Cognitive and psychosocial outcomes of mechanically ventilated intensive care patients with and without delirium

Abstract Objective Delirium is common in intensive care patients and is associated with short- and long-term adverse outcomes. We investigated the long-term risk of cognitive impairment and post-traumatic stress disorder (PTSD) in intensive care patients with and without delirium. Methods This is a prospective cohort study in ICUs in two Australian university-affiliated hospitals. Patients were eligible if they were older than 18 years, mechanically ventilated for more than 24 h and did not meet exclusion criteria. Delirium was assessed using the Confusion Assessment Method for Intensive Care Unit. Variables assessing cognitive function and PTSD symptoms were collected at ICU discharge, after 6 and 12 months: Mini-Mental State Examination, Telephone Interview for Cognitive Status, Impact of Events Scale-Revised and Informant Questionnaire for Cognitive Decline (caregiver). Results 103 participants were included of which 36% developed delirium in ICU. Patients with delirium were sicker and had longer duration of mechanical ventilation and ICU length of stay. After 12 months, 41/60 (68.3%) evaluable patients were cognitively impaired, with 11.6% representing the presence of symptoms consistent with dementia. When evaluated by the patient’s caregiver, the patient’s cognitive function was found to be severely impaired in a larger proportion of patients (14/60, 23.3%). Delirium was associated with worse cognitive function at ICU discharge, but not with long-term cognitive function. IES-R scores, measuring PTSD symptoms, were significantly higher in patients who had delirium compared to patients without delirium. In regression analysis, delirium was independently associated with cognitive function at ICU discharge and PTSD symptoms at 12 months. Conclusions Intensive care survivors have significant rates of long-term cognitive decline and PTSD symptoms. Delirium in ICU was independently associated with short-term but not long-term cognitive function, and with long-term PTSD symptoms. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12616001116415, 15/8/2016 retrospectively registered, https://www.anzctr.org.a

Demonstration of the temporal matter-wave Talbot effect for trapped matter waves

We demonstrate the temporal Talbot effect for trapped matter waves using ultracold atoms in an optical lattice. We investigate the phase evolution of an array of essentially non-interacting matter waves and observe matter-wave collapse and revival in the form of a Talbot interference pattern. By using long expansion times, we image momentum space with sub-recoil resolution, allowing us to observe fractional Talbot fringes up to 10th order.Comment: 17 pages, 7 figure

Azimuthal anisotropy and correlations in p+p, d+Au and Au+Au collisions at 200 GeV

We present the first measurement of directed flow ($v_1$) at RHIC. $v_1$ is found to be consistent with zero at pseudorapidities $\eta$ from -1.2 to 1.2, then rises to the level of a couple of percent over the range $2.4 < |\eta| < 4$. The latter observation is similar to data from NA49 if the SPS rapidities are shifted by the difference in beam rapidity between RHIC and SPS. Back-to-back jets emitted out-of-plane are found to be suppressed more if compared to those emitted in-plane, which is consistent with {\it jet quenching}. Using the scalar product method, we systematically compared azimuthal correlations from p+p, d+Au and Au+Au collisions. Flow and non-flow from these three different collision systems are discussed.Comment: Quark Matter 2004 proceeding, 4 pages, 3 figure

Azimuthal anisotropy: the higher harmonics

We report the first observations of the fourth harmonic (v_4) in the azimuthal distribution of particles at RHIC. The measurement was done taking advantage of the large elliptic flow generated at RHIC. The integrated v_4 is about a factor of 10 smaller than v_2. For the sixth (v_6) and eighth (v_8) harmonics upper limits on the magnitudes are reported.Comment: 4 pages, 6 figures, contribution to the Quark Matter 2004 proceeding

Kaon Production and Kaon to Pion Ratio in Au+Au Collisions at \snn=130 GeV

Mid-rapidity transverse mass spectra and multiplicity densities of charged and neutral kaons are reported for Au+Au collisions at \snn=130 GeV at RHIC. The spectra are exponential in transverse mass, with an inverse slope of about 280 MeV in central collisions. The multiplicity densities for these particles scale with the negative hadron pseudo-rapidity density. The charged kaon to pion ratios are $K^+/\pi^- = 0.161 \pm 0.002 {\rm (stat)} \pm 0.024 {\rm (syst)}$ and $K^-/\pi^- = 0.146 \pm 0.002 {\rm (stat)} \pm 0.022 {\rm (syst)}$ for the most central collisions. The $K^+/\pi^-$ ratio is lower than the same ratio observed at the SPS while the $K^-/\pi^-$ is higher than the SPS result. Both ratios are enhanced by about 50% relative to p+p and $\bar{\rm p}$+p collision data at similar energies.Comment: 6 pages, 3 figures, 1 tabl

All-optical switching and strong coupling using tunable whispering-gallery-mode microresonators

We review our recent work on tunable, ultrahigh quality factor whispering-gallery-mode bottle microresonators and highlight their applications in nonlinear optics and in quantum optics experiments. Our resonators combine ultra-high quality factors of up to Q = 3.6 \times 10^8, a small mode volume, and near-lossless fiber coupling, with a simple and customizable mode structure enabling full tunability. We study, theoretically and experimentally, nonlinear all-optical switching via the Kerr effect when the resonator is operated in an add-drop configuration. This allows us to optically route a single-wavelength cw optical signal between two fiber ports with high efficiency. Finally, we report on progress towards strong coupling of single rubidium atoms to an ultra-high Q mode of an actively stabilized bottle microresonator.Comment: 20 pages, 24 figures. Accepted for publication in Applied Physics B. Changes according to referee suggestions: minor corrections to some figures and captions, clarification of some points in the text, added references, added new paragraph with results on atom-resonator interactio

Strange Resonance Production in p+p and Au+Au Collisions at RHIC Energies

Resonance yields and spectra from elementary p+p and Au+Au collisions at $\sqrt{s_{\rm NN}} =$ 200 GeV from the STAR experiment at RHIC are presented and discussed in terms of chemical and thermal freeze-out conditions. Thermal models do not adequately describe the yields of the resonance production in central Au+Au collisions. The approach to include elastic hadronic interactions between chemical freeze-out and thermal freeze-out suggests a time of $\Delta \tau>$5 fm/c.Comment: 4 pages, 7 figures, proceedings of the Quark Matter 2004, in Oakland, California, to be published in Journal of Physics G: Nuclear and Particle Physic

Identified particles at large transverse momenta in STAR in Au+Au collisions @ sqrt(s_NN) = 200 GeV

We report measurements of the ratios of identified hadrons (pi,K,p,Lambda) in Au+Au collisions at sqrt(s_NN) = 200 GeV as a function of both collision centrality and transverse momentum (p_T). Ratios of anti-baryon to baryon yields are independent of p_T within 2<p_T <6 GeV/c indicating that, for such a range, our measurements are inconsistent with theoretical pQCD calculations predicting a decrease due to a stronger contribution from valence quark scattering. For both strange and non-strange species, a strong baryon enhancement relative to meson yields is observed as a function of collision centrality in this intermediate p_T region, leading to p/pi and Lambda/K ratios greater than unity. The nuclear modification factor, R_cp (central relative to peripheral collisions), is used to illustrate the interplay between jet quenching and hadron production. The physics implications of these measurements are discussed with reference to different theoretical models.Comment: 5 pages, 4 figures. Proceedings of Quark Matter 2004 Conference, Jan 2004, Oakland, USA. Submitted to Journal of Physics

High-pTp_{T} electron distributions in d+Au and p+p collisions at RHIC

We present preliminary measurements of electron and positron spectra in d+Au and p+p collisions at $\sqrt{s_{NN}}=200$ GeV for $1.5 < p_{T} < 7.0$ GeV/c. These measurements were carried out using the STAR Time Projection Chamber (TPC) and the Barrel Electromagnetic calorimeter (EMC). Overall hadron rejection factors in the range of $10^{5}$ have been achieved. In this work we describe the measurement technique used to discriminate electrons from hadrons and compare the results for single electron spectra with Pythia based pQCD calculations for electrons from heavy-quark semi-leptonic decays.Comment: Quark Matter 2004 conference proceeding