Public health lessons from a pilot programme to reduce mother-to-child transmission of HIV-1 in Khayelitsha

Objective. Short-course antiretroviral therapy (ART) has been shown to be effective in reducing mother-to-child transmission (MTCT) of HIV-1. This article details the public health lessons learnt from a district-based pilot programme where a short-murse zidovudine (ZDV) regimen has been used in a typical South African peri-urban setting.Methods. The pilot programme was initiated at two midwife obstetric units in January 1999. Lay counsellors conducted pre- and post-test counselling and nurses took blood for HIV enzyme-linked imrnunosorbent assay (EUSA) testing. Shortcourse ZDV was administered antenatally (from 36 weeks gestation) and during labour. Mother-infant pairs were followed up at eight child health clinics where free formula feed was dispensed weekly. Infants received co-trimoxazole prophylaxis and were EUSA tested for HIV at 9 and 18 months. After 17 months protocol changes aimed at eliminating weaknesses included initiation of ZDV at 34 weeks, self-administration of the first dose of ZDV with the onset of labour, and rapid HIV testing for both mothers and infants.Results. Voluntary counselling and testing was shown to be highly acceptable, with individual counselling more effective than group counselling. Based on less than optimal availability of records, ZDV utilisation was encouraging with up to 59% of subjects initiating treatment, 3 weeks' median duration of ZDV use, and up to 88% receiving at least one intrapartum ZDV dose. Self-administration of the intrapartum dose reached 41%.Conclusions. Short-course antenatal and intrapartum ART to prevent MTCT of HIV1 was shown to be feasible

Massive Gravity Theories and limits of Ghost-free Bigravity models

We construct a class of theories which extend New Massive Gravity to higher orders in curvature in any dimension. The lagrangians arise as limits of a new class of bimetric theories of Lovelock gravity, which are unitary theories free from the Boulware-Deser ghost. These Lovelock bigravity models represent the most general non-chiral ghost-free theories of an interacting massless and massive spin-two field in any dimension. The scaling limit is taken in such a way that unitarity is explicitly broken, but the Boulware-Deser ghost remains absent. This automatically implies the existence of a holographic $c$-theorem for these theories. We also show that the Born-Infeld extension of New Massive Gravity falls into our class of models demonstrating that this theory is also free of the Boulware-Deser ghost. These results extend existing connections between New Massive Gravity, bigravity theories, Galileon theories and holographic $c$-theorems.Comment: 11+5 page

Comments on Holographic Entanglement Entropy and RG Flows

Using holographic entanglement entropy for strip geometry, we construct a candidate for a c-function in arbitrary dimensions. For holographic theories dual to Einstein gravity, this c-function is shown to decrease monotonically along RG flows. A sufficient condition required for this monotonic flow is that the stress tensor of the matter fields driving the holographic RG flow must satisfy the null energy condition over the holographic surface used to calculate the entanglement entropy. In the case where the bulk theory is described by Gauss-Bonnet gravity, the latter condition alone is not sufficient to establish the monotonic flow of the c-function. We also observe that for certain holographic RG flows, the entanglement entropy undergoes a 'phase transition' as the size of the system grows and as a result, evolution of the c-function may exhibit a discontinuous drop.Comment: References adde

Holographic GB gravity in arbitrary dimensions

We study the properties of the holographic CFT dual to Gauss-Bonnet gravity in general $D \ge 5$ dimensions. We establish the AdS/CFT dictionary and in particular relate the couplings of the gravitational theory to the universal couplings arising in correlators of the stress tensor of the dual CFT. This allows us to examine constraints on the gravitational couplings by demanding consistency of the CFT. In particular, one can demand positive energy fluxes in scattering processes or the causal propagation of fluctuations. We also examine the holographic hydrodynamics, commenting on the shear viscosity as well as the relaxation time. The latter allows us to consider causality constraints arising from the second-order truncated theory of hydrodynamics.Comment: 48 pages, 9 figures. v2: New discussion on free fields in subsection 3.3 and new appendix B on conformal tensor fields. Added comments on the relation between the central charge appearing in the two-point function and the "central charge" characterizing the entropy density in the discussion. References adde

The Dawning Era of Personalized Medicine Exposes a Gap in Medical Education

Medical student Keyan Salari argues that it is crucial that medical students be trained to use and interpret patients' genetic information appropriately and responsibly

Holographic studies of quasi-topological gravity

Quasi-topological gravity is a new gravitational theory including curvature-cubed interactions and for which exact black hole solutions were constructed. In a holographic framework, classical quasi-topological gravity can be thought to be dual to the large $N_c$ limit of some non-supersymmetric but conformal gauge theory. We establish various elements of the AdS/CFT dictionary for this duality. This allows us to infer physical constraints on the couplings in the gravitational theory. Further we use holography to investigate hydrodynamic aspects of the dual gauge theory. In particular, we find that the minimum value of the shear-viscosity-to-entropy-density ratio for this model is $\eta/s \simeq 0.4140/(4\pi)$.Comment: 45 pages, 6 figures. v2: References adde

Wilsonian Approach to Fluid/Gravity Duality

The problem of gravitational fluctuations confined inside a finite cutoff at radius $r=r_c$ outside the horizon in a general class of black hole geometries is considered. Consistent boundary conditions at both the cutoff surface and the horizon are found and the resulting modes analyzed. For general cutoff $r_c$ the dispersion relation is shown at long wavelengths to be that of a linearized Navier-Stokes fluid living on the cutoff surface. A cutoff-dependent line-integral formula for the diffusion constant $D(r_c)$ is derived. The dependence on $r_c$ is interpreted as renormalization group (RG) flow in the fluid. Taking the cutoff to infinity in an asymptotically AdS context, the formula for $D(\infty)$ reproduces as a special case well-known results derived using AdS/CFT. Taking the cutoff to the horizon, the effective speed of sound goes to infinity, the fluid becomes incompressible and the Navier-Stokes dispersion relation becomes exact. The resulting universal formula for the diffusion constant $D(horizon)$ reproduces old results from the membrane paradigm. Hence the old membrane paradigm results and new AdS/CFT results are related by RG flow. RG flow-invariance of the viscosity to entropy ratio $\eta /s$ is shown to follow from the first law of thermodynamics together with isentropy of radial evolution in classical gravity. The ratio is expected to run when quantum gravitational corrections are included.Comment: 34 pages, harvmac, clarified boundary conditio

Holographic current correlators at finite coupling and scattering off a supersymmetric plasma

By studying the effect of the order(\alpha'^3) string theory corrections to type IIB supergravity, including those corrections involving the Ramond-Ramond five-form field strength, we obtain the corrected equations of motion of an Abelian perturbation of the AdS_5-Schwarzschild black hole. We then use the gauge theory/string theory duality to examine the coupling-constant dependence of vector current correlators associated to a gauged U(1) sub-group of the global R-symmetry group of strongly-coupled N=4 supersymmetric Yang-Mills theory at finite temperature. The corrections induce a set of higher-derivative operators for the U(1) gauge field, but their effect is highly suppressed. We thus find that the order(\alpha'^3) corrections affect the vector correlators only indirectly, through the corrected metric. We apply our results to investigate scattering off a supersymmetric Yang-Mills plasma at low and high energy. In the latter regime, where Deep Inelastic Scattering is expected to occur, we find an enhancement of the plasma structure functions in comparison with the infinite 't Hooft coupling result.Comment: 38 pages, 6 figures, minor clarifications added, typos corrected, references adde