`Third' Quantization of Vacuum Einstein Gravity and Free Yang-Mills Theories

Based on the algebraico-categorical (:sheaf-theoretic and sheaf cohomological) conceptual and technical machinery of Abstract Differential Geometry, a new, genuinely background spacetime manifold independent, field quantization scenario for vacuum Einstein gravity and free Yang-Mills theories is introduced. The scheme is coined `third quantization' and, although it formally appears to follow a canonical route, it is fully covariant, because it is an expressly functorial `procedure'. Various current and future Quantum Gravity research issues are discussed under the light of 3rd-quantization. A postscript gives a brief account of this author's personal encounters with Rafael Sorkin and his work.Comment: 43 pages; latest version contributed to a fest-volume celebrating Rafael Sorkin's 60th birthday (Erratum: in earlier versions I had wrongly written that the Editor for this volume is Daniele Oriti, with CUP as publisher. I apologize for the mistake.

Atrial fibrillation in embolic stroke of undetermined source: role of advanced imaging of left atrial function

\ua9 The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. AIMS: Atrial fibrillation (AF) is detected in over 30% of patients following an embolic stroke of undetermined source (ESUS) when monitored with an implantable loop recorder (ILR). Identifying AF in ESUS survivors has significant therapeutic implications, and AF risk is essential to guide screening with long-term monitoring. The present study aimed to establish the role of left atrial (LA) function in subsequent AF identification and develop a risk model for AF in ESUS. METHODS AND RESULTS: We conducted a single-centre retrospective case-control study including all patients with ESUS referred to our institution for ILR implantation from December 2009 to September 2019. We recorded clinical variables at baseline and analysed transthoracic echocardiograms in sinus rhythm. Univariate and multivariable analyses were performed to inform variables associated with AF. Lasso regression analysis was used to develop a risk prediction model for AF. The risk model was internally validated using bootstrapping. Three hundred and twenty-three patients with ESUS underwent ILR implantation. In the ESUS population, 293 had a stroke, whereas 30 had suffered a transient ischaemic attack as adjudicated by a senior stroke physician. Atrial fibrillation of any duration was detected in 47.1%. The mean follow-up was 710 days. Following lasso regression with backwards elimination, we combined increasing lateral PA (the time interval from the beginning of the P wave on the surface electrocardiogram to the beginning of the A\u27 wave on pulsed wave tissue Doppler of the lateral mitral annulus) [odds ratio (OR) 1.011], increasing Age (OR 1.035), higher Diastolic blood pressure (OR 1.027), and abnormal LA reservoir Strain (OR 0.973) into a new PADS score. The probability of identifying AF can be estimated using the formula. Model discrimination was good [area under the curve (AUC) 0.72]. The PADS score was internally validated using bootstrapping with 1000 samples of 150 patients showing consistent results with an AUC of 0.73. CONCLUSION: The novel PADS score can identify the risk of AF on prolonged monitoring with ILR following ESUS and should be considered a dedicated risk stratification tool for decision-making regarding the screening strategy for AF in stroke.One-third of patients with a type of stroke called embolic stroke of undetermined source (ESUS) also have a heart condition called atrial fibrillation (AF), which increases their risk of having another stroke. However, we do not know why some patients with ESUS develop AF. To figure this out, we studied 323 patients with ESUS and used a special device to monitor their heart rhythm continuously for up to 3 years, an implantable loop recorder. We also looked at their medical history, performed a heart ultrasound, and identified some factors that increase the risk of identifying AF in the future. Factors associated with future AF include older age, higher diastolic blood pressure, and problems with the co-ordination and function of the upper left chamber of the heart called the left atrium.Based on these factors, we created a new scoring system that can identify patients who are at higher risk of developing AF better than the current scoring systems, the PADS score. This can potentially help doctors provide more targeted and effective treatment to these patients, ultimately aiming to reduce their risk of having another stroke

Pain outcomes in patients with bone metastases from advanced cancer: assessment and management with bone-targeting agents

Bone metastases in advanced cancer frequently cause painful complications that impair patient physical activity and negatively affect quality of life. Pain is often underreported and poorly managed in these patients. The most commonly used pain assessment instruments are visual analogue scales, a single-item measure, and the Brief Pain Inventory Questionnaire-Short Form. The World Health Organization analgesic ladder and the Analgesic Quantification Algorithm are used to evaluate analgesic use. Bone-targeting agents, such as denosumab or bisphosphonates, prevent skeletal complications (i.e., radiation to bone, pathologic fractures, surgery to bone, and spinal cord compression) and can also improve pain outcomes in patients with metastatic bone disease. We have reviewed pain outcomes and analgesic use and reported pain data from an integrated analysis of randomized controlled studies of denosumab versus the bisphosphonate zoledronic acid (ZA) in patients with bone metastases from advanced solid tumors. Intravenous bisphosphonates improved pain outcomes in patients with bone metastases from solid tumors. Compared with ZA, denosumab further prevented pain worsening and delayed the need for treatment with strong opioids. In patients with no or mild pain at baseline, denosumab reduced the risk of increasing pain severity and delayed pain worsening along with the time to increased pain interference compared with ZA, suggesting that use of denosumab (with appropriate calcium and vitamin D supplementation) before patients develop bone pain may improve outcomes. These data also support the use of validated pain assessments to optimize treatment and reduce the burden of pain associated with metastatic bone disease

Zoledronic Acid Preserves Bone Structure and Increases Survival but Does Not Limit Tumour Incidence in a Prostate Cancer Bone Metastasis Model

Background The bisphosphonate, zoledronic acid (ZOL), can inhibit osteoclasts leading to decreased osteoclastogenesis and osteoclast activity in bone. Here, we used a mixed osteolytic/osteoblastic murine model of bone-metastatic prostate cancer, RM1(BM), to determine how inhibiting osteolysis with ZOL affects the ability of these cells to establish metastases in bone, the integrity of the tumour-bearing bones and the survival of the tumour-bearing mice. Methods The model involves intracardiac injection for arterial dissemination of the RM1(BM) cells in C57BL/6 mice. ZOL treatment was given via subcutaneous injections on days 0, 4, 8 and 12, at 20 and 100 µg/kg doses. Bone integrity was assessed by micro-computed tomography and histology with comparison to untreated mice. The osteoclast and osteoblast activity was determined by measuring serum tartrate-resistant acid phosphatase 5b (TRAP 5b) and osteocalcin, respectively. Mice were euthanased according to predetermined criteria and survival was assessed using Kaplan Meier plots. Findings Micro-CT and histological analysis showed that treatment of mice with ZOL from the day of intracardiac injection of RM1(BM) cells inhibited tumour-induced bone lysis, maintained bone volume and reduced the calcification of tumour-induced endochondral osteoid material. ZOL treatment also led to a decreased serum osteocalcin and TRAP 5b levels. Additionally, treated mice showed increased survival compared to vehicle treated controls. However, ZOL treatment did not inhibit the cells ability to metastasise to bone as the number of bone-metastases was similar in both treated and untreated mice. Conclusions ZOL treatment provided significant benefits for maintaining the integrity of tumour-bearing bones and increased the survival of tumour bearing mice, though it did not prevent establishment of bone-metastases in this model. From the mechanistic view, these observations confirm that tumour-induced bone lysis is not a requirement for establishment of these bone tumours

Energy dependence of kaon-to-proton ratio fluctuations in central Pb+Pb collisions from sNN\sqrt{s_{NN}} = 6.3 to 17.3 GeV

Kaons and protons carry large parts of two conserved quantities, strangeness and baryon number. It is argued that their correlation and thus also fluctuations are sensitive to conditions prevailing at the anticipated parton-hadron phase boundary. Fluctuations of the $(\mathrm{K}^+ + \mathrm{K}^-)/(\mathrm{p}+\bar{\mathrm{p}})$ and $\mathrm{K}^+/\mathrm{p}$ ratios have been measured for the first time by NA49 in central Pb+Pb collisions at 5 SPS energies between $\sqrt{s_{NN}}$= 6.3 GeV and 17.3 GeV. Both ratios exhibit a change of sign in $\sigma_{\mathrm{dyn}}$, a measure of non-statistical fluctuations, around $\sqrt{s_{NN}}$ = 8 GeV. Below this energy, $\sigma_{\mathrm{dyn}}$ is positive, indicating higher fluctuation compared to a mixed event background sample, while for higher energies, $\sigma_{\mathrm{dyn}}$ is negative, indicating correlated emission of kaons and protons. The results are compared to UrQMD calculations which which give a good description at the higher SPS energies, but fail to reproduce the transition to positive values.Comment: 5 pages, 4 figure

System-size and centrality dependence of charged kaon and pion production in nucleus-nucleus collisions at 40A GeV and158A GeV beam energy

Measurements of charged pion and kaon production are presented in centrality selected Pb+Pb collisions at 40A GeV and 158A GeV beam energy as well as in semi-central C+C and Si+Si interactions at 40A GeV. Transverse mass spectra, rapidity spectra and total yields are determined as a function of centrality. The system-size and centrality dependence of relative strangeness production in nucleus-nucleus collisions at 40A GeV and 158A GeV beam energy are derived from the data presented here and published data for C+C and Si+Si collisions at 158A GeV beam energy. At both energies a steep increase with centrality is observed for small systems followed by a weak rise or even saturation for higher centralities. This behavior is compared to calculations using transport models (UrQMD and HSD), a percolation model and the core-corona approach.Comment: 32 pages, 14 figures, 4 tables, typo table II correcte

Transition Radiation Spectra of Electrons from 1 to 10 GeV/c in Regular and Irregular Radiators

We present measurements of the spectral distribution of transition radiation generated by electrons of momentum 1 to 10 GeV/c in different radiator types. We investigate periodic foil radiators and irregular foam and fiber materials. The transition radiation photons are detected by prototypes of the drift chambers to be used in the Transition Radiation Detector (TRD) of the ALICE experiment at CERN, which are filled with a Xe, CO2 (15 %) mixture. The measurements are compared to simulations in order to enhance the quantitative understanding of transition radiation production, in particular the momentum dependence of the transition radiation yield.Comment: 18 pages, 15 figures, submitted to Nucl. Instr. Meth. Phys. Res.

Antideuteron and deuteron production in mid-central Pb+Pb collisions at 158AA GeV

Production of deuterons and antideuterons was studied by the NA49 experiment in the 23.5% most central Pb+Pb collisions at the top SPS energy of $\sqrt{s_{NN}}$=17.3 GeV. Invariant yields for $\bar{d}$ and $d$ were measured as a function of centrality in the center-of-mass rapidity range $-1.2<y<-0.6$. Results for $\bar{d}(d)$ together with previously published $\bar{p}(p)$ measurements are discussed in the context of the coalescence model. The coalescence parameters $B_2$ were deduced as a function of transverse momentum $p_t$ and collision centrality.Comment: 9 figure

Pion emission from the T2K replica target: method, results and application

The T2K long-baseline neutrino oscillation experiment in Japan needs precise predictions of the initial neutrino flux. The highest precision can be reached based on detailed measurements of hadron emission from the same target as used by T2K exposed to a proton beam of the same kinetic energy of 30 GeV. The corresponding data were recorded in 2007-2010 by the NA61/SHINE experiment at the CERN SPS using a replica of the T2K graphite target. In this paper details of the experiment, data taking, data analysis method and results from the 2007 pilot run are presented. Furthermore, the application of the NA61/SHINE measurements to the predictions of the T2K initial neutrino flux is described and discussed.Comment: updated version as published by NIM