Membrane paradigm realized?

Are there any degrees of freedom on the black hole horizon? Using the `membrane paradigm' we can reproduce coarse-grained physics outside the hole by assuming a fictitious membrane just outside the horizon. But to solve the information puzzle we need `real' degrees of freedom at the horizon, which can modify Hawking's evolution of quantum modes. We argue that recent results on gravitational microstates imply a set of real degrees of freedom just outside the horizon; the state of the hole is a linear combination of rapidly oscillating gravitational solutions with support concentrated just outside the horizon radius. The collective behavior of these microstate solutions may give a realization of the membrane paradigm, with the fictitious membrane now replaced by real, explicit degrees of freedom.Comment: 8 pages, Latex, 3 figures (Essay given second place in Gravity Research Foundation essay competition 2010

Human stature and development with special reference to Indian population

Background: Variation in human height around the globe as well as within a specific region or population is considered as reflection of health, wellbeing and long and short term adaptations. Human height is determined by a combination of genetic and environmental factors particularly diet and healthcare plays a significant role. Undernutrition during early childhood leads to stunting and poverty is one of the important causes of undernutrition. Still, it was reported that human height has steadily increased over the past two centuries across the globe. This trend is in line with general improvements in health and nutrition during this period. Historical data on heights tends to come from soldiers (conscripts), convicted criminals, slaves and servants. It is for this reason much of the historical data focuses on men. Recent data on heights uses additional sources including surveys and medical records. Here, the primary objective is to understand the variation of height around the globe with special reference to Indian population and to assess the relationship with human development index (HDI) and stature. Material and Methods: For present investigation three dataset on stature were analyzed from three different databases. Primarily, the investigation is based on anthropometric data collected on adult males of 18+ years of age belonging to 118 caste/tribe/ethnic/religious groups residing in 161 districts of 14 states of Indian Union. The data was collected by the trained physical anthropologists of Anthropological Survey of India, following standard techniques using standard instruments. Measurements were taken on adult apparently healthy males. Efforts were also made to exclude closely related individuals. Verbal informed consent was obtained from the study participants and they were illustrated in detail about the study objectives. A total of 43952 adult males were measured for height. The representative samples were drawn from each of the district of the states. To achieve the goal of representative sample, data was collected from different caste/tribe/religious group residing in every particular district and state. These states covered for present investigation are homeland of 759 million populations, which is 62.7% of the total population of India. The second database is based on two consecutive anthropometric surveys conducted in Sagar district of Madhya Pradesh (Central India). The first survey was part of Anthropometric survey conducted by Anthropological survey during 1970s. The second one was conducted during 2006 which was limited to 5 ethnic/caste/religious groups. To understand the global variation and predictors of human stature, country-wise average heights were obtained from across the globe. To understand the secular trend and predictors of human stature the data on country-wise average stature around the globe was collected. Simultaneously, data on Human Development Index (HDI) were obtained to understand the impact of development on adult Human Stature. Results: There is wide variation in stature of adult male and females around the globe on the basis of ethnic origin, geographical location, climate and socio-economic conditions. On the basis of Indian data, it was found that ethnic and regional variation in adult human stature is predominated by their ethnic origin.The tribes (ST) have shortest stature (161.45±5.95 cm) followed by scheduled castes (SC), other backward castes (OBC), Jain, Muslims and General Castes (GC). The Sikhs are tallest in India with an average height of 169.09±6.59 cm. Besides caste and occupation, nutritional status was also found to be determinants of adult stature. Significant regional variation in stature was observed in India with Meghalaya males being shortest and Haryana and Punjab males being tallest in this dataset. The regression analysis was computed to find out the role of development in determining the stature around the globe. Conclusion: Variation of human height is modulated by both genetic makeup and environment predictors. Adult stature is an outcome of nutrition and health care available during infancy, childhood and adolescence. Income, occupation, caste (Indian), ethnicity, climate, geo-political environment and development etc. are main determinants of human stature. In Indian context PanHindu caste stratification is one of the predominant determinants of stature

Entanglement Interpretation of Black Hole Entropy in String Theory

We show that the entropy resulting from the counting of microstates of non extremal black holes using field theory duals of string theories can be interpreted as arising from entanglement. The conditions for making such an interpretation consistent are discussed. First, we interpret the entropy (and thermodynamics) of spacetimes with non degenerate, bifurcating Killing horizons as arising from entanglement. We use a path integral method to define the Hartle-Hawking vacuum state in such spacetimes and discuss explicitly its entangled nature and its relation to the geometry. If string theory on such spacetimes has a field theory dual, then, in the low-energy, weak coupling limit, the field theory state that is dual to the Hartle-Hawking state is a thermofield double state. This allows the comparison of the entanglement entropy with the entropy of the field theory dual, and thus, with the Bekenstein-Hawking entropy of the black hole. As an example, we discuss in detail the case of the five dimensional anti-de Sitter, black hole spacetime

Horizons, Constraints, and Black Hole Entropy

Black hole entropy appears to be ``universal''--many independent calculations, involving models with very different microscopic degrees of freedom, all yield the same density of states. I discuss the proposal that this universality comes from the behavior of the underlying symmetries of the classical theory. To impose the condition that a black hole be present, we must partially break the classical symmetries of general relativity, and the resulting Goldstone boson-like degrees of freedom may account for the Bekenstein-Hawking entropy. In particular, I demonstrate that the imposition of a ``stretched horizon'' constraint modifies the algebra of symmetries at the horizon, allowing the use of standard conformal field theory techniques to determine the asymptotic density of states. The results reproduce the Bekenstein-Hawking entropy without any need for detailed assumptions about the microscopic theory.Comment: 16 pages, talk given at the "Peyresq Physics 10 Meeting on Micro and Macro structures of spacetime

Formation and Evolution of Supermassive Black Holes

The correlation between the mass of supermassive black holes in galaxy nuclei and the mass of the galaxy spheroids or bulges (or more precisely their central velocity dispersion), suggests a common formation scenario for galaxies and their central black holes. The growth of bulges and black holes can commonly proceed through external gas accretion or hierarchical mergers, and are both related to starbursts. Internal dynamical processes control and regulate the rate of mass accretion. Self-regulation and feedback are the key of the correlation. It is possible that the growth of one component, either BH or bulge, takes over, breaking the correlation, as in Narrow Line Seyfert 1 objects. The formation of supermassive black holes can begin early in the universe, from the collapse of Population III, and then through gas accretion. The active black holes can then play a significant role in the re-ionization of the universe. The nuclear activity is now frequently invoked as a feedback to star formation in galaxies, and even more spectacularly in cooling flows. The growth of SMBH is certainly there self-regulated. SMBHs perturb their local environment, and the mergers of binary SMBHs help to heat and destroy central stellar cusps. The interpretation of the X-ray background yields important constraints on the history of AGN activity and obscuration, and the census of AGN at low and at high redshifts reveals the downsizing effect, already observed for star formation. History appears quite different for bright QSO and low-luminosity AGN: the first grow rapidly at high z, and their number density decreases then sharply, while the density of low-luminosity objects peaks more recently, and then decreases smoothly.Comment: 31 pages, 13 figures, review paper for Astrophysics Update

Black Hole Thermodynamics and Statistical Mechanics

We have known for more than thirty years that black holes behave as thermodynamic systems, radiating as black bodies with characteristic temperatures and entropies. This behavior is not only interesting in its own right; it could also, through a statistical mechanical description, cast light on some of the deep problems of quantizing gravity. In these lectures, I review what we currently know about black hole thermodynamics and statistical mechanics, suggest a rather speculative "universal" characterization of the underlying states, and describe some key open questions.Comment: 35 pages, Springer macros; for the Proceedings of the 4th Aegean Summer School on Black Hole

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17 : analysis for the Global Burden of Disease Study 2017

Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation