A Life-Threatening Emergency Exacerbated by Untreated Mental Illness in a Low-Barrier Health Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage. Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment. Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we assessed that she understood the implications of declining care, despite her mental illness. After extensive patient-centered and trauma-informed discussions, she accepted medical treatment. Conclusions: This case highlights the importance of patient-centered communication and team-based care during emergencies and refusal of care. Shared decision-making and trauma-informed care are appropriate methods for assessing the capacity of patients with severe mental illness in acute and life-threatening conditions

Status of the Micromegas semi-DHCAL

The activities towards the fabrication and test of a 1 m3 semi-digital hadronic calorime- ter are reviewed. The prototype sampling planes would consist of 1 m2 Micromegas chambers with 1 cm2 granularity and embedded 2 bits readout suitable for PFA calorime- try at an ILC detector. The design of the 1 m2 chamber is presented first, followed by an overview of the basic performance of small prototypes. The basic units composing the 1 m2 chamber are 32 \times 48 cm2 boards with integrated electronics and a micro-mesh. Results of character- ization tests of such boards are shown. Micromegas as a proportional detector is well suited for semi-digital hadronic calorimetry. In order to quantify the gain in perfor- mance when using one or more thresholds, simulation studies are being carried out, some of which will be reported in this contribution

MICROMEGAS chambers for hadronic calorimetry at a future linear collider

Prototypes of MICROMEGAS chambers, using bulk technology and analog readout, with 1x1cm2 readout segmentation have been built and tested. Measurements in Ar/iC4H10 (95/5) and Ar/CO2 (80/20) are reported. The dependency of the prototypes gas gain versus pressure, gas temperature and amplification gap thickness variations has been measured with an 55Fe source and a method for temperature and pressure correction of data is presented. A stack of four chambers has been tested in 200GeV/c and 7GeV/c muon and pion beams respectively. Measurements of response uniformity, detection efficiency and hit multiplicity are reported. A bulk MICROMEGAS prototype with embedded digital readout electronics has been assembled and tested. The chamber layout and first results are presented

Large Area Micromegas Chambers with Embedded Front-end Electronics for Hadron Calorimetry

AbstractMicromegas (Micro-mesh gaseous structure) is an attractive technology for applications in particle physics experiments (TPC, calorimeters, muon systems, etc.). The most important results of an extensive R&D program aiming to develop a new generation of a fine-grained hadron calorimeter with low power consumption digital readout using Micromegas chambers as an active element are presented. In 2010, the first large scale prototype of Micromegas chamber with almost 8000 readout channels has been built and tested with high energy particle beams at CERN. The fundamental results, such as detection effciency, hit multiplicity, gain stability, response uniformity and effect of power pulsing of the detector front-end electronics are reported. Eventually, the development and test of the second generation of the large scale prototype with new readout electronics and some important improvements of its mechanical design is described and the prospective towards the construction of a technological prototype of a 4.5 λ deep digital calorimeter for a future linear collider is also given

Recent results of Micromegas sDHCAL with a new readout chip

Calorimetry at future linear colliders could be based on a particle flow approach where granularity is the key to high jet energy resolution. Among different technologies, Micromegas chambers with 1 cm2 pad segmentation are studied for the active medium of a hadronic calorimeter. A chamber of 1 m2 with 9216 channels read out by a low noise front-end ASIC called MICROROC has recently been constructed and tested. Chamber design, ASIC circuitry and preliminary test beam results are reported