8 research outputs found

    Multidimensional continued fractions, dynamical renormalization and KAM theory

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    The disadvantage of `traditional' multidimensional continued fraction algorithms is that it is not known whether they provide simultaneous rational approximations for generic vectors. Following ideas of Dani, Lagarias and Kleinbock-Margulis we describe a simple algorithm based on the dynamics of flows on the homogeneous space SL(2,Z)\SL(2,R) (the space of lattices of covolume one) that indeed yields best possible approximations to any irrational vector. The algorithm is ideally suited for a number of dynamical applications that involve small divisor problems. We explicitely construct renormalization schemes for (a) the linearization of vector fields on tori of arbitrary dimension and (b) the construction of invariant tori for Hamiltonian systems.Comment: 51 page

    Pharmacokinetic and Pharmacodynamic Aspects of Peyote and Mescaline: Clinical and Forensic Repercussions

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    Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

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    Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement
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