Notes

Self-protection predicts reduced readiness to be able to say i'm sorry.
A previously healthy 25-year-old Asian male was admitted with acute respiratory failure due to COVID-19 pneumonia to our intensive care unit. He received empiric therapy and higher level of respiratory support via a high flow nasal cannula. Notably, human metapneumovirus was detected from the nasopharyngeal swab by RT-PCR. Six days post-ICU admission, sinusitis was clinically and sonographically detected. RMC-7977 cost SARS-CoV-2 was detected in the fluid aspirated from the antrum. The patient has made an uneventful recovery. Further studies are required to investigate co-infections with SARS-CoV-2 and other viruses.The Fourth Circuit Court of Appeals' March 13, 2020 decision in Williams v. Dimension Health Corporation reintroduced scrutiny on the lesser-known mandate of The Emergency Medical Treatment and Active Labor Act (EMTALA) concerning good faith admission to the hospital. EMTALA was enacted by Congress in 1986 to prevent patient dumping by prohibiting hospitals with emergency departments from refusing to provide emergency medical treatment to patients unable to pay for treatment, and prohibiting the transfer of those patients before their emergency medical conditions are stabilized. The reach of EMTALA ends when a patient is admitted and consequently becomes an inpatient, because then the hospital believes the patient would benefit from admission, and discharge and transfer would not occur as outlined in EMTALA. This paper examines the analysis of this mandate in Williams v. Dimension Health Corporation, and closely investigates one particular aspect of it that admission must be made in good faith; otherwise, application of EMTALA's screening and stabilization requirements has not yet terminated, and hospitals can still be found culpable.The recent changes to expand the permissible scope of medical student documentation draw ample parallels to historical efforts to increase the clinical role of medical learners. While the expanded role of medical student documentation holds the potential for increased community preceptorship and enhanced medical student participation in patient care, it also comes with possible consequences for preceptors, students, and patients. The authors posit that while the rule changes represent important steps forward, further guidance around how these rules are to be implemented will be necessary before the healthcare system can reap their full benefit.Field hospitals have long been used to extend health care capabilities in times of crisis. In response to the pandemic and an anticipated surge in patients, Rhode Island Gov. Gina Raimondo announced a plan to create three field hospitals, or "alternate hospital sites" (AHS), totaling 1,000 beds, in order to expand the state's hospital capacity. Following China's Fangcang shelter hospital model, the Lifespan AHS (LAHS) planning group attempted to identify existing public venues that could support rapid conversion to a site for large numbers of patients at a reasonable cost. After discussions with many stakeholders - pharmacy, laboratory, healthcare providers, security, emergency medical services, and infection control - design and equipment recommendations were given to the architects during daily teleconferencing and site visits. Specific patient criteria for the LAHS were established, staffing was prioritized, and clinical protocols were designed to facilitate care. Simulations using 4 different scenarios were practiced in order to assure proper patient care and flow, pharmacy utilization, and staffing.We demonstrate and optimize a tri-layer vertical coupler for a silicon nitride (Si3N4) multilayer platform operating at a 2 µm band. The large spacing between the topmost and bottommost layers of a gradient structure enables ultra-low crossing loss and interlayer crosstalk without affecting the efficiency interlayer transition. We achieve a 0.31 dB transition loss, ultra-low multi-layer crosstalk of -59.3 dB at a crossing angle of 90° with an interlayer gap of 2300 nm at 1950nm. With width optimization of this structure, the fabrication tolerances toward lateral misalignment of two stages in this coupler have increased 61% and 56%, respectively. We also propose a vertical coupler, based on this design, with mode selectivity and achieve an extinction ratio of less then 15 dB for wavelengths in the 1910-1990 range. Meanwhile, a multi-layer interlaced AWGs centered at 1950nm and based on vertical coupler has been demonstrated. The proposed vertical couplers exhibit potential for application in large-scale photonic-integrated circuits and broadly in photonic devices.Nutrient profile determination for plant materials is an important task to determine the quality and safety of the human diet. Laser-induced breakdown spectroscopy (LIBS) is an atomic emission spectrometry of the material component analytical technique. However, quantitative analysis of plant materials using LIBS usually suffers from matrix effects and nonlinear self-absorption. To overcome this problem, a hybrid quantitative analysis model of the partial least squares-artificial neural network (PLS-ANN) was used to detect the compositions of plant materials in the air. Specifically, fifty-eight plant materials were prepared to split into calibration, validation and prediction sets. Nine nutrient composition profiles of Mg, Fe, N, Al, B, Ca, K, Mn, and P were employed as the target elements for quantitative analysis. It demonstrated that the prediction ability can be significantly improved by the use of the PLS-ANN hybrid model compared to the method of standard calibration. Take Mg and K as examples, the root-mean-square errors of calibration (RMSEC) of Mg and K were decreased from 0.0295 to 0.0028 wt.% and 0.2884 to 0.0539 wt.%, and the mean percent prediction errors (MPE) were decreased from 5.82 to 4.22% and 8.82 to 4.12%, respectively. This research provides a new way to improve the accuracy of LIBS for quantitative analysis of plant materials.Vergence-accommodation conflict (VAC) is a major challenge in optical-see through augmented reality (AR) system. To resolve this conflict, many approaches are proposed, for instance, by means of adjustment of the projected virtual image to coincide with the surroundings, called image registration, which is more often referred to as varifocal function. In this paper, a varifocal AR system is demonstrated by adopting electrically tunable liquid crystal (LC) plane-parallel plates to solve VAC problem. The LC plates provide electrically tunable optical paths when the directors of LC molecules are re-orientated with applied voltages, which leads to a corresponding change of light speed for an extraordinary wave. To provide a sufficient tunable optical path, three pieces of multiple-layered LC structures are used with the total thickness of the active LC layers (∼510 μm). In experiments, the projected virtual image can be adjusted from 1.4 m to 2.1 m away from the AR system, while the thickness of LC plane-parallel plates are only less than 3 mm without any mechanical moving part. When light propagates in the uniaxial LC layers, the wave vector and the Poynting vector are different. The longitudinal displacement of the image plane is determined by Poynting vectors rather than wave vectors. As a result, the analysis of the AR system should be based on Poynting vectors during geometrical optical analysis. Surprisingly, the tunable range of the longitudinal displacement of Poynting vectors is 2-fold larger than the tunable range of the wave vectors. Moreover, the virtual image shifts in opposite directions with respect to the Poynting vectors and wave vectors. The proposed AR system is not only simple but also thin, and it exhibits a large clear aperture. The investigation here paves the way to a simple solution of the VAC problem for augmented reality systems.We describe the guided acoustic-wave Brillouin scattering (GAWBS) phase noise characteristics in multi-core fibers (MCFs) used for a digital coherent optical fiber transmission both experimentally and analytically. We first describe the GAWBS phase noise in an uncoupled four-core fiber with a 125 µm cladding and compare the phase noise spectrum with that of a standard single-mode fiber (SSMF). We found that, unlike SSMF where the R0,m mode is dominant, off-center cores in MCF are affected by higher-order TRn,m modes. We then report measurement results for GAWBS phase noise in a 19-core fiber with a 240 µm cladding. The results indicate that the cores exhibit different spectral profiles depending on their distance from the center of the fiber, but the amount of phase noise generated in each core is almost identical. These results provide a useful insight into the space division multiplexing transmission impairments in digital coherent transmissions using MCF.Here, we present the design and simulation of an ultrawide-bandwidth on-chip spectrometer that can be used in various applications, e.g. spectral tissue sensing. It covers 1200 nm wavelength range (400 nm-1600 nm) with 2 nm spectral resolution. The overall design size is only 3 × 3 cm2. The ultra-wide spectral range is made possible by using novel on-chip band-pass filters for the coarse wavelength division. The fine resolution is provided by the arrayed waveguide gratings. The band-pass filter is formed by using bend waveguides and adiabatic full-couplers. The additional loss caused by the band-pass filter is relatively small. The proposed spectrometer covers entire 400 nm-1600 nm range continuously with low crosstalk values. We envision that this design can be used in several different applications including food safety, agriculture, industrial inspection, optical imaging, and biomedical research.We present a deep learning (DL) framework based on a conditional generative adversarial network (CGAN) to perform compressive optical image hiding (COIH) with a single-pixel detector. An end-to-end compressive sensing generative adversarial network (eCSGAN) is developed, achieving the approximate equivalent model of an inverse system of a nonlinear COIH model, to reconstruct two-dimensional secret images directly from real acquired one-dimensional compressive sampling signals without the need of any security keys of the COIH system such as the sequence of illumination patterns, the host image, etc. Moreover, detailed comparisons between the image reconstructed using eCSGAN and compressive sensing (CS) shows that the proposed method can remarkably increase the quality in image reconstruction with a lower sampling rate. The feasibility and security of the proposed method are demonstrated by the numerical simulations and optical experiment results.One of the most significant bottlenecks in achieving kilojoule-level high-energy petawatt (PW) to hundreds-petawatt (100PW) lasers is the requirement of as large as meter-sized gratings so as to avoid the laser-induced damage in the compressor. High-quality meter-sized gratings have so far been difficult to manufacture. This paper proposes a new in-house (intra-) beam-splitting compressor based on the property that the damage threshold of gratings depends on the pulse duration. The proposed scheme will simultaneously improve the stability, save on expensive gratings, and simplify compressor size because the split beams share the first two parallel gratings. Furthermore, as the transmitted wavefront of a glass plate can be better and more precisely controlled than the diffraction wavefront of a large grating, we propose glass plates with designed transmitted wavefront to compensate for the wavefront distortion introduced by the second and third gratings, and other in-house optics, such as the beam splitter. This simple and economical method can compensate for the space-time distortion in the compressor, and thus improve focal intensity, which otherwise cannot be compensated by a deformable mirror outside the compressor.
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