379 research outputs found
Formation of a molecular Bose-Einstein condensate and an entangled atomic gas by Feshbach resonance
Processes of association in an atomic Bose-Einstein condensate, and
dissociation of the resulting molecular condensate, due to Feshbach resonance
in a time-dependent magnetic field, are analyzed incorporating non-mean-field
quantum corrections and inelastic collisions. Calculations for the Na atomic
condensate demonstrate that there exist optimal conditions under which about
80% of the atomic population can be converted to a relatively long-lived
molecular condensate (with lifetimes of 10 ms and more). Entangled atoms in
two-mode squeezed states (with noise reduction of about 30 dB) may also be
formed by molecular dissociation. A gas of atoms in squeezed or entangled
states can have applications in quantum computing, communications, and
measurements.Comment: LaTeX, 5 pages with 4 figures, uses REVTeX
Individualization of piperacillin dosing for critically ill patients: Dosing software to optimize antimicrobial therapy
Piperacillin-tazobactam is frequently used for empirical and targeted therapy of infections in critically ill patients. Considerable pharmacokinetic (PK) variability is observed in critically ill patients. By estimating an individual's PK, dosage optimization Bayesian estimation techniques can be used to calculate the appropriate piperacillin regimen to achieve desired drug exposure targets. The aim of this study was to establish a population PK model for piperacillin in critically ill patients and then analyze the performance of the model in the dose optimization software program BestDose. Linear, with estimated creatinine clearance and weight as covariates, Michaelis-Menten (MM) and parallel linear/MM structural models were fitted to the data from 146 critically ill patients with nosocomial infection. Piperacillin concentrations measured in the first dosing interval, from each of 8 additional individuals, combined with the population model were embedded into the dose optimization software. The impact of the number of observations was assessed. Precision was assessed by (i) the predicted piperacillin dosage and by (ii) linear regression of the observed-versus-predicted piperacillin concentrations from the second 24 h of treatment. We found that a linear clearance model with creatinine clearance and weight as covariates for drug clearance and volume of distribution, respectively, best described the observed data. When there were at least two observed piperacillin concentrations, the dose optimization software predicted a mean piperacillin dosage of 4.02 g in the 8 patients administered piperacillin doses of 4.00 g. Linear regression of the observed-versus-predicted piperacillin concentrations for 8 individuals after 24 h of piperacillin dosing demonstrated an r2 of > 0.89. In conclusion, for most critically ill patients, individualized piperacillin regimens delivering a target serum piperacillin concentration is achievable. Further validation of the dosage optimization software in a clinical trial is required. Copyrigh
Control of an atom laser using feedback
A generalised method of using feedback to control Bose-Einstein condensates
is introduced. The condensates are modelled by the Gross-Pitaevskii equation,
so only semiclassical fluctations can be suppressed, and back-action from the
measurement is ignored. We show that for any available control, a feedback
scheme can be found to reduce the energy while the appropriate moment is still
dynamic. We demonstrate these schemes by considering a condensate trapped in a
harmonic potential that can be modulated in strength and position. The
formalism of our feedback scheme also allows the inclusion of certain types of
non-linear controls. If the non-linear interaction between the atoms can be
controlled via a Feshbach resonance, we show that the feedback process can
operate with a much higher efficiency.Comment: 6 pages, 7 figure
Bose-Einstein condensate collapse: a comparison between theory and experiment
We solve the Gross-Pitaevskii equation numerically for the collapse induced
by a switch from positive to negative scattering lengths. We compare our
results with experiments performed at JILA with Bose-Einstein condensates of
Rb-85, in which the scattering length was controlled using a Feshbach
resonance. Building on previous theoretical work we identify quantitative
differences between the predictions of mean-field theory and the results of the
experiments. Besides the previously reported difference between the predicted
and observed critical atom number for collapse, we also find that the predicted
collapse times systematically exceed those observed experimentally. Quantum
field effects, such as fragmentation, that might account for these
discrepancies are discussed.Comment: 4 pages, 2 figure
Exploring the pharmacokinetics of phenoxymethylpenicillin (Penicillin-V) in adults: a healthy volunteer study
This healthy volunteer study aimed to explore Phenoxymethylpenicillin (Penicillin-V) pharmacokinetics (PK) to support the planning of large, dosing studies in adults. Volunteers were dosed with penicillin-V at steady state. Total and unbound penicillin-V serum concentration was determined and a base population PK model were fitted to the data
Validation of a 5-item Tool to Measure Patient Assessment of Clinician Compassion in the Emergency Department.
BACKGROUND: To test if the 5-item compassion measure (a tool previously validated in the outpatient setting to measure patient assessment of clinician compassion) is a valid and reliable tool to quantify a distinct construct (i.e. clinical compassion) among patients evaluated in the emergency department (ED).
METHODS: Cross-sectional study conducted in three academic emergency departments in the U.S. between November 2018 and April 2019. We enrolled adult patients who were evaluated in the EDs of the participating institutions and administered the 5-item compassion measure after completion of care in the ED. Validity testing was performed using confirmatory factor analysis. Cronbach\u27s alpha was used to test reliability. Convergent validity with patient assessment of overall satisfaction questions was tested using Spearman correlation coefficients and we tested if the 5-item compassion measure assessed a construct distinct from overall patient satisfaction using confirmatory factor analysis.
RESULTS: We analyzed 866 patient responses. Confirmatory factor analysis found all five items loaded well on a single construct and our model was found to have good fit. Reliability was excellent (Cronbach\u27s alpha = 0.93) among the entire cohort. These results remained consistent on sub-analyses stratified by individual institutions. The 5-item compassion measure had moderate correlation with overall patient satisfaction (r = 0.66) and patient recommendation of the ED to friends and family (r = 0.57), but reflected a patient experience domain (i.e. compassionate care) distinctly different from patient satisfaction.
CONCLUSIONS: The 5-item compassion measure is a valid and reliable tool to measure patient assessment of clinical compassion in the ED
Mode Selectivity and Stability of Continuously Pumped Atom Lasers
A semiclassical, multimode model of a continuously pumped atom laser is presented. For a spatially independent coupling process it is found that the system is unstable below a critical scattering length. As large atomic interactions will increase the phase diffusion of the lasing mode, it is desirable to obtain a stable atom laser with low nonlinearity. It is shown that spatially dependent pumping stabilizes the atom laser to a finite number of modes, and can induce single-mode operation
Stimulated Raman adiabatic passage from an atomic to a molecular Bose-Einstein condensate
The process of stimulated Raman adiabatic passage (STIRAP) provides a
possible route for the generation of a coherent molecular Bose-Einstein
condensate (BEC) from an atomic BEC. We analyze this process in a
three-dimensional mean-field theory, including atom-atom interactions and
non-resonant intermediate levels. We find that the process is feasible, but at
larger Rabi frequencies than anticipated from a crude single-mode lossless
analysis, due to two-photon dephasing caused by the atomic interactions. We
then identify optimal strategies in STIRAP allowing one to maintain high
conversion efficiencies with smaller Rabi frequencies and under experimentally
less demanding conditions.Comment: Final published versio
Partial pressure of arterial carbon dioxide after resuscitation from cardiac arrest and neurological outcome: A prospective multi-center protocol-directed cohort study
Aims
Partial pressure of arterial carbon dioxide (PaCO2) is a regulator of cerebral blood flow after brain injury. We sought to test the association between PaCO2 after resuscitation from cardiac arrest and neurological outcome.
Methods
A prospective protocol-directed cohort study across six hospitals. Inclusion criteria: age ≥ 18, non-traumatic cardiac arrest, mechanically ventilated after return of spontaneous circulation (ROSC), and receipt of targeted temperature management. Per protocol, PaCO2 was measured by arterial blood gas analyses at one and six hours after ROSC. We determined the mean PaCO2 over this initial six hours after ROSC. The primary outcome was good neurological function at hospital discharge, defined a priori as a modified Rankin Scale ≤ 3. Multivariable Poisson regression analysis was used to test the association between PaCO2 and neurological outcome.
Results
Of the 280 patients included, the median (interquartile range) PaCO2 was 44 (37-52) mmHg and 30% had good neurological function. We found mean PaCO2 had a quadratic (inverted “U” shaped) association with good neurological outcome, with a mean PaCO2 of 68 mmHg having the highest predictive probability of good neurological outcome, and worse neurological outcome at higher and lower PaCO2. Presence of metabolic acidosis attenuated the association between PaCO2 and good neurological outcome, with a PaCO2 of 51 mmHg having the highest predictive probability of good neurological outcome among patients with metabolic acidosis.
Conclusion
PaCO2 has a “U” shaped association with neurological outcome, with mild to moderate hypercapnia having the highest probability of good neurological outcome
Association Between Elevated Mean Arterial Blood Pressure and Neurologic Outcome After Resuscitation From Cardiac Arrest: Results From a Multicenter Prospective Cohort Study
Objective:
Laboratory studies suggest elevated blood pressure after resuscitation from cardiac arrest may be protective; however, clinical data are limited. We sought to test the hypothesis that elevated post-resuscitation mean arterial blood pressure (MAP) is associated with neurological outcome.
Design:
Pre-planned analysis of a prospective cohort study.
Setting:
Six academic hospitals in the United States.
Patients:
Adult, non-traumatic cardiac arrest patients treated with targeted temperature management after return of spontaneous circulation (ROSC).
Interventions:
MAP was measured non-invasively after ROSC and every hour during the initial six hours after ROSC.
Measures and Main Results:
We calculated the mean MAP and a priori dichotomized subjects into two groups: mean MAP 70–90 and > 90 mmHg. The primary outcome was good neurological function, defined as a modified Rankin Scale (mRS) ≤ 3. The mRS was prospectively determined at hospital discharge. Of the 269 patients included, 159 (59%) had a mean MAP > 90 mmHg. Good neurological function at hospital discharge occurred in 30% of patients in the entire cohort, and was significantly higher in patients with a mean MAP > 90 mmHg (42%) as compared to MAP 70–90 mmHg (15%) [absolute risk difference 27% (95% CI 17%−37%)]. In a multivariable Poisson regression model adjusting for potential confounders, mean MAP > 90 mmHg was associated with good neurological function, adjusted relative risk 2.46 (95% CI 2.09–2.88). Over ascending ranges of mean MAP, there was a dose-response increase in probability of good neurological outcome, with mean MAP > 110 mmHg having the strongest association, adjusted relative risk 2.97 (95% CI 1.86 – 4.76).
Conclusions:
Elevated blood pressure during the initial six hours after resuscitation from cardiac arrest was independently associated with good neurological function at hospital discharge. Further investigation is warranted to determine if targeting an elevated MAP would improve neurologic outcome after cardiac arrest
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