Hospitalized women experiencing an episode of excessive oral anticoagulation had a higher bleeding risk than men.

OBJECTIVE: Overanticoagulated medical inpatients may be particularly prone to bleeding complications. Among medical inpatients with excessive oral anticoagulation (AC), we sought to identify patient and treatment factors associated with bleeding. METHODS: We prospectively identified consecutive patients receiving oral AC admitted to the medical ward of a university hospital (February-July 2006) who had at least one international normalized ratio (INR) value >3.0 during the hospital stay. We recorded patient characteristics, AC-related factors, and concomitant treatments (e.g., platelet inhibitors) that increase the bleeding risk. The outcome was overall bleeding, defined as the occurrence of major or minor bleeding during the hospital stay. We used logistic regression to explore patient and treatment factors associated with bleeding. RESULTS: Overall, 145 inpatients with excessive oral AC comprised our study sample. Atrial fibrillation (59%) and venous thromboembolism (28%) were the most common indications for AC. Twelve patients (8.3%) experienced a bleeding event. Of these, 8 had major bleeding. Women had a somewhat higher risk of major bleeding than men (12.5% vs 4.1%, p = 0.08). Multivariable analysis demonstrated that female gender was independently associated with bleeding (odds ratio [OR] 4.3, 95% confidence interval [95% C1] 1.1-17.8). Age, history of major bleeding, value of the index INR, and concomitant treatment with platelet inhibitors were not independent predictors of bleeding. CONCLUSIONS: We found that hospitalized women experiencing an episode of excessive oral AC have a 4-fold increased risk of bleeding compared with men. Whether overanticoagulated women require more aggressive measures of AC reversal must be examined in further studies.

Front and domain growth in the presence of gravity

Front and domain growth of a binary mixture in the presence of a gravitational field is studied. The interplay of bulk- and surface-diffusion mechanisms is analyzed. An equation for the evolution of interfaces is derived from a time-dependent Ginzburg-Landau equation with a concentration-dependent diffusion coefficient. Scaling arguments on this equation give the exponents of a power-law growth. Numerical integrations of the Ginzburg-Landau equation corroborate the theoretical analysis.

Higher-order colored-noise effects in multivariable systems

We extend the partial resummation technique of Fokker-Planck terms for multivariable stochastic differential equations with colored noise. As an example, a model system of a Brownian particle with colored noise is studied. We prove that the asymmetric behavior found in analog simulations is due to higher-order terms which are left out in that technique. On the contrary, the systematic ¿-expansion approach can explain the analog results.

Gauge group and reality conditions in Ashtekar's complex formulation of canonical gravity

We discuss reality conditions and the relation between spacetime diffeomorphisms and gauge transformations in Ashtekars complex formulation of general relativity. We produce a general theoretical framework for the stabilization algorithm for the reality conditions, which is different from Diracs method of stabilization of constraints. We solve the problem of the projectability of the diffeomorphism transformations from configuration-velocity space to phase space, linking them to the reality conditions. We construct the complete set of canonical generators of the gauge group in the phase space which includes all the gauge variables. This result proves that the canonical formalism has all the gauge structure of the Lagrangian theory, including the time diffeomorphisms.

Impact of Pseudomonas fluorescens strain CHA0 and a derivative with improved biocontrol activity on the culturable resident bacterial community on cucumber roots

Information on the effects of released wild-type or genetically engineered bacteria on resident bacterial communities is important to assess the potential risks associated with the introduction of these organisms into agroecosystems. The rifampicin-resistant biocontrol strain Pseudomonas fluorescens CHA0-Rif and its derivative CHA0-Rif/pME3424, which has improved biocontrol activity and enhanced production of the antibiotics 2,4-diacetylphloroglucinol (Phl) and pyoluteorin (Plt), were introduced into soil microcosms and the culturable bacterial community developing on cucumber roots was investigated 10 and 52 days later. The introduction of either of the two strains led to a transiently enhanced metabolic activity of the bacterial community on glucose dimers and polymers as measured with BIOLOG GN plates, but natural succession between the two sampling dates changed the metabolic activity of the bacterial community more than did the inoculants. The introduced strains did not significantly affect the abundance of dominant genotypic groups of culturable bacteria discriminated by restriction analysis of amplified 16S rDNA of 2500 individual isolates. About 30-50% of the resident bacteria were very sensitive to Phl and Plt, but neither the wild-type nor CHA0-Rif/pME3424 changed the proportion of sensitive and resistant bacteria in situ. In microcosms with a synthetic bacterial community, both biocontrol strains reduced the population of a strain of Pseudomonas but did not affect the abundance of four other bacterial strains including two highly antibiotic-sensitive isolates. We conclude that detectable perturbations in the metabolic activity of the resident bacterial community caused by the biocontrol strain CHA0-Rif are (i) transient, (ii) similar for the genetically improved derivative CHA0-Rif/pME3424 and (iii) less pronounced than changes in the community structure during plant growth.

Higher order Lagrangian systems: Geometric structures, Dynamics, and Constraints

In order to study the connections between Lagrangian and Hamiltonian formalisms constructed from aperhaps singularhigher-order Lagrangian, some geometric structures are constructed. Intermediate spaces between those of Lagrangian and Hamiltonian formalisms, partial Ostrogradskiis transformations and unambiguous evolution operators connecting these spaces are intrinsically defined, and some of their properties studied. Equations of motion, constraints, and arbitrary functions of Lagrangian and Hamiltonian formalisms are thoroughly studied. In particular, all the Lagrangian constraints are obtained from the Hamiltonian ones. Once the gauge transformations are taken into account, the true number of degrees of freedom is obtained, both in the Lagrangian and Hamiltonian formalisms, and also in all the intermediate formalisms herein defined.

Stochastic semiclassical gravity

In the first part of this paper, we show that the semiclassical Einstein-Langevin equation, introduced in the framework of a stochastic generalization of semiclassical gravity to describe the back reaction of matter stress-energy fluctuations, can be formally derived from a functional method based on the influence functional of Feynman and Vernon. In the second part, we derive a number of results for background solutions of semiclassical gravity consisting of stationary and conformally stationary spacetimes and scalar fields in thermal equilibrium states. For these cases, fluctuation-dissipation relations are derived. We also show that particle creation is related to the vacuum stress-energy fluctuations and that it is enhanced by the presence of stochastic metric fluctuations.

Mode decomposition and renormalization in semiclassical gravity

We compute the influence action for a system perturbatively coupled to a linear scalar field acting as the environment. Subtleties related to divergences that appear when summing over all the modes are made explicit and clarified. Being closely connected with models used in the literature, we show how to completely reconcile the results obtained in the context of stochastic semiclassical gravity when using mode decomposition with those obtained by other standard functional techniques.

Proposed gravitational wave observatory based on solid elastic spheres

Spherical gravitational wave (GW) detectors offer a wealth of so far unexplored possibilities to detect gravitational radiation. We find that a sphere can be used as a powerful testbed for any metric theory of gravity, not only general relativity as considered so far, by making use of a deconvolution procedure for all the electric components of the Riemann tensor. We also find that the spheres cross section is large at two frequencies, and advantageous at higher frequencies in the sense that a single antenna constitutes a real xylophone in its own. Proposed GW networks will greatly benefit from this. The main features of a two large sphere observatory are reported.

Induced quantum metric fluctuations and the validity of semiclassical gravity

We propose a criterion for the validity of semiclassical gravity (SCG) which is based on the stability of the solutions of SCG with respect to quantum metric fluctuations. We pay special attention to the two-point quantum correlation functions for the metric perturbations, which contain both intrinsic and induced fluctuations. These fluctuations can be described by the Einstein-Langevin equation obtained in the framework of stochastic gravity. Specifically, the Einstein-Langevin equation yields stochastic correlation functions for the metric perturbations which agree, to leading order in the large N limit, with the quantum correlation functions of the theory of gravity interacting with N matter fields. The homogeneous solutions of the Einstein-Langevin equation are equivalent to the solutions of the perturbed semiclassical equation, which describe the evolution of the expectation value of the quantum metric perturbations. The information on the intrinsic fluctuations, which are connected to the initial fluctuations of the metric perturbations, can also be retrieved entirely from the homogeneous solutions. However, the induced metric fluctuations proportional to the noise kernel can only be obtained from the Einstein-Langevin equation (the inhomogeneous term). These equations exhibit runaway solutions with exponential instabilities. A detailed discussion about different methods to deal with these instabilities is given. We illustrate our criterion by showing explicitly that flat space is stable and a description based on SCG is a valid approximation in that case.

Cosmological perturbations from stochastic gravity

In inflationary cosmological models driven by an inflaton field the origin of the primordial inhomogeneities which are responsible for large-scale structure formation are the quantum fluctuations of the inflaton field. These are usually calculated using the standard theory of cosmological perturbations, where both the gravitational and the inflaton fields are linearly perturbed and quantized. The correlation functions for the primordial metric fluctuations and their power spectrum are then computed. Here we introduce an alternative procedure for calculating the metric correlations based on the Einstein-Langevin equation which emerges in the framework of stochastic semiclassical gravity. We show that the correlation functions for the metric perturbations that follow from the Einstein-Langevin formalism coincide with those obtained with the usual quantization procedures when the scalar field perturbations are linearized. This method is explicitly applied to a simple model of chaotic inflation consisting of a Robertson-Walker background, which undergoes a quasi-de Sitter expansion, minimally coupled to a free massive quantum scalar field. The technique based on the Einstein-Langevin equation can, however, deal naturally with the perturbations of the scalar field even beyond the linear approximation, as is actually required in inflationary models which are not driven by an inflaton field, such as Starobinsky¿s trace-anomaly driven inflation or when calculating corrections due to nonlinear quantum effects in the usual inflaton driven models.

Stability of de Sitter spacetime under isotropic perturbations in semiclassical gravity

A spatially flat Robertson-Walker spacetime driven by a cosmological constant is nonconformally coupled to a massless scalar field. The equations of semiclassical gravity are explicitly solved for this case, and a self-consistent de Sitter solution associated with the Bunch-Davies vacuum state is found (the effect of the quantum field is to shift slightly the effective cosmological constant). Furthermore, it is shown that the corrected de Sitter spacetime is stable under spatially isotropic perturbations of the metric and the quantum state. These results are independent of the free renormalization parameters.