A puzzle about rates of change

Most of our best scientific descriptions of the world employ rates of change of some continuous quantity with respect to some other continuous quantity. For instance, in classical physics we arrive at a particle’s velocity by taking the time-derivative of its position, and we arrive at a particle’s acceleration by taking the time-derivative of its velocity. Because rates of change are defined in terms of other continuous quantities, most think that facts about some rate of change obtain in virtue of facts about those other continuous quantities. For example, on this view facts about a particle’s velocity at a time obtain in virtue of facts about how that particle’s position is changing at that time. In this paper we raise a puzzle for this orthodox reductionist account of rate of change quantities and evaluate some possible replies. We don’t decisively come down in favour of one reply over the others, though we say some things to support taking our puzzle to cast doubt on the standard view that spacetime is continuous

A puzzle about rates of change

Most of our best scientific descriptions of the world employ rates of change of some continuous quantity with respect to some other continuous quantity. For instance, in classical physics we arrive at a particle’s velocity by taking the time-derivative of its position, and we arrive at a particle’s acceleration by taking the time-derivative of its velocity. Because rates of change are defined in terms of other continuous quantities, most think that facts about some rate of change obtain in virtue of facts about those other continuous quantities. For example, on this view facts about a particle’s velocity at a time obtain in virtue of facts about how that particle’s position is changing at that time. In this paper we raise a puzzle for this orthodox reductionist account of rate of change quantities and evaluate some possible replies. We don’t decisively come down in favour of one reply over the others, though we say some things to support taking our puzzle to cast doubt on the standard view that spacetime is continuous

Yielding dynamics of a Herschel-Bulkley fluid: a critical-like fluidization behaviour

The shear-induced fluidization of a carbopol microgel is investigated during long start-up experiments using combined rheology and velocimetry in Couette cells of varying gap widths and boundary conditions. As already described in [Divoux et al., {\it Phys. Rev. Lett.}, 2010, {\bf 104}, 208301], we show that the fluidization process of this simple yield stress fluid involves a transient shear-banding regime whose duration $\tau_f$ decreases as a power law of the applied shear rate \gp. Here we go one step further by an exhaustive investigation of the influence of the shearing geometry through the gap width $e$ and the boundary conditions. While slip conditions at the walls seem to have a negligible influence on the fluidization time $\tau_f$, different fluidization processes are observed depending on \gp and $e$: the shear band remains almost stationary for several hours at low shear rates or small gap widths before strong fluctuations lead to a homogeneous flow, whereas at larger values of \gp or $e$, the transient shear band is seen to invade the whole gap in a much smoother way. Still, the power-law behaviour appears as very robust and hints to critical-like dynamics. To further discuss these results, we propose (i) a qualitative scenario to explain the induction-like period that precedes full fluidization and (ii) an analogy with critical phenomena that naturally leads to the observed power laws if one assumes that the yield point is the critical point of an underlying out-of-equilibrium phase transition.Comment: 16 pages, 14+2 figures, published in Soft Matte

Clinical Utility of Echocardiography in Former Preterm Infants with Bronchopulmonary Dysplasia.

BackgroundThe clinical utility of echocardiography for the diagnosis of pulmonary vascular disease (PVD) in former preterm infants with bronchopulmonary dysplasia (BPD) is not established. Elevated pulmonary vascular resistance (PVR) rather than pulmonary artery pressure (PAP) is the hallmark of PVD. We evaluated the utility of echocardiography in infants with BPD in diagnosing pulmonary hypertension and PVD (PVR >3 Wood units × m2) assessed by cardiac catheterization.MethodsA retrospective single center study of 29 infants born ≤29 weeks of gestational age with BPD who underwent cardiac catheterization and echocardiography was performed. PVD was considered present by echocardiography if the tricuspid valve regurgitation jet peak velocity was >2.9 m/sec, post-tricuspid valve shunt systolic flow velocity estimated a right ventricular systolic pressure >35 mm Hg, or systolic septal flattening was present. The utility (accuracy, sensitivity, and positive predictive value [PPV]) of echocardiography in the diagnosis of PVD was tested. Subgroup analysis in patients without post-tricuspid valve shunts was performed. Echocardiographic estimations of right ventricular pressure, dimensions, function, and pulmonary flow measurements were evaluated for correlation with PVR.ResultsThe duration between echocardiography and cardiac catheterization was a median of 1 day (interquartile range, 1-4 days). Accuracy, sensitivity, and PPV of echocardiography in diagnosing PVD were 72%, 90.5%, and 76%, respectively. Accuracy, sensitivity, and PPV increased to 93%, 91.7%, and 100%, respectively, when infants with post-tricuspid valve shunts were excluded. Echocardiography had poor accuracy in estimating the degree of PAP elevation by cardiac catheterization. In infants without post-tricuspid valve shunts, there was moderate to good correlation between indexed PVR and right ventricular myocardial performance index (rho = 0.89, P = .005), systolic to diastolic time index (0.84, P < .001), right to left ventricular diameter ratio at end systole (0.66, P = .003), and pulmonary artery acceleration time (0.48, P = .05).ConclusionsEchocardiography performs well in screening for PVD in infants with BPD and may be diagnostic in the absence of a post-tricuspid valve shunt. However, cardiac catheterization is needed to assess the degree of PAP elevation and PVR. The diagnostic utility of echocardiographic measurements that correlate with PVR should be evaluated prospectively in this patient population

Lawful Persistence

The central aim of this paper is to use a particular view about how the laws of nature govern the evolution of our universe in order to develop and evaluate the two main competing options in the metaphysics of persistence, namely endurantism and perdurantism. We begin by motivating the view that our laws of nature dictate not only qualitative facts about the future, but also which objects will instantiate which qualitative properties. We then show that both traditional doctrines in the metaphysics of persistence must take on surprising further commitments in order to vindicate our universe being law-governed in this strong sense. For example, we argue that endurantists should adopt a particular version of monism, and that perdurantists should adopt a qualitativist doctrine that dispenses with all individuals at the fundamental level

Nonlinearity of the left ventricular end-systolic wall stress-velocity of fiber shortening relation in young pigs: A potential pitfall in its use as a single-beat index of contractility

AbstractObjectives. We sought to evaluate in the young heart the primary assumptions on which the current use of the mean “velocity of fiber shortening corrected for heart rate” as a noninvasive index of contractility are based.Background. End-systolic wall stress-velocity of fiber shortening relation has been applied as a single-beat, load-independent index of contractility in children. This use is based on poorly validated assumptions of linearity, parallel shifts with changing contractile state and inotropic sensitivity of the end-systolic wall stress-velocity of fiber shortening relation.Methods. In eight anesthetized young piglets, 5F micromanometric catheters were placed in the ascending aorta and balloon occlusion catheters in the descending aorta. End-systolic wall stress and velocity of fiber shortening were calculated from aortic pressure and M-mode echocardiography under six conditions: in three contractile states 1) baseline, 2) increased contractility during dobutamine infusion (10 μg/kg per min), and 3) decreased contractility after propranolol injection (1 mg/kg), each at two afterload states (normal and increased load by partial aortic occlusion).Results. Dobutamine increased and propranolol decreased afterloadd-matched velocity of fiber shortening corrected for heart rate significantly to 140% aid 77% of baseline, respectively. However, the slope of end-systolic wall stress-velocity of fiber shortening was (251% of baseline) during dobutamine infusion, which also significantly decreased wall stress, and was much less (27% of baseline) after propranolol injection, which increased wall stress.Conclusions. The velocity of fiber shortening corrected for heart rate did change predictably with changes in contractility and as such can be ued noninvasively in the temporal evaluation of individual patients undergoing therapeutic interventions or to define the natural history of a disease process. However, the relation on which it is based is not defined by parallel straight lines across contractile states, so that abnormal single measurements may reflect only the nonlinearity of the relation rather than in contractility. Thus, we recommend that the end-systolic wall stress-velocity of fiber shortening relation should not be used as a single-beat index of contractility

Development and Utility of Quality Metrics for Ambulatory Pediatric Cardiology in Kawasaki Disease.

The Adult Congenital and Pediatric Cardiology (ACPC) Section of the American College of Cardiology sought to develop quality indicators/metrics for ambulatory pediatric cardiology practice. The objective of this study was to report the creation of metrics for patients with Kawasaki disease. Over a period of 5 months, 12 pediatric cardiologists developed 24 quality metrics based on the most relevant statements, guidelines, and research studies pertaining to Kawasaki disease. Of the 24 metrics, the 8 metrics deemed the most important, feasible, and valid were sent on to the ACPC for consideration. Seven of the 8 metrics were approved using the RAND method by an expert panel. All 7 metrics approved by the ACPC council were accepted by ACPC membership after an "open comments" process. They have been disseminated to the pediatric cardiology community for implementation by the ACPC Quality Network

Results of 102 cases of complete repair of congenital heart defects in patients weighing 700 to 2500 grams

AbstractBackground: Published data suggest that low birth weight is a risk factor for poor outcome in corrective surgery for many cardiac defects. Congenital heart defects in low birth weight infants are typically managed with supportive therapy or palliative operations, with definitive repair delayed. The morbidity associated with such approaches is high. Methods: Since 1990 complete repair of congenital heart defects (other than patent ductus arteriosus) has been performed in 102 infants no larger than 2500 g (median 2100 g, range 700-2500 g), including 16 no larger than 1500 g. Defects included ventricular septal defect (n = 22), tetralogy of Fallot complexes (n = 20), transposition complexes (n = 13), aortic coarctation (n = 12), interrupted arch (n = 10), truncus arteriosus (n = 8), atrioventricular septal defect (n = 6), total anomalous pulmonary venous return (n = 5), and other (n = 6). Results: Preoperative morbidity was more common among patients referred late for surgical correction. There were 10 early deaths (10%) attributable to cardiac failure (n = 4), arrhythmia (n = 1), multiorgan failure (n = 1), sepsis (n = 1), idiopathic coronary artery intimal necrosis (n = 1), foot gangrene (n = 1), and pulmonary hemorrhage (n = 1). No patient had postbypass intracerebral hemorrhage. At follow-up (median 36 months) there were 8 late deaths, and 8 patients underwent 10 reinterventions. There was no evidence of neurologic sequelae attributable to the operation. Conclusions: In general, delaying repair of congenital heart defects in low birth weight infants does not confer a benefit and is associated with higher preoperative morbidity. Complete repair of both simple and complex lesions can be achieved in such cases with good results. Growth after repair approximates the normal curve for low birth weight infants without heart disease. It is recommended that such infants, especially when they have symptoms, undergo early surgical repair rather than prolonged medical management or other forms of palliation. (J Thorac Cardiovasc Surg 1999;117:324-31