CSIP - a Novel Photon-Counting Detector Applicable for the SPICA Far-Infrared Instrument

We describe a novel GaAs/AlGaAs double-quantum-well device for the infrared photon detection, called Charge-Sensitive Infrared Phototransistor (CSIP). The principle of CSIP detector is the photo-excitation of an intersubband transition in a QW as an charge integrating gate and the signal amplification by another QW as a channel with very high gain, which provides us with extremely high responsivity (10^4 -- 10^6 A/W). It has been demonstrated that the CSIP designed for the mid-infrared wavelength (14.7 um) has an excellent sensitivity; the noise equivalent power (NEP) of 7x10^-19 W/rHz with the quantum efficiency of ~2%. Advantages of the CSIP against the other highly sensitive detectors are, huge dynamic range of >10^6, low output impedance of 10^3 -- 10^4 Ohms, and relatively high operation temperature (>2K). We discuss possible applications of the CSIP to FIR photon detection covering 35 -- 60 um waveband, which is a gap uncovered with presently available photoconductors.Comment: To appear in Proc. Workshop "The Space Infrared Telescope for Cosmology & Astrophysics: Revealing the Origins of Planets and Galaxies". Eds. A.M. Heras, B. Swinyard, K. Isaak, and J.R. Goicoeche

The Influence of Spatial Resolution due to Hot-Wire Sensors on Measurements in Wall-Bounded Turbulence.

Reassessment of compiled data reveal that recorded scatter in the hot-wire measured near-wall peak in viscous-scaled streamwise turbulence intensity is due in large part to the simultaneous competing effects of Reynolds number and viscous-scaled wire-length l ( lUt n, where l is the wirelength, Ut is friction velocity and n is kinematic viscosity). These competing factors can explain much of the disparity in existing literature, in particular explaining how previous studies have incorrectly concluded that the inner-scaled near-wall peak is independent of Re. We also investigate the appearance of the, so-called, ‘outerpeak’ in the broadband streamwise intensity, found by some researchers to occur within the log-region of high Reynolds number boundary layers. We show that this ‘outer-peak’ is most likely a symptom of attenuation of small-scales due to large l . Fully mapped energy spectra, obtained with two different l , are presented to demonstrate this phenomena. The spatial attenuation resulting from wires with large l effectively filters small-scale fluctuations from the recorded signal

Exercise is delayed in critically ill patients: a five year observational study in an Australian tertiary intensive care unit

Duration of bed rest among critically ill patients in ICU has been associated with development of persistent weakness that can last for more than five years. Commencing early exercise interventions in ICU is likely to reduce critically ill patients’ physical dysfunction. However, critically ill patients often experience prolonged periods of bed rest and inactivity. This study examined the timing of commencement of exercise interventions, including sitting out of bed and upright mobilisation, following physiological stability in critically ill patients and describes key clinical outcomes. Participants included consecutive patients admitted for >48 hours to a 25-bed Australian mixed medical and surgical adult ICU between July 2009 and June 2014. Time taken for patients to achieve neurological, cardiorespiratory and cardiovascular (physiological) stability was calculated and timing of initial sitting out of bed and upright mobilisation was recorded. A small number of patients (n=206, 6.0%) did not achieve physiological stability. A substantial proportion of patients (n=1377, 40.1%) did not complete any mobilisation or sitting activities. For patients (n=1851, 53.9%) who did undertake mobilisation or sitting activities, activity commenced a median (IQR) of 3.6 (2.0, 7.7) days after ICU admission. This represented a median (IQR) delay after physiological stability of 2.3 (1.3, 4.4) days for mobilisation and 2.7 (1.5, 5.7) days for sitting. In-hospital mortality was 14.3% (n=491) for patients who did not participate in exercise interventions, compared to 2.6% (n=89) for patients who exercised whilst in ICU

Critical Care Cycling Study (CYCLIST) trial protocol: a randomised controlled trial of usual care plus additional in-bed cycling sessions versus usual care in the critically ill

Introduction In-bed cycling with patients with critical illness has been shown to be safe and feasible, and improves physical function outcomes at hospital discharge. The effects of early in-bed cycling on reducing the rate of skeletal muscle atrophy, and associations with physical and cognitive function are unknown. Methods and analysis A single-centre randomised controlled trial in a mixed medical-surgical intensive care unit (ICU) will be conducted. Adult patients (n=68) who are expected to be mechanically ventilated for more than 48 hours and remain in ICU for a further 48 hours from recruitment will be randomly allocated into either (1) a usual care group or (2) a group that receives usual care and additional in-bed cycling sessions. The primary outcome is change in rectus femoris cross-sectional area at day 10 in comparison to baseline measured by blinded assessors. Secondary outcome measures include muscle strength, incidence of ICU-acquired weakness, handgrip strength, time to achieve functional milestones (sitting out of bed, walking), Functional Status Score in ICU, ICU Mobility Scale, 6 min walk test 1week postICU discharge, incidence of delirium and quality of life (EuroQol Five Dimensions questionnaire Five Levels scale). Quality of life assessments will be conducted post-ICU admission at day 10, 3 and 6 months after acute hospital discharge. Participants in the intervention group will complete an acceptability of intervention questionnaire. Ethics and dissemination Appropriate ethical approval from Metro South Health Human Research Ethics Committee has been attained. Results will be published in peer-reviewed publications and presented at scientific conferences to assist planning of future multicentre randomised controlled trials (if indicated) that will test in-bed cycling as an intervention to improve the physical, cognitive and health-related quality of life outcomes of patients with critical illness

Results of an international Delphi consensus in epilepsy with myoclonic atonic seizures/ Doose syndrome

OBJECTIVE: To establish a standard framework for early phenotypic diagnosis, investigations, expected findings from investigations, evolution, effective therapies and prognosis in the syndrome of Epilepsy with myoclonic atonic seizures (EMAS) / Doose syndrome. METHODS: A core study group (CSG) interested in EMAS was convened. CSG then identified and nominated 15 experts in the field of EMAS. This expert panel (EP) from English speaking nations was invited to participate in anonymous questionnaires. A literature review was provided to them (supplement 1). Three rounds of questionnaires were sent to identify areas of consensus, strength of consensus and areas of contention. RESULTS: Strong consensus was obtained regarding the clinical phenotype of EMAS: myoclonic atonic seizure was identified among others as a mandatory seizure type with typical onset of afebrile seizures between one and six years. A new term "stormy phase" (SP) was designated to delineate a characteristic phenotypic evolution in EMAS patients associated with seizure worsening. Strong consensus regarding the existence and time of onset of the SP, mandatory investigations to be performed early and later in the clinical course of EMAS, first and second tier treatment and prognostic factors for poor outcome were identified. Areas of lack of consensus included some seizure types that are necessary to diagnose EMAS, interictal EEG findings that prognosticate the course of EMAS, overall duration of SP, time to complete remission, and best approach to treat drug resistant EMAS. SIGNIFICANCE: Expert consensus on core diagnostic criteria of EMAS necessary for natural history studies, phenotype-genotype correlations, and clinical trials including comparative studies was demonstrated. Areas of disagreements (especially prognostic features; treatment options) need further research

Is the homophone advantage influenced by post-lexical effects?

No Abstract availabl

In-bed Cycling with Critically Ill Patients: Practical Lessons From a Randomised Trial

Introduction: In-bed cycling for critically ill patients is a rehabilitative exercise that may help improve patients’ functional status at hospital discharge. In-bed cycling is not currently implemented early during a patients’ critical illness. Objectives: To identify if early in-bed cycling could be safely implemented following a patients’ admission to ICU and to identify the barriers and facilitators to implementation of in-bed cycling within ICU. Methods: A randomised controlled trial comparing usual care physio-therapy with additional in-bed cycling within a tertiary mixed medical, surgical, trauma ICU was conducted. Number of sessions of in-bed cycling planned, conducted, distance and duration cycled, haemodynamic parameters and occurrence of pre-defined adverse events were recorded. A diary of intervention implementation processes and outcomes was kept to identify barriers and facilitators to implementation of in-bed cycling. Results: Thirty-seven participants completed 276 of 304 (90.8%) planned in-bed cycling interventions. Participants completed a median (IQR) of 6 (4,8) in-bed cycling sessions. Participants commenced in-bed cycling a median (IQR) of 2.3 (1.8,3.1) days following ICU admission. Participants cycled a mean (SD) 27.7 (5.2) minutes per session and mean (SD) 3.23km (1.63km) per session and maintained haemodynamic stability. Two minor adverse events (0.7% of sessions) occurred that required clinician intervention (increased respiratory rate and oxygen desaturation). These events required adjustment to ventilator settings without any long-term consequences. The main barriers to the implementation of in-bed cycling sessions were patient fatigue (n = 9), delirium (n = 5) and haemodynamic instability (n = 4). Timing of initiation of the intervention following morning chest x-ray round with independent implementation by a physiotherapist were identified as the main facilitators to the in-bed cycling intervention. Conclusions: In-bed cycling commencing within 2 to 3 days of a patients’ ICU admission was both safe and feasible. Adverse events were rare and the main barrier to implementation of in-bed cycling sessions was patient fatigue.<br/