Effect of intraoperative fluid optimisation on renal function in patients undergoing emergency abdominal surgery; a randomised controlled pilot study (ISRCTN 11799696) Fluid optimisation for emergency surgery

<b>Background:</b> Emergency abdominal surgery carries a high risk of postoperative morbidity and mortality. Goal directed therapy has been advocated to improve outcome in high-risk surgery. The aim of the present pilot study was to examine the effect of goal directed therapy using fluid alone on postoperative renal function and organ failure score in patients undergoing emergency abdominal surgery. <b>Methods:</b> This prospective randomised pilot study included patients over the age of 50 undergoing emergency abdominal surgery. In the intervention group pulse pressure variation measurements were used to guide fluid boluses of 6% Hydroxyethylstarch 130/0.4. The control group received standard care. Serum urea, creatinine and cystatin C levels were measured prior to and at the end of surgery and postoperatively on day 1, day 3 and day 5. <b>Results:</b> Thirty patients were recruited. One patient died prior to surgery and was excluded from the analysis. The intervention group received a median of 750ml of hydroxyethylstarch. The peak values of postoperative urea were 6.9 (2.7–31.8) vs. 6.4 (3.5–11.5)mmol/l (p=0.425), creatinine 100 (60–300) vs. 85 (65–150) μmol/l (p=0.085) and cystatin C 1.09 (0.66–4.94) vs. 1.01 (0.33–2.29)mg/dl (p=0.352) in the control and intervention group, respectively. <b>Conclusions:</b> In the present pilot study replacing the identified fluid deficit was not associated with a change in renal function. These results do not preclude that goal directed therapy using fluid alone may have an effect on renal function but they would suggest that the effect size of fluid optimisation alone on renal function is small

Solving Problems of Practice in Education

The authors identify and discuss the many complexities involved in the translation of scientific information in the social sciences into forms usable for solving problems of practice in education. As a means of appropriately handling these complexities and the issues that arise, they prescribe a series of stages to be followed from the advent of a practitioner's situational problem to the design of a response to it. They assert that unless the process of translation is conducted with the prescribed level of understanding, appreciation, and rigor, the application of knowledge will be inaccurate.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68934/2/10.1177_107554708400600103.pd

A 750 mW, continuous-wave, solid-state laser source at 313 nm for cooling and manipulating trapped 9Be+ ions

We present a solid-state laser system that generates 750 mW of continuous-wave single-frequency output at 313 nm. Sum-frequency generation with fiber lasers at 1550 nm and 1051 nm produces up to 2 W at 626 nm. This visible light is then converted to UV by cavity-enhanced second-harmonic generation. The laser output can be tuned over a 495 GHz range, which includes the 9Be+ laser cooling and repumping transitions. This is the first report of a narrow-linewidth laser system with sufficient power to perform fault-tolerant quantum-gate operations with trapped 9Be+ ions by use of stimulated Raman transitions.Comment: 9 pages, 4 figure

Power counting and effective field theory for charmonium

We hypothesize that the correct power counting for charmonia is in the parameter Lambda_QCD/m_c, but is not based purely on dimensional analysis (as is HQET). This power counting leads to predictions which differ from those resulting from the usual velocity power counting rules of NRQCD. In particular, we show that while Lambda_QCD/m_c power counting preserves the empirically verified predictions of spin symmetry in decays, it also leads to new predictions which include: A hierarchy between spin singlet and triplet octet matrix elements in the J/psi system. A quenching of the net polarization in production at large transverse momentum. No end point enhancement in radiative decays. We discuss explicit tests which can differentiate between the traditional and new theories of NRQCD.Comment: 18 pages, 1 figure Replaced plot of the psi polarization parameter alpha as a function of transverse momentum. Alpha is now closer to zero for large transverse moment

Modeling quark-hadron duality for relativistic, confined fermions

We discuss a model for the study of quark-hadron duality in inclusive electron scattering based on solving the Dirac equation numerically for a scalar confining linear potential and a vector color Coulomb potential. We qualitatively reproduce the features of quark-hadron duality for all potentials considered, and discuss similarities and differences to previous models that simplified the situation by treating either the quarks or all particles as scalars. We discuss the scaling results for PWIA and FSI, and the approach to scaling using the analog of the Callan-Gross relation for y-scaling.Comment: 38 pages, 21 figure

A Phenomenological Analysis of Heavy Hadron Lifetimes

A phenomenological analysis of lifetimes of bottom and charmed hadrons within the framework of the heavy quark expansion is performed. The baryon matrix element is evaluated using the bag model and the nonrelativistic quark model. We find that bottom-baryon lifetimes follow the pattern $\tau(\Omega_b)\simeq\tau(\Xi_b^-)>\tau(\Lambda_b)\simeq\tau(\Xi_b^0)$. However, neither the lifetime ratio $\tau(\Lambda_b)/\tau( B_d)$ nor the absolute decay rates of the $\Lambda_b$ baryon and $B$ mesons can be explained. One way of solving both difficulties is to allow the presence of linear $1/m_Q$ corrections by scaling the inclusive nonleptonic width with the fifth power of the hadron mass $m_{H_Q}$ rather than the heavy quark mass $m_Q$. The hierarchy of bottom baryon lifetimes is dramatically modified to $\tau(\Lambda_b)>\tau(\Xi_b^-)>\tau(\Xi_b^0)>\tau( \Omega_b)$: The longest-lived $\Omega_b$ among bottom baryons in the OPE prescription now becomes shortest-lived. The replacement of $m_Q$ by $m_{H_Q}$ in nonleptonic widths is natural and justified in the PQCD-based factorization approach formulated in terms of hadron-level kinematics. For inclusive charmed baryon decays, we argue that since the heavy quark expansion does not converge, local duality cannot be tested in this case. We show that while the ansatz of substituting the heavy quark mass by the hadron mass provides a much better description of the charmed-baryon lifetime {\it ratios}, it appears unnatural and unpredictive for describing the {\it absolute} inclusive decay rates of charmed baryons, contrary to the bottom case.Comment: 35 pages, to appear in Phys. Rev. The CDF result on the lifetime ratio of Lambda_b and B_d is discusse

GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer

Predicting when a patient with advanced cancer is dying is a challenge and currently no prognostic test is available. We hypothesised that a dying process from cancer is associated with metabolic changes and specifically with changes in volatile organic compounds (VOCs). We analysed urine from patients with lung cancer in the last weeks of life by headspace gas chromatography mass spectrometry. Urine was acidified or alkalinised before analysis. VOC changes in the last weeks of life were identified using univariate, multivariate and linear regression analysis; 12 VOCs increased (11 from the acid dataset, 2 from the alkali dataset) and 25 VOCs decreased (23 from the acid dataset and 3 from the alkali dataset). A Cox Lasso prediction model using 8 VOCs predicted dying with an AUC of 0.77, 0.78 and 0.85 at 30, 20 and 10 days and stratified patients into a low (median 10 days), medium (median 50 days) or high risk of survival. Our data supports the hypothesis there are specific metabolic changes associated with the dying. The VOCs identified are potential biomarkers of dying in lung cancer and could be used as a tool to provide additional prognostic information to inform expert clinician judgement and subsequent decision making

Symmetries of a class of nonlinear fourth order partial differential equations

In this paper we study symmetry reductions of a class of nonlinear fourth order partial differential equations \be u_{tt} = \left(\kappa u + \gamma u^2\right)_{xx} + u u_{xxxx} +\mu u_{xxtt}+\alpha u_x u_{xxx} + \beta u_{xx}^2, \ee where $\alpha$, $\beta$, $\gamma$, $\kappa$ and $\mu$ are constants. This equation may be thought of as a fourth order analogue of a generalization of the Camassa-Holm equation, about which there has been considerable recent interest. Further equation (1) is a ``Boussinesq-type'' equation which arises as a model of vibrations of an anharmonic mass-spring chain and admits both ``compacton'' and conventional solitons. A catalogue of symmetry reductions for equation (1) is obtained using the classical Lie method and the nonclassical method due to Bluman and Cole. In particular we obtain several reductions using the nonclassical method which are no} obtainable through the classical method

Branch-and-lift algorithm for deterministic global optimization in nonlinear optimal control

This paper presents a branch-and-lift algorithm for solving optimal control problems with smooth nonlinear dynamics and potentially nonconvex objective and constraint functionals to guaranteed global optimality. This algorithm features a direct sequential method and builds upon a generic, spatial branch-and-bound algorithm. A new operation, called lifting, is introduced, which refines the control parameterization via a Gram-Schmidt orthogonalization process, while simultaneously eliminating control subregions that are either infeasible or that provably cannot contain any global optima. Conditions are given under which the image of the control parameterization error in the state space contracts exponentially as the parameterization order is increased, thereby making the lifting operation efficient. A computational technique based on ellipsoidal calculus is also developed that satisfies these conditions. The practical applicability of branch-and-lift is illustrated in a numerical example. © 2013 Springer Science+Business Media New York