Can remifentanil use in obstetrics be improved by optimal patient-controlled analgesia bolus timing?

Background The safety of patient-controlled i.v. analgesia (PCA) with remifentanil for obstetrical analgesia remains a matter of concern. The efficacy of remifentanil bolus application, that is, the coincidence between pain and remifentanil effect-site concentration, may be improved by forecasting contractions, but it is not known whether such a technique would also improve safety. Methods We recorded pain intensity during labour continuously using a handheld dynamometer in 43 parturients. Using these data, we compared different models in their ability to predict future contractions. In addition, we modelled remifentanil effect-site concentration using three simulated modes of bolus administration, with and without prediction of future contractions. Results The average duration of pain during contractions recorded by the dynamometer was 45 [14 standard deviation (sd)] s. The time interval between painful contractions was highly variable, with a mean of 151 (31 sd) s during the first and 154 (52 sd) s during the second recording. Using a simple algorithm (three-point moving average), the sd of the difference between predicted and observed inter-contraction intervals can be reduced from 0.95 to 0.79 min. However, the coincidence between remifentanil concentration and pain during contraction is not substantially improved when using these models to guide remifentanil bolus application. Conclusions Because of the large variability of inter-contraction intervals, the use of prediction models will not influence the mean remifentanil concentration in-between contractions. Using models predicting future contractions to improve the timing of remifentanil PCA bolus administration will not diminish the need of continuous clinical surveillance and other safety measure

Three fermions in a box at the unitary limit: universality in a lattice model

We consider three fermions with two spin components interacting on a lattice model with an infinite scattering length. Low lying eigenenergies in a cubic box with periodic boundary conditions, and for a zero total momentum, are calculated numerically for decreasing values of the lattice period. The results are compared to the predictions of the zero range Bethe-Peierls model in continuous space, where the interaction is replaced by contact conditions. The numerical computation, combined with analytical arguments, shows the absence of negative energy solution, and a rapid convergence of the lattice model towards the Bethe-Peierls model for a vanishing lattice period. This establishes for this system the universality of the zero interaction range limit.Comment: 6 page

Information theory of open fragmenting systems

An information theory description of finite systems explicitly evolving in time is presented. We impose a MaxEnt variational principle on the Shannon entropy at a given time while the constraints are set at a former time. The resulting density matrix contains explicit time odd components in the form of collective flows. As a specific application we consider the dynamics of the expansion in connection with heavy ion experiments. Lattice gas and classical molecular dynamics simulations are shown. © 2007 American Institute of Physics.Fil:Ison, M.J. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina.Fil:Dorso, C.O. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina

Apparent annual survival of staging ruffs during a period of population decline: insights from sex and site-use related differences

The ruff Philomachus pugnax, a lekkingshorebird wintering in Africa and breeding across northernEurasia, declined severely in its western range. Based on acapture-mark-resighting programme (2004–2011) in thewesternmost staging area in Friesland (the Netherlands),we investigated changes in apparent annual survival inrelation to age and sex to explore potential causes ofdecline. We also related temporal variation in apparentsurvival to environmental factors. We used the Capture-Mark-Recapture multievent statistical framework to overcomebiases in survival estimates after testing for hiddenheterogeneity of detection. This enabled the estimation ofthe probability to belong to high or low detectabilityclasses. Apparent survival varied between years but wasnot related to weather patterns along the flyway, or to floodlevels in the Sahel. Over time, a decline in apparent survivalis suggested. Due to a short data series and flag loss inthe last period this cannot be verified. Nevertheless, thepatterns in sex-specific detectability and survival lead tonew biological insights. Among highly detectable birds,supposedly most reliant on Friesland, males survived betterthan females (?/HDmales = 0.74, range 0.51–0.93;?/HDfemales = 0.51, range 0.24–0.81). Among lowdetectable birds, the pattern is reversed (?/LDmales = 0.64,range 0.37–0.89; ?/LDfemales = 0.73, range 0.48–0.93).Probably the staging population contains a mixture of sexspecificmigration strategies. A loss of staging femalescould greatly affect the dynamics of the western ruffpopulation. Further unravelling of these population processesrequires geographically extended demographicmonitoring and the use of tracking devices

Non-Linear Vibrations in Nuclei

We have perfomed Time Dependant Hartree-Fock (TDHF) calculations on the non linear response of nuclei. We have shown that quadrupole (and dipole) motion produces monopole (and quadrupole) oscillations in all atomic nuclei. We have shown that these findings can be interpreted as a large coupling between one and two phonon states leading to large anharmonicities.Comment: 4 pages, 3 figure

An exact stochastic mean-field approach to the fermionic many-body problem

We investigate a reformulation of the dynamics of interacting fermion systems in terms of a stochastic extension of Time Dependent Hartree-Fock equations. The noise is found from a path-integral representation of the evolution operator and allows to interpret the exact N-body state as a coherent average over Slater determinants evolving under the random mean-fied. The full density operator and the expectation value of any observable are then reconstructed using pairs of stochastic uncorrelated wave functions. The imaginary time propagation is also presented and gives a similar stochastic one-body scheme which converges to the exact ground state without developing a sign problem. In addition, the growth of statistical errors is examined to show that the stochastic formulation never explode in a finite dimensional one-body space. Finally, we consider initially correlated systems and present some numerical implementations in exactly soluble models to analyse the precision and the stability of the approach in practical cases

Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma

Objectives The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. Methods Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. Results On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P = 0.0455) and T215Y (P = 0.0455). Conclusions In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performe

The Unitary Gas and its Symmetry Properties

The physics of atomic quantum gases is currently taking advantage of a powerful tool, the possibility to fully adjust the interaction strength between atoms using a magnetically controlled Feshbach resonance. For fermions with two internal states, formally two opposite spin states, this allows to prepare long lived strongly interacting three-dimensional gases and to study the BEC-BCS crossover. Of particular interest along the BEC-BCS crossover is the so-called unitary gas, where the atomic interaction potential between the opposite spin states has virtually an infinite scattering length and a zero range. This unitary gas is the main subject of the present chapter: It has fascinating symmetry properties, from a simple scaling invariance, to a more subtle dynamical symmetry in an isotropic harmonic trap, which is linked to a separability of the N-body problem in hyperspherical coordinates. Other analytical results, valid over the whole BEC-BCS crossover, are presented, establishing a connection between three recently measured quantities, the tail of the momentum distribution, the short range part of the pair distribution function and the mean number of closed channel molecules.Comment: 63 pages, 8 figures. Contribution to the Springer Lecture Notes in Physics "BEC-BCS Crossover and the Unitary Fermi gas" edited by Wilhelm Zwerger. Revised version correcting a few typo

A user's guide to optimal transport

This text is an expanded version of the lectures given by the first author in the 2009 CIME summer school of Cetraro. It provides a quick and reasonably account of the classical theory of optimal mass transportation and of its more recent developments, including the metric theory of gradient flows, geometric and functional inequalities related to optimal transportation, the first and second order differential calculus in the Wasserstein space and the synthetic theory of metric measure spaces with Ricci curvature bounded from below