Semiclassical Time Evolution and Trace Formula for Relativistic Spin-1/2 Particles

We investigate the Dirac equation in the semiclassical limit \hbar --> 0. A semiclassical propagator and a trace formula are derived and are shown to be determined by the classical orbits of a relativistic point particle. In addition, two phase factors enter, one of which can be calculated from the Thomas precession of a classical spin transported along the particle orbits. For the second factor we provide an interpretation in terms of dynamical and geometric phases.Comment: 8 pages, no figure

Limitations on the superposition principle: superselection rules in non-relativistic quantum mechanics

The superposition principle is a very basic ingredient of quantum theory. What may come as a surprise to many students, and even to many practitioners of the quantum craft, is tha superposition has limitations imposed by certain requirements of the theory. The discussion of such limitations arising from the so-called superselection rules is the main purpose of this paper. Some of their principal consequences are also discussed. The univalence, mass and particle number superselection rules of non-relativistic quantum mechanics are also derived using rather simple methods.Comment: 22 pages, no figure

Equations of Motion of Spinning Relativistic Particle in Electromagnetic and Gravitational Fields

We consider the motion of a spinning relativistic particle in external electromagnetic and gravitational fields, to first order in the external field, but to an arbitrary order in spin. The noncovariant spin formalism is crucial for the correct description of the influence of the spin on the particle trajectory. We show that the true coordinate of a relativistic spinning particle is its naive, common coordinate \r. Concrete calculations are performed up to second order in spin included. A simple derivation is presented for the gravitational spin-orbit and spin-spin interactions of a relativistic particle. We discuss the gravimagnetic moment (GM), a specific spin effect in general relativity. It is shown that for the Kerr black hole the gravimagnetic ratio, i.e., the coefficient at the GM, equals unity (just as for the charged Kerr hole the gyromagnetic ratio equals two). The equations of motion obtained for relativistic spinning particle in external gravitational field differ essentially from the Papapetrou equations.Comment: 32 pages, latex, Plenary talk at the Fairbank Meeting on the Lense--Thirring Effect, Rome-Pescara, 29/6-4/7 199

Equations of Motion of Spinning Relativistic Particle in External Fields

We consider the motion of a spinning relativistic particle in external electromagnetic and gravitational fields, to first order in the external field, but to an arbitrary order in spin. The correct account for the spin influence on the particle trajectory is obtained with the noncovariant description of spin. Concrete calculations are performed up to second order in spin included. A simple derivation is presented for the gravitational spin-orbit and spin-spin interactions of a relativistic particle. We discuss the gravimagnetic moment (GM), a specific spin effect in general relativity. It is demonstrated that for the Kerr black hole the gravimagnetic ratio, i.e., the coefficient at the GM, equals to unity (as well as for the charged Kerr hole the gyromagnetic ratio equals to two). The equations of motion obtained for relativistic spinning particle in external gravitational field differ essentially from the Papapetrou equations.Comment: 22 pages, latex, no figure

From dynamical scaling to local scale-invariance: a tutorial

Dynamical scaling arises naturally in various many-body systems far from equilibrium. After a short historical overview, the elements of possible extensions of dynamical scaling to a local scale-invariance will be introduced. Schr\"odinger-invariance, the most simple example of local scale-invariance, will be introduced as a dynamical symmetry in the Edwards-Wilkinson universality class of interface growth. The Lie algebra construction, its representations and the Bargman superselection rules will be combined with non-equilibrium Janssen-de Dominicis field-theory to produce explicit predictions for responses and correlators, which can be compared to the results of explicit model studies. At the next level, the study of non-stationary states requires to go over, from Schr\"odinger-invariance, to ageing-invariance. The ageing algebra admits new representations, which acts as dynamical symmetries on more general equations, and imply that each non-equilibrium scaling operator is characterised by two distinct, independent scaling dimensions. Tests of ageing-invariance are described, in the Glauber-Ising and spherical models of a phase-ordering ferromagnet and the Arcetri model of interface growth.Comment: 1+ 23 pages, 2 figures, final for

Rationale and design of BISTRO: a randomized controlled trial to determine whether bioimpedance spectroscopy guided fluid management maintains residual kidney function in incident haemodialysis patients

Background: Preserved residual kidney function (RKF) and normal fluid status are associated with better patient outcomes in incident haemodialysis patients. The objective of this trial is to determine whether using bioimpedance technology in prescribing the optimal post-dialysis weight can reduce the rate of decline of RKF and potentially improve patient outcomes. Methods/Design: 516 patients commencing haemodialysis, aged >18 with RKF of > 3 ml/min/1.73 m2 or a urine volume >500 ml per day or per the shorter inter-dialytic period will be consented and enrolled into a pragmatic, open label, randomized controlled trial. The intervention is incorporation of bioimpedance spectroscopy (BI) determination of normally hydrated weight to set a post-dialysis target weight that limits volume depletion, compared to current standard practice. Clinicians and participants will be blinded to BI measures in the control group and a standardized record capturing management of fluid status will be used in all participants. Primary outcome is preservation of residual kidney function assessed as time to anuria (≤100 ml/day or ≤200 ml urine volume in the short inter-dialytic period). A sample size of 516 was based upon a cumulative incidence of 30% anuria in the control group and 20% in the treatment group and 11% competing risks (death, transplantation) over 10 months, with up to 2 years follow-up. Secondary outcomes include rate of decline in small solute clearance, significant adverse events, hospitalization, loss of vascular access, cardiovascular events and interventions, dialysis efficacy and safety, dialysis-related symptoms and quality of life. Economic evaluation will be carried out to determine the cost-effectiveness of the intervention. Analyses will be adjusted for patient characteristics and dialysis unit practice patterns relevant to fluid management. Discussion: This trial will establish the added value of undertaking BI measures to support clinical management of fluid status and establish the relationship between fluid status and preservation of residual kidney function in incident haemodialysis patients. Trial registration: ISCCTN Number: 11342007, completed 26/04/2016; NIHR Portfolio number: CPMS31766; Sponsor: Keele University Keywords: Fluid status, Body composition, Residual kidney function, Haemodialysis, Bioimpedance, Fluid management, Health economic

Plasma Levels of Middle Molecules to Estimate Residual Kidney Function in Haemodialysis without Urine Collection

© 2015 Vilar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/Licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.BACKGROUND: Residual Kidney Function (RKF) is associated with survival benefits in haemodialysis (HD) but is difficult to measure without urine collection. Middle molecules such as Cystatin C and β2-microglobulin accumulate in renal disease and plasma levels have been used to estimate kidney function early in this condition. We investigated their use to estimate RKF in patients on HD. DESIGN: Cystatin C, β2-microglobulin, urea and creatinine levels were studied in patients on incremental high-flux HD or hemodiafiltration(HDF). Over sequential HD sessions, blood was sampled pre- and post-session 1 and pre-session 2, for estimation of these parameters. Urine was collected during the whole interdialytic interval, for estimation of residual GFR (GFRResidual = mean of urea and creatinine clearance). The relationships of plasma Cystatin C and β2-microglobulin levels to GFRResidual and urea clearance were determined. RESULTS: Of the 341 patients studied, 64% had urine output>100 ml/day, 32.6% were on high-flux HD and 67.4% on HDF. Parameters most closely correlated with GFRResidual were 1/β2-micoglobulin (r2 0.67) and 1/Cystatin C (r2 0.50). Both these relationships were weaker at low GFRResidual. The best regression model for GFRResidual, explaining 67% of the variation, was: GFRResidual = 160.3 · (1/β2m) - 4.2. Where β2m is the pre-dialysis β2 microglobulin concentration (mg/L). This model was validated in a separate cohort of 50 patients using Bland-Altman analysis. Areas under the curve in Receiver Operating Characteristic analysis aimed at identifying subjects with urea clearance≥2 ml/min/1.73 m2 was 0.91 for β2-microglobulin and 0.86 for Cystatin C. A plasma β2-microglobulin cut-off of ≤19.2 mg/L allowed identification of patients with urea clearance ≥2 ml/min/1.73 m2 with 90% specificity and 65% sensitivity. CONCLUSION: Plasma pre-dialysis β2-microglobulin levels can provide estimates of RKF which may have clinical utility and appear superior to cystatin C. Use of cut-off levels to identify patients with RKF may provide a simple way to individualise dialysis dose based on RKF.Peer reviewe

Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Globally, the number of patients undergoing maintenance dialysis is increasing, yet throughout the world there is significant variability in the practice of initiating dialysis. Factors such as availability of resources, reasons for starting dialysis, timing of dialysis initiation, patient education and preparedness, dialysis modality and access, as well as varied \u201ccountry-specific\u201d factors significantly affect patient experiences and outcomes. As the burden of end-stage kidney disease (ESKD) has increased globally, there has also been a growing recognition of the importance of patient involvement in determining the goals of care and decisions regarding treatment. In January 2018, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference focused on dialysis initiation, including modality choice, access, and prescription. Here we present a summary of the conference discussions, including identified knowledge gaps, areas of controversy, and priorities for research. A major novel theme represented during the conference was the need to move away from a \u201cone-size-fits-all\u201d approach to dialysis and provide more individualized care that incorporates patient goals and preferences while still maintaining best practices for quality and safety. Identifying and including patient-centered goals that can be validated as quality indicators in the context of diverse health care systems to achieve equity of outcomes will require alignment of goals and incentives between patients, providers, regulators, and payers that will vary across health care jurisdictions

Long-term outcome of chronic dialysis in children

As the prevalence of children on renal replacement therapy (RRT) increases world wide and such therapy comprises at least 2% of any national dialysis or transplant programme, it is essential that paediatric nephrologists are able to advise families on the possible outcome for their child on dialysis. Most children start dialysis with the expectation that successful renal transplantation is an achievable goal and will provide the best survival and quality of life. However, some will require long-term dialysis or may return intermittently to dialysis during the course of their chronic kidney disease (CKD). This article reviews the available outcome data for children on chronic dialysis as well as extrapolating data from the larger adult dialysis experience to inform our paediatric practice. The multiple factors that may influence outcome, and, particularly, those that can potentially be modified, are discussed