SARS Transmission among Hospital Workers in Hong Kong

Despite infection control measures, breakthrough transmission of severe acute respiratory syndrome (SARS) occurred for many hospital workers in Hong Kong. We conducted a case-control study of 72 hospital workers with SARS and 144 matched controls. Inconsistent use of goggles, gowns, gloves, and caps was associated with a higher risk for SARS infection (unadjusted odds ratio 2.42 to 20.54, p < 0.05). The likelihood of SARS infection was strongly associated with the amount of personal protection equipment perceived to be inadequate, having <2 hours of infection control training, and not understanding infection control procedures. No significant differences existed between the case and control groups in the proportion of workers who performed high-risk procedures, reported minor protection equipment problems, or had social contact with SARS-infected persons. Perceived inadequacy of personal protection equipment supply, infection control training <2 hours, and inconsistent use of personal protection equipment when in contact with SARS patients were significant independent risk factors for SARS infection

Hamiltonian thermodynamics of a Lovelock black hole

We consider the Hamiltonian dynamics and thermodynamics of spherically symmetric spacetimes within a one-parameter family of five-dimensional Lovelock theories. We adopt boundary conditions that make every classical solution part of a black hole exterior, with the spacelike hypersurfaces extending from the horizon bifurcation three-sphere to a timelike boundary with fixed intrinsic metric. The constraints are simplified by a Kucha\v{r}-type canonical transformation, and the theory is reduced to its true dynamical degrees of freedom. After quantization, the trace of the analytically continued Lorentzian time evolution operator is interpreted as the partition function of a thermodynamical canonical ensemble. Whenever the partition function is dominated by a Euclidean black hole solution, the entropy is given by the Lovelock analogue of the Bekenstein-Hawking entropy; in particular, in the low temperature limit the system exhibits a dominant classical solution that has no counterpart in Einstein's theory. The asymptotically flat space limit of the partition function does not exist. The results indicate qualitative robustness of the thermodynamics of five-dimensional Einstein theory upon the addition of a nontrivial Lovelock term.Comment: 22 pages, REVTeX v3.

Reduced phase space formalism for spherically symmetric geometry with a massive dust shell

We perform a Hamiltonian reduction of spherically symmetric Einstein gravity with a thin dust shell of positive rest mass. Three spatial topologies are considered: Euclidean (R^3), Kruskal (S^2 x R), and the spatial topology of a diametrically identified Kruskal (RP^3 - {a point at infinity}). For the Kruskal and RP^3 topologies the reduced phase space is four-dimensional, with one canonical pair associated with the shell and the other with the geometry; the latter pair disappears if one prescribes the value of the Schwarzschild mass at an asymptopia or at a throat. For the Euclidean topology the reduced phase space is necessarily two-dimensional, with only the canonical pair associated with the shell surviving. A time-reparametrization on a two-dimensional phase space is introduced and used to bring the shell Hamiltonians to a simpler (and known) form associated with the proper time of the shell. An alternative reparametrization yields a square-root Hamiltonian that generalizes the Hamiltonian of a test shell in Minkowski space with respect to Minkowski time. Quantization is briefly discussed. The discrete mass spectrum that characterizes natural minisuperspace quantizations of vacuum wormholes and RP^3-geons appears to persist as the geometrical part of the mass spectrum when the additional matter degree of freedom is added.Comment: 36 pages, REVTeX v3.1 with amsfonts. (References updated; minor typos corrected.

Hamiltonian thermodynamics of the Reissner-Nordstr\"om-anti-de Sitter black hole

We consider the Hamiltonian dynamics and thermodynamics of spherically symmetric Einstein-Maxwell spacetimes with a negative cosmological constant. We impose boundary conditions that enforce every classical solution to be an exterior region of a Reissner-Nordstr\"om-anti-de Sitter black hole with a nondegenerate Killing horizon, with the spacelike hypersurfaces extending from the horizon bifurcation two-sphere to the asymptotically anti-de Sitter infinity. The constraints are simplified by a canonical transformation, which generalizes that given by Kucha\v{r} in the spherically symmetric vacuum Einstein theory, and the theory is reduced to its true dynamical degrees of freedom. After quantization, the grand partition function of a thermodynamical grand canonical ensemble is obtained by analytically continuing the Lorentzian time evolution operator to imaginary time and taking the trace. A~similar analysis under slightly modified boundary conditions leads to the partition function of a thermodynamical canonical ensemble. The thermodynamics in each ensemble is analyzed, and the conditions that the (grand) partition function be dominated by a classical Euclidean black hole solution are found. When these conditions are satisfied, we recover in particular the Bekenstein-Hawking entropy. The limit of a vanishing cosmological constant is briefly discussed. (This paper is dedicated to Karel Kucha\v{r} on the occasion of his sixtieth birthday.)Comment: 34 pages, REVTeX v3.0. (Minor corrections and presentational revisions; added references.

Effect of real-time computer-aided polyp detection system (ENDO-AID) on adenoma detection in endoscopists-in-training: a randomized trial

Background The effect of computer-aided polyp detection (CADe) on adenoma detection rate (ADR) among endoscopists-in-training remains unknown. Methods We performed a single-blind, parallel-group, randomized controlled trial in Hong Kong between April 2021 and July 2022 (NCT04838951). Eligible subjects undergoing screening/surveillance/diagnostic colonoscopies were randomized 1:1 to receive colonoscopies with CADe (ENDO-AID(OIP-1), Olympus Co., Japan) or not (control) during withdrawal. Procedures were performed by endoscopists-in-training with <500 procedures and <3 years’ experience. Randomization was stratified by patient age, sex, and endoscopist experience (beginner vs intermediate-level, <200 vs 200-500 procedures). Image enhancement and distal attachment devices were disallowed. Subjects with incomplete colonoscopies or inadequate bowel preparation were excluded. Treatment allocation was blinded to outcome assessors. The primary outcome was ADR. Secondary outcomes were ADR for different adenoma sizes and locations, mean number of adenomas, and non-neoplastic resection rate. Results 386 and 380 subjects were randomized to CADe and control groups, respectively. The overall ADR was significantly higher in CADe than control group (57.5% vs 44.5%, adjusted relative risk 1.41, 95%CI 1.17-1.72, p<0.001). The ADRs for <5mm (40.4% vs 25.0%) and 5-10mm adenomas (36.8% vs 29.2%) were higher in CADe group. The ADRs were higher in CADe group in both right (42.0% vs 30.8%) and left colon (34.5% vs 27.6%), but there was no significant difference in advanced ADR. The ADRs were higher in CADe group among beginners (60.0% vs 41.9%) and intermediate-level endoscopists (56.5% vs 45.5%). Mean number of adenomas (1.48 vs 0.86) and non-neoplastic resection rate were higher in CADe group (52.1% vs 35.0%). Conclusions Among endoscopists-in-training, the use of CADe during colonoscopies was associated with increased overall ADR. (ClinicalTrials.gov: NCT04838951

Bile acids destabilise HIF-1a and promote anti-tumour phenotypes in cancer cell models.

BACKGROUND: The role of the microbiome has become synonymous with human health and disease. Bile acids, as essential components of the microbiome, have gained sustained credibility as potential modulators of cancer progression in several disease models. At physiological concentrations, bile acids appear to influence cancer phenotypes, although conflicting data surrounds their precise physiological mechanism of action. Previously, we demonstrated bile acids destabilised the HIF-1a subunit of the Hypoxic-Inducible Factor-1 (HIF-1) transcription factor. HIF-1 overexpression is an early biomarker of tumour metastasis and is associated with tumour resistance to conventional therapies, and poor prognosis in a range of different cancers. METHODS: Here we investigated the effects of bile acids on the cancer growth and migratory potential of cell lines where HIF-1a is known to be active under hypoxic conditions. HIF-1a status was investigated in A-549 lung, DU-145 prostate and MCF-7 breast cancer cell lines exposed to bile acids (CDCA and DCA). Cell adhesion, invasion, migration was assessed in DU-145 cells while clonogenic growth was assessed in all cell lines. RESULTS: Intracellular HIF-1a was destabilised in the presence of bile acids in all cell lines tested. Bile acids were not cytotoxic but exhibited greatly reduced clonogenic potential in two out of three cell lines. In the migratory prostate cancer cell line DU-145, bile acids impaired cell adhesion, migration and invasion. CDCA and DCA destabilised HIF-1a in all cells and significantly suppressed key cancer progression associated phenotypes; clonogenic growth, invasion and migration in DU-145 cells. CONCLUSIONS: These findings suggest previously unobserved roles for bile acids as physiologically relevant molecules targeting hypoxic tumour progression

The Atacama Cosmology Telescope: Cosmological parameters from three seasons of data

We present constraints on cosmological and astrophysical parameters from high-resolution microwave background maps at 148 GHz and 218 GHz made by the Atacama Cosmology Telescope (ACT) in three seasons of observations from 2008 to 2010. A model of primary cosmological and secondary foreground parameters is fit to the map power spectra and lensing deflection power spectrum, including contributions from both the thermal Sunyaev-Zeldovich (tSZ) effect and the kinematic Sunyaev-Zeldovich (kSZ) effect, Poisson and correlated anisotropy from unresolved infrared sources, radio sources, and the correlation between the tSZ effect and infrared sources. The power ell^2 C_ell/2pi of the thermal SZ power spectrum at 148 GHz is measured to be 3.4 +\- 1.4 muK^2 at ell=3000, while the corresponding amplitude of the kinematic SZ power spectrum has a 95% confidence level upper limit of 8.6 muK^2. Combining ACT power spectra with the WMAP 7-year temperature and polarization power spectra, we find excellent consistency with the LCDM model. We constrain the number of effective relativistic degrees of freedom in the early universe to be Neff=2.79 +\- 0.56, in agreement with the canonical value of Neff=3.046 for three massless neutrinos. We constrain the sum of the neutrino masses to be Sigma m_nu < 0.39 eV at 95% confidence when combining ACT and WMAP 7-year data with BAO and Hubble constant measurements. We constrain the amount of primordial helium to be Yp = 0.225 +\- 0.034, and measure no variation in the fine structure constant alpha since recombination, with alpha/alpha0 = 1.004 +/- 0.005. We also find no evidence for any running of the scalar spectral index, dns/dlnk = -0.004 +\- 0.012.Comment: 26 pages, 22 figures. This paper is a companion to Das et al. (2013) and Dunkley et al. (2013). Matches published JCAP versio

The Atacama Cosmology Telescope: Data Characterization and Map Making

We present a description of the data reduction and mapmaking pipeline used for the 2008 observing season of the Atacama Cosmology Telescope (ACT). The data presented here at 148 GHz represent 12% of the 90 TB collected by ACT from 2007 to 2010. In 2008 we observed for 136 days, producing a total of 1423 hours of data (11 TB for the 148 GHz band only), with a daily average of 10.5 hours of observation. From these, 1085 hours were devoted to a 850 deg^2 stripe (11.2 hours by 9.1 deg) centered on a declination of -52.7 deg, while 175 hours were devoted to a 280 deg^2 stripe (4.5 hours by 4.8 deg) centered at the celestial equator. We discuss sources of statistical and systematic noise, calibration, telescope pointing, and data selection. Out of 1260 survey hours and 1024 detectors per array, 816 hours and 593 effective detectors remain after data selection for this frequency band, yielding a 38% survey efficiency. The total sensitivity in 2008, determined from the noise level between 5 Hz and 20 Hz in the time-ordered data stream (TOD), is 32 micro-Kelvin sqrt{s} in CMB units. Atmospheric brightness fluctuations constitute the main contaminant in the data and dominate the detector noise covariance at low frequencies in the TOD. The maps were made by solving the least-squares problem using the Preconditioned Conjugate Gradient method, incorporating the details of the detector and noise correlations. Cross-correlation with WMAP sky maps, as well as analysis from simulations, reveal that our maps are unbiased at multipoles ell > 300. This paper accompanies the public release of the 148 GHz southern stripe maps from 2008. The techniques described here will be applied to future maps and data releases.Comment: 20 pages, 18 figures, 6 tables, an ACT Collaboration pape