Causality and the speed of sound

A usual causal requirement on a viable theory of matter is that the speed of sound be at most the speed of light. In view of various recent papers querying this limit, the question is revisited here. We point to various issues confronting theories that violate the usual constraint.Comment: v2: additional discussion on models that appear to have superluminal signal speeds; version to appear in GR

The baryon vertex with magnetic flux

In this letter we generalise the baryon vertex configuration of AdS/CFT by adding a suitable instantonic magnetic field on its worldvolume, dissolving D-string charge. A careful analysis of the configuration shows that there is an upper bound on the number of dissolved strings. This should be a manifestation of the stringy exclusion principle. We provide a microscopical description of this configuration in terms of a dielectric effect for the dissolved strings.Comment: 17 pages, 2 figures. V2: reference added. V3: version to appear in JHE

The superstring Hagedorn temperature in a pp-wave background

The thermodynamics of type IIB superstring theory in the maximally supersymmetric plane wave background is studied. We compute the thermodynamic partition function for non-interacting strings exactly and the result differs slightly from previous computations. We clarify some of the issues related to the Hagedorn temperature in the limits of small and large constant RR 5-form. We study the thermodynamic behavior of strings in the case of $AdS_3 \times S^3 \times T^4$ geometries in the presence of NS-NS and RR 3-form backgrounds. We also comment on the relationship of string thermodynamics and the thermodynamic behavior of the sector of Yang-Mills theory which is the holographic dual of the string theory.Comment: 22 pages, JHEP style, minor misprints corrected, some comments adde

The Bethe-Ansatz for N=4 Super Yang-Mills

We derive the one loop mixing matrix for anomalous dimensions in N=4 Super Yang-Mills. We show that this matrix can be identified with the Hamiltonian of an integrable SO(6) spin chain with vector sites. We then use the Bethe ansatz to find a recipe for computing anomalous dimensions for a wide range of operators. We give exact results for BMN operators with two impurities and results up to and including first order 1/J corrections for BMN operators with many impurities. We then use a result of Reshetikhin's to find the exact one-loop anomalous dimension for an SO(6) singlet in the limit of large bare dimension. We also show that this last anomalous dimension is proportional to the square root of the string level in the weak coupling limit.Comment: 35 pages, 3 figures, LaTeX; v2 references added, typos corrected, \Lambda fixed; v3 expanded discussion of higher loops in conclusion, matches published versio

Small deformations of supersymmetric Wilson loops and open spin-chains

We study insertions of composite operators into Wilson loops in N=4 supersymmetric Yang-Mills theory in four dimensions. The loops follow a circular or straight path and the composite insertions transform in the adjoint representation of the gauge group. This provides a gauge invariant way to define the correlator of non-singlet operators. Since the basic loop preserves an SL(2,R) subgroup of the conformal group, we can assign a conformal dimension to those insertions and calculate the corrections to the classical dimension in perturbation theory. The calculation turns out to be very similar to that of single-trace local operators and may also be expressed in terms of a spin-chain. In this case the spin-chain is open and at one-loop order has Neumann boundary conditions on the type of scalar insertions that we consider. This system is integrable and we write the Bethe ansatz describing it. We compare the spectrum in the limit of large angular momentum both in the dilute gas approximation and the thermodynamic limit to the relevant string solution in the BMN limit and in the full AdS_5 x S^5 metric and find agreement.Comment: 40 pages, amstex, 4 figures. V2: Corrected eqn (2.14) and some equations in section 5. Version to appear in JHE

A 250 GHz planar low noise Schottky receiver

A planar quasi-optical Schottky receiver based on the quasi-integrated horn antenna has been developed and tested over the 230–280GHz bandwidth. The receiver consists of a planar GaAs Schottky diode placed at the feed of a dipole-probe suspended on a thin dielectric membrane in an etched-pyramidal horn cavity. The diode has a 1.2 Μm anode diameter and a low parasitic capacitance due to the use of an etched surface channel. The antenna-mixer results in a measured DSB conversion loss and noise temperature at 258GHz of 7.2dB±0.5dB and 1310K±70K, respectively, at room temperature. The design is compatible with SIS mixers, and the low cost of fabrication and simplicity makes it ideal for submillimeter-wave imaging arrays requiring a 10–20% bandwidth.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44552/1/10762_2005_Article_BF02084284.pd

Herschel/HIFI measurements of the ortho/para ratio in water towards Sagittarius B2(M) and W31C

We present Herschel/HIFI observations of the fundamental rotational transitions of ortho- and para-H16 2 O and H18 2 O in absorption towards Sagittarius B2(M) and W31C. The ortho/para ratio in water in the foreground clouds on the line of sight towards these bright continuum sources is generally consistent with the statistical high-temperature ratio of 3, within the observational uncertainties. However, somewhat unexpectedly, we derive a low ortho/para ratio of 2.35±0.35, corresponding to a spin temperature of ∼27 K, towards Sagittarius B2(M) at velocities of the expanding molecular ring. Water molecules in this region appear to have formed with, or relaxed to, an ortho/para ratio close to the value corresponding to the local temperature of the gas and dust

Impact of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination and Booster on Coronavirus Disease 2019 (COVID-19) Symptom Severity over Time in the COVID-OUT Trial

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has decreasing protection from acquiring any infection with emergence of new variants; however, vaccination continues to protect against progression to severe coronavirus disease 2019 (COVID-19). The impact of vaccination status on symptoms over time is less clear. Methods: Within a randomized trial on early outpatient COVID-19 therapy testing metformin, ivermectin, and/or fluvoxamine, participants recorded symptoms daily for 14 days. Participants were given a paper symptom diary allowing them to circle the severity of 14 symptoms as none (0), mild (1), moderate (2), or severe (3). This is a secondary analysis of clinical trial data on symptom severity over time using generalized estimating equations comparing those unvaccinated, SARS-CoV-2 vaccinated with primary vaccine series only, or vaccine-boosted. Results: The parent clinical trial prospectively enrolled 1323 participants, of whom 1062 (80%) prospectively recorded some daily symptom data. Of these, 480 (45%) were unvaccinated, 530 (50%) were vaccinated with primary series only, and 52 (5%) vaccine-boosted. Overall symptom severity was least for the vaccine-boosted group and most severe for unvaccinated at baseline and over the 14 days (P <. 001). Individual symptoms were least severe in the vaccine-boosted group including cough, chills, fever, nausea, fatigue, myalgia, headache, and diarrhea, as well as smell and taste abnormalities. Results were consistent over Delta and Omicron variant time periods. Conclusions: SARS-CoV-2 vaccine-boosted participants had the least severe symptoms during COVID-19, which abated the quickest over time. Clinical Trial Registration. NCT04510194

Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial

Background: Post-COVID-19 condition (also known as long COVID) is an emerging chronic illness potentially affecting millions of people. We aimed to evaluate whether outpatient COVID-19 treatment with metformin, ivermectin, or fluvoxamine soon after SARS-CoV-2 infection could reduce the risk of long COVID. Methods: We conducted a decentralised, randomised, quadruple-blind, parallel-group, phase 3 trial (COVID-OUT) at six sites in the USA. We included adults aged 30–85 years with overweight or obesity who had COVID-19 symptoms for fewer than 7 days and a documented SARS-CoV-2 positive PCR or antigen test within 3 days before enrolment. Participants were randomly assigned via 2 × 3 parallel factorial randomisation (1:1:1:1:1:1) to receive metformin plus ivermectin, metformin plus fluvoxamine, metformin plus placebo, ivermectin plus placebo, fluvoxamine plus placebo, or placebo plus placebo. Participants, investigators, care providers, and outcomes assessors were masked to study group assignment. The primary outcome was severe COVID-19 by day 14, and those data have been published previously. Because the trial was delivered remotely nationwide, the a priori primary sample was a modified intention-to-treat sample, meaning that participants who did not receive any dose of study treatment were excluded. Long COVID diagnosis by a medical provider was a prespecified, long-term secondary outcome. This trial is complete and is registered with ClinicalTrials.gov, NCT04510194. Findings: Between Dec 30, 2020, and Jan 28, 2022, 6602 people were assessed for eligibility and 1431 were enrolled and randomly assigned. Of 1323 participants who received a dose of study treatment and were included in the modified intention-to-treat population, 1126 consented for long-term follow-up and completed at least one survey after the assessment for long COVID at day 180 (564 received metformin and 562 received matched placebo; a subset of participants in the metformin vs placebo trial were also randomly assigned to receive ivermectin or fluvoxamine). 1074 (95%) of 1126 participants completed at least 9 months of follow-up. 632 (56·1%) of 1126 participants were female and 494 (43·9%) were male; 44 (7·0%) of 632 women were pregnant. The median age was 45 years (IQR 37–54) and median BMI was 29·8 kg/m2 (IQR 27·0–34·2). Overall, 93 (8·3%) of 1126 participants reported receipt of a long COVID diagnosis by day 300. The cumulative incidence of long COVID by day 300 was 6·3% (95% CI 4·2–8·2) in participants who received metformin and 10·4% (7·8–12·9) in those who received identical metformin placebo (hazard ratio [HR] 0·59, 95% CI 0·39–0·89; p=0·012). The metformin beneficial effect was consistent across prespecified subgroups. When metformin was started within 3 days of symptom onset, the HR was 0·37 (95% CI 0·15–0·95). There was no effect on cumulative incidence of long COVID with ivermectin (HR 0·99, 95% CI 0·59–1·64) or fluvoxamine (1·36, 0·78–2·34) compared with placebo. Interpretation: Outpatient treatment with metformin reduced long COVID incidence by about 41%, with an absolute reduction of 4·1%, compared with placebo. Metformin has clinical benefits when used as outpatient treatment for COVID-19 and is globally available, low-cost, and safe. Funding: Parsemus Foundation; Rainwater Charitable Foundation; Fast Grants; UnitedHealth Group Foundation; National Institute of Diabetes, Digestive and Kidney Diseases; National Institutes of Health; and National Center for Advancing Translational Sciences

Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19

BACKGROUND Early treatment to prevent severe coronavirus disease 2019 (Covid-19) is an important component of the comprehensive response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. METHODS In this phase 3, double-blind, randomized, placebo-controlled trial, we used a 2-by-3 factorial design to test the effectiveness of three repurposed drugs - metformin, ivermectin, and fluvoxamine - in preventing serious SARS-CoV-2 infection in nonhospitalized adults who had been enrolled within 3 days after a confirmed diagnosis of infection and less than 7 days after the onset of symptoms. The patients were between the ages of 30 and 85 years, and all had either overweight or obesity. The primary composite end point was hypoxemia (≤93% oxygen saturation on home oximetry), emergency department visit, hospitalization, or death. All analyses used controls who had undergone concurrent randomization and were adjusted for SARSCoV-2 vaccination and receipt of other trial medications. RESULTS A total of 1431 patients underwent randomization; of these patients, 1323 were included in the primary analysis. The median age of the patients was 46 years; 56% were female (6% of whom were pregnant), and 52% had been vaccinated. The adjusted odds ratio for a primary event was 0.84 (95% confidence interval [CI], 0.66 to 1.09; P=0.19) with metformin, 1.05 (95% CI, 0.76 to 1.45; P=0.78) with ivermectin, and 0.94 (95% CI, 0.66 to 1.36; P=0.75) with fluvoxamine. In prespecified secondary analyses, the adjusted odds ratio for emergency department visit, hospitalization, or death was 0.58 (95% CI, 0.35 to 0.94) with metformin, 1.39 (95% CI, 0.72 to 2.69) with ivermectin, and 1.17 (95% CI, 0.57 to 2.40) with fluvoxamine. The adjusted odds ratio for hospitalization or death was 0.47 (95% CI, 0.20 to 1.11) with metformin, 0.73 (95% CI, 0.19 to 2.77) with ivermectin, and 1.11 (95% CI, 0.33 to 3.76) with fluvoxamine. CONCLUSIONS None of the three medications that were evaluated prevented the occurrence of hypoxemia, an emergency department visit, hospitalization, or death associated with Covid-19