Geometrical Constraints on the Cosmological Constant

The cosmological constant problem is examined under the assumption that the extrinsic curvature of the space-time contributes to the vacuum. A compensation mechanism based on a variable cosmological term is proposed. Under a suitable hypothesis on the behavior of the extrinsic curvature, we find that an initially large $\Lambda(t)$ rolls down rapidly to zero during the early stages of the universe. Using perturbation analysis, it is shown that such vacuum behaves essentially as a spin-2 field which is independent of the metric.Comment: [email protected], 17 pages, Latex, 2 figures obtained by reques

Black Hole Formation with an Interacting Vacuum Energy Density

We discuss the gravitational collapse of a spherically symmetric massive core of a star in which the fluid component is interacting with a growing vacuum energy density. The influence of the variable vacuum in the collapsing core is quantified by a phenomenological \beta-parameter as predicted by dimensional arguments and the renormalization group approach. For all reasonable values of this free parameter, we find that the vacuum energy density increases the collapsing time but it cannot prevent the formation of a singular point. However, the nature of the singularity depends on the values of \beta. In the radiation case, a trapped surface is formed for \beta<1/2 whereas for \beta>1/2, a naked singularity is developed. In general, the critical value is \beta=1-2/3(1+\omega), where the \omega-parameter describes the equation of state of the fluid component.Comment: 9 pages, 8 figure

Thermodynamics of Decaying Vacuum Cosmologies

The thermodynamic behavior of vacuum decaying cosmologies is investigated within a manifestly covariant formulation. Such a process corresponds to a continuous irreversible energy flow from the vacuum component to the created matter constituents. It is shown that if the specific entropy per particle remains constant during the process, the equilibrium relations are preserved. In particular, if the vacuum decays into photons, the energy density $\rho$ and average number density of photons $n$ scale with the temperature as $\rho \sim T^{4}$ and $n \sim T^{3}$. The temperature law is determined and a generalized Planckian type form of the spectrum, which is preserved in the course of the evolution, is also proposed. Some consequences of these results for decaying vacuum FRW type cosmologies as well as for models with ``adiabatic'' photon creation are discussed.Comment: 21 pages, uses LATE

Exact Black Hole and Cosmological Solutions in a Two-Dimensional Dilaton-Spectator Theory of Gravity

Exact black hole and cosmological solutions are obtained for a special two-dimensional dilaton-spectator ($\phi-\psi$) theory of gravity. We show how in this context any desired spacetime behaviour can be determined by an appropriate choice of a dilaton potential function $V(\phi)$ and a ``coupling function'' $l(\phi)$ in the action. We illustrate several black hole solutions as examples. In particular, asymptotically flat double- and multiple- horizon black hole solutions are obtained. One solution bears an interesting resemblance to the $2D$ string-theoretic black hole and contains the same thermodynamic properties; another resembles the $4D$ Reissner-Nordstrom solution. We find two characteristic features of all the black hole solutions. First the coupling constants in $l(\phi)$ must be set equal to constants of integration (typically the mass). Second, the spectator field $\psi$ and its derivative $\psi^{'}$ both diverge at any event horizon. A test particle with ``spectator charge" ({\it i.e.} one coupled either to $\psi$ or $\psi^{'}$), will therefore encounter an infinite tidal force at the horizon or an ``infinite potential barrier'' located outside the horizon respectively. We also compute the Hawking temperature and entropy for our solutions. In $2D$ $FRW$ cosmology, two non-singular solutions which resemble two exact solutions in $4D$ string-motivated cosmology are obtained. In addition, we construct a singular model which describes the $4D$ standard non-inflationary big bang cosmology ($big-bang\rightarrow radiation\rightarrow dust$). Motivated by the similaritiesbetween $2D$ and $4D$ gravitational field equations in $FRW$ cosmology, we briefly discuss a special $4D$ dilaton-spectator action constructed from the bosonic part of the low energy heterotic string action andComment: 34 pgs. Plain Tex, revised version contains some clarifying comments concerning the relationship between the constants of integration and the coupling constants

Primary Gastrointestinal Diffuse Large B Cell Lymphoma Presenting with Cold Agglutinin Disease

Cold agglutinin disease (CAD) is an autoimmune hemolytic anemia (AIHA) generally caused by IgM autoantibodies which exhibit maximal reactivity at 4°C. CAD can be idiopathic or secondary to some diseases and/or conditions. Only a minority of cases of secondary AIHA in non-Hodgkin's lymphoma (NHL) are associated with cold antibodies. Diffuse large B cell lymphoma (DLBCL) is the most common subtype of NHLs with a proportion of nearly 30% of all adult cases. 40% of patients with DLBCL have an extranodal disease or at least disease initially confined to extranodal sites. The most common extranodal site is the gastrointestinal tract. We present a patient with primary gastrointestinal DLBCL who presented with CAD and was treated with a CHOP-Rituximab regimen

The Operator Product Expansion of the Lowest Higher Spin Current at Finite N

For the N=2 Kazama-Suzuki(KS) model on CP^3, the lowest higher spin current with spins (2, 5/2, 5/2,3) is obtained from the generalized GKO coset construction. By computing the operator product expansion of this current and itself, the next higher spin current with spins (3, 7/2, 7/2, 4) is also derived. This is a realization of the N=2 W_{N+1} algebra with N=3 in the supersymmetric WZW model. By incorporating the self-coupling constant of lowest higher spin current which is known for the general (N,k), we present the complete nonlinear operator product expansion of the lowest higher spin current with spins (2, 5/2, 5/2, 3) in the N=2 KS model on CP^N space. This should coincide with the asymptotic symmetry of the higher spin AdS_3 supergravity at the quantum level. The large (N,k) 't Hooft limit and the corresponding classical nonlinear algebra are also discussed.Comment: 62 pages; the footnotes added, some redundant appendices removed, the presentations in the whole paper improved and to appear in JHE

Responding to Young People's Health Risks in Primary Care: A Cluster Randomised Trial of Training Clinicians in Screening and Motivational Interviewing.

OBJECTIVE: To evaluate the effectiveness of a complex intervention implementing best practice guidelines recommending clinicians screen and counsel young people across multiple psychosocial risk factors, on clinicians' detection of health risks and patients' risk taking behaviour, compared to a didactic seminar on young people's health. DESIGN: Pragmatic cluster randomised trial where volunteer general practices were stratified by postcode advantage or disadvantage score and billing type (private, free national health, community health centre), then randomised into either intervention or comparison arms using a computer generated random sequence. Three months post-intervention, patients were recruited from all practices post-consultation for a Computer Assisted Telephone Interview and followed up three and 12 months later. Researchers recruiting, consenting and interviewing patients and patients themselves were masked to allocation status; clinicians were not. SETTING: General practices in metropolitan and rural Victoria, Australia. PARTICIPANTS: General practices with at least one interested clinician (general practitioner or nurse) and their 14-24 year old patients. INTERVENTION: This complex intervention was designed using evidence based practice in learning and change in clinician behaviour and general practice systems, and included best practice approaches to motivating change in adolescent risk taking behaviours. The intervention involved training clinicians (nine hours) in health risk screening, use of a screening tool and motivational interviewing; training all practice staff (receptionists and clinicians) in engaging youth; provision of feedback to clinicians of patients' risk data; and two practice visits to support new screening and referral resources. Comparison clinicians received one didactic educational seminar (three hours) on engaging youth and health risk screening. OUTCOME MEASURES: Primary outcomes were patient report of (1) clinician detection of at least one of six health risk behaviours (tobacco, alcohol and illicit drug use, risks for sexually transmitted infection, STI, unplanned pregnancy, and road risks); and (2) change in one or more of the six health risk behaviours, at three months or at 12 months. Secondary outcomes were likelihood of future visits, trust in the clinician after exit interview, clinician detection of emotional distress and fear and abuse in relationships, and emotional distress at three and 12 months. Patient acceptability of the screening tool was also described for the intervention arm. Analyses were adjusted for practice location and billing type, patients' sex, age, and recruitment method, and past health risks, where appropriate. An intention to treat analysis approach was used, which included multilevel multiple imputation for missing outcome data. RESULTS: 42 practices were randomly allocated to intervention or comparison arms. Two intervention practices withdrew post allocation, prior to training, leaving 19 intervention (53 clinicians, 377 patients) and 21 comparison (79 clinicians, 524 patients) practices. 69% of patients in both intervention (260) and comparison (360) arms completed the 12 month follow-up. Intervention clinicians discussed more health risks per patient (59.7%) than comparison clinicians (52.7%) and thus were more likely to detect a higher proportion of young people with at least one of the six health risk behaviours (38.4% vs 26.7%, risk difference [RD] 11.6%, Confidence Interval [CI] 2.93% to 20.3%; adjusted odds ratio [OR] 1.7, CI 1.1 to 2.5). Patients reported less illicit drug use (RD -6.0, CI -11 to -1.2; OR 0.52, CI 0.28 to 0.96), and less risk for STI (RD -5.4, CI -11 to 0.2; OR 0.66, CI 0.46 to 0.96) at three months in the intervention relative to the comparison arm, and for unplanned pregnancy at 12 months (RD -4.4; CI -8.7 to -0.1; OR 0.40, CI 0.20 to 0.80). No differences were detected between arms on other health risks. There were no differences on secondary outcomes, apart from a greater detection of abuse (OR 13.8, CI 1.71 to 111). There were no reports of harmful events and intervention arm youth had high acceptance of the screening tool. CONCLUSIONS: A complex intervention, compared to a simple educational seminar for practices, improved detection of health risk behaviours in young people. Impact on health outcomes was inconclusive. Technology enabling more efficient, systematic health-risk screening may allow providers to target counselling toward higher risk individuals. Further trials require more power to confirm health benefits. TRIAL REGISTRATION: ISRCTN.com ISRCTN16059206

Tunneling in Λ\Lambda Decaying Cosmologies and the Cosmological Constant Problem

The tunneling rate, with exact prefactor, is calculated to first order in $\hbar$ for an empty closed Friedmann-Robertson-Walker (FRW) universe with decaying cosmological term $\Lambda \sim R^{-m}$ ($R$ is the scale factor and $m$ is a parameter $0\leq m \leq 2$). This model is equivalent to a cosmology with the equation of state $p_{\chi}=(m/3 -1)\rho_{\chi}$. The calculations are performed by applying the dilute-instanton approximation on the corresponding Duru-Kleinert path integral. It is shown that the highest tunneling rate occurs for $m=2$ corresponding to the cosmic string matter universe. The obtained most probable cosmological term, like one obtained by Strominger, accounts for a possible solution to the cosmological constant problem.Comment: 21 pages, REVTEX, The section 3 is considerably completed including some physical mechanisms supporting the time variation of the cosmological constant, added references for the section 3. Accepted to be published in Phys. Rev.

Evaluation of the impact of a school gardening intervention on children's fruit and vegetable intake: a randomised controlled trial.

Background: Current academic literature suggests that school gardening programmes can provide an interactive environment with the potential to change children’s fruit and vegetable intake. This is the first cluster randomised controlled trial (RCT) designed to evaluate whether a school gardening programme can have an effect on children’s fruit and vegetable intake. Methods: The trial included children from 23 schools; these schools were randomised into two groups, one to receive the Royal Horticultural Society (RHS)-led intervention and the other to receive the less involved Teacher-led intervention. A 24-hour food diary (CADET) was used to collect baseline and follow-up dietary intake 18 months apart. Questionnaires were also administered to evaluate the intervention implementation. Results: A total of 641 children completed the trial with a mean age of 8.1 years (95% CI: 8.0, 8.4). The unadjusted results from multilevel regression analysis revealed that for combined daily fruit and vegetable intake the Teacher-led group had a higher daily mean change of 8 g (95% CI: −19, 36) compared to the RHS-led group -32 g (95% CI: −60, −3). However, after adjusting for possible confounders this difference was not significant (intervention effect: −40 g, 95% CI: −88, 1; p = 0.06). The adjusted analysis of process measures identified that if schools improved their gardening score by 3 levels (a measure of school gardening involvement - the scale has 6 levels from 0 ‘no garden’ to 5 ‘community involvement’), irrespective of group allocation, children had, on average, a daily increase of 81 g of fruit and vegetable intake (95% CI: 0, 163; p = 0.05) compared to schools that had no change in gardening score. Conclusions: This study is the first cluster randomised controlled trial designed to evaluate a school gardening intervention. The results have found very little evidence to support the claims that school gardening alone can improve children’s daily fruit and vegetable intake. However, when a gardening intervention is implemented at a high level within the school it may improve children’s daily fruit and vegetable intake by a portion. Improving children’s fruit and vegetable intake remains a challenging task

Another exact inflationary solution

A new closed-form inflationary solution is given for a hyperbolic interaction potential. The method used to arrive at this solution is outlined as it appears possible to generate additional sets of equations which satisfy the model. In addition a new form of decaying cosmological constant is presented.Comment: 10 pages, 0 figure