor in terms of a single unknown function of the radial co-ordinate, plus two arbitrary constants. Conditions for the stress-energy tensor to be regular at event horizons (including the extremal and ``ultra-extremal'' cases) are then derived using generalized Kruskal-like co-ordinates. These results should be useful for future calculations of the RSET for static quantum states on spherically symmetric black hole geometries in any number of space-time dimensions.Comment: 9 pages, no figures, RevTeX4, references added, accepted for publication in General Relativity and Gravitatio

Thermal Decay of the Cosmological Constant into Black Holes

We show that the cosmological constant may be reduced by thermal production of membranes by the cosmological horizon, analogous to a particle ``going over the top of the potential barrier", rather than tunneling through it. The membranes are endowed with charge associated with the gauge invariance of an antisymmetric gauge potential. In this new process, the membrane collapses into a black hole, thus the net effect is to produce black holes out of the vacuum energy associated with the cosmological constant. We study here the corresponding Euclidean configurations ("thermalons"), and calculate the probability for the process in the leading semiclassical approximation.Comment: 14 pages, 6 figures. Minor correction

Effects of a balanced translocation between chromosomes 1 and 11 disrupting the DISC1 locus on white matter integrity

Objective Individuals carrying rare, but biologically informative genetic variants provide a unique opportunity to model major mental illness and inform understanding of disease mechanisms. The rarity of such variations means that their study involves small group numbers, however they are amongst the strongest known genetic risk factors for major mental illness and are likely to have large neural effects. DISC1 (Disrupted in Schizophrenia 1) is a gene containing one such risk variant, identified in a single Scottish family through its disruption by a balanced translocation of chromosomes 1 and 11; t(1;11) (q42.1;q14.3). Method Within the original pedigree, we examined the effects of the t(1;11) translocation on white matter integrity, measured by fractional anisotropy (FA). This included family members with (n = 7) and without (n = 13) the translocation, along with a clinical control sample of patients with psychosis (n = 34), and a group of healthy controls (n = 33). Results We report decreased white matter integrity in five clusters in the genu of the corpus callosum, the right inferior fronto-occipital fasciculus, acoustic radiation and fornix. Analysis of the mixed psychosis group also demonstrated decreased white matter integrity in the above regions. FA values within the corpus callosum correlated significantly with positive psychotic symptom severity. Conclusions We demonstrate that the t(1;11) translocation is associated with reduced white matter integrity in frontal commissural and association fibre tracts. These findings overlap with those shown in affected patients with psychosis and in DISC1 animal models and highlight the value of rare but biologically informative mutations in modeling psychosis

A Brane World Perspective on the Cosmological Constant and the Hierarchy Problems

We elaborate on the recently proposed static brane world scenario, where the effective 4-D cosmological constant is exponentially small when parallel 3-branes are far apart. We extend this result to a compactified model with two positive tension branes. Besides an exponentially small effective 4-D cosmological constant, this model incorporates a Randall-Sundrum-like solution to the hierarchy problem. Furthermore, the exponential factors for the hierarchy problem and the cosmological constant problem obey an inequality that is satisfied in nature. This inequality implies that the cosmological constant problem can be explained if the hierarchy problem is understood. The basic idea generalizes to the multibrane world scenario. We discuss models with piecewise adjustable bulk cosmological constants (to be determined by the 5-dimensional Einstein equation), a key element of the scenario. We also discuss the global structure of this scenario and clarify the physical properties of the particle (Rindler) horizons that are present. Finally, we derive a 4-D effective theory in which all observers on all branes not separated by particle horizons measure the same Newton's constant and 4-D cosmological constant.Comment: revtex, 63 pages, 8 figures, one table, revised version, more discussions on the global structure, references adde