Entropy and bispectral index for assessment of sedation, analgesia and the effects of unpleasant stimuli in critically ill patients: an observational study

INTRODUCTION: Sedative and analgesic drugs are frequently used in critically ill patients. Their overuse may prolong mechanical ventilation and length of stay in the intensive care unit. Guidelines recommend use of sedation protocols that include sedation scores and trials of sedation cessation to minimize drug use. We evaluated processed electroencephalography (response and state entropy and bispectral index) as an adjunct to monitoring effects of commonly used sedative and analgesic drugs and intratracheal suctioning. METHODS: Electrodes for monitoring bispectral index and entropy were placed on the foreheads of 44 critically ill patients requiring mechanical ventilation and who previously had no brain dysfunction. Sedation was targeted individually using the Ramsay Sedation Scale, recorded every 2 hours or more frequently. Use of and indications for sedative and analgesic drugs and intratracheal suctioning were recorded manually and using a camera. At the end of the study, processed electroencephalographical and haemodynamic variables collected before and after each drug application and tracheal suctioning were analyzed. Ramsay score was used for comparison with processed electroencephalography when assessed within 15 minutes of an intervention. RESULTS: The indications for boli of sedative drugs exhibited statistically significant, albeit clinically irrelevant, differences in terms of their association with processed electroencephalographical parameters. Electroencephalographical variables decreased significantly after bolus, but a specific pattern in electroencephalographical variables before drug administration was not identified. The same was true for opiate administration. At both 30 minutes and 2 minutes before intratracheal suctioning, there was no difference in electroencephalographical or clinical signs in patients who had or had not received drugs 10 minutes before suctioning. Among patients who received drugs, electroencephalographical parameters returned to baseline more rapidly. In those cases in which Ramsay score was assessed before the event, processed electroencephalography exhibited high variation. CONCLUSIONS: Unpleasant or painful stimuli and sedative and analgesic drugs are associated with significant changes in processed electroencephalographical parameters. However, clinical indications for drug administration were not reflected by these electroencephalographical parameters, and barely by sedation level before drug administration or tracheal suction. This precludes incorporation of entropy and bispectral index as target variables for sedation and analgesia protocols in critically ill patients.

Highly Efficient IR to NIR Upconversion in Gd2O2S: Er3+ for Photovoltaic Applications

Upconversion (UC) is a promising option to enhance the efficiency of solar cells by conversion of sub-bandgap infrared photons to higher energy photons that can be utilized by the solar cell. The UC quantum yield is a key parameter for a successful application. Here the UC luminescence properties of Er3+-doped Gd2O2S are investigated by means of luminescence spectroscopy, quantum yield measurements, and excited state dynamics experiments. Excitation into the maximum of the 4I15/2 → 4I13/2 Er3+ absorption band around 1500 nm induces very efficient UC emission from different Er3+ excited states with energies above the silicon bandgap, in particular, the emission originating from the 4I11/2 state around 1000 nm. Concentration dependent studies reveal that the highest UC quantum yield is realized for a 10% Er3+-doping concentration. The UC luminescence is compared to the well-known Er3+-doped β-NaYF4 UC material for which the highest UC quantum yield has been reported for 25% Er3+. The UC internal quantum yields were measured in this work for Gd2O2S: 10%Er3+ and β-NaYF4: 25%Er3+ to be 12 ± 1% and 8.9 ± 0.7%, respectively, under monochromatic excitation around 1500 nm at a power of 700 W/m2. The UC quantum yield reported here for Gd2O2S: 10%Er3+ is the highest value achieved so far under monochromatic excitation into the 4I13/2 Er3+ level. Power dependence and lifetime measurements were performed to understand the mechanisms responsible for the efficient UC luminescence. We show that the main process yielding 4I11/2 UC emission is energy transfer UC.

Successful pacing using a batteryless sunlight-powered pacemaker.

AIMS Today's cardiac pacemakers are powered by batteries with limited energy capacity. As the battery's lifetime ends, the pacemaker needs to be replaced. This surgical re-intervention is costly and bears the risk of complications. Thus, a pacemaker without primary batteries is desirable. The goal of this study was to test whether transcutaneous solar light could power a pacemaker. METHODS AND RESULTS We used a three-step approach to investigate the feasibility of sunlight-powered cardiac pacing. First, the harvestable power was estimated. Theoretically, a subcutaneously implanted 1 cm(2) solar module may harvest ∼2500 µW from sunlight (3 mm implantation depth). Secondly, ex vivo measurements were performed with solar cells placed under pig skin flaps exposed to a solar simulator and real sunlight. Ex vivo measurements under real sunlight resulted in a median output power of 4941 µW/cm(2) [interquartile range (IQR) 3767-5598 µW/cm(2), median skin flap thickness 3.0 mm (IQR 2.7-3.3 mm)]. The output power strongly depended on implantation depth (ρSpearman = -0.86, P < 0.001). Finally, a batteryless single-chamber pacemaker powered by a 3.24 cm(2) solar module was implanted in vivo in a pig to measure output power and to pace. In vivo measurements showed a median output power of >3500 µW/cm(2) (skin flap thickness 2.8-3.84 mm). Successful batteryless VVI pacing using a subcutaneously implanted solar module was performed. CONCLUSION Based on our results, we estimate that a few minutes of direct sunlight (irradiating an implanted solar module) allow powering a pacemaker for 24 h using a suitable energy storage. Thus, powering a pacemaker by sunlight is feasible and may be an alternative energy supply for tomorrow's pacemakers.

Electronic tuning effects via π-linkers in tetrathiafulvalene-based dyes

Four new tetrathiafulvalene (TTF)-based dyes featured with a donor–bridge–acceptor (D–π–A) structure were synthesized and characterized. All of them undergo two reversible oxidations to form stable radical cation and dication species. The electronic interactions between the TTF donor and the cyanoacrylic acid acceptor through the different π-linkers have been demonstrated by the presence of a photo-induced intramolecular charge-transfer (ICT) absorption band in the visible region. A red shift of the ICT state can be finely tuned by the degree of aromaticity and extended conjugation of π-bridges. To some extent, the oxidation potentials of these dyes are affected by the nature of π-bridges. They have been applied in organic dye-sensitized solar cells, showing relatively low power conversion efficiencies of up to 0.87% due to substantial charge recombination losses.

[Future cardiac pacemakers – technical visions].

Cardiac pacemakers are routinely used for the treatment of bradyarrhythmias. Contemporary pacemakers are reliable and allow for a patient specific programming. However, pacemaker replacements due to battery depletion are common (~25 % of all implantation procedures) and bear the risk of complications. Batteryless pacemakers may allow overcoming this limitation. To power a batteryless pacemaker, a mechanism for intracorporeal energy harvesting is required. Such a generator may consist out of subcutaneously implanted solar cells, transforming the small amount of transcutaneously available light into electrical energy. Alternatively, intravascular turbines may harvest energy from the blood flow. Energy may also be harvested from the ventricular wall motion by a dedicated mechanical clockwork converting motion into electrical energy. All these approaches have successfully been tested in vivo. Pacemaker leads constitute another Achilles heel of contemporary pacemakers. Thus, leadless devices are desired. Miniaturized pacemaker circuits and suitable energy harvesting mechanisms (incorporated in a single device) may allow catheter-based implantation of the pacemaker in the heart. Such miniaturized battery- and leadless pacemakers would combine the advantages of both approaches and overcome major limitations of today’s systems.

Carbon/oxygen ratios, clay composition and gas-hydrate saturation of ODP Leg 164 sites

The analyses of downhole log data from Ocean Drilling Program (ODP) boreholes on the Blake Ridge at Sites 994, 995, and 997 indicate that the Schlumberger geochemical logging tool (GLT) may yield useful gas hydrate reservoir data. In neutron spectroscopy downhole logging, each element has a characteristic gamma ray that is emitted from a given neutron-element interaction. Specific elements can be identified by their characteristic gamma-ray signature, with the intensity of emission related to the atomic elemental concentration. By combining elemental yields from neutron spectroscopy logs, reservoir parameters including porosities, lithologies, formation fluid salinities, and hydrocarbon saturations (including gas hydrate) can be calculated. Carbon and oxygen elemental data from the GLT was used to determine gas hydrate saturations at all three sites (Sites 994, 995, and 997) drilled on the Blake Ridge during Leg 164. Detailed analyses of the carbon and oxygen content of various sediments and formation fluids were used to construct specialized carbon/oxygen ratio (COR) fan charts for a series of hypothetical gas hydrate accumulations. For more complex geologic systems, a modified version of the standard three-component COR hydrocarbon saturation equation was developed and used to calculate gas hydrate saturations on the Blake Ridge. The COR-calculated gas hydrate saturations (ranging from about 2% to 14% bulk volume gas hydrate) from the Blake Ridge compare favorably to the gas hydrate saturations derived from electrical resistivity log measurements.

Experimental Model to estimate shading losses on PV arrays

This paper presents a simple mathematical model to estimateshadinglosses on PVarrays. The model is applied directly to power calculations, without the need to consider the whole current–voltage curve. This allows the model to be used with common yield estimation software. The model takes into account both the shaded fraction of the array area and the number of blocks (a group of solar cells protected by a bypass diode) affected by shade. The results of an experimental testing campaign on several shaded PVarrays to check the validity of model are also reported.

Roadmap towards efficiencies over 40% at ultra-high concentrations (> 1000 suns)

High efficiency solar cells working under ultra-high concentrations (>;1000X) have been shown to be a promising solution to decrease the cost of PV electricity, increase the efficiency and circumvent the material availability restrictions for massive PV penetration. A detailed analysis of the limitations of our current triple junction solar cell (36.2% at 700X), in the quest to maximize efficiency at 1000X, shows that the main improvements to tackle are: a) implementation of a high band gap tunnel junction; b) increase the band gap of the top cell; c) fine current matching tune; d) enhancement of the front contact process. This constitutes our roadmap to reach an efficiency over 41%

Real-time reliability test for a CPV module based on a power degradation model

Models based on degradation are powerful and useful tools to evaluate the reliability of those devices in which failure happens because of degradation in the performance parameters. This paper presents a procedure for assessing the reliability of concentrator photovoltaic (CPV) modules operating outdoors in real-time conditions. With this model, the main reliability functions are predicted. This model has been applied to a real case with a module composed of GaAs single-junction solar cells and total internal reflection (TIR) optics

High-efficiency Köhler photovoltaic concentrators with external light confinement

Metal grid lines are a vital element in multijunction solar cells in order to take out from the cell the generated photocurrent. Nevertheless all this implies certain shadowing factor and thus certain reflectivity on cells surface that lowers its light absorption. This reflectivity produces a loss in electrical efficiency and thus a loss in global energy production for CPV systems. We present here an optical design for recovering this portion of reflected light, and thus leading to a system efficiency increase. This new design is based on an external confinement cavity, an optical element able to redirect the light reflected by the cell towards its surface again. It has been possible thanks to the recent invention of the advanced Köhler concentrators by LPI, likely to integrate one of these cavities easily. We have proven the excellent performance of these cavities integrated in this kind of CPV modules offering outstanding results: 33.2% module electrical efficiency @Tcell=25ºC and relative efficiency and Isc gains of over 6%.

Evidence of charge carrier number fluctuations in InN thin films?

Due to its small band-gap and its high mobility, InN is a promising material for a large number of key applications like band-gap engineering for high efficiency solar cells, light emitting diodes, and high speed devices. Unfortunately, it has been reported that this material exhibits strong surface charge accumulation which may depend on the type of surface. Current investigations are conducted in order to explain the mechanisms which govern such a behavior and to look for ways of avoiding it and/or finding applications that may use such an effect. In this framework, low frequency noise measurements have been performed at different temperatures on patterned MBE grown InN layers. The evolution of the 1/f noise level with temperature in the 77 K-300 K range is consistent with carrier number fluctuations thus indicating surface mechanisms: the surface charge accumulation is confirmed by the noise measurements.

E-beam nanopatterning for the selective area growth of III-V nitride nanorods

GaN/InGaN nanorods have attracted much scientific interest during the last decade because of their unique optical and electrical properties [1,2]. The high crystal quality and the absence of extended defects make them ideal candidates for the fabrication of high efficiency opto-electronic devices such as nano-photodetectors, light-emitting diodes, and solar cells [1-3]. Nitrides nanorods are commonly grown in the self-assembled mode by plasma-assisted molecular beam epitaxy (MBE) [4]. However, self-assembled nanorods are characterized by inhomogeneous heights and diameters, which render the device processing very difficult and negatively affect the electronic transport properties of the final device. For this reason, the selective area growth (SAG) mode has been proposed, where the nanorods preferentially grow on pre-defined sites on a pre-patterned substrate [5].

Towards 35% Efficient Concentrator Modules Based On LPI Köhler Concentrators With External Confinement Cavities

Multijunction solar cells present a certain reflectivity on its surface that lowers its light absorption. This reflectivity produces a loss in electrical efficiency and thus a loss in global energy production for CPV systems. We present here an optical design for recovering this portion of reflected light, and thus leading to a system efficiency increase. This new design is based on an external confinement cavity, an optical element able to redirect the light reflected by the cell towards its surface again. We have proven the excellent performance of these cavities integrated in CPV modules offering outstanding results: 33.2% module electrical efficiency @Tcell  =  25 °C and relative efficiency and Isc gains of over 6%

Analysis of the Mechanical Properties of Multicrystalline and Monocrystalline Silicon Wafers Manufactured by Casting Methods

Quasi-monocrystalline silicon wafers have appeared as a critical innovation in the PV industry, joining the most favourable characteristics of the conventional substrates: the higher solar cell efficiencies of monocrystalline Czochralski-Si (Cz-Si) wafers and the lower cost and the full square-shape of the multicrystalline ones. However, the quasi-mono ingot growth can lead to a different defect structure than the typical Cz-Si process. Thus, the properties of the brand-new quasi-mono wafers, from a mechanical point of view, have been for the first time studied, comparing their strength with that of both Cz-Si mono and typical multicrystalline materials. The study has been carried out employing the four line bending test and simulating them by means of FE models. For the analysis, failure stresses were fitted to a three-parameter Weibull distribution. High mechanical strength was found in all the cases. The low quality quasi-mono wafers, interestingly, did not exhibit critical strength values for the PV industry, despite their noticeable density of extended defects.