Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation.

Ablation of the left atrium using either radiofrequency (RF) or cryothermal energy is an effective treatment for atrial fibrillation (AF) and is the most frequent type of cardiac ablation procedure performed. Although generally safe, collateral injury to surrounding structures, particularly the esophagus, remains a concern. Cooling or warming the esophagus to counteract the heat from RF ablation, or the cold from cryoablation, is a method that is used to reduce thermal esophageal injury, and there are increasing data to support this approach. This protocol describes the use of a commercially available esophageal temperature management device to cool or warm the esophagus to reduce esophageal injury during left atrial ablation. The temperature management device is powered by standard water-blanket heat exchangers, and is shaped like a standard orogastric tube placed for gastric suctioning and decompression. Water circulates through the device in a closed-loop circuit, transferring heat across the silicone walls of the device, through the esophageal wall. Placement of the device is analogous to the placement of a typical orogastric tube, and temperature is adjusted via the external heat-exchanger console

Discussing life expectancy with surgical patients: Do patients want to know and how should this information be delivered?

<p>Abstract</p> <p>Background</p> <p>Predicted patient life expectancy (LE) and survival probability (SP), based on a patient's medical history, are important components of surgical decision-making and informed consent. The objective of this study was to assess patients' interpretation of and desire to know information relating to LE, in addition to establishing the most effective format for discussion.</p> <p>Methods</p> <p>A cross sectional survey of 120 patients (mean age = 68.7 years, range 50–90 years), recruited from general urological and surgical outpatient clinics in one District General and one Teaching hospital in Southwest England (UK) was conducted. Patients were included irrespective of their current diagnosis or associated comorbidity. Hypothetical patient case scenarios were used to assess patients' desire to know LE and SP, in addition to their preferred presentation format.</p> <p>Results</p> <p>58% of patients expressed a desire to know their LE and SP, if it were possible to calculate, with 36% not wishing to know either. Patients preferred a combination of numerical and pictorial formats in discussing LE and SP, with numerical, verbal and pictorial formats alone least preferred. 71% patients ranked the survival curve as either their first or second most preferred graph, with 76% rating facial figures their least preferred. No statistically significant difference was noted between sexes or educational backgrounds.</p> <p>Conclusion</p> <p>A proportion of patients seem unwilling to discuss their LE and SP. This may relate to their current diagnosis, level of associated comorbidity or degree of understanding. However it is feasible that by providing this information in a range of presentation formats, greater engagement in the shared decision-making process can be encouraged.</p

Entropy bounds in terms of the w parameter

In a pair of recent articles [PRL 105 (2010) 041302 - arXiv:1005.1132; JHEP 1103 (2011) 056 - arXiv:1012.2867] two of the current authors have developed an entropy bound for equilibrium uncollapsed matter using only classical general relativity, basic thermodynamics, and the Unruh effect. An odd feature of that bound, S <= A/2, was that the proportionality constant, 1/2, was weaker than that expected from black hole thermodynamics, 1/4. In the current article we strengthen the previous results by obtaining a bound involving the (suitably averaged) w parameter. Simple causality arguments restrict this averaged parameter to be <= 1. When equality holds, the entropy bound saturates at the value expected based on black hole thermodynamics. We also add some clarifying comments regarding the (net) positivity of the chemical potential. Overall, we find that even in the absence of any black hole region, we can nevertheless get arbitrarily close to the Bekenstein entropy.Comment: V1: 14 pages. V2: One reference added. V3: This version accepted for publication in JHE

Graviton Vertices and the Mapping of Anomalous Correlators to Momentum Space for a General Conformal Field Theory

We investigate the mapping of conformal correlators and of their anomalies from configuration to momentum space for general dimensions, focusing on the anomalous correlators $TOO$, $TVV$ - involving the energy-momentum tensor $(T)$ with a vector $(V)$ or a scalar operator ($O$) - and the 3-graviton vertex $TTT$. We compute the $TOO$, $TVV$ and $TTT$ one-loop vertex functions in dimensional regularization for free field theories involving conformal scalar, fermion and vector fields. Since there are only one or two independent tensor structures solving all the conformal Ward identities for the $TOO$ or $TVV$ vertex functions respectively, and three independent tensor structures for the $TTT$ vertex, and the coefficients of these tensors are known for free fields, it is possible to identify the corresponding tensors in momentum space from the computation of the correlators for free fields. This works in general $d$ dimensions for $TOO$ and $TVV$ correlators, but only in 4 dimensions for $TTT$, since vector fields are conformal only in $d=4$. In this way the general solution of the Ward identities including anomalous ones for these correlators in (Euclidean) position space, found by Osborn and Petkou is mapped to the ordinary diagrammatic one in momentum space. We give simplified expressions of all these correlators in configuration space which are explicitly Fourier integrable and provide a diagrammatic interpretation of all the contact terms arising when two or more of the points coincide. We discuss how the anomalies arise in each approach [...]Comment: 57 pages, 7 figures. Refs adde

M-Horizons

We solve the Killing spinor equations and determine the near horizon geometries of M-theory that preserve at least one supersymmetry. The M-horizon spatial sections are 9-dimensional manifolds with a Spin(7) structure restricted by geometric constraints which we give explicitly. We also provide an alternative characterization of the solutions of the Killing spinor equation, utilizing the compactness of the horizon section and the field equations, by proving a Lichnerowicz type of theorem which implies that the zero modes of a Dirac operator coupled to 4-form fluxes are Killing spinors. We use this, and the maximum principle, to solve the field equations of the theory for some special cases and present some examples.Comment: 36 pages, latex. Reference added, minor typos correcte

Serum-Free Cryopreservation of Five Mammalian Cell Lines in Either a Pelleted or Suspended State

Herein we have explored two practical aspects of cryopreserving cultured mammalian cells during routine laboratory maintenance. First, we have examined the possibility of using a serum-free, hence more affordable, cryopreservative. Using five mammalian lines (Crandell Feline Kidney, MCF7, A72, WI 38 and NB324K), we found that the serum-free alternative preserves nearly as efficiently as the serum-containing preservatives. Second, we compared cryostorage of those cells in suspended versus a pellet form using both aforementioned cryopreservatives. Under our conditions, cells were in general recovered equally well in a suspended versus a pellet form

Heterotic Black Horizons

We show that the supersymmetric near horizon geometry of heterotic black holes is either an AdS_3 fibration over a 7-dimensional manifold which admits a G_2 structure compatible with a connection with skew-symmetric torsion, or it is a product R^{1,1} * S^8, where S^8 is a holonomy Spin(7) manifold, preserving 2 and 1 supersymmetries respectively. Moreover, we demonstrate that the AdS_3 class of heterotic horizons can preserve 4, 6 and 8 supersymmetries provided that the geometry of the base space is further restricted. Similarly R^{1,1} * S^8 horizons with extended supersymmetry are products of R^{1,1} with special holonomy manifolds. We have also found that the heterotic horizons with 8 supersymmetries are locally isometric to AdS_3 * S^3 * T^4, AdS_3 * S^3 * K_3 or R^{1,1} * T^4 * K_3, where the radii of AdS_3 and S^3 are equal and the dilaton is constant.Comment: 35 pages, latex. Minor alterations to equation (3.11) and section 4.1, the conclusions are not affecte

State-space Manifold and Rotating Black Holes

We study a class of fluctuating higher dimensional black hole configurations obtained in string theory/ $M$-theory compactifications. We explore the intrinsic Riemannian geometric nature of Gaussian fluctuations arising from the Hessian of the coarse graining entropy, defined over an ensemble of brane microstates. It has been shown that the state-space geometry spanned by the set of invariant parameters is non-degenerate, regular and has a negative scalar curvature for the rotating Myers-Perry black holes, Kaluza-Klein black holes, supersymmetric $AdS_5$ black holes, $D_1$-$D_5$ configurations and the associated BMPV black holes. Interestingly, these solutions demonstrate that the principal components of the state-space metric tensor admit a positive definite form, while the off diagonal components do not. Furthermore, the ratio of diagonal components weakens relatively faster than the off diagonal components, and thus they swiftly come into an equilibrium statistical configuration. Novel aspects of the scaling property suggest that the brane-brane statistical pair correlation functions divulge an asymmetric nature, in comparison with the others. This approach indicates that all above configurations are effectively attractive and stable, on an arbitrary hyper-surface of the state-space manifolds. It is nevertheless noticed that there exists an intriguing relationship between non-ideal inter-brane statistical interactions and phase transitions. The ramifications thus described are consistent with the existing picture of the microscopic CFTs. We conclude with an extended discussion of the implications of this work for the physics of black holes in string theory.Comment: 44 pages, Keywords: Rotating Black Holes; State-space Geometry; Statistical Configurations, String Theory, M-Theory. PACS numbers: 04.70.-s Physics of black holes; 04.70.Bw Classical black holes; 04.70.Dy Quantum aspects of black holes, evaporation, thermodynamics; 04.50.Gh Higher-dimensional black holes, black strings, and related objects. Edited the bibliograph

Serotonin Differentially Regulates Short- and Long-Term Prediction of Rewards in the Ventral and Dorsal Striatum

BACKGROUND: The ability to select an action by considering both delays and amount of reward outcome is critical for maximizing long-term benefits. Although previous animal experiments on impulsivity have suggested a role of serotonin in behaviors requiring prediction of delayed rewards, the underlying neural mechanism is unclear. METHODOLOGY/PRINCIPAL FINDINGS: To elucidate the role of serotonin in the evaluation of delayed rewards, we performed a functional brain imaging experiment in which subjects chose small-immediate or large-delayed liquid rewards under dietary regulation of tryptophan, a precursor of serotonin. A model-based analysis revealed that the activity of the ventral part of the striatum was correlated with reward prediction at shorter time scales, and this correlated activity was stronger at low serotonin levels. By contrast, the activity of the dorsal part of the striatum was correlated with reward prediction at longer time scales, and this correlated activity was stronger at high serotonin levels. CONCLUSIONS/SIGNIFICANCE: Our results suggest that serotonin controls the time scale of reward prediction by differentially regulating activities within the striatum