Preventive analgesia and novel strategies for the prevention of chronic post-surgical pain

Chronic post-surgical pain (CPSP) is a serious complication of major surgery that can impair a patient’s quality of life. The development of CPSP is a complex process which involves biologic, psychosocial, and environmental mechanisms that have yet to be fully understood. Currently perioperative pharmacologic interventions aim to suppress and prevent sensitization with the aim of reducing pain and analgesic requirement in acute as well as long-term pain . Despite the detrimental effects of CPSP on patients, the body of literature focused on treatment strategies to reduce CPSP remains limited and continues to be understudied. This article reviews the main pharmacologic candidates for the treatment of CPSP, discusses the future of preventive analgesia, and considers novel strategies to help treat acute postoperative pain and lessen the risk that it becomes chronic. In addition, this article highlights important areas of focus for clinical practice including: multimodal management of CPSP patients, psychological modifiers of the pain experience, and the development of a Transitional Pain Service specifically designed to manage patients at high risk of developing chronic post-surgical pain.HC is supported by a Merit Award (Department of Anaesthesia, University of Toronto) and the STAGE Training Program in Genetic Epidemiology (Canadian Institutes of Health Research, CIHR) and a grant by the Physicians Services Incorporated Foundation. JK is supported by a Canada Research Chair in Health Psychology. The authors of this manuscript have no conflicts of interest to declare

Metal-superconductor transition at zero temperature: A case of unusual scaling

An effective field theory is derived for the normal metal-to-superconductor quantum phase transition at T=0. The critical behavior is determined exactly for all dimensions d>2. Although the critical exponents \beta and \nu do not exist, the usual scaling relations, properly reinterpreted, still hold. A complete scaling description of the transition is given, and the physics underlying the unusual critical behavior is discussed. Quenched disorder leads to anomalously strong T_c-fluctuations which are shown to explain the experimentally observed broadening of the transition in low-T_c thin films.Comment: 4 pp., no figs, final version as publishe

Antiferromagnetic Heisenberg chains with bond alternation and quenched disorder

We consider S=1/2 antiferromagnetic Heisenberg chains with alternating bonds and quenched disorder, which represents a theoretical model of the compound CuCl_{2x}Br_{2(1-x)}(\gamma-{pic})_2. Using a numerical implementation of the strong disorder renormalization group method we study the low-energy properties of the system as a function of the concentration, x, and the type of correlations in the disorder. For perfect correlation of disorder the system is in the random dimer (Griffiths) phase having a concentration dependent dynamical exponent. For weak or vanishing disorder correlations the system is in the random singlet phase, in which the dynamical exponent is formally infinity. We discuss consequences of our results for the experimentally measured low-temperature susceptibility of CuCl_{2x}Br_{2(1-x)}(\gamma-{pic})_2

Explicit Renormalization Group for D=2 random bond Ising model with long-range correlated disorder

We investigate the explicit renormalization group for fermionic field theoretic representation of two-dimensional random bond Ising model with long-range correlated disorder. We show that a new fixed point appears by introducing a long-range correlated disorder. Such as the one has been observed in previous works for the bosonic ($\phi^4$) description. We have calculated the correlation length exponent and the anomalous scaling dimension of fermionic fields at this fixed point. Our results are in agreement with the extended Harris criterion derived by Weinrib and Halperin.Comment: 5 page

Site-diluted three dimensional Ising Model with long-range correlated disorder

We study two different versions of the site-diluted Ising model in three dimensions with long-range spatially correlated disorder by Monte Carlo means. We use finite-size scaling techniques to compute the critical exponents of these systems, taking into account the strong scaling-corrections. We find a $\nu$ value that is compatible with the analytical predictions.Comment: 19 pages, 1 postscript figur

Random quantum magnets with long-range correlated disorder: Enhancement of critical and Griffiths-McCoy singularities

We study the effect of spatial correlations in the quenched disorder on random quantum magnets at and near a quantum critical point. In the random transverse field Ising systems disorder correlations that decay algebraically with an exponent rho change the universality class of the transition for small enough rho and the off-critical Griffiths-McCoy singularities are enhanced. We present exact results for 1d utilizing a mapping to fractional Brownian motion and generalize the predictions for the critical exponents and the generalized dynamical exponent in the Griffiths phase to d>=2.Comment: 4 pages RevTeX, 1 eps-figure include

Method for Generating Long-Range Correlations for Large Systems

We propose a new method to generate a sequence of random numbers with long-range power-law correlations that overcomes known difficulties associated with large systems. The new method presents an improvement on the commonly-used methods. We apply the algorithm to generate enhanced diffusion, isotropic and anisotropic self-affine surfaces, and isotropic and anisotropic correlated percolation.Comment: 4 pages, REVTEX, figures available upon request from [email protected]

Disorder-induced critical behavior in driven diffusive systems

Using dynamic renormalization group we study the transport in driven diffusive systems in the presence of quenched random drift velocity with long-range correlations along the transport direction. In dimensions $d\mathopen< 4$ we find fixed points representing novel universality classes of disorder-dominated self-organized criticality, and a continuous phase transition at a critical variance of disorder. Numerical values of the scaling exponents characterizing the distributions of relaxation clusters are in good agreement with the exponents measured in natural river networks

Obligations in the Shade: The Application of Fiduciary Directors’ Duties to Shadow Directors

This paper argues that shadow directors, as defined in English law, ought to owe the full range of directors’ duties, both fiduciary and non-fiduciary, enacted in the Companies Act 2006 (CA 2006), ss 171-177, to the relevant company under their influence. Following the enactment of the recent Small Business, Enterprise and Employment Act (SBEEA) 2015, these general duties are likely to apply to shadow directors, although there is still a case to be made as to why shadow directors should owe fiduciary duties to the relevant company. It is argued here that such a relationship is fiduciary in nature, but the current approach deployed in the English courts, based upon the application of Finn’s originally formulated ‘undertaking’ test alone, is inadequate. Given these inadequacies, it is proposed that the Canadian ‘power and discretion’ test be deployed alongside the ‘undertaking’ test, in order to provide a far more comprehensive justification for the application of fiduciary obligations to shadow directors. This position is supported by establishing a theoretical basis for the ‘power and discretion’ test, via Paul Miller’s ‘fiduciary powers theory’, as well as considering the application of such a test to shadow directors