Direct exoplanet imaging with small-angle Vortex coronagraphs

Vortex coronagraphs are among the most promising solutions to perform high contrast imaging at small angular separations from bright stars. They enhance the dynamic range at very small inner working angle (down to the diffraction limit of the telescope) and provide a clear 360 degree discovery space for high-contrast direct imaging of exoplanets. In this talk, we will report on the first scientific results obtained with Vortex coronagraphs installed on 10-m class telescopes (i.e., the VLT and the LBT) and on the recent installation of one Vortex at Keck. We will describe the in-lab and on-sky performance of the Vortex, and describe the lessons learned after a few years of operation. Finally, we will discuss the prospects of our vortices for future extremely large telescopes and space missions.VORTE

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Birefringence measurements of diamond space-variant subwavelength gratings

Subwavelength gratings are gratings with periods smaller than the incident wavelength. They possess form birefringence, which depends on the grating parameters. This paper presents the results of an experimental method designed to measure the birefringent properties of diamond subwavelength gratings in the mid-infrared. The method consists of monitoring the intensity transmitted through one polarizer, a subwavelength grating, and a second polarizer for various orientations of the first polarizer. By fitting the intensity variation as a function of the orientation of the first polarizer, one can compute the phase shift induced by the grating, its local fast axis orientation, and the ratio of the transverse electric and transverse magnetic transmission efficiencies. The paper describes the method principle and its mathematical model. Then, several numerical simulations of different subwavelength gratings are presented and their results are discussed. Finally, the optical setup is described and the measurements of one subwavelength grating are displayed and compared with the values expected from the manufacturing process. © 2018 Optical Society of America

Discovery of a point-like source and a third spiral arm in the transition disk around the Herbig Ae star MWC 758

International audienceContext. Transition disks offer the extraordinary opportunity to look for newly born planets and investigate the early stages of planet formation. Aims. In this context we observed the Herbig A5 star MWC 758 with the L'-band vector vortex coronagraph installed in the near-infrared camera and spectrograph NIRC2 at the Keck II telescope, with the aim of unveiling the nature of the spiral structure by constraining the presence of planetary companions in the system. Methods. Our high-contrast imaging observations show a bright (∆L = 7.0 ± 0.3 mag) point-like emission, south of MWC 758 at a deprojected separation of ∼20 au (r = 0. 111 ± 0. 004) from the central star. We also recover the two spiral arms (south-east and northwest), already imaged by previous studies in polarized light, and discover a third one to the southwest of the star. No additional companions were detected in the system down to 5 Jupiter masses beyond 0. 6 from the star. Results. We propose that the bright L'-band emission could be caused by the presence of an embedded and accreting protoplanet, although the possibility of it being an asymmetric disk feature cannot be excluded. The spiral structure is probably not related to the protoplanet candidate, unless on an inclined and eccentric orbit, and it could be due to one (or more) yet undetected planetary companions at the edge of or outside the spiral pattern. Future observations and additional simulations will be needed to shed light on the true nature of the point-like source and its link with the spiral arms

Human-Machine Interface for the Control of Multi-Function Systems Based on Electrocutaneous Menu: Application to Multi-Grasp Prosthetic Hands.

Modern assistive devices are very sophisticated systems with multiple degrees of freedom. However, an effective and user-friendly control of these systems is still an open problem since conventional human-machine interfaces (HMI) cannot easily accommodate the system's complexity. In HMIs, the user is responsible for generating unique patterns of command signals directly triggering the device functions. This approach can be difficult to implement when there are many functions (necessitating many command patterns) and/or the user has a considerable impairment (limited number of available signal sources). In this study, we propose a novel concept for a general-purpose HMI where the controller and the user communicate bidirectionally to select the desired function. The system first presents possible choices to the user via electro-tactile stimulation; the user then acknowledges the desired choice by generating a single command signal. Therefore, the proposed approach simplifies the user communication interface (one signal to generate), decoding (one signal to recognize), and allows selecting from a number of options. To demonstrate the new concept the method was used in one particular application, namely, to implement the control of all the relevant functions in a state of the art commercial prosthetic hand without using any myoelectric channels. We performed experiments in healthy subjects and with one amputee to test the feasibility of the novel approach. The results showed that the performance of the novel HMI concept was comparable or, for some outcome measures, better than the classic myoelectric interfaces. The presented approach has a general applicability and the obtained results point out that it could be used to operate various assistive systems (e.g., prosthesis vs. wheelchair), or it could be integrated into other control schemes (e.g., myoelectric control, brain-machine interfaces) in order to improve the usability of existing low-bandwidth HMIs.Open-Access-Publikationsfonds 2015peerReviewe