Hystérie compliquée d’extase : temps et biens de consommation dans la maladie d’une paysanne savoyarde dans les années 1820

Fondé sur un manuscrit encore inédit des années 1820, co-écrit par deux médecins, Antoine Despine et Alexandre Bertrand, cet article étudie l’histoire du cas d’une jeune paysanne savoyarde inconnue, Nanette Leroux, diagnostiquée comme souffrant « d’hystérie compliquée d’extase ». Vivant près des thermes d’Aix-les-Bains, Nanette devint une des patientes du médecin Despine, – directeur de cet établissement – qui la soigna par charité et la traita par hydrothérapie et magnétisme animal. En état somnambulique à la fois naturel et provoqué, Nanette représentait de manière répétée l’événement qui avait provoqué sa maladie : « un attentat à la pudeur » perpétré par un garde champêtre. Tentant de situer la maladie de Nanette aussi précisément que possible dans son contexte historique, cet article en souligne deux aspects : l’insistance sur la différence entre le temps biologique (représenté par les périodes menstruelles de Nanette) et le temps social (représenté par la montre qu’elle demande et dont elle croit qu’elle pourra la soigner) ; et la fascination de Nanette pour les produits de consommation disponibles sur le marché naissant de cette région encore en marge.Based on an unpublished manuscript of the 1820s coauthored by two physicians, Antoine Despine and Alexandre Bertrand, this article examines the case history of an obscure Savoyard peasant girl, Nanette Leroux, diagnosed as suffering from “hysteria complicated by ecstasy”. Living near the spa at Aix-les-Bains, Nanette became the charity patient of its medical director, Despine, who treated her with hydrotherapy and animal magnetism. In somnambulic states both natural and provoked, Nanette repeatedly enacted the event that precipitated her illness – an “offense against her modesty” by the local policeman. Attempting to situate Nanette’s illness as firmly as possible in its historical context, the article highlights two aspects of it : its emphasis on the difference between biological time (represented by Nanette’s menstrual periods) and social time (represented by the watch that she requests and that she believes will cure her) ; and Nanette’s fascination with the commodities available on the nascent marketplace of this peripheral region

Renormalized Lindblad Driving: A Numerically-Exact Nonequilibrium Quantum Impurity Solver

The accurate characterization of nonequilibrium strongly-correlated quantum systems has been a longstanding challenge in many-body physics. Notable among them are quantum impurity models, which appear in various nanoelectronic and quantum computing applications. Despite their seeming simplicity, they feature correlated phenomena, including emergent energy scales and non-Fermi-liquid physics, requiring renormalization group treatment. This has typically been at odds with the description of their nonequilibrium steady-state under finite bias, which exposes their nature as open quantum systems. We present a novel numerically-exact method for obtaining the nonequilibrium state of a general quantum impurity coupled to metallic leads at arbitrary voltage or temperature bias, which we call "RL-NESS" (Renormalized Lindblad-driven NonEquilibrium Steady-State). It is based on coherently coupling the impurity to discretized leads which are treated exactly. These leads are furthermore weakly coupled to reservoirs described by Lindblad dynamics which impose voltage or temperature bias. Going beyond previous attempts, we exploit a hybrid discretization scheme for the leads together with Wilson's numerical renormalization group, in order to probe exponentially small energy scales. The steady-state is then found by evolving a matrix-product density operator via real-time Lindblad dynamics, employing a dissipative generalization of the time-dependent density matrix renormalization group. In the long-time limit, this procedure converges to the steady-state at finite bond dimension due to the introduced dissipation, which bounds the growth of entanglement. We test the method against the exact solution of the noninteracting resonant level model. We demonstrate its power using an interacting two-level model, for which it correctly reproduces the known limits, and gives the full $I$-$V$ curve between them

An orbit-preserving discretization of the classical Kepler problem

We present a remarkable discretization of the classical Kepler problem which preserves its trajectories and all integrals of motion. The points of any discrete orbit belong to an appropriate continuous trajectory.Comment: 7 page

Comparison of Uncultured Marrow Mononuclear Cells and Culture-Expanded Mesenchymal Stem Cells in 3D Collagen-Chitosan Microbeads for Orthopedic Tissue Engineering

Stem cell-based therapies have shown promise in enhancing repair of bone and cartilage. Marrow-derived mesenchymal stem cells (MSC) are typically expanded in vitro to increase cell number, but this process is lengthy, costly, and there is a risk of contamination and altered cellular properties. Potential advantages of using fresh uncultured bone marrow mononuclear cells (BMMC) include heterotypic cell and paracrine interactions between MSC and other marrow-derived cells including hematopoietic, endothelial, and other progenitor cells. In the present study, we compared the osteogenic and chondrogenic potential of freshly isolated BMMC to that of cultured-expanded MSC, when encapsulated in three-dimensional (3D) collagen-chitosan microbeads. The effect of low and high oxygen tension on cell function and differentiation into orthopedic lineages was also examined. Freshly isolated rat BMMC (25?106 cells/mL, containing an estimated 5?104 MSC/mL) or purified and culture-expanded rat bone marrow-derived MSC (2?105 cells/mL) were added to a 65?35?wt% collagen-chitosan hydrogel mixture and fabricated into 3D microbeads by emulsification and thermal gelation. Microbeads were cultured in control MSC growth media in either 20% O2 (normoxia) or 5% O2 (hypoxia) for an initial 3 days, and then in control, osteogenic, or chondrogenic media for an additional 21 days. Microbead preparations were evaluated for viability, total DNA content, calcium deposition, and osteocalcin and sulfated glycosaminoglycan expression, and they were examined histologically. Hypoxia enhanced initial progenitor cell survival in fresh BMMC-microbeads, but it did not enhance osteogenic potential. Fresh uncultured BMMC-microbeads showed a similar degree of osteogenesis as culture-expanded MSC-microbeads, even though they initially contained only 1/10th the number of MSC. Chondrogenic differentiation was not strongly supported in any of the microbead formulations. This study demonstrates the microbead-based approach to culturing and delivering cells for tissue regeneration, and suggests that fresh BMMC may be an alternative to using culture-expanded MSC for bone tissue engineering.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140225/1/ten.tea.2013.0151.pd

A generalized quantum microcanonical ensemble

We discuss a generalized quantum microcanonical ensemble. It describes isolated systems that are not necessarily in an eigenstate of the Hamilton operator. Statistical averages are obtained by a combination of a time average and a maximum entropy argument to resolve the lack of knowledge about initial conditions. As a result, statistical averages of linear observables coincide with values obtained in the canonical ensemble. Non-canonical averages can be obtained by taking into account conserved quantities which are non-linear functions of the microstate.Comment: improved version, new titl

Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS) to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR), and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The process and experiences described provide a model for development of other DSSs that translate written guidelines into actionable, real-time clinical recommendations.http://deepblue.lib.umich.edu/bitstream/2027.42/78267/1/1748-5908-5-26.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/2/1748-5908-5-26.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/3/1748-5908-5-26-S3.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/4/1748-5908-5-26-S2.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/5/1748-5908-5-26-S1.TIFFPeer Reviewe