The Initial-Value Problem of Spherically Symmetric Wyman Sector Nonsymmetric Gravitational Theory

We cast the four-dimensional field equations of the Nonsymmetric Gravitational Theory (NGT) into a form appropriate for numerical study. In doing so, we have restricted ourselves to spherically symmetric spacetimes, and we have kept only the Wyman sector of the theory. We investigate the well-posedness of the initial-value problem of NGT for a particular data set consisting of a pulse in the antisymmetric field on an asymptotically flat space background. We include some analytic results on the solvability of the initial-value problem which allow us to place limits on the regions of the parameter space where the initial-value problem is solvable. These results are confirmed by numerically solving the constraints.Comment: REVTeX 3.0 with epsf macros and AMS symbols, 18 pages, 9 figure

Abelian Anomalies in Nonlocal Regularization

Nonlocal regularization of QED is shown to possess an axial anomaly of the same form as other regularization schemes. The Noether current is explicitly constructed and the symmetries are shown to be violated, whereas the identities constructed when one properly considers the contribution from the path integral measure are respected. We also discuss the barrier to quantizing the fully gauged chiral invariant theory, and consequences.Comment: 21 pages, UTPT-93-0

The dynamical stability of the static real scalar field solutions to the Einstein-Klein-Gordon equations revisited

We re-examine the dynamical stability of the nakedly singular, static, spherical ly symmetric solutions of the Einstein-Klein Gordon system. We correct an earlier proof of the instability of these solutions, and demonstrate that there are solutions to the massive Klein-Gordon system that are perturbatively stable.Comment: 13 pages, uses Elsevier style files. To appear in Phys. Lett.

The Dynamical Instability of Static, Spherically Symmetric Solutions in Nonsymmetric Gravitational Theories

We consider the dynamical stability of a class of static, spherically-symmetric solutions of the nonsymmetric gravitational theory. We numerically reproduce the Wyman solution and generate new solutions for the case where the theory has a nontrivial fundamental length scale \mu^{-1}. By considering spherically symmetric perturbations of these solutions we show that the Wyman solutions are generically unstable.Comment: 13 pages, uses amslatex, graphicx and subfigure package

Large-scale associations between the leukocyte transcriptome and BOLD responses to speech differ in autism early language outcome subtypes.

Heterogeneity in early language development in autism spectrum disorder (ASD) is clinically important and may reflect neurobiologically distinct subtypes. Here, we identified a large-scale association between multiple coordinated blood leukocyte gene coexpression modules and the multivariate functional neuroimaging (fMRI) response to speech. Gene coexpression modules associated with the multivariate fMRI response to speech were different for all pairwise comparisons between typically developing toddlers and toddlers with ASD and poor versus good early language outcome. Associated coexpression modules were enriched in genes that are broadly expressed in the brain and many other tissues. These coexpression modules were also enriched in ASD-associated, prenatal, human-specific, and language-relevant genes. This work highlights distinctive neurobiology in ASD subtypes with different early language outcomes that is present well before such outcomes are known. Associations between neuroimaging measures and gene expression levels in blood leukocytes may offer a unique in vivo window into identifying brain-relevant molecular mechanisms in ASD

A paediatric pain assessment and management survey at Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa

Background. Painful experiences are common in the paediatric inpatient population. Immaturity and cognitive impairment may preclude clear description of such experiences, and requests for analgesia when needed. Methods of pain assessment and guidelines for treatment in the paediatric population are well established, but are not widely used. Limited data suggest that the situation is similar in South Africa (SA).Objectives. To review the assessment and management of pain in SA medical paediatric inpatients. The primary objective was to determine the proportion of children who receive analgesia where indicated. The secondary objectives were to determine the prevalence of pain, at presentation and among admitted patients, whether pain evaluations were performed and pain treated, and the adequacy of such treatment.Methods. A prospective cross-sectional survey of medical paediatric inpatients at Rahima Moosa Mother and Child Hospital (RMMCH) in Johannesburg, SA, was conducted. The tool used for data collection was specifically designed for the study, with sections for demographic data, patient or caregiver interview, and chart review. Pain assessments were done using the revised Face, Legs, Activity, Cry, Consolability Scale and the Neonatal/Infant Pain Scale. The analysis consisted of descriptive statistics of epidemiological data and comparative statistics using grouped variables, with the level of significance set at p<0.05.Results. The sample consisted of 74 children, aged between 3 days and 4 years. Male patients accounted for 58% of the cohort. The prevalence of pain at admission was 73% (n=53). Eight percent (n=6) of the study sample had pain evaluation at admission, and only 1 child had been evaluated for pain within the preceding 24 hours. Of the 74 patients reviewed, 10% (n=7) received appropriate analgesia. Paracetamol was given to 31% of patients (n=23), either for pyrexia or for an undocumented indication. More than half of the study sample (59%; n=44) received no analgesia. The presence of pain, both by caregiver report (p=0.62) and by pain score (p=0.074), was not associated with the administration of analgesia.Conclusion. Pain in the paediatric population at RMMCH was found to be common, but it was seldom assessed, and validated pain scores were rarely used. The result was inadequate pain management in all the four domains of assessment, intervention, reassessment and ongoing management

Evaluation of excess 234Th activity in sediments as an indicator of food quality for deep-sea deposit feeders

Deep-sea deposit feeders selectively ingest large volumes of sediment. Knowledge of the nature of this selectivity will help to elucidate the limiting nutritional requirements and geochemical impacts of these abundant animals. Shallow-water and theoretical studies suggest that deep-sea deposit feeders should select particles rich in protein, bacterial biomass, and/or chloropigment concentrations. Recent studies indicate that deep-sea megafaunal deposit feeders exhibit strong gut enrichment of excess (xs) 234Th activity, even though 234Thxs lacks nutritional value. To explore the significance of selective ingestion of 234Thxs activity, we evaluated the correlations between 234Thxs activity and three potential tracers of deposit feeder food quality: chlorophyll a (chl a), enzymatically hydrolyzable amino acids (EHAA), and adenosine triphosphate (ATP). Surface sediments from three quiescent bathyal basins off Southern California (San Nicolas, Santa Catalina, and San Clemente) were collected by a multiple corer and analyzed for 234Thxs activity, chl a, EHAA, ATP, and total organic carbon and nitrogen. 234Thxs activity was positively correlated with chl a and phaeopigment concentrations and negatively correlated with EHAA concentrations. Excess 234Th was not linearly correlated with concentrations of ATP, organic carbon, or total nitrogen. The results suggest that deep-sea deposit feeders select sediments with high 234Thxs activity because it is associated with recently settled phytodetrital material. There is no evidence that this 234Thxs-rich material has particularly high concentrations of labile amino acids or microbial biomass. Phytodetrital material may be an important source of some other limiting nutrient to deep-sea deposit feeders, e.g., polyunsaturated fatty acids, labile organic carbon and/or vitamins

Wits Transplant Unit Annual Report 2022: Adult and paediatric liver transplantation

In 2022, the Wits Transplant Unit performed 57 liver transplants: 33/57 adult (58%) and 24/57 paediatric (42%) recipients. At the beginning of 2022, 28 candidates were on the adult waitlist. Forty-six candidates were added to the waitlist during the year. Sixty-five percent of waitlisted candidate were transplanted. Adult candidates remained on the waitlist for longer than previous years, with 52% of them waitlisted for less than one year before undergoing liver transplantation. There was a decrease in adult pretransplant mortality to 9% in 2021 from 25% in 2020. The most common aetiology in waitlist candidates was alcoholic steatohepatitis (ASH)/non-alcoholic steatohepatitis (NASH) (36%) and in recipients cholestatic (primary sclerosing cholangitis (PSC) and primary biliary sclerosis (PBC)) (40%). Most adult recipients received a deceased donor graft (79%). Unadjusted recipient one- and three-year survivals were 75% (95% confidence interval (CI) 65 - 83) and 74% (95% CI 65 - 81), respectively. In the paediatric population, the most common aetiologies for both pretransplant candidates and transplant recipients remained cholestatic disease and acute liver failure. There was a decrease in paediatric pretransplant mortality from 27% in 2017 to 6% in 2021. Unlike the adult cohort, most paediatric recipients received a living donor graft (79%). Unadjusted one-year and three-year survival rates were 85% (95% CI 75 - 92) and 68% (95% CI 56 - 77), respectively.

ABO-incompatible liver transplantation – exploring utilitarian solutions to restricted access and organ shortages: A single-centre experience from Johannesburg, South Africa

Background. Liver transplantation is the definitive management for severe acute liver failure refractory to supportive management, and end- stage chronic liver failure. Owing to a shortage of deceased liver donors, South Africa requires innovative techniques to broaden the donor pool. Objectives. This study evaluated the outcomes of the Wits Transplant Unit ABO-incompatible liver transplant (ABOi-LT) programme. Methods. This retrospective record review compared all adult and paediatric patients receiving ABO-compatible (ABOc) and ABO-incompatible (ABOi) liver transplants from January 2014 to December 2021 with a minimum one-year follow-up. Primary outcomes were recipient and graft survival and secondary outcomes included vascular, enteric and biliary complications, relook surgery, acute cellular rejection (ACR) and lenghth of hospital stay. Cox proportional hazards regression was performed to examine the effect of ABO-compatibility group on recipient and graft survival. The relationship between the ABO-compatibility group and categorical outcomes was assessed by binomial regression. Results. During the study period, 532 liver transplants were performed; 44/532 (8%) were ABOi of which 14/44 (32%) were paediatric and 30/44 (68%) adult recipients. Within the pediatric group, the proportion of transplants performed for acute liver failure was significantly higher in the ABOi group (7/14; 50%) compared with the ABOc group (33/207; 16%) (p=0.005). Comparable recipient and graft survival estimates were noted: one-, three- and five-year recipient survival in the ABOi group was 77% (95% confidence interval (CI) 44 - 92), 58% (95% CI 17 - 84) and 58% (95% CI 17 - 84) respectively. There were significantly increased relative risks of relook surgery for the ABOi group compared with the ABOc group, both overall (relative risk (RR) 1.74; 95% CI 1.10 - 2.75) and at 90 days (RR 2.28; 95% CI 1.27 - 4.11); and also, for pre-discharge bloodstream infection (BSI), (RR 1.84; 95% CI 1.11 - 3.06). In adults, there were significantly more acute indications for liver transplantation in the ABOi (10/30; 33%) compared with the ABOc group (26/281; 9%) (p=0.0007) with the most common cause being drug or toxin ingestion (16/36; 44%). For the ABOi group, recipient survival estimates (95% CI) at 1, 3 and 5 years were 71% (50 - 84), 63% (41 - 78) and 58% (37 - 75) which, as noted with complication rates, were similar between ABO groups. Conclusion. This study confirms ABOi-LT as a feasible option to increase the liver donor pool in this organ-depleted setting as recipient survival and complication rates were similar between ABO-compatibility groups

The paediatric liver transplant experience in Johannesburg, South Africa: A broad overview and update

Background: The Wits Transplant Unit performed its first paediatric liver transplant in 2005. Initial experiences from the unit were published in 2012 and 2014. Since then, significant progress has been made in capacity-building the unit, improving outcomes and enhancing service delivery. This paper presents a broad overview and update of the unit’s 17-year experience.   Methods: We conducted a retrospective review of all paediatric liver transplants performed in Johannesburg from 1 January 2005 to 31 December 2021 with a minimum one-year follow-up. Data were accessed from the Wits Donald Gordon Medical Centre Paediatric Liver Transplant Research Database (University of the Witwatersrand Human Research Ethics approval: M190749). The following data were collected: donor and recipient sociodemographic and clinical characteristics, details of transplant procedures, donor grafts and recipient outcomes (post-operative complications, graft and recipient survival).   Results: A total of 270 transplants were performed during the review period. Two thirds of recipients (n=180, 67%) were younger than 5 years at time of transplant and half (n=135, 50%) received a living donor graft. The most common indication for liver transplant was biliary atresia, followed by acute liver failure. Unadjusted recipient survival was 80% (95% CI: 75-85%) at one year, and 68% (95% CI: 59-75%) at five years. Waiting list mortality decreased from 27.3% in 2017 to 5.9% in 2021. One hundred and fifty-four (57.0%) recipients experienced at least one type of intervention requiring surgical complication - the most common being biliary in nature (n = 91; 33.7%).   Conclusion: Over last seventeen years, a sustainable paediatric liver transplantation service has been established in Johannesburg. Living donor, split and ABO incompatible liver transplants have been incorporated in response to the severe organ shortage in South Africa. However, our outcomes can be improved. Additionally, a national transplant initiative to coordinate timeous referrals and expand access to liver transplantation for children with severe acute and chronic liver failure is advised