Helmholtz solitons in diffusive Kerr-type media

Nonlinear interfaces separating two diffusive Kerr-type media exhibit dual switching between total internal reflection and transmission. This property is found within a weakly nonlocal regime when both a nonparaxial treatment of the problem and a full two-dimensional model for carrier diffusion are assumed. The theoretical model is shown to predict an effective cubic-quintic nonlinearity with competing terms that produces such property. The validity of the analysis is contrasted with a full set of numerical simulations

The inherent overlapping in the parallel calculation of the Laplacian

Producción CientíficaA new approach for the parallel computation of the Laplacian in the Fourier domain is presented. This numerical problem inherits the intrinsic sequencing involved in the calculation of any multidimensional Fast Fourier Transform (FFT) where blocking communications assure that its computation is strictly carried out dimension by dimension. Such data dependency vanishes when one considers the Laplacian as the sum of n independent one-dimensional kernels, so that computation and communication can be naturally overlapped with nonblocking communications. Overlapping is demonstrated to be responsible for the speedup figures we obtain when our approach is compared to state-of-the-art parallel multidimensional FFTs.Junta de Castilla León (grant number VA296P18

Dark solitons at nonlinear interfaces

The refraction of dark solitons at a planar boundary separating two defocusing Kerr media is simulated and analyzed, for the first time (to our knowledge). Analysis is based on the nonlinear Helmholtz equation and is thus valid for any angle of incidence. A new law, governing refraction of black solitons, is combined with one describing bright soliton refraction to yield a generalized Snell’s law whose validity is verified numerically. The complexity of gray soliton refraction is also analyzed, and illustrated by a change from external to internal refraction on varying the soliton contrast parameter

Nonlinear interfaces: intrinsically nonparaxial regimes and effects

The behaviour of optical solitons at planar nonlinear boundaries is a problem rich in intrinsically nonparaxial regimes that cannot be fully addressed by theories based on the nonlinear Schrödinger equation. For instance, large propagation angles are typically involved in external refraction at interfaces. Using a recently proposed generalized Snell's law for Helmholtz solitons, we analyse two such effects: nonlinear external refraction and total internal reflection at interfaces where internal and external refraction, respectively, would be found in the absence of nonlinearity. The solutions obtained from the full numerical integration of the nonlinear Helmholtz equation show excellent agreement with the theoretical predictions

Widely varying giant Goos–Hänchen shifts from airy beams at nonlinear interfaces

We present a numerical study of the giant Goos–Hänchen shifts (GHSs) obtained from an Airy beam impinging on a nonlinear interface. To avoid any angular restriction associated with the paraxial approximation, the analysis is based on the nonlinear Helmholtz equation. We report the existence of nonstandard nonlinear GHSs displaying an extreme sensitivity to the input intensity and the existence of multiple critical values. These intermittent and oscillatory regimes can be explained in terms of competition between critical coupling to a surface mode and soliton emission from the refracted beam component and how this interplay varies with localization of the initial Airy beam

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake