Tracheostomy decannulation: marathons and finish lines

Critically ill patients with a tracheostomy who are recovering from respiratory failure eventually require evaluation for airway decannulation. Although expert recommendations guide decisions for managing decannulation, few if any investigative data exist to inform evidence-based care. Consequently, practice variation limits the effectiveness of weaning from tracheostomy. In an investigation reported in this issue of Critical Care, the authors surveyed experienced physicians and respiratory therapists to assess their opinions on managing airway decannulation and identified several clinical factors that they recommend for selecting patients for tracheostomy tube removal. The authors propose that these factors can assist with designing clinical trials of tracheostomy decannulation. Pending completion of such studies, this report underscores the problem of practice variation in managing tracheotomized patients after critical illness. An important implication of the study is that care providers should recognize our knowledge deficit and develop systematic protocols for improving patient care using quality improvement techniques. Such models exist in the literature for adult patients and for children with tracheostomies who are managed by expert teams with requisite knowledge and skills

Hamiltonian approach to QCD in Coulomb gauge - a survey of recent results

I report on recent results obtained within the Hamiltonian approach to QCD in Coulomb gauge. Furthermore this approach is compared to recent lattice data, which were obtained by an alternative gauge fixing method and which show an improved agreement with the continuum results. By relating the Gribov confinement scenario to the center vortex picture of confinement it is shown that the Coulomb string tension is tied to the spatial string tension. For the quark sector a vacuum wave functional is used which explicitly contains the coupling of the quarks to the transverse gluons and which results in variational equations which are free of ultraviolet divergences. The variational approach is extended to finite temperatures by compactifying a spatial dimension. The effective potential of the Polyakov loop is evaluated from the zero-temperature variational solution. For pure Yang--Mills theory, the deconfinement phase transition is found to be second order for SU(2) and first order for SU(3), in agreement with the lattice results. The corresponding critical temperatures are found to be $275 \, \mathrm{MeV}$ and $280 \, \mathrm{MeV}$, respectively. When quarks are included, the deconfinement transition turns into a cross-over. From the dual and chiral quark condensate one finds pseudo-critical temperatures of $198 \, \mathrm{MeV}$ and $170 \, \mathrm{MeV}$, respectively, for the deconfinement and chiral transition.Comment: Talk given by H. Reinhardt at "5th Winter Workshop on Non-Perturbative Quantum Field Theory", 22-24 March 2017, Sophia-Antipolis, France. arXiv admin note: text overlap with arXiv:1609.09370, arXiv:1510.03286, arXiv:1607.0814

Partial spin freezing in the quasi-two-dimensional La2(Cu,Li)O4

In conventional spin glasses, the magnetic interaction is not strongly anisotropic and the entire spin system freezes at low temperature. In La2(Cu,Li)O4, for which the in-plane exchange interaction dominates the interplane one, only a fraction of spins with antiferromagnetic correlations extending to neighboring planes become spin-glass. The remaining spins with only in-plane antiferromagnetic correlations remain spin-liquid at low temperature. Such a novel partial spin freezing out of a spin-liquid observed in this cold neutron scattering study is likely due to a delicate balance between disorder and quantum fluctuations in the quasi-two dimensional S=1/2 Heisenberg system.Comment: 4 pages, 4 figure

Chiral Correction to the Spin Fluctuation Feedback in two-dimensional p-wave Superconductors

We consider the stability of the superconducting phase for spin-triplet p-wave pairing in a quasi-two-dimensional system. We show that in the absence of spin-orbit coupling there is a chiral contribution to spin fluctuation feedback which is related to spin quantum Hall effect in a chiral superconducting phase. We show that this mechanism supports the stability of a chiral p-wave state.Comment: 8 pages. The final version is accepted for publication in Europhys Let