Concurrent π\pi-vector fields and energy beta-change

The present paper deals with an \emph{intrinsic} investigation of the notion of a concurrent $\pi$-vector field on the pullback bundle of a Finsler manifold $(M,L)$. The effect of the existence of a concurrent $\pi$-vector field on some important special Finsler spaces is studied. An intrinsic investigation of a particular $\beta$-change, namely the energy $\beta$-change ($\widetilde{L}^{2}(x,y)=L^{2}(x,y)+ B^{2}(x,y) with \ B:=g(\bar{\zeta},\bar{\eta})$;$\bar{\zeta} $being a concurrent$\pi$-vector field), is established. The relation between the two Barthel connections$\Gamma$and$\widetilde{\Gamma}$, corresponding to this change, is found. This relation, together with the fact that the Cartan and the Barthel connections have the same horizontal and vertical projectors, enable us to study the energy$\beta$-change of the fundamental linear connection in Finsler geometry: the Cartan connection, the Berwald connection, the Chern connection and the Hashiguchi connection. Moreover, the change of their curvature tensors is concluded. It should be pointed out that the present work is formulated in a prospective modern coordinate-free form.Comment: 27 pages, LaTex file, Some typographical errors corrected, Some formulas simpifie

Einstein Geometrization Philosophy and Differential Identities in PAP-Geometry

The importance of Einstein's geometrization philosophy, as an alternative to the least action principle, in constructing general relativity (GR), is illuminated. The role of differential identities in this philosophy is clarified. The use of Bianchi identity to write the field equations of GR is shown. Another similar identity in the absolute parallelism geometry is given. A more general differential identity in the parameterized absolute parallelism geometry is derived. Comparison and interrelationships between the above mentioned identities and their role in constructing field theories are discussed.Comment: LaTeX file, 17 pages, comments and criticism are welcom

Generalized β\beta-conformal change and special Finsler spaces

In this paper, we investigate the change of Finslr metrics $$L(x,y) \to\bar{L}(x,y) = f(e^{\sigma(x)}L(x,y),\beta(x,y)),$$ which we refer to as a generalized $\beta$-conformal change. Under this change, we study some special Finsler spaces, namely, quasi C-reducible, semi C-reducible, C-reducible, $C_2$-like, $S_3$-like and $S_4$-like Finsler spaces. We also obtain the transformation of the T-tensor under this change and study some interesting special cases. We then impose a certain condition on the generalized $\beta$-conformal change, which we call the b-condition, and investigate the geometric consequences of such condition. Finally, we give the conditions under which a generalized $\beta$-conformal change is projective and generalize some known results in the literature.Comment: References added, some modifications are performed, LateX file, 24 page

On Finslerized Absolute Parallelism spaces

The aim of the present paper is to construct and investigate a Finsler structure within the framework of a Generalized Absolute Parallelism space (GAP-space). The Finsler structure is obtained from the vector fields forming the parallelization of the GAP-space. The resulting space, which we refer to as a Finslerized Parallelizable space, combines within its geometric structure the simplicity of GAP-geometry and the richness of Finsler geometry, hence is potentially more suitable for applications and especially for describing physical phenomena. A study of the geometry of the two structures and their interrelation is carried out. Five connections are introduced and their torsion and curvature tensors derived. Some special Finslerized Parallelizable spaces are singled out. One of the main reasons to introduce this new space is that both Absolute Parallelism and Finsler geometries have proved effective in the formulation of physical theories, so it is worthy to try to build a more general geometric structure that would share the benefits of both geometries.Comment: Some references added and others removed, PACS2010, Typos corrected, Amendemrnts and revisions performe

Teleparallel Lagrange Geometry and a Unified Field Theory

In this paper, we construct a field theory unifying gravity and electromagnetism in the context of Extended Absolute Parallelism (EAP-) geometry. This geometry combines, within its structure, the geometric richness of the tangent bundle and the mathematical simplicity of Absolute Parallelism (AP-) geometry. The constructed field theory is a generalization of the Generalized Field Theory (GFT) formulated by Mikhail and Wanas. The theory obtained is purely geometric. The horizontal (resp. vertical) field equations are derived by applying the Euler-Lagrange equations to an appropriate horizontal (resp. vertical) scalar Lagrangian. The symmetric part of the resulting horizontal (resp. vertical) field equations gives rise to a generalized form of Einstein's field equations in which the horizontal (resp. vertical) energy-momentum tensor is purely geometric. The skew-symmetric part of the resulting horizontal (resp. vertical) field equations gives rise to a generalized form of Maxwell equations in which the electromagnetic field is purely geometric. Some interesting special cases, which reveal the role of the nonlinear connection in the obtained field equations, are examined. Finally, the condition under which our constructed field equations reduce to the GFT is explicitly established.Comment: Latex file, 33 page

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century