Clean Time-Dependent String Backgrounds from Bubble Baths

We consider the set of controlled time-dependent backgrounds of general relativity and string theory describing ``bubbles of nothing'', obtained via double analytic continuation of black hole solutions. We analyze their quantum stability, uncover some novel features of their dynamics, identify their causal structure and observables, and compute their particle production spectrum. We present a general relation between squeezed states, such as those arising in cosmological particle creation, and nonlocal theories on the string worldsheet. The bubble backgrounds have various aspects in common with de Sitter space, Rindler space, and moving mirror systems, but constitute controlled solutions of general relativity and string theory with no external forces. They provide a useful theoretical laboratory for studying issues of observables in systems with cosmological horizons, particle creation, and time-dependent string perturbation theory.Comment: 38 pages, harvmac big, 6 figure

Quality of Life and Clinical Outcomes in Elderly Patients Treated with Ventricular Pacing as Compared with Dual-Chamber Pacing

ABSTRACT Background Standard clinical practice permits the use of either single-chamber ventricular pacemakers or dual-chamber pacemakers for most patients who require cardiac pacing. Ventricular pacemakers are less expensive, but dual-chamber pacemakers are believed to be more physiologic. However, it is not known whether either type of pacemaker results in superior clinical outcomes. Methods The Pacemaker Selection in the Elderly study was a 30-month, single-blind, randomized, controlled comparison of ventricular pacing and dualchamber pacing in 407 patients 65 years of age or older in 29 centers. Patients received a dual-chamber pacemaker that had been randomly programmed to either ventricular pacing or dual-chamber pacing. The primary end point was health-related quality of life as measured by the 36-item Medical Outcomes Study Short-Form General Health Survey. Results The average age of the patients was 76 years (range, 65 to 96), and 60 percent were men. Quality of life improved significantly after pacemaker implantation (P0.001), but there were no differences between the two pacing modes in either the quality of life or prespecified clinical outcomes (including cardiovascular events or death). However, 53 patients assigned to ventricular pacing (26 percent) were crossed over to dual-chamber pacing because of symptoms related to the pacemaker syndrome. Patients with sinus-node dysfunction, but not those with atrioventricular block, had moderately better quality of life and cardiovascular functional status with dual-chamber pacing than with ventricular pacing. Trends of borderline statistical significance in clinical end points favoring dual-chamber pacing were observed in patients with sinus-node dysfunction, but not in those with atrioventricular block. Conclusions The implantation of a permanent pacemaker improves health-related quality of life. The quality-of-life benefits associated with dualchamber pacing as compared with ventricular pacing are observed principally in the subgroup of patients with sinus-node dysfunction. (N Engl J Med 1998;338:1097-104.

On Smooth Time-Dependent Orbifolds and Null Singularities

We study string theory on a non-singular time-dependent orbifold of flat space, known as the `null-brane'. The orbifold group, which involves only space-like identifications, is obtained by a combined action of a null Lorentz transformation and a constant shift in an extra direction. In the limit where the shift goes to zero, the geometry of this orbifold reproduces an orbifold with a light-like singularity, which was recently studied by Liu, Moore and Seiberg (hep-th/0204168). We find that the backreaction on the geometry due to a test particle can be made arbitrarily small, and that there are scattering processes which can be studied in the approximation of a constant background. We quantize strings on this orbifold and calculate the torus partition function. We construct a basis of states on the smooth orbifold whose tree level string interactions are nonsingular. We discuss the existence of physical modes in the singular orbifold which resolve the singularity. We also describe another way of making the singular orbifold smooth which involves a sandwich pp-wave.Comment: 24 pages, one figur

Quality of life and clinical outcomes in elderly patients treated with ventricular pacing as compared with dual-chamber pacing. Pacemaker Selection in the Elderly Investigators.

BackgroundStandard clinical practice permits the use of either single-chamber ventricular pacemakers or dual-chamber pacemakers for most patients who require cardiac pacing. Ventricular pacemakers are less expensive, but dual-chamber pacemakers are believed to be more physiologic. However, it is not known whether either type of pacemaker results in superior clinical outcomes.MethodsThe Pacemaker Selection in the Elderly study was a 30-month, single-blind, randomized, controlled comparison of ventricular pacing and dual-chamber pacing in 407 patients 65 years of age or older in 29 centers. Patients received a dual-chamber pacemaker that had been randomly programmed to either ventricular pacing or dual-chamber pacing. The primary end point was health-related quality of life as measured by the 36-item Medical Outcomes Study Short-Form General Health Survey.ResultThe average age of the patients was 76 years (range, 65 to 96), and 60 percent were men. Quality of life improved significantly after pacemaker implantation (P<0.001), but there were no differences between the two pacing modes in either the quality of life or prespecified clinical outcomes (including cardiovascular events or death). However, 53 patients assigned to ventricular pacing (26 percent) were crossed over to dual-chamber pacing because of symptoms related to the pacemaker syndrome. Patients with sinus-node dysfunction, but not those with atrioventricular block, had moderately better quality of life and cardiovascular functional status with dual-chamber pacing than with ventricular pacing. Trends of borderline statistical significance in clinical end points favoring dual-chamber pacing were observed in patients with sinus-node dysfunction, but not in those with atrioventricular block.ConclusionThe implantation of a permanent pacemaker improves health-related quality of life. However, the quality-of-life benefits associated with dual-chamber pacing as compared with ventricular pacing are observed principally in the subgroup of patients with sinus-node dysfunction