Simulating Bosonic Baths with Error Bars.

We derive rigorous truncation-error bounds for the spin-boson model and its generalizations to arbitrary quantum systems interacting with bosonic baths. For the numerical simulation of such baths, the truncation of both the number of modes and the local Hilbert-space dimensions is necessary. We derive superexponential Lieb-Robinson-type bounds on the error when restricting the bath to finitely many modes and show how the error introduced by truncating the local Hilbert spaces may be efficiently monitored numerically. In this way we give error bounds for approximating the infinite system by a finite-dimensional one. As a consequence, numerical simulations such as the time-evolving density with orthogonal polynomials algorithm (TEDOPA) now allow for the fully certified treatment of the system-environment interaction.

Probability distributions for measures of placental shape and morphology.

Birthweight at delivery is a standard cumulative measure of placental growth, but is a crude summary of other placental characteristics, such as, e.g., the chorionic plate size, and the shape and position of the umbilical cord insertion. Distributions of such measures across a cohort reveal information about the developmental history of the chorionic plate which is unavailable from an analysis based solely on the mean and standard deviation. Various measures were determined from digitized images of chorionic plates obtained from the pregnancy, infection, and nutrition study, a prospective cohort study of preterm birth in central North Carolina between 2002 and 2004. Centroids (geometric centers) and umbilical cord insertions were taken directly from the images. Chorionic plate outlines were obtained from an interpolation based on a Fourier series, while eccentricity (of the best-fit ellipse), skewness, and kurtosis were determined from the method of moments. Histograms of each variable were compared against the normal, lognormal, and Lévy distributions. Only a single measure (eccentricity) followed a normal distribution. All others followed lognormal or 'heavy-tailed' distributions for moderate to extreme deviations from the mean, where the relative likelihood far exceeded those of a normal distribution.

The Gal3p-Gal80p-Gal4p transcription switch of yeast: Gal3p destabilizes the Gal80p-Gal4p complex in response to galactose and ATP.

The Gal3, Gal80, and Gal4 proteins of Saccharomyces cerevisiae comprise a signal transducer that governs the galactose-inducible Gal4p-mediated transcription activation of GAL regulon genes. In the absence of galactose, Gal80p binds to Gal4p and prohibits Gal4p from activating transcription, whereas in the presence of galactose, Gal3p binds to Gal80p and relieves its inhibition of Gal4p. We have found that immunoprecipitation of full-length Gal4p from yeast extracts coprecipitates less Gal80p in the presence than in the absence of Gal3p, galactose, and ATP. We have also found that retention of Gal80p by GSTG4AD (amino acids [aa] 768 to 881) is markedly reduced in the presence compared to the absence of Gal3p, galactose, and ATP. Consistent with these in vitro results, an in vivo two-hybrid genetic interaction between Gal80p and Gal4p (aa 768 to 881) was shown to be weaker in the presence than in the absence of Gal3p and galactose. These compiled results indicate that the binding of Gal3p to Gal80p results in destabilization of a Gal80p-Gal4p complex. The destabilization was markedly higher for complexes consisting of G4AD (aa 768 to 881) than for full-length Gal4p, suggesting that Gal80p relocated to a second site on full-length Gal4p. Congruent with the idea of a second site, we discovered a two-hybrid genetic interaction involving Gal80p and the region of Gal4p encompassing aa 225 to 797, a region of Gal4p linearly remote from the previously recognized Gal80p binding peptide within Gal4p aa 768 to 881.

Novel Gal3 proteins showing altered Gal80p binding cause constitutive transcription of Gal4p-activated genes in Saccharomyces cerevisiae.

Gal4p-mediated activation of galactose gene expression in Saccharomyces cerevisiae normally requires both galactose and the activity of Gal3p. Recent evidence suggests that in cells exposed to galactose, Gal3p binds to and inhibits Ga180p, an inhibitor of the transcriptional activator Gal4p. Here, we report on the isolation and characterization of novel mutant forms of Gal3p that can induce Gal4p activity independently of galactose. Five mutant GAL3(c) alleles were isolated by using a selection demanding constitutive expression of a GAL1 promoter-driven HIS3 gene. This constitutive effect is not due to overproduction of Gal3p. The level of constitutive GAL gene expression in cells bearing different GAL3(c) alleles varies over more than a fourfold range and increases in response to galactose. Utilizing glutathione S-transferase-Gal3p fusions, we determined that the mutant Gal3p proteins show altered Gal80p-binding characteristics. The Gal3p mutant proteins differ in their requirements for galactose and ATP for their Gal80p-binding ability. The behavior of the novel Gal3p proteins provides strong support for a model wherein galactose causes an alteration in Gal3p that increases either its ability to bind to Gal80p or its access to Gal80p. With the Gal3p-Gal80p interaction being a critical step in the induction process, the Gal3p proteins constitute an important new reagent for studying the induction mechanism through both in vivo and in vitro methods.

Nalbuphine after major gynecologic surgery. Comparison of patient-controlled analgesia and intramuscular injections.

A randomized investigation compared the efficacy and safety of nalbuphine administered by two methods, a patient-controlled infuser system and intramuscular (IM) injections, after major gynecologic surgery. Forty-seven patients were randomly assigned to receive nalbuphine by either method. The 22 patients using the infuser were given a 2.0-mg, incremental dose with a 10-minute lock-out interval between doses. A similar group receiving 10-15 mg IM every three hours served as the control. Misprogramming, overdosage, depressed respiration and drug dependence were not encountered. Self-administration provided equally satisfactory sedation and more immediate pain relief without painful injections. Although patients with the infuser had the ability to self-administer more medication, they did not use higher doses of nalbuphine than did the IM group. The additional cost of the infuser system was offset by the satisfaction expressed by the patients and by the improved nursing efficiency. Nalbuphine administered with a patient-controlled infuser provided an effective balance between analgesia and sedation and offered advantages over IM injections.

Combined continuous and demand narcotic dosing for patient-controlled analgesia after cesarean section.

New patient-controlled analgesia devices can deliver an analgesic by continuous infusion along with demand dosing. This prospective investigation involving postcesarean-section patients was undertaken to determine whether a combination of continuous infusion and demand dosing of meperidine would provide more effective analgesia than would demand dosing alone during the first 24 hours. During a 12-month period, 171 patients were prescribed meperidine postoperatively, using a 5- to 10-mg demand dose no more frequently than every 10 minutes. Patients were assigned to groups receiving no continuous infusion or infusion at rates of 10, 20, or 30 mg/h. The groups receiving continuous infusion showed more immediate and sustained pain relief, with no serious complications. All patients were able to understand the nurse, became ambulatory, and tolerated liquids on the first postoperative day. The infusion rate of 20 mg/h was most acceptable in requiring fewer demand doses while providing satisfactory pain relief without undesired sedation. In conclusion, a system combining continuous infusion and demand dosing was preferable to demand dosing alone, and added no apparent hazards.

Partial attenuation of hemodynamic responses to rapid sequence induction and intubation with labetalol.

The effectiveness of labetalol (a combination nonselective beta and alpha-1-adrenergic receptor antagonist) in modifying hemodynamic responses associated with rapid sequence induction and tracheal intubation was evaluated. In a double-blind study, 24 ASA physical status I or II male patients scheduled for elective surgery were given either IV labetalol, 0.25 mg/kg (n = 8) or 0.75 mg/kg (n = 8), or a saline placebo (n = 8). Five minutes later, patients were given oxygen by mask and IV vecuronium, 0.01 mg/kg. Ten minutes after giving labetalol or placebo, cricoid pressure was applied and anesthesia was induced with IV sodium thiopental (4 mg/kg) and succinylcholine (1.5 mg/kg) 1 minute prior to intubation. The mean duration of laryngoscopy was 17 +/- 3 seconds. Prior to induction, the 0.25 mg/kg and 0.75 mg/kg doses of labetalol significantly (p less than 0.05) reduced mean arterial pressure by 4.4 +/- 1.9 and by 8.6 +/- 2.0 mmHg, respectively, but did not significantly alter heart rate or cardiac output. The 0.75 mg/kg dose of labetalol also significantly (p less than 0.05) decreased total peripheral resistance by 10.1 +/- 3.0%. Within 30 seconds after intubation, patients in all three groups exhibited increases in heart rate, mean arterial pressure, total peripheral resistance, and rate pressure product and a decrease in stroke volume. However, patients in the 0.25 and 0.75 mg/kg labetalol groups, compared to those in the placebo group, had significantly lower increases in peak heart rate (33 +/- 2 and 27 +/- 3 vs. 44 +/- 7 beats/minute), peak mean arterial pressure (38 +/- 6 and 38 +/- 7 vs. 58 +/- 7 mmHg), and peak rate pressure product (7,726 +/- 260 and 7,215 +/- 300 vs. 14,023 +/- 250 units). The results show that these doses of labetalol significantly blunt, but do not completely block, autonomic responses to rapid sequence induction and intubation.

Third- and fourth-degree perineal tears. 50 year's experience at a university hospital.

An investigation was undertaken to determine if the incidence of third- and fourth-degree perineal tears has changed and, if so, what the predisposing factors might be. Data were analyzed for a 50-year period (1935-1985). An increased frequency of such tears was found after 1965, when mediolateral episiotomies were replaced almost entirely by midline ones. A constant combined rate of 17% for third- and fourth-degree tears was found for the last decade. When compared with a similar group without such tears, women with extensive tears were more likely to be nulliparous and teenage and to require epidural anesthesia, oxytocin and/or forceps application. When the incidence of tears was compared with that at a nearby community hospital, it was found to be higher at our university medical center. Excluding physician inexperience, the reason was the greater frequency of teenage pregnancies and more common use of epidural anesthesia and oxytocin at our hospital. Rectovaginal fistulae and anal incontinence requiring repair occurred in less than 1% of the total cases. Since midline episiotomies are now being performed often, third- and fourth-degree perineal tears will continue to be common and will depend on the patient population, physician experience and intrapartum hospital policies.

Effect of verapamil on pulmonary reflexes in the vascularly isolated canine lung: physiology.

Breathing frequency (BF) may be affected by changes in the percent inspired CO2 administered to vascularly isolated lungs. Pulmonary CO2 probably affects BF, in part, through a secondary effect of CO2 on airway smooth muscle. To further determine the role of pulmonary mechanics in the pulmonary CO2-mediated BF response, Verapamil, a Ca++ blocking agent which blocks hypocapnic airway constriction, was administered to the vascularly isolated lungs of the dog. Verapamil blocked the hypocapnic airway constriction which occurred when pulmonary CO2 was reduced; however, the decrease in BF was not only blocked but in some animals there was an increase in BF. Also, the decrease in BF produced by hyperinflation of the lungs (Hering-Breuer reflex) was either blocked or an increase in BF occurred after administration of Verapamil.