Anomalous Thermostat and Intraband Discrete Breathers

We investigate the dynamics of a macroscopic system which consists of an anharmonic subsystem embedded in an arbitrary harmonic lattice, including quenched disorder. Elimination of the harmonic degrees of freedom leads to a nonlinear Langevin equation for the anharmonic coordinates. For zero temperature, we prove that the support of the Fourier transform of the memory kernel and of the time averaged velocity-velocity correlations functions of the anharmonic system can not overlap. As a consequence, the asymptotic solutions can be constant, periodic,quasiperiodic or almost periodic, and possibly weakly chaotic. For a sinusoidal trajectory with frequency $\Omega$ we find that the energy $E_T$ transferred to the harmonic system up to time $T$ is proportional to $T^{\alpha}$. If $\Omega$ equals one of the phonon frequencies $\omega_\nu$, it is $\alpha=2$. We prove that there is a full measure set such that for $\Omega$ in this set it is $\alpha=0$, i.e. there is no energy dissipation. Under certain conditions there exists a zero measure set such that for $\Omega \in this set the dissipation rate is nonzero and may be subdissipative$(0 \leq \alpha < 1)$or superdissipative$(1 <\alpha \leq 2)$. Consequently, the harmonic bath does act as an anomalous thermostat. Intraband discrete breathers are such solutions which do not relax. We prove for arbitrary anharmonicity and small but finite coupling that intraband discrete breathers with frequency$\Omega$exist for all$\Omega$in a Cantor set$\mathcal{C}(k)$of finite Lebesgue measure. This is achieved by estimating the contribution of small denominators appearing in the memory kernel. For$\Omega\in\mathcal{C}(k)$the small denominators do not lead to divergencies such that this kernel is a smooth and bounded function in$t$.Comment: Physica D in prin

Manual instructivo para la atención integral en Ginecología Infantojuvenil

Background: the Infant-youngsters Gynecology is a very sensitive branch of Gynecology, for the ages of its patients and the topics that it studies. Objective: to elaborate an instructive manual on Infant-youngsters Gynecology for teaching, for general practitioners and Gynecology and Obstetrics specialists who work in the Primary Health cares (PHC). Method: it was carried out a cross-sectional descriptive study in "Mariana Grajales" Gynecological-obstetric University Hospital, from January to December 2014. The sample comprised 12 experienced professors in Infant-youngsters Gynecology. Theoretical methods were used: analytic-synthetic and inductive-deductive for the theoretical background, the elaboration of the research report and to explain concepts related with the topic; empiric ones: documental analysis of the study program and the post-graduate courses to value the updating level in its contents, and the survey to the professors to determine the content cores that should be approached in the instructive material. Results: it is evidenced the necessity of updating the contents related with the management and performance protocols in connection with Infant-youngsters affections, that´s why an instructive manual was elaborated with the topics that the consulted professors suggested: menstrual disorders, post-menarche, infections and congenital malformations. Conclusions: the instructive manual for the comprehensive attention in Infant-youngsters Gynecology was evaluated as pertinent, with quality and practical usefulness by specialists' criteria, because it contributes to perfect the preparation of the doctors involved in the excellence attention that demands the referred service. Fundamento: la Ginecología Infantojuvenil es una rama muy sensible de la Ginecología, por las edades de sus pacientes y los temas que estudia.Objetivo: elaborar un manual instructivo sobre Ginecología Infantojuvenil para la docencia dirigido a los médicos generales y los especialistas en Ginecología y Obstetricia que laboran en la Atención Primaria de Salud (APS).Método: se realizó un estudio descriptivo transversal en el Hospital Universitario Gineco-Obstétrico “Mariana Grajales”, de enero a diciembre de 2014. La muestra estuvo constituída por 12 docentes con experiencias en la Ginecología Infantojuvenil. Se utilizaron métodos teóricos: analítico-sintético e inductivo-deductivo para la fundamentación teórica, la elaboración del informe investigativo y explicar conceptos relacionados con el tema; empíricos: análisis documental del programa de estudio y los cursos de postgrado para valorar el grado de actualización en dichos contenidos, y la encuesta a docentes para determinar los núcleos de contenido que debían ser abordados en el material instructivo.Resultados: se evidencia la necesidad de actualizar los contenidos relacionados con el manejo y protocolos de actuación en relación con las afecciones infantojuveniles, por lo que se elaboró un manual instructivo con los temas demandados por los docentes consultados: trastornos menstruales posmenarquia, infecciones y malformaciones congénitas.Conclusiones: el “Manual instructivo para la atención integral en Ginecología Infantojuvenil” fue evaluado como pertinente, de calidad y utilidad práctica por criterio de especialistas, porque contribuye a perfeccionar la preparación de los médicos involucrados en la atención de excelencia que demanda la prestación del referido servicio.

HARMONI at ELT: overview of the capabilities and expected performance of the ELT's first light, adaptive optics assisted integral field spectrograph.

International audienc

Higher Fluid Balance Increases the Risk of Death from Sepsis: Results from a Large International Audit∗

Objectives: Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. Design: Observational cohort study. Setting: Seven hundred and thirty ICUs in 84 countries. Patients: All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission. Measurements and Main Results: ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (-90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (-951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock. Conclusions: In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death