A Characterisation of Strong Wave Tails in Curved Space-Times

A characterisation of when wave tails are strong is proposed. The existence of a curvature induced tail (i.e. a Green's function term whose support includes the interior of the light-cone) is commonly understood to cause backscattering of the field governed by the relevant wave equation. Strong tails are characterised as those for which the purely radiative part of the field is backscattered. With this definition, it is shown that electromagnetic waves in asymptotically flat space-times and fields governed by tail-free propagation have weak tails, but minimally coupled scalar fields in a cosmological scenario have strong tails.Comment: 17 pages, Revtex, to appear in Classical and Quantum Gravit

Blending Geospatial Technology and Traditional Ecological Knowledge to Enhance Restoration Decision-Support Processes in Coastal Louisiana

More informed coastal restoration decisions have become increasingly important given limited resources available for restoration projects and the increasing magnitude of marsh degradation and loss across the Gulf Coast. This research investigated the feasibility and benefits of integrating geospatial technology with the traditional ecological knowledge (TEK) of an indigenous Louisiana coastal population to assess the impacts of current and historical ecosystem change on community viability. The primary goal was to provide coastal resource managers with a decision-support tool that allows for a more comprehensive method of assessing localized ecological change in the Gulf Coast region, which can also benefit human community sustainability. Using remote sensing (RS) and geographic information systems (GIS) mapping products, integrated with a coastal community’s TEK to achieve this goal, the research team determined a method for producing vulnerability/sustainability mapping products for an ecosystem-dependent livelihood base of a coastal population based on information derived from RS imagery prioritized with TEK. This study also demonstrates how such an approach can engage affected community residents who are interested in determining and addressing the causes and mitigating the decline of marsh habitat. Historical image data sets of the study area were acquired to understand evolution of land change to current conditions and project future vulnerability. Image-processing procedures were developed and applied to produce maps that detail land change in the study area at time intervals from 1968 to 2009. This information was combined in a GIS with acquired TEK and scientific data sets relating to marsh vegetation health and vulnerability characteristics to produce mapping products that provide new information for use in the coastal restoration decision-making process. This information includes: (1) marsh areas that are most vulnerable; and (2) the areas that are most significant to community sustainability

Abnormal Involuntary Movement Scale in Tardive Dyskinesia:Minimal Clinically Important Difference

Background A minimal clinically important difference has not been established for the Abnormal Involuntary Movement Scale in patients with tardive dyskinesia. Valbenazine is a vesicular monoamine transporter 2 inhibitor approved for the treatment of tardive dyskinesia in adults. Efficacy in randomized, double�blind, placebo�controlled trials was defined as the change from baseline in Abnormal Involuntary Movement Scale total score (sum of items 1�7). Objectives To estimate an minimal clinically important difference for the Abnormal Involuntary Movement Scale using valbenazine trial data and an anchor�based method. Methods Data were pooled from three 6�week double�blind, placebo�controlled trials: KINECT (NCT01688037), KINECT 2 (NCT01733121), and KINECT 3 (NCT02274558). Valbenazine doses were pooled for analyses as follows: “low dose,� which includes 40 or 50 mg/day; and “high dose,� which includes 75 or 80 mg/day. Mean changes from baseline in Abnormal Involuntary Movement Scale total score were analyzed in all participants (valbenazine� and placebo�treated) with a Clinical Global Impression of Change�Tardive Dyskinesia or Patient Global Impression of Change score of 1 (very much improved) to 3 (minimally improved). Results The least squares mean improvement from baseline to week 6 in Abnormal Involuntary Movement Scale total score was significantly greater with valbenazine (low dose: –2.4; high dose: –3.2; both, P < 0.001) versus placebo (–0.7). An minimal clinically important difference of 2 points was estimated based on least squares mean changes in Abnormal Involuntary Movement Scale total score in participants with a Clinical Global Impression of Change�Tardive Dyskinesia score ≤3 at week 6 (mean change: –2.2; median change: –2) or Patient Global Impression of Change score ≤3 at week 6 (mean change: –2.0; median change: –2). Conclusions Results from an anchor�based method indicate that a 2�point decrease in Abnormal Involuntary Movement Scale total score may be considered clinically important. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society

Dynamical extensions for shell-crossing singularities

We derive global weak solutions of Einstein's equations for spherically symmetric dust-filled space-times which admit shell-crossing singularities. In the marginally bound case, the solutions are weak solutions of a conservation law. In the non-marginally bound case, the equations are solved in a generalized sense involving metric functions of bounded variation. The solutions are not unique to the future of the shell-crossing singularity, which is replaced by a shock wave in the present treatment; the metric is bounded but not continuous.Comment: 14 pages, 1 figur

On isotropic cylindrically symmetric stellar models

We attempt to match the most general cylindrically symmetric vacuum space-time with a Robertson-Walker interior. The matching conditions show that the interior must be dust filled and that the boundary must be comoving. Further, we show that the vacuum region must be polarized. Imposing the condition that there are no trapped cylinders on an initial time slice, we can apply a result of Thorne's and show that trapped cylinders never evolve. This results in a simplified line element which we prove to be incompatible with the dust interior. This result demonstrates the impossibility of the existence of an isotropic cylindrically symmetric star (or even a star which has a cylindrically symmetric portion). We investigate the problem from a different perspective by looking at the expansion scalars of invariant null geodesic congruences and, applying to the cylindrical case, the result that the product of the signs of the expansion scalars must be continuous across the boundary. The result may also be understood in relation to recent results about the impossibility of the static axially symmetric analogue of the Einstein-Straus model.Comment: 13 pages. To appear in Classical and Quantum Gravit

Population-level emergence of bedaquiline and clofazimine resistance-associated variants among patients with drug-resistant tuberculosis in southern Africa: a phenotypic and phylogenetic analysis

Background: Bedaquiline and clofazimine are important drugs in the treatment of drug-resistant tuberculosis and are commonly used across southern Africa, although drug susceptibility testing is not routinely performed. In this study, we did a genotypic and phenotypic analysis of drug-resistant Mycobacterium tuberculosis isolates from cohort studies in hospitals in KwaZulu-Natal, South Africa, to identify resistance-associated variants (RAVs) and assess the extent of clofazimine and bedaquiline cross-resistance. We also used a comprehensive dataset of whole-genome sequences to investigate the phylogenetic and geographical distribution of bedaquiline and clofazimine RAVs in southern Africa. Methods: In this study, we included M tuberculosis isolates reported from the PRAXIS study of patients with drug-resistant tuberculosis treated with bedaquiline (King Dinuzulu Hospital, Durban) and three other cohort studies of drug-resistant tuberculosis in other KwaZulu-Natal hospitals, and sequential isolates from six persistently culture-positive patients with extensively drug-resistant tuberculosis at the KwaZulu-Natal provincial referral laboratory. Samples were collected between 2013 and 2019. Microbiological cultures were done as part of all parent studies. We sequenced whole genomes of included isolates and measured bedaquiline and clofazimine minimum inhibitory concentrations (MICs) for isolates identified as carrying any Rv0678 variant or previously published atpE, pepQ, and Rv1979c RAVs, which were the subject of the phenotypic study. We combined all whole-genome sequences of M tuberculosis obtained in this study with publicly available sequence data from other tuberculosis studies in southern Africa (defined as the countries of the Southern African Development Community), including isolates with Rv0678 variants identified by screening public genomic databases. We used this extended dataset to reconstruct phylogenetic relationships across lineage 2 and 4 M tuberculosis isolates. Findings: We sequenced the whole genome of 648 isolates from 385 patients with drug-resistant tuberculosis recruited into cohort studies in KwaZulu-Natal, and 28 isolates from six patients from the KwaZulu-Natal referral laboratory. We identified 30 isolates with Rv0678 RAVs from 16 (4%) of 391 patients. We did not identify any atpE, pepQ, or Rv1979c RAVs. MICs were measured for 21 isolates with Rv0678 RAVs. MICs were above the critical concentration for bedaquiline resistance in nine (43%) of 21 isolates, in the intermediate category in nine (43%) isolates, and within the wild-type range in three (14%) isolates. Clofazimine MICs in genetically wild-type isolates ranged from 0·12-0·5 μg/mL, and in isolates with RAVs from 0·25-4·0 μg/mL. Phylogenetic analysis of the extended dataset including M tuberculosis isolates from southern Africa resolved multiple emergences of Rv0678 variants in lineages 2 and 4, documented two likely nosocomial transmission events, and identified the spread of a possibly bedaquiline and clofazimine cross-resistant clone in eSwatini. We also identified four patients with pepQ frameshift mutations that may confer resistance. Interpretation: Bedaquiline and clofazimine cross-resistance in southern Africa is emerging repeatedly, with evidence of onward transmission largely due to Rv0678 mutations in M tuberculosis. Roll-out of bedaquiline and clofazimine treatment in the setting of limited drug susceptibility testing could allow further spread of resistance. Designing strong regimens would help reduce the emergence of resistance. Drug susceptibility testing is required to identify where resistance does emerge. Funding: Wellcome Trust, National Institute of Allergy and Infectious Diseases and National Center for Advancing Translational Sciences of the National Institutes of Health

The Central Singularity in Spherical Collapse

The gravitational strength of the central singularity in spherically symmetric space-times is investigated. Necessary conditions for the singularity to be gravitationally weak are derived and it is shown that these are violated in a wide variety of circumstances. These conditions allow conclusions to be drawn about the nature of the singularity without having to integrate the geodesic equations. In particular, any geodesic with a non-zero amount of angular momentum which impinges on the singularity terminates in a strong curvature singularity.Comment: 17 pages; revised and corrected with improved result

Strengths of singularities in spherical symmetry

Covariant equations characterizing the strength of a singularity in spherical symmetry are derived and several models are investigated. The difference between central and non-central singularities is emphasised. A slight modification to the definition of singularity strength is suggested. The gravitational weakness of shell crossing singularities in collapsing spherical dust is proven for timelike geodesics, closing a gap in the proof.Comment: 16 pages, revtex. V2. Classification of irregular singular points completed, Comments and references on singularities with a continuous metric amende