A Quantum Bousso Bound

The Bousso bound requires that one quarter the area of a closed codimension two spacelike surface exceeds the entropy flux across a certain lightsheet terminating on the surface. The bound can be violated by quantum effects such as Hawking radiation. It is proposed that at the quantum level the bound be modified by adding to the area the quantum entanglement entropy across the surface. The validity of this quantum Bousso bound is proven in a two-dimensional large N dilaton gravity theory.Comment: 17 page

Doctors’ recognition and management of melanoma patients’ risk: an Australian population-based study

Background Guidelines recommend that health professionals identify and manage individuals at high risk of developing melanoma, but there is limited population-based evidence demonstrating real-world practices. Objective A population-based, observational study was conducted in the state of New South Wales, Australia to determine doctors’ knowledge of melanoma patients’ risk and to identify factors associated with better identification and clinical management. Methods Data were analysed for 1889 patients with invasive, localised melanoma in the Melanoma Patterns of Care study. This study collected data on all melanoma diagnoses notified to the state’s cancer registry during a 12-month period from 2006 to 2007, as well as questionnaire data from the doctors involved in their care. Results Three-quarters (74%) of patients had doctors who were aware of their risk factor status with respect to personal and family history of melanoma and the presence of many moles. Doctors working in general practice, skin cancer clinics and dermatology settings had better knowledge of patients’ risk factors than plastic surgeons. Doctors were 15% more likely to know the family history of younger melanoma patients (<40 years) than of those ≥80 years (95% confidence interval 4–26%). Early detection-related follow-up advice was more likely to be given to younger patients, by doctors aware of their patients’ risk status, by doctors practising in plastic surgery, dermatology and skin cancer clinic settings, and by female doctors. Conclusion Both patient-related and doctor-related factors were associated with doctors’ recognition and management of melanoma patients’ risk and could be the focus of strategies for improving care

Atmospheres of Magnetized Neutron Stars: Vacuum Polarization and Partially Ionized Models

We construct hydrogen atmosphere models for magnetized neutron stars in radiative equilibrium with surface fields B=10^12-5x10^14 G and effective temperatures T_eff a few x 10^5-10^6 K by solving the full radiative transfer equations for both polarization modes in the magnetized hydrogen plasma. The atmospheres directly determine the characteristics of thermal emission from isolated neutron stars. We study the effects of vacuum polarization and bound atoms on the atmosphere structure and spectra. For the lower magnetic field models (B 10^12 G), the spectral features due to neutral atoms lie at extreme UV and very soft X-ray energies and therefore are not likely to be observed. However, the continuum flux is also different from the fully ionized case, especially at lower energies. For the higher magnetic field models, we find that vacuum polarization softens the high energy tail of the thermal spectrum. We show that this depression of continuum flux strongly suppresses not only the proton cyclotron line but also spectral features due to bound species; therefore spectral lines or features in thermal radiation are more difficult to observe when the neutron star magnetic field is > 10^14 G.Comment: 6 pages, 6 figures, submitted to Adv Sp Res: Proceedings of the 34th COSPAR Scientific Assembly, E1.4 "High Energy Studies of Supernova Remnants and Neutron Stars

Mild parenchymal lung disease and/or low diffusion capacity impacts survival and treatment response in patients diagnosed with idiopathic pulmonary arterial hypertension

There are limited published data defining survival and treatment response in patients with mild lung disease and/or reduced gas transfer who fulfil diagnostic criteria for idiopathic pulmonary arterial hypertension (IPAH). Patients diagnosed with IPAH between 2001–19 were identified in the ASPIRE registry. Using pre-specified criteria based on CT imaging and spirometry, patients with a diagnosis of IPAH and no lung disease were termed IPAHno-LD (n=303), and those with minor-mild emphysema or fibrosis were described as IPAHmild-LD (n=190). Survival was significantly better in IPAHno-LD than in IPAHmild-LD (1 and 5-year survival 95% and 70% versus 78% and 22% respectively, p<0.0001). In the combined group of IPAHno-LD and IPAHmild-LD, independent predictors of higher mortality were increasing age, lower DLCO, lower exercise capacity and a diagnosis of IPAHmild-LD (p all <0.05). Exercise capacity and quality of life improved (p both <0.0001) following treatment in patients with IPAHno-LD but not IPAHmild-LD. A proportion of patients with IPAHno-LD had a DLCO <45%; these patients had poorer survival than patients with DLCO ≥45% although demonstrated improved exercise capacity following treatment. The presence of even mild parenchymal lung disease in patients who would be classified as IPAH according to current recommendations has a significant adverse effect on outcomes. This phenotype can be identified using lung function testing and clinical CT reports. Patients with IPAH, no lung disease and severely reduced DLCO may represent a further distinct phenotype. These data suggest that RCTs of targeted therapies in patients with these phenotypes are required

Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

BACKGROUND: There are conflicting data on the effects of antipsychotic medications on delirium in patients in the intensive care unit (ICU). METHODS: In a randomized, double-blind, placebo-controlled trial, we assigned patients with acute respiratory failure or shock and hypoactive or hyperactive delirium to receive intravenous boluses of haloperidol (maximum dose, 20 mg daily), ziprasidone (maximum dose, 40 mg daily), or placebo. The volume and dose of a trial drug or placebo was halved or doubled at 12-hour intervals on the basis of the presence or absence of delirium, as detected with the use of the Confusion Assessment Method for the ICU, and of side effects of the intervention. The primary end point was the number of days alive without delirium or coma during the 14-day intervention period. Secondary end points included 30-day and 90-day survival, time to freedom from mechanical ventilation, and time to ICU and hospital discharge. Safety end points included extrapyramidal symptoms and excessive sedation. RESULTS: Written informed consent was obtained from 1183 patients or their authorized representatives. Delirium developed in 566 patients (48%), of whom 89% had hypoactive delirium and 11% had hyperactive delirium. Of the 566 patients, 184 were randomly assigned to receive placebo, 192 to receive haloperidol, and 190 to receive ziprasidone. The median duration of exposure to a trial drug or placebo was 4 days (interquartile range, 3 to 7). The median number of days alive without delirium or coma was 8.5 (95% confidence interval [CI], 5.6 to 9.9) in the placebo group, 7.9 (95% CI, 4.4 to 9.6) in the haloperidol group, and 8.7 (95% CI, 5.9 to 10.0) in the ziprasidone group (P=0.26 for overall effect across trial groups). The use of haloperidol or ziprasidone, as compared with placebo, had no significant effect on the primary end point (odds ratios, 0.88 [95% CI, 0.64 to 1.21] and 1.04 [95% CI, 0.73 to 1.48], respectively). There were no significant between-group differences with respect to the secondary end points or the frequency of extrapyramidal symptoms. CONCLUSIONS: The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium. (Funded by the National Institutes of Health and the VA Geriatric Research Education and Clinical Center; MIND-USA ClinicalTrials.gov number, NCT01211522 .)

Late Holocene isotope hydrology of Lake Qinghai, NE Tibetan Plateau: effective moisture variability and atmospheric circulation changes

A sub-centennial-resolution record of lacustrine carbonate oxygen isotopes (δ&lt;sup&gt;18&lt;/sup&gt;O&lt;sub&gt;C&lt;/sub&gt;) from the closed-basin Lake Qinghai on the NE Tibetan Plateau shows pronounced variability over the past 1500 years. Changes in δ&lt;sup&gt;18&lt;/sup&gt;O&lt;sub&gt;C&lt;/sub&gt; in hydrologically closed lakes are often interpreted in terms of changing effective moisture. Under this interpretation our record would imply increasing effective moisture during the Little Ice Age (LIA) compared to the Medieval Warm Period (MWP). However, independent evidence from other archives strongly suggests the Asian summer monsoon was stronger during the MWP and weakened during the LIA. Controls other than effective moisture (the balance of water inputs over evaporative loss) must therefore have contributed to the δ&lt;sup&gt;18&lt;/sup&gt;O&lt;sub&gt;C&lt;/sub&gt; values. We propose the LIA signal in Lake Qinghai resulted from a reduction in evaporation caused by colder air temperatures, coupled with a decrease in oxygen isotope composition of input waters as a result of an increase in the relative importance of westerly-derived precipitation. Our results caution against simplistic interpretations of carbonate oxygen isotope records from hydrologically closed lakes and suggest all possible controlling factors must be taken into account in order to avoid misleading palaeoclimatic reconstructions

Exploring morphological correlations among H2CO, 12CO, MSX and continuum mappings

There are relatively few H2CO mappings of large-area giant molecular cloud (GMCs). H2CO absorption lines are good tracers for low-temperature molecular clouds towards star formation regions. Thus, the aim of the study was to identify H2CO distributions in ambient molecular clouds. We investigated morphologic relations among 6-cm continuum brightness temperature (CBT) data and H2CO (111-110; Nanshan 25-m radio telescope), 12CO (1--0; 1.2-m CfA telescope) and midcourse space experiment (MSX) data, and considered the impact of background components on foreground clouds. We report simultaneous 6-cm H2CO absorption lines and H110\alpha radio recombination line observations and give several large-area mappings at 4.8 GHz toward W49 (50'\times50'), W3 (70'\times90'), DR21/W75 (60'\times90') and NGC2024/NGC2023 (50'\times100') GMCs. By superimposing H2CO and 12CO contours onto the MSX color map, we can compare correlations. The resolution for H2CO, 12CO and MSX data was about 10', 8' and 18.3", respectively. Comparison of H2CO and 12CO contours, 8.28-\mu m MSX colorscale and CBT data revealed great morphological correlation in the large area, although there are some discrepancies between 12CO and H2CO peaks in small areas. The NGC2024/NGC2023 GMC is a large area of HII regions with a high CBT, but a H2CO cloud to the north is possible against the cosmic microwave background. A statistical diagram shows that 85.21% of H2CO absorption lines are distributed in the intensity range from -1.0 to 0 Jy and the \Delta V range from 1.206 to 5 km/s.Comment: 18 pages, 22 figures, 5 tables. Accepted to be published in Astrophysics and Space Scienc

Flux Backgrounds in 2D String Theory

We study RR flux backgrounds in two dimensional type 0 string theories. In particular, we study the relation between the 0A matrix model and the extremal black hole in two dimensions. Using T-duality we find a dual flux background in type 0B theory and propose its matrix model description. When the Fermi level is set to zero this system remains weakly coupled and exhibits a larger symmetry related to the structure of flux vacua. Finally, we construct a two dimensional type IIB background as an orbifold of the 0B background.Comment: Harvmac, 40 pages, 6 figs, minor changes, references adde