Attractor states and infrared scaling in de Sitter space

The renormalized expectation value of the energy-momentum tensor for a scalar field with any mass m and curvature coupling xi is studied for an arbitrary homogeneous and isotropic physical initial state in de Sitter spacetime. We prove quite generally that has a fixed point attractor behavior at late times, which depends only on m and xi, for any fourth order adiabatic state that is infrared finite. Specifically, when m^2 + xi R > 0, approaches the Bunch-Davies de Sitter invariant value at late times, independently of the initial state. When m = xi = 0, it approaches instead the de Sitter invariant Allen-Folacci value. When m = 0 and xi \ge 0 we show that this state independent asymptotic value of the energy-momentum tensor is proportional to the conserved geometrical tensor (3)H_{ab}, which is related to the behavior of the quantum effective action of the scalar field under global Weyl rescaling. This relationship serves to generalize the definition of the trace anomaly in the infrared for massless, non-conformal fields. In the case m^2 + xi R = 0, but m and xi separately different from zero, grows linearly with cosmic time at late times. For most values of m and xi in the tachyonic cases, m^2 + xi R grows exponentially at late cosmic times for all physically admissable initial states.Comment: 30 pages, 6 figures, 46 kB tar.gz fil

Penumbral Rescue by normobaric O = O administration in patients with ischemic stroke and target mismatch proFile (PROOF): Study protocol of a phase IIb trial.

Oxygen is essential for cellular energy metabolism. Neurons are particularly vulnerable to hypoxia. Increasing oxygen supply shortly after stroke onset could preserve the ischemic penumbra until revascularization occurs. PROOF investigates the use of normobaric oxygen (NBO) therapy within 6 h of symptom onset/notice for brain-protective bridging until endovascular revascularization of acute intracranial anterior-circulation occlusion. Randomized (1:1), standard treatment-controlled, open-label, blinded endpoint, multicenter adaptive phase IIb trial. Primary outcome is ischemic core growth (mL) from baseline to 24 h (intention-to-treat analysis). Secondary efficacy outcomes include change in NIHSS from baseline to 24 h, mRS at 90 days, cognitive and emotional function, and quality of life. Safety outcomes include mortality, intracranial hemorrhage, and respiratory failure. Exploratory analyses of imaging and blood biomarkers will be conducted. Using an adaptive design with interim analysis at 80 patients per arm, up to 456 participants (228 per arm) would be needed for 80% power (one-sided alpha 0.05) to detect a mean reduction of ischemic core growth by 6.68 mL, assuming 21.4 mL standard deviation. By enrolling endovascular thrombectomy candidates in an early time window, the trial replicates insights from preclinical studies in which NBO showed beneficial effects, namely early initiation of near 100% inspired oxygen during short temporary ischemia. Primary outcome assessment at 24 h on follow-up imaging reduces variability due to withdrawal of care and early clinical confounders such as delayed extubation and aspiration pneumonia. ClinicalTrials.gov: NCT03500939; EudraCT: 2017-001355-31