EPISYNC study : Predictors of patient-ventilator asynchrony in a prospective cohort of patients under invasive mechanical ventilation - Study protocol

Funding: The Episync study is supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), grant number 2015/19122-4.Introduction: Patient-ventilator asynchrony is common during the entire period of invasive mechanical ventilation (MV) and is associated with worse clinical outcomes. However, risk factors associated with asynchrony are not completely understood. The main objectives of this study are to estimate the incidence of asynchrony during invasive MV and its association with respiratory mechanics and other baseline patient characteristics. Methods and analysis: We designed a prospective cohort study of patients admitted to the intensive care unit (ICU) of a university hospital. Inclusion criteria are adult patients under invasive MV initiated for less than 72 hours, and with expectation of remaining under MV for more than 24 hours. Exclusion criteria are high flow bronchopleural fistula, inability to measure respiratory mechanics and previous tracheostomy. Baseline assessment includes clinical characteristics of patients at ICU admission, including severity of illness, reason for initiation of MV, and measurement of static mechanics of the respiratory system. We will capture ventilator waveforms during the entire MV period that will be analysed with dedicated software (Better Care, Barcelona, Spain), which automatically identifies several types of asynchrony and calculates the asynchrony index (AI). We will use a linear regression model to identify risk factors associated with AI. To assess the relationship between survival and AI we will use Kaplan-Meier curves, log rank tests and Cox regression. The calculated sample size is 103 patients. The statistical analysis will be performed by the software R Programming (www.R-project.org) and will be considered statistically significant if the p value is less than 0.05. Ethics and dissemination: The study was approved by the Ethics Committee of Instituto do Coração, School of Medicine, University of São Paulo, Brazil, and informed consent was waived due to the observational nature of the study. We aim to disseminate the study findings through peer-reviewed publications and national and international conference presentations. Trial registration number: NCT02687802; Pre-results

Energy and Momentum densities of cosmological models, with equation of state ρ=μ\rho=\mu, in general relativity and teleparallel gravity

We calculated the energy and momentum densities of stiff fluid solutions, using Einstein, Bergmann-Thomson and Landau-Lifshitz energy-momentum complexes, in both general relativity and teleparallel gravity. In our analysis we get different results comparing the aforementioned complexes with each other when calculated in the same gravitational theory, either this is in general relativity and teleparallel gravity. However, interestingly enough, each complex's value is the same either in general relativity or teleparallel gravity. Our results sustain that (i) general relativity or teleparallel gravity are equivalent theories (ii) different energy-momentum complexes do not provide the same energy and momentum densities neither in general relativity nor in teleparallel gravity. In the context of the theory of teleparallel gravity, the vector and axial-vector parts of the torsion are obtained. We show that the axial-vector torsion vanishes for the space-time under study.Comment: 15 pages, no figures, Minor typos corrected; version to appear in International Journal of Theoretical Physic

Gravitational Energy of Kerr and Kerr Anti-de Sitter Space-times in the Teleparallel Geometry

In the context of the Hamiltonian formulation of the teleparallel equivalent of general relativity we compute the gravitational energy of Kerr and Kerr Anti-de Sitter (Kerr-AdS) space-times. The present calculation is carried out by means of an expression for the energy of the gravitational field that naturally arises from the integral form of the constraint equations of the formalism. In each case, the energy is exactly computed for finite and arbitrary spacelike two-spheres, without any restriction on the metric parameters. In particular, we evaluate the energy at the outer event horizon of the black holes.Comment: 11 pages, 1 figure, to appear in JHEP11(2003)00

Feigin-Frenkel center in types B, C and D

For each simple Lie algebra g consider the corresponding affine vertex algebra V_{crit}(g) at the critical level. The center of this vertex algebra is a commutative associative algebra whose structure was described by a remarkable theorem of Feigin and Frenkel about two decades ago. However, only recently simple formulas for the generators of the center were found for the Lie algebras of type A following Talalaev's discovery of explicit higher Gaudin Hamiltonians. We give explicit formulas for generators of the centers of the affine vertex algebras V_{crit}(g) associated with the simple Lie algebras g of types B, C and D. The construction relies on the Schur-Weyl duality involving the Brauer algebra, and the generators are expressed as weighted traces over tensor spaces and, equivalently, as traces over the spaces of singular vectors for the action of the Lie algebra sl_2 in the context of Howe duality. This leads to explicit constructions of commutative subalgebras of the universal enveloping algebras U(g[t]) and U(g), and to higher order Hamiltonians in the Gaudin model associated with each Lie algebra g. We also introduce analogues of the Bethe subalgebras of the Yangians Y(g) and show that their graded images coincide with the respective commutative subalgebras of U(g[t]).Comment: 29 pages, constructions of Pfaffian-type Sugawara operators and commutative subalgebras in universal enveloping algebras are adde

Attractor Solutions in f(T) Cosmology

In this paper, we explore the cosmological implications of interacting dark energy model in a torsion based gravity namely $f(T)$. Assuming dark energy interacts with dark matter and radiation components, we examine the stability of this model by choosing different forms of interaction terms. We consider three different forms of dark energy: cosmological constant, quintessence and phantom energy. We then obtain several attractor solutions for each dark energy model interacting with other components. This model successfully explains the coincidence problem via the interacting dark energy scenario.Comment: 10 pages, 23 figures, version accepted for publication in European Physical Journal C (2012

A Generalization of Quantum Stein's Lemma

We present a generalization of quantum Stein's Lemma to the situation in which the alternative hypothesis is formed by a family of states, which can moreover be non-i.i.d.. We consider sets of states which satisfy a few natural properties, the most important being the closedness under permutations of the copies. We then determine the error rate function in a very similar fashion to quantum Stein's Lemma, in terms of the quantum relative entropy. Our result has two applications to entanglement theory. First it gives an operational meaning to an entanglement measure known as regularized relative entropy of entanglement. Second, it shows that this measure is faithful, being strictly positive on every entangled state. This implies, in particular, that whenever a multipartite state can be asymptotically converted into another entangled state by local operations and classical communication, the rate of conversion must be non-zero. Therefore, the operational definition of multipartite entanglement is equivalent to its mathematical definition.Comment: 30 pages. (see posting by M. Piani arXiv:0904.2705 for a different proof of the strict positiveness of the regularized relative entropy of entanglement on every entangled state). published version

Static Anisotropic Solutions in f(T) Theory

In a previously work, we undertook a static and anisotropic content in $f(T)$ theory and obtained new spherically symmetric solutions considering a constant torsion and some particular conditions for the pressure. In this paper, still in the framework of $f(T)$ theory, new spherically symmetric solutions are obtained, first considering the general case of an isotropic fluid and later the anisotropic content case in which the generalized conditions for the matter content are considered such that the energy density, the radial and tangential pressures depend on the algebraic $f(T)$ and its derivative $f_{T}(T)$. Moreover, we obtain the algebraic function $f(T)$ through the reconstruction method for two cases and also study a polytropic model for the stellar structure.Comment: 23 pages, Published in Euro. Phys. J.

Annihilation vs. Decay: Constraining dark matter properties from a gamma-ray detection

Most proposed dark matter candidates are stable and are produced thermally in the early Universe. However, there is also the possibility of unstable (but long-lived) dark matter, produced thermally or otherwise. We propose a strategy to distinguish between dark matter annihilation and/or decay in the case that a clear signal is detected in gamma-ray observations of Milky Way dwarf spheroidal galaxies with gamma-ray experiments. The sole measurement of the energy spectrum of an indirect signal would render the discrimination between these cases impossible. We show that by examining the dependence of the intensity and energy spectrum on the angular distribution of the emission, the origin could be identified as decay, annihilation, or both. In addition, once the type of signal is established, we show how these measurements could help to extract information about the dark matter properties, including mass, annihilation cross section, lifetime, dominant annihilation and decay channels, and the presence of substructure. Although an application of the approach presented here would likely be feasible with current experiments only for very optimistic dark matter scenarios, the improved sensitivity of upcoming experiments could enable this technique to be used to study a wider range of dark matter models.Comment: 29 pp, 8 figs; replaced to match published version (minor changes and some new references

Massive stars as thermonuclear reactors and their explosions following core collapse

Nuclear reactions transform atomic nuclei inside stars. This is the process of stellar nucleosynthesis. The basic concepts of determining nuclear reaction rates inside stars are reviewed. How stars manage to burn their fuel so slowly most of the time are also considered. Stellar thermonuclear reactions involving protons in hydrostatic burning are discussed first. Then I discuss triple alpha reactions in the helium burning stage. Carbon and oxygen survive in red giant stars because of the nuclear structure of oxygen and neon. Further nuclear burning of carbon, neon, oxygen and silicon in quiescent conditions are discussed next. In the subsequent core-collapse phase, neutronization due to electron capture from the top of the Fermi sea in a degenerate core takes place. The expected signal of neutrinos from a nearby supernova is calculated. The supernova often explodes inside a dense circumstellar medium, which is established due to the progenitor star losing its outermost envelope in a stellar wind or mass transfer in a binary system. The nature of the circumstellar medium and the ejecta of the supernova and their dynamics are revealed by observations in the optical, IR, radio, and X-ray bands, and I discuss some of these observations and their interpretations.Comment: To be published in " Principles and Perspectives in Cosmochemistry" Lecture Notes on Kodai School on Synthesis of Elements in Stars; ed. by Aruna Goswami & Eswar Reddy, Springer Verlag, 2009. Contains 21 figure