Loop Quantum Cosmology II: Volume Operators

Volume operators measuring the total volume of space in a loop quantum theory of cosmological models are constructed. In the case of models with rotational symmetry an investigation of the Higgs constraint imposed on the reduced connection variables is necessary, a complete solution of which is given for isotropic models; in this case the volume spectrum can be calculated explicitly. It is observed that the stronger the symmetry conditions are the smaller is the volume spectrum, which can be interpreted as level splitting due to broken symmetries. Some implications for quantum cosmology are presented.Comment: 21 page

New Loop Representations for 2+1 Gravity

Since the gauge group underlying 2+1-dimensional general relativity is non-compact, certain difficulties arise in the passage from the connection to the loop representations. It is shown that these problems can be handled by appropriately choosing the measure that features in the definition of the loop transform. Thus, ``old-fashioned'' loop representations - based on ordinary loops - do exist. In the case when the spatial topology is that of a two-torus, these can be constructed explicitly; {\it all} quantum states can be represented as functions of (homotopy classes of) loops and the scalar product and the action of the basic observables can be given directly in terms of loops.Comment: 28pp, 1 figure (postscript, compressed and uuencoded), TeX, Pennsylvania State University, CGPG-94/5-

Loop Quantum Cosmology I: Kinematics

The framework of quantum symmetry reduction is applied to loop quantum gravity with respect to transitively acting symmetry groups. This allows to test loop quantum gravity in a large class of minisuperspaces and to investigate its features - e.g. the discrete volume spectrum - in certain cosmological regimes. Contrary to previous studies of quantum cosmology (minisuperspace quantizations) the symmetry reduction is carried out not at the classical level but on an auxiliary Hilbert space of the quantum theory before solving the constraints. Therefore, kinematical properties like volume quantization survive the symmetry reduction. In this first part the kinematical framework, i.e. implementation of the quantum symmetry reduction and quantization of Gauss and diffeomorphism constraints, is presented for Bianchi class A models as well as locally rotationally symmetric and spatially isotropic closed and flat models.Comment: 24 page

Independent Loop Invariants for 2+1 Gravity

We identify an explicit set of complete and independent Wilson loop invariants for 2+1 gravity on a three-manifold $M=\R\times\Sigma^g$, with $\Sigma^g$ a compact oriented Riemann surface of arbitrary genus $g$. In the derivation we make use of a global cross section of the $PSU(1,1)$-principal bundle over Teichm\"uller space given in terms of Fenchel-Nielsen coordinates.Comment: 11pp, 2 figures (postscript, compressed and uu-encoded), TeX, Pennsylvania State University, CGPG-94/7-

Piecewise Rational Manifold Surfaces with Sharp Features

We present a construction of a piecewise rational free-form surface of arbitrary topological genus which may contain sharp features: creases, corners or cusps. The surface is automatically generated from a given closed triangular mesh. Some of the edges are tagged as sharp ones, defining the features on the surface. The surface is C s smooth, for an arbitrary value of s, except for the sharp features defined by the user. Our method is based on the manifold construction and follows the blending approach

Environmental modifiers of RTS,S/AS01 malaria vaccine efficacy in Lilongwe, Malawi

Background: RTS,S/AS01 is the first vaccine against malaria to undergo pilot implementation, beginning in 2019 and vaccinating 360,000 children per year in Malawi, Ghana, and Kenya. The four-dose vaccine is given as a primary three-dose series with a fourth dose given approximately 18 months later. The efficacy of RTS,S/AS01 was variable among the 11 sites participating in the 2009-2014 phase III trial (MALARIA-055, NCT00866619), possibly due to differences in transmission intensity. However, a within-site examination of environmental factors related to transmission intensity and their impact on vaccine efficacy has yet to be conducted. Methods: We implemented the phase III RTS,S/AS01 trial at the Malawi site, which enrolled 1578 infants (6-12 weeks) and children (5-17 months) living in the Lilongwe District in Central Malawi and followed them for 3 years between 2009 and 2014. A global positioning system survey and an ecological questionnaire were conducted to collect participant household locations and characteristics, while additional data on background malaria prevalence were obtained from a concurrent Malaria Transmission Intensity (MTI) survey. Negative binomial regression models were used to assess whether the efficacy of the vaccine varied by estimated background malaria prevalence, household roof type, or amount of nearby vegetation. Results: Vaccine efficacy did not significantly vary by estimated malaria prevalence or by roof type. However, increased vegetation cover was associated with an increase in the efficacy of the three-dose primary RTS,S/AS01 series in the 18 months before the fourth dose and a decrease in the efficacy of the primary vaccine series in the second 18 months following, if the fourth dose was not given. Vegetation cover did not alter the efficacy of the fourth dose in a statistically or practically significant manner. Conclusions: Vegetation coverage in this study site might be a proxy for nearness to rivers or branching, shallow wetlands called "dambos"which could serve as breeding sites for mosquitoes. We observed statistically significant modification of the efficacy of RTS,S/AS01 by forest cover, suggesting that initial vaccine efficacy and the importance of the fourth dose varies based on ecological context. Trial registration: Efficacy of GSK Biologicals' Candidate Malaria Vaccine (257049) Against Malaria Disease Caused by P. falciparum Infection in Infants and Children in Africa. NCT00866619 prospectively registered 20 March 2009

Case reduction and cost-effectiveness of the RTS,S/AS01 malaria vaccine alongside bed nets in Lilongwe, Malawi

Background: RTS,S/AS01, the most advanced vaccine against malaria, is now undergoing pilot implementation in Malawi, Ghana, and Kenya where an estimated 360,000 children will be vaccinated each year. In this study we evaluate RTS,S/AS01 alongside bed net use and estimate cost-effectiveness. Methods: RTS,S/AS01 phase III trial and bed net prevalence data were used to determine the effect of vaccination in the urban/periurban and rural areas of Lilongwe, Malawi. Cost data were used to calculate the cost-effectiveness of various interventions over three years. Findings: Since bed nets reduce malaria incidence and homogeneous vaccine efficacy was assumed, participants without bed nets received greater relative benefit from vaccination with RTS,S/AS01 than participants with bed nets. Similarly, since malaria incidence in rural Lilongwe is higher than in urban Lilongwe, the impact and cost-effectiveness of vaccine interventions is increased in rural areas. In rural Lilongwe, we estimated that vaccinating one child without a bed net would prevent 2·59 (1·62 to 3·38) cases of malaria over three years, corresponding to a cost of $10·08 (7·71 to 16·13) per case averted. Alternatively, vaccinating one child with a bed net would prevent 1·59 (0·87 to 2·57) cases, corresponding to$16·43 (10·16 to 30·06) per case averted. Providing RTS,S/AS01 to 30,000 children in rural Lilongwe was estimated to cost $782,400 and to prevent 58,611 (35,778 to 82,932) cases of malaria over a three-year period. Joint interventions providing both vaccination and bed nets (to those without them) were estimated to prevent additional cases of malaria and to be similarly cost-effective, compared to vaccine-only interventions. Interpretation: To maximize malaria prevention, vaccination and bed net distribution programs could be integrated. Funding: Impacts of Environment, Host Genetics and Antigen Diversity on Malaria Vaccine Efficacy (1R01AI137410-01

Nitrous oxide may not increase the risk of cancer recurrence after colorectal surgery: a follow-up of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Even the best cancer surgery is usually associated with minimal residual disease. Whether these remaining malignant cells develop into clinical recurrence is at least partially determined by adequacy of host defense, especially natural killer cell function. Anesthetics impair immune defenses to varying degrees, but nitrous oxide appears to be especially problematic. We therefore tested the hypothesis that colorectal-cancer recurrence risk is augmented by nitrous oxide administration during colorectal surgery.</p> <p>Methods</p> <p>We conducted a 4- to 8-year follow-up of 204 patients with colorectal cancer who were randomly assigned to 65% nitrous oxide (n = 97) or nitrogen (n = 107), balanced with isoflurane and remifentanil. The primary outcome was the time to cancer recurrence. Our primary analysis was a multivariable Cox-proportional-hazards regression model that included relevant baseline variables. In addition to treatment group, the model considered patient age, tumor grade, dissemination, adjacent organ invasion, vessel invasion, and the number of nodes involved. The study had 80% power to detect a 56% or greater reduction in recurrence rates (i.e., hazard ratio of 0.44 or less) at the 0.05 significance level.</p> <p>Results</p> <p>After adjusting for significant baseline covariables, risk of recurrence did not differ significantly for nitrous oxide and nitrogen, with a hazard ratio estimate (95% CI) of 1.10 (0.66, 1.83), <it>P </it>= 0.72. No two-way interactions with the treatment were statistically significant.</p> <p>Conclusion</p> <p>Colorectal-cancer recurrence risks were not greatly different in patients who were randomly assigned to 65% nitrous oxide or nitrogen during surgery. Our results may not support avoiding nitrous oxide use to prevent recurrence of colorectal cancer.</p> <p>Implications Statement</p> <p>The risk of colorectal cancer recurrence was similar in patients who were randomly assigned to 65% nitrous oxide or nitrogen during colorectal surgery.</p> <p>Trial Registration</p> <p>Current Controlled Clinical Trials NCT00781352 <url>http://www.clinicaltrials.gov</url></p