A Solution to the Graceful Exit Problem in Pre-Big Bang Cosmology

We examine the string cosmology equations with a dilaton potential in the context of the Pre-Big Bang Scenario with the desired scale factor duality, and give a generic algorithm for obtaining solutions with appropriate evolutionary properties. This enables us to find pre-big bang type solutions with suitable dilaton behaviour that are regular at $t=0$, thereby solving the graceful exit problem. However to avoid fine tuning of initial data, an `exotic' equation of state is needed that relates the fluid properties to the dilaton field. We discuss why such an equation of state should be required for reliable dilaton behaviour at late times.Comment: 16 pages LaTeX, 5 figures. To appear in Physical Review

Clinical diagnostic utility of IP-10 and LAM antigen levels for the diagnosis of tuberculous pleural effusions in a high burden setting

Background: Current tools for the diagnosis of tuberculosis pleural effusions are sub-optimal. Data about the value of new diagnostic technologies are limited, particularly, in high burden settings. Preliminary case control studies have identified IFN-γ-inducible-10kDa protein (IP-10) as a promising diagnostic marker; however, its diagnostic utility in a day-to-day clinical setting is unclear. Detection of LAM antigen has not previously been evaluated in pleural fluid. Methods: We investigated the comparative diagnostic utility of established (adenosine deaminase [ADA]), more recent (standardized nucleic-acid-amplification-test [NAAT]) and newer technologies (a standardized LAM mycobacterial antigendetection assay and IP-10 levels) for the evaluation of pleural effusions in 78 consecutively recruited South African tuberculosis suspects. All consenting participants underwent pleural biopsy unless contra-indicated or refused. The reference standard comprised culture positivity for M. tuberculosis or histology suggestive of tuberculosis. Principal Findings: Of 74 evaluable subjects 48, 7 and 19 had definite, probable and non-TB, respectively. IP-10 levels were significantly higher in TB vs non-TB participants (p<0.0001). The respective outcomes [sensitivity, specificity, PPV, NPV %] for the different diagnostic modalities were: ADA at the 30 IU/L cut-point [96; 69; 90; 85], NAAT [6; 93; 67; 28], IP-10 at the 28,170 pg/ml ROC-derived cut-point [80; 82; 91; 64], and IP-10 at the 4035 pg/ml cut-point [100; 53; 83; 100]. Thus IP-10, using the ROC-derived cut-point, missed ~20% of TB cases and mis-diagnosed ~20% of non-TB cases. By contrast, when a lower cut-point was used a negative test excluded TB. The NAAT had a poor sensitivity but high specificity. LAM antigendetection was not diagnostically useful. Conclusion: Although IP-10, like ADA, has sub-optimal specificity, it may be a clinically useful rule-out test for tuberculous pleural effusions. Larger multi-centric studies are now required to confirm our findings

Stability analysis of cosmological models through Liapunov's method

We investigate the general asymptotic behaviour of Friedman-Robertson-Walker (FRW) models with an inflaton field, scalar-tensor FRW cosmological models and diagonal Bianchi-IX models by means of Liapunov's method. This method provides information not only about the asymptotic stability of a given equilibrium point but also about its basin of attraction. This cannot be obtained by the usual methods found in the literature, such as linear stability analysis or first order perturbation techniques. Moreover, Liapunov's method is also applicable to non-autonomous systems. We use this advantadge to investigate the mechanism of reheating for the inflaton field in FRW models.Comment: Latex file, 8 pages, no figures, accepted for publication in Class. & Quant. Gra

Bounce behaviour in Kantowski-Sachs and Bianchi Cosmologies

Many cosmological scenarios envisage either a bounce of the universe at early times, or collapse of matter locally to form a black hole which re-expands into a new expanding universe region. Energy conditions preclude this happening for ordinary matter in general relativistic universes, but scalar or dilatonic fields can violate some of these conditions, and so could possibly provide bounce behaviour. In this paper we show that such bounces cannot occur in Kantowski-Sachs models without violating the {\it reality condition} $\dot{\phi}^2\geq 0$. This also holds true for other isotropic spatially homogenous Bianchi models, with the exception of closed Friedmann-Robertson-Walker and Bianchi IX models; bounce behaviour violates the {\em weak energy condition} $\rho\geq 0$ and $\rho+p\geq 0$. We turn to the Randall-Sundrum type braneworld scenario for a possible resolution of this problem.Comment: Matches published versio

Solution generating in scalar-tensor theories with a massless scalar field and stiff perfect fluid as a source

We present a method for generating solutions in some scalar-tensor theories with a minimally coupled massless scalar field or irrotational stiff perfect fluid as a source. The method is based on the group of symmetries of the dilaton-matter sector in the Einstein frame. In the case of Barker's theory the dilaton-matter sector possesses SU(2) group of symmetries. In the case of Brans-Dicke and the theory with "conformal coupling", the dilaton- matter sector has $SL(2,R)$ as a group of symmetries. We describe an explicit algorithm for generating exact scalar-tensor solutions from solutions of Einstein-minimally-coupled-scalar-field equations by employing the nonlinear action of the symmetry group of the dilaton-matter sector. In the general case, when the Einstein frame dilaton-matter sector may not possess nontrivial symmetries we also present a solution generating technique which allows us to construct exact scalar-tensor solutions starting with the solutions of Einstein-minimally-coupled-scalar-field equations. As an illustration of the general techniques, examples of explicit exact solutions are constructed. In particular, we construct inhomogeneous cosmological scalar-tensor solutions whose curvature invariants are everywhere regular in space-time. A generalization of the method for scalar-tensor-Maxwell gravity is outlined.Comment: 10 pages,Revtex; v2 extended version, new parts added and some parts rewritten, results presented more concisely, some simple examples of homogeneous solutions replaced with new regular inhomogeneous solutions, typos corrected, references and acknowledgements added, accepted for publication in Phys.Rev.

The age of anxiety? It depends where you look: changes in STAI trait anxiety, 1970–2010

Purpose Population-level surveys suggest that anxiety has been increasing in several nations, including the USA and UK. We sought to verify the apparent anxiety increases by looking for systematic changes in mean anxiety questionnaire scores from research publications. Methods We analyzed all available mean State–Trait Anxiety Inventory scores published between 1970 and 2010. We collected 1703 samples, representing more than 205,000 participants from 57 nations. Results Results showed a significant anxiety increase worldwide, but the pattern was less clear in many individual nations. Our analyses suggest that any increase in anxiety in the USA and Canada may be limited to students, anxiety has decreased in the UK, and has remained stable in Australia. Conclusions Although anxiety may have increased worldwide, it might not be increasing as dramatically as previously thought, except in specific populations, such as North American students. Our results seem to contradict survey results from the USA and UK in particular. We do not claim that our results are more reliable than those of large population surveys. However, we do suggest that mental health surveys and other governmental sources of disorder prevalence data may be partially biased by changing attitudes toward mental health: if respondents are more aware and less ashamed of their anxiety, they are more likely to report it to survey takers. Analyses such as ours provide a useful means of double-checking apparent trends in large population surveys

Structure and stability of the Lukash plane-wave spacetime

We study the vacuum, plane-wave Bianchi $VII{}_{h}$ spacetimes described by the Lukash metric. Combining covariant with orthonormal frame techniques, we describe these models in terms of their irreducible kinematical and geometrical quantities. This covariant description is used to study analytically the response of the Lukash spacetime to linear perturbations. We find that the stability of the vacuum solution depends crucially on the background shear anisotropy. The stronger the deviation from the Hubble expansion, the more likely the overall linear instability of the model. Our analysis addresses rotational, shear and Weyl curvature perturbations and identifies conditions sufficient for the linear growth of these distortions.Comment: Revised version, references added. To appear in Class. Quantum Gra

Palliative radiotherapy in addition to self-expanding metal stent for improving dysphagia and survival in advanced oesophageal cancer (ROCS: Radiotherapy after Oesophageal Cancer Stenting):study protocol for a randomized controlled trial

Background: The single most distressing symptom for patients with advanced esophageal cancer is dysphagia. Amongst the more effective treatments for relief of dysphagia is insertion of a self-expanding metal stent (SEMS). It is possible that the addition of a palliative dose of external beam radiotherapy may prolong the relief of dysphagia and provide additional survival benefit. The ROCS trial will assess the effect of adding palliative radiotherapy after esophageal stent insertion. Methods/Design: The study is a randomized multicenter phase III trial, with an internal pilot phase, comparing stent alone versus stent plus palliative radiotherapy in patients with incurable esophageal cancer. Eligible participants are those with advanced esophageal cancer who are in need of stent insertion for primary management of dysphagia. Radiotherapy will be administered as 20 Gray (Gy) in five fractions over one week or 30 Gy in 10 fractions over two weeks, within four weeks of stent insertion. The internal pilot will assess rates and methods of recruitment; pre-agreed criteria will determine progression to the main trial. In total, 496 patients will be randomized in a 1:1 ratio with follow up until death. The primary outcome is time to progression of patient-reported dysphagia. Secondary outcomes include survival, toxicity, health resource utilization, and quality of life. An embedded qualitative study will explore the feasibility of patient recruitment by examining patients’ motivations for involvement and their experiences of consent and recruitment, including reasons for not consenting. It will also explore patients’ experiences of each trial arm. Discussion: The ROCS study will be a challenging trial studying palliation in patients with a poor prognosis. The internal pilot design will optimize methods for recruitment and data collection to ensure that the main trial is completed on time. As a pragmatic trial, study strengths include collection of all follow-up data in the usual place of care, and a focus on patient-reported, rather than disease-orientated, outcomes. Exploration of patient experience and health economic analyses will be integral to the assessment of benefit for patients and the NHS

The use of discrete choice experiments to inform health workforce policy: a systematic review.

BACKGROUND: Discrete choice experiments have become a popular study design to study the labour market preferences of health workers. Discrete choice experiments in health, however, have been criticised for lagging behind best practice and there are specific methodological considerations for those focused on job choices. We performed a systematic review of the application of discrete choice experiments to inform health workforce policy. METHODS: We searched for discrete choice experiments that examined the labour market preferences of health workers, including doctors, nurses, allied health professionals, mid-level and community health workers. We searched Medline, Embase, Global Health, other databases and grey literature repositories with no limits on date or language and contacted 44 experts. Features of choice task and experimental design, conduct and analysis of included studies were assessed against best practice. An assessment of validity was undertaken for all studies, with a comparison of results from those with low risk of bias and a similar objective and context. RESULTS: Twenty-seven studies were included, with over half set in low- and middle-income countries. There were more studies published in the last four years than the previous ten years. Doctors or medical students were the most studied cadre. Studies frequently pooled results from heterogeneous subgroups or extrapolated these results to the general population. Only one third of studies included an opt-out option, despite all health workers having the option to exit the labour market. Just five studies combined results with cost data to assess the cost effectiveness of various policy options. Comparison of results from similar studies broadly showed the importance of bonus payments and postgraduate training opportunities and the unpopularity of time commitments for the uptake of rural posts. CONCLUSIONS: This is the first systematic review of discrete choice experiments in human resources for health. We identified specific issues relating to this application of which practitioners should be aware to ensure robust results. In particular, there is a need for more defined target populations and increased synthesis with cost data. Research on a wider range of health workers and the generalisability of results would be welcome to better inform policy

Electrode Kinetics of Vanadium Flow Batteries: Contrasting Responses of V\u3csup\u3eII\u3c/sup\u3e-V\u3csup\u3eIII\u3c/sup\u3e and V\u3csup\u3eIV\u3c/sup\u3e-V\u3csup\u3eV\u3c/sup\u3e to Electrochemical Pretreatment of Carbon

Electrochemical impedance spectroscopy and cyclic voltammetry were used to investigate the electrode kinetics of VII-VIII and VIV-VV in H2SO4 on glassy carbon, carbon paper, carbon xerogel, and carbon fibers. It was shown that, for all carbon materials investigated, the kinetics of VII-VIII is enhanced by anodic, and inhibited by cathodic, treatment of the electrode; in contrast, the kinetics of VIV-VV is inhibited by anodic, and enhanced by cathodic, treatment. The potential region for each of these effects varied only slightly with carbon material. Rate constants were always greater for VIV-VV than for VII-VIII except when anodized electrodes were compared, which may explain discrepancies in the literature. The observed effects are attributed to oxygen-containing functional-groups on the electrode surface. The considerable differences between the potentials at which enhancement of VII-VIII and inhibition of VIV-VV occur indicates that they do not correspond to a common oxidized state of the electrode. Likewise inhibition of VII-VIII and enhancement of VIV-VV do not correspond to a common reduced state of the electrode. It is possible that enhancement of both VII-VIII and VIV-VV is due to the same (active) state of the electrode