From Clock Synchronization to Dark Matter as a Relativistic Inertial Effect

Lecture at BOSS2011 on relativistic metrology, on clock synchronization, relativistic dynamics and non-inertial frames in Minkowski spacetime, on relativistic atomic physics, on ADM canonical tetrad gravity in asymptotically Minkowskian spacetimes, on the York canonical basis identifying the inertial (gauge) and tidal degrees of freedom of the gravitational field, on the Post-Minkowskian linearization in 3-orthogonal gauges, on the Post-Newtonian limit of matter Hamilton equations, on the possibility to interpret dark matter as a relativistic inertial effect connected with relativistic metrology (i.e. clock synchronization) in Einstein GR.Comment: 90 pages. Lecture at BOSS201

Effect of lung ultrasound-guided fluid deresuscitation on duration of ventilation in intensive care unit patients (CONFIDENCE): protocol for a multicentre randomised controlled trial.

BACKGROUND: Fluid therapy is a common intervention in critically ill patients. It is increasingly recognised that deresuscitation is an essential part of fluid therapy and delayed deresuscitation is associated with longer invasive ventilation and length of intensive care unit (ICU) stay. However, optimal timing and rate of deresuscitation remain unclear. Lung ultrasound (LUS) may be used to identify fluid overload. We hypothesise that daily LUS-guided deresuscitation is superior to deresuscitation without LUS in critically ill patients expected to undergo invasive ventilation for more than 24 h in terms of ventilator free-days and being alive at day 28. METHODS: The "effect of lung ultrasound-guided fluid deresuscitation on duration of ventilation in intensive care unit patients" (CONFIDENCE) is a national, multicentre, open-label, randomised controlled trial (RCT) in adult critically ill patients that are expected to be invasively ventilated for at least 24 h. Patients with conditions that preclude a negative fluid balance or LUS examination are excluded. CONFIDENCE will operate in 10 ICUs in the Netherlands and enrol 1000 patients. After hemodynamic stabilisation, patients assigned to the intervention will receive daily LUS with fluid balance recommendations. Subjects in the control arm are deresuscitated at the physician's discretion without the use of LUS. The primary endpoint is the number of ventilator-free days and being alive at day 28. Secondary endpoints include the duration of invasive ventilation; 28-day mortality; 90-day mortality; ICU, in hospital and total length of stay; cumulative fluid balance on days 1-7 after randomisation and on days 1-7 after start of LUS examination; mean serum lactate on days 1-7; the incidence of reintubations, chest drain placement, atrial fibrillation, kidney injury (KDIGO stadium ≥ 2) and hypernatremia; the use of invasive hemodynamic monitoring, and chest-X-ray; and quality of life at day 28. DISCUSSION: The CONFIDENCE trial is the first RCT comparing the effect of LUS-guided deresuscitation to routine care in invasively ventilated ICU patients. If proven effective, LUS-guided deresuscitation could improve outcomes in some of the most vulnerable and resource-intensive patients in a manner that is non-invasive, easy to perform, and well-implementable. TRIAL REGISTRATION: ClinicalTrials.gov NCT05188092. Registered since January 12, 2022

Communist Revolution and Peasant Mobilisation in the Hinterland of North China: The Early Years

This chapter examines the depiction by populism in the domain of 'popular culture' of what purports to be its non-capitalist/non-socialist alternative: in short, the socio-economic and political structure of its 'imaginary' as this involves a symptomatic opposition between the utopic and dystopic. Using the pseudonym of Ivan Kremnev, the Russian neo-populist theoretician A. V. Chayanov wrote the utopian fiction The Journey of My Brother Alexei to the Land of Peasant Utopia. Accordingly, the utopic vision of Chayanov entails traversing time but not space; the protagonists in his narrative are projected forward into a future within the same demarcated space. Much of the populist discourse which structures the agrarian myth is present in the films of Frank Capra, who directed not only Lost Horizon but also Mr Deeds Goes to Town (1936), Mr Smith Goes to Washington (1939) and t's a Wonderful Life (1946)