Magnetic Monopoles as Agents of Chiral Symmetry Breaking in U(1) Lattice Gauge Theory

We present results suggesting that magnetic monopoles can account for chiral symmetry breaking in abelian gauge theory. Full U(1) configurations from a lattice simulation are factorized into magnetic monopole and photon contributions. The expectation is computed using the monopole configurations and compared to results for the full U(1) configurations. It is shown that excellent agreement between the two values of is obtained if the effect of photons, which "dress" the composite operator psibarpsi, is included. This can be estimated independently by measurements of the physical fermion mass in the photon background.Comment: 14 pages REVTeX, including 5 figure

Monopoles at Finite Volume and Temperature in SU(2) Lattice Gauge Theory

We resolve a discrepancy between the SU(2) spacial string tension at finite temperature, and the value obtained by monopoles in the maximum Abelian gauge. Previous work had incorrectly omitted a term due to Dirac sheets. When this term is included, the monopole and full SU(2) determinations of the spacial string tension agree to within the statistical errors of the monopole calculation.Comment: 8 pages, Latex files: msum.tex,msum.aux packaged with uufile

Large Loops of Magnetic Current and Confinement in Four Dimensional U(1)U(1) Lattice Gauge Theory

We calculate the heavy quark potential from the magnetic current due to monopoles in four dimensional $U(1)$ lattice gauge theory. The magnetic current is found from link angle configurations using the DeGrand-Toussaint identification method. The link angle configurations are generated in a cosine action simulation on a $24^4$ lattice. The magnetic current is resolved into large loops which wrap around the lattice and simple loops which do not. Wrapping loops are found only in the confined phase. It is shown that the long range part of the heavy quark potential, in particular the string tension, can be calculated solely from the large, wrapping loops of magnetic current.Comment: 15 pages (Latex file plus 3 postscript files appended), Univeristy of Illinois Preprint ILL-(TH)-93-\#1

String Tension from Monopoles in SU(2) Lattice Gauge Theory

The axis for Figure 2 was wrong. It has been fixed and the postscript file replaced (The file was called comp.ps).Comment: (22 pages latex (revtex); 2 figures appended as postscript files - search for mono.ps and comp.ps. Figures mailed on request--send a note to [email protected]) Preprint ILL-(TH)-94-#1

The Maximal Abelian Gauge, Monopoles, and Vortices in SU(3) Lattice Gauge Theory

We report on calculations of the heavy quark potential in SU(3) lattice gauge theory. Full SU(3) results are compared to three cases which involve gauge-fixing and projection. All of these start from the maximal abelian gauge (MAG), in its simplest form. The first case is abelian projection to U(1)xU(1). The second keeps only the abelian fields of monopoles in the MAG. The third involves an additional gauge-fixing to the indirect maximal center gauge (IMCG), followed by center projection to Z(3). At one gauge fixing/configuration, the string tensions calculated from MAG U(1)xU(1), MAG monopoles, and IMCG Z(3) are all less than the full SU(3) string tension. The projected string tensions further decrease, by approximately 10%, when account is taken of gauge ambiguities. Comparison is made with corresponding results for SU(2). It is emphasized that the formulation of the MAG is more subtle for SU(3) than for SU(2), and that the low string tensions may be caused by the simple MAG form used. A generalized MAG for SU(3) is formulated.Comment: 22 pages, latex, 2 postscript figures. Replaced version has added data at beta=6.0, analysis of Gribov ambiguities, extended tables of results, discussion of scalin

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

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified