Simulations of the Nonlinear Helmholtz Equation: Arrest of Beam Collapse, Nonparaxial Solitons, and Counter-Propagating Beams

We solve the (2+1)D nonlinear Helmholtz equation (NLH) for input beams that collapse in the simpler NLS model. Thereby, we provide the first ever numerical evidence that nonparaxiality and backscattering can arrest the collapse. We also solve the (1+1)D NLH and show that solitons with radius of only half the wavelength can propagate over forty diffraction lengths with no distortions. In both cases we calculate the backscattered field, which has not been done previously. Finally, we compute the dynamics of counter-propagating solitons using the NLH model, which is more comprehensive than the previously used coupled NLS model.Comment: 6 pages, 6 figures, Lette

Constraints on the spacetime metric around seven "bare" AGNs using X-ray reflection spectroscopy

We present the study of a sample of seven "bare" active galactic nuclei (AGN) observed with Suzaku. We interpret the spectrum of these sources with a relativistic reflection component and we employ our model RELXILL_NK to test the Kerr nature of their supermassive black holes. We constrain the Johannsen deformation parameters $\alpha_{13}$ and $\alpha_{22}$, in which the Kerr metric is recovered when $\alpha_{13} = \alpha_{22} = 0$. All our measurements are consistent with the hypothesis that the spacetime geometry around these supermassive objects is described by the Kerr solution. For some sources, we obtain quite strong constraints on $\alpha_{13}$ and $\alpha_{22}$ when compared to those found in our previous studies. We discuss the systematic uncertainties in our tests and the implications of our results.Comment: 15 pages, 12 figures. v2: refereed versio

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Black holes, gravitational waves and fundamental physics: a roadmap

The grand challenges of contemporary fundamental physics—dark matter, dark energy, vacuum energy, inflation and early universe cosmology, singularities and the hierarchy problem—all involve gravity as a key component. And of all gravitational phenomena, black holes stand out in their elegant simplicity, while harbouring some of the most remarkable predictions of General Relativity: event horizons, singularities and ergoregions. The hitherto invisible landscape of the gravitational Universe is being unveiled before our eyes: the historical direct detection of gravitational waves by the LIGO-Virgo collaboration marks the dawn of a new era of scientific exploration. Gravitational-wave astronomy will allow us to test models of black hole formation, growth and evolution, as well as models of gravitational-wave generation and propagation. It will provide evidence for event horizons and ergoregions, test the theory of General Relativity itself, and may reveal the existence of new fundamental fields. The synthesis of these results has the potential to radically reshape our understanding of the cosmos and of the laws of Nature. The purpose of this work is to present a concise, yet comprehensive overview of the state of the art in the relevant fields of research, summarize important open problems, and lay out a roadmap for future progress. This write-up is an initiative taken within the framework of the European Action on 'Black holes, Gravitational waves and Fundamental Physics'