Ocean Acidification: Legal and Policy Responses to Address Climate Change\u27s Evil Twin

Much attention has been devoted to the problem of global climate change, but the effects of carbon dioxide on the world’s oceans has been largely underappreciated. Oceanic absorption of carbon dioxide is working fundamental changes on ocean chemistry, increasing the acidity of the oceans, and threatening the stability of the oceans’ ecosystems. The United States has responded to these emergent threats with a policy agenda heavily oriented toward data production, but light on action that might reverse the course of ocean acidification. This Article contends that this policy approach is ill-suited to the known risks of intensifying ocean acidification. The author recommends a shift toward a more action-oriented policy agenda aimed at preventing ocean acidification from reaching perilous levels. In particular, this article recommends using the statutory tools already available under the Clean Water Act to preserve coastal carbon sinks, to establish more protective marine water quality standards for pH, and to implement regional TMDLs for carbon dioxide. The cost of delay is simply too high to forgo direct action to combat ocean acidification. Reprinted with permission from 20 N.Y.U. Envtl. L.J. 507 (2014)

Using chronic kidney disease trigger tools for safety and learning: a qualitative evaluation in East London primary care

Background An innovative programme to improve identification and management of chronic kidney disease (CKD) in primary care was implemented across three clinical commissioning groups (CCGs) in 2016. This included a falling estimated glomerular filtration rate (eGFR) trigger tool built from data within the electronic health record (EHR). This patient safety tool notifies GP practices when falling eGFR values are identified. By alerting clinicians to patients with possible CKD progression the tool invites clinical review, the option for specialist advice, and written reflection on management. Aim To identify practitioner perceptions of trigger tool use and value from interview data, and compare these with the written reflections on clinical management recorded within the tools. Method Eight semi-structured interviews with 6 GPs, 1 pharmacist and 1 practice manager were recorded and transcribed. Thematic analysis of the interview transcripts was undertaken using framework analysis. The free-text reflective comments recorded in the trigger tools of 1,921 cases were organised by referral category ‘yes’ and ‘no’, with each category stratified by age into ‘younger’ and ‘older’ cases. Subsequently the themes arising from the interviews were compared with the descriptive analysis of the reflective comments. Findings Three themes emerged from interviews: Getting started, Patient safety and Practitioner and Practice learning. Well organised practices found the tool was readily embedded into workflow and expressed greater motivation for using it. The trigger tool was seen to contribute to patient safety, and as a tool for learning about CKD management, both individually and as a practice. Reflective comments from 1,921 trigger tools were examined, these supported the theme of patient safety from the interviews. However the free text data, stratified by age, challenged the expectation that younger cases would have higher referral rates, driven by a higher level of risk for CKD progression. Conclusion Building electronic trigger tools from the EHR can identify patients with a falling eGFR prompting review of the eGFR trajectory and management plan. Interview and reflective data illustrated that practice use of the trigger tool supported the patient safety agenda and in addition encouraged team and individual learning about CKD management

Global Aspects of T-Duality, Gauged Sigma Models and T-Folds

The gauged sigma-model argument that string backgrounds related by T-dual give equivalent quantum theories is revisited, taking careful account of global considerations. The topological obstructions to gauging sigma-models give rise to obstructions to T-duality, but these are milder than those for gauging: it is possible to T-dualise a large class of sigma-models that cannot be gauged. For backgrounds that are torus fibrations, it is expected that T-duality can be applied fibrewise in the general case in which there are no globally-defined Killing vector fields, so that there is no isometry symmetry that can be gauged; the derivation of T-duality is extended to this case. The T-duality transformations are presented in terms of globally-defined quantities. The generalisation to non-geometric string backgrounds is discussed, the conditions for the T-dual background to be geometric found and the topology of T-folds analysed.Comment: Minor corrections and addition

Backreacted T-folds and non-geometric regions in configuration space

We provide the backreaction of the T-fold doubly T-dual to a background with NSNS three-form flux on a three-torus. We extend the backreacted T-fold to include cases with a flux localized in one out of three directions. We analyze the resulting monodromy domain walls and vortices. In these backgrounds, we give an analysis of the action of T-duality on observables like charges and Wilson surfaces. We analyze arguments for the existence of regions in the configuration space of second quantized string theory that cannot be reduced to geometry. Finally, by allowing for space-dependent moduli, we find a supergravity solution which is a T-fold with hyperbolic monodromies.Comment: 25 pages, 4 figures; v2: minor changes, reference adde

Heterotic-type IIA duality with fluxes

In this paper we study a possible non-perturbative dual of the heterotic string compactified on K3 x T^2 in the presence of background fluxes. We show that type IIA string theory compactified on manifolds with SU(3) structure can account for a subset of the possible heterotic fluxes. This extends our previous analysis to a case of a non-perturbative duality with fluxes.Comment: 26 pages, minor corrections; version to appear in JHE

On supergravity solutions of space-like Dp-branes

Recently the time dependent solutions of type II supergravities in $d = 10$, with the metric having the symmetry $ISO(p+1) \times SO(8-p, 1)$ have been given by two groups (Chen-Gal'tsov-Gutperle (CGG), [hep-th/0204071] and Kruczenski-Myers-Peet (KMP), [hep-th/0204144]). The supergravity solutions correspond to space-like D$p$-branes in type II string theory. While the CGG solution is a four parameter solution, the KMP solution is a three parameter solution and so in general they are different. This difference can be attributed to the fact that unlike the CGG solution, KMP uses a specific boundary condition for the metric and the dilaton field. It is shown that when we impose the boundary conditions used in the KMP solution to the CGG solution then both become three parameter solutions and they map to each other under a coordinate transformation along with a Hodge duality of the field strength. We also give the relations between the parameters characterizing the two solutions.Comment: 14 pages, LaTeX, v2: minor corrections and a reference adde

Does aspirin or non-aspirin non-steroidal anti-inflammatory drug use prevent colorectal cancer in inflammatory bowel disease?

AIM: To determine whether aspirin or non-aspirin non-steroidal anti-inflammatory drugs (NA-NSAIDs) prevent colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD). METHODS: We performed a systematic review and meta-analysis. We searched for articles reporting the risk of CRC in patients with IBD related to aspirin or NA-NSAID use. Pooled odds ratios (OR) and 95%CIs were determined using a random-effects model. Publication bias was assessed using Funnel plots and Egger’s test. Heterogeneity was assessed using Cochran’s Q and the I2 statistic. RESULTS: Eight studies involving 14917 patients and 3 studies involving 1282 patients provided data on the risk of CRC in patients with IBD taking NA-NSAIDs and aspirin respectively. The pooled OR of developing CRC after exposure to NA-NSAIDs in patients with IBD was 0.80 (95%CI: 0.39-1.21) and after exposure to aspirin it was 0.66 (95%CI: 0.06-1.39). There was significant heterogeneity (I2 > 50%) between the studies. There was no change in the effect estimates on subgroup analyses of the population studied or whether adjustment or matching was performed. CONCLUSION: There is a lack of high quality evidence on this important clinical topic. From the available evidence NA-NSAID or aspirin use does not appear to be chemopreventative for CRC in patients with IBD