Cavity-Enhanced 2D Material Quantum Emitters Deterministically Integrated with Silicon Nitride Microresonators.

Optically active defects in 2D materials, such as hexagonal boron nitride (hBN) and transition-metal dichalcogenides (TMDs), are an attractive class of single-photon emitters with high brightness, operation up to room temperature, site-specific engineering of emitter arrays with strain and irradiation techniques, and tunability with external electric fields. In this work, we demonstrate a novel approach to precisely align and embed hBN and TMDs within background-free silicon nitride microring resonators. Through the Purcell effect, high-purity hBN emitters exhibit a cavity-enhanced spectral coupling efficiency of up to 46% at room temperature, exceeding the theoretical limit (up to 40%) for cavity-free waveguide-emitter coupling and demonstrating nearly a 1 order of magnitude improvement over previous work. The devices are fabricated with a CMOS-compatible process and exhibit no degradation of the 2D material optical properties, robustness to thermal annealing, and 100 nm positioning accuracy of quantum emitters within single-mode waveguides, opening a path for scalable quantum photonic chips with on-demand single-photon sources.

Who's challenging who training for staff empathy towards adults with challenging behaviour: cluster randomised controlled trial.

BACKGROUND: One in five adults with intellectual disabilities (ID) known to services display challenging behaviours (CBs), and these individuals are at risk for restrictive practices and poor care. Staff attitudes may contribute to the development and/or maintenance of CBs. We investigated the effectiveness of co-produced Who's Challenging Who? training delivered by people with ID to staff. METHOD: This study involved a cluster randomised controlled trial (RCT) of Who's Challenging Who? training with follow-up at six and 20 weeks post-randomisation. PARTICIPANTS: two staff from each of 118 residential care settings for adults with ID at least one of whom displayed aggressive CB. PRIMARY OUTCOME: Self-reported Staff Empathy for people with Challenging Behaviour Questionnaire. ANALYSIS: intention to treat of all randomised settings. ISCRTN registration: ISRCTN53763600. RESULTS: 118 residential settings (including 236 staff) were randomised to either receive training (59 settings) or to receive training after a delay (59 settings). The primary analysis included data from 121 staff in 76 settings (51% of staff, 64% of settings). The adjusted mean difference on the transformed (cubed) Staff Empathy for people with Challenging Behaviour Questionnaire score at the primary end point was 1073.2 (95% CI: -938.1 to 3084.5, P = 0.296) in favour of the intervention group (effect size Cohen's d = .19). CONCLUSIONS: This is the first large-scale RCT of a co-produced training course delivered by people with ID. Findings indicated a small positive (but statistically non-significant) effect on increased staff empathy at 20 weeks, and small to moderate effects for staff reported secondary outcomes in favour of the intervention group.

Self-assembly and surface behaviour of pure and mixed zwitterionic amphiphiles in a deep eutectic solvent.

Recent investigations have shown that deep eutectic solvents provide a suitable environment for self-organisation of biomolecules, in particular phospholipids and proteins. However, the solvation of complex lyophilic moieties by deep eutectic solvents still remains unclear. Here we explore the behaviour of zwitterionic surfactants in choline chloride:glycerol eutectic mixture. Dodecyl-2-(trimethylammonio)ethylphosphate and N-alkyl-N,N-dimethyl-3-ammonio-1-propanesulfonate (alkyl = dodecyl, tetradecyl) surfactants were investigated by means of surface tension, X-ray reflectivity and small-angle neutron scattering. These surfactants were found to remain surface active and form globular micelles in deep eutectic solvents. Still, the surface behaviour of these species was found to differ depending on the headgroup and tail structure. The morphology of the micelles also slightly varies between surfactants, demonstrating differences in the packing of individual monomers. The characteristics of mixtures of the dodecyl surfactants is also reported, showing a deviation from ideal mixing associated with attractive interactions between sulfobetaine and phosphocholine headgroups. Such non-ideality results in variation of the surface behaviour and self-assembly of these surfactant mixtures. The results presented here will potentially lead to the development of new alternatives for drug-delivery, protein solubilisation and biosensing through a better fundamental understanding of the behaviour of zwitterionic surfactants in deep eutectic solvents.

Electronic Enhancement of the Exciton Coherence Time in Charged Quantum Dots.

Minimizing decoherence due to coupling of a quantum system to its fluctuating environment is at the forefront of quantum information and photonics research. Nature sets the ultimate limit, however, given by the strength of the system's coupling to the electromagnetic field. Here, we establish the ability to electronically control this coupling and enhance the optical coherence time of the charged exciton transition in quantum dots embedded in a photonic waveguide. By manipulating the electronic wave functions through an applied lateral electric field, we increase the coherence time from ∼1.4 to ∼2.7 ns. Numerical calculations reveal that longer coherence arises from the separation of charge carriers by up to ∼6 nm, which leads to a 30% weaker transition dipole moment. The ability to electronically control the coherence time opens new avenues for quantum communication and novel coupling schemes between distant qubits.

Biexciton formation and exciton coherent coupling in layered GaSe.

Nonlinear two-dimensional Fourier transform (2DFT) and linear absorption spectroscopy are used to study the electronic structure and optical properties of excitons in the layered semiconductor GaSe. At the 1s exciton resonance, two peaks are identified in the absorption spectra, which are assigned to splitting of the exciton ground state into the triplet and singlet states. 2DFT spectra acquired for co-linear polarization of the excitation pulses feature an additional peak originating from coherent energy transfer between the singlet and triplet. At cross-linear polarization of the excitation pulses, the 2DFT spectra expose a new peak likely originating from bound biexcitons. The polarization dependent 2DFT spectra are well reproduced by simulations using the optical Bloch equations for a four level system, where many-body effects are included phenomenologically. Although biexciton effects are thought to be strong in this material, only moderate contributions from bound biexciton creation can be observed. The biexciton binding energy of ∼2 meV was estimated from the separation of the peaks in the 2DFT spectra. Temperature dependent absorption and 2DFT measurements, combined with "ab initio" theoretical calculations of the phonon spectra, indicate strong interaction with the A1 (') phonon mode. Excitation density dependent 2DFT measurements reveal excitation induced dephasing and provide a lower limit for the homogeneous linewidth of the excitons in the present GaSe crystal.

Coherent coupling of excitons and trions in a photoexcited CdTe/CdMgTe quantum well.

We present zero-, one-, and two-quantum two-dimensional coherent spectra of excitons and trions in a CdTe/(Cd,Mg)Te quantum well. The set of spectra provides a unique and comprehensive picture of the coherent nonlinear optical response. Distinct peaks in the spectra are manifestations of exciton-exciton and exciton-trion coherent coupling. Excellent agreement using density matrix calculations highlights the essential role of many-body effects on the coupling. Strong exciton-trion coherent interactions open up the possibility for novel conditional control schemes in coherent optoelectronics.

Robust parameter extraction for decision support using multimodal intensive care data.

Digital information flow within the intensive care unit (ICU) continues to grow, with advances in technology and computational biology. Recent developments in the integration and archiving of these data have resulted in new opportunities for data analysis and clinical feedback. New problems associated with ICU databases have also arisen. ICU data are high-dimensional, often sparse, asynchronous and irregularly sampled, as well as being non-stationary, noisy and subject to frequent exogenous perturbations by clinical staff. Relationships between different physiological parameters are usually nonlinear (except within restricted ranges), and the equipment used to measure the observables is often inherently error-prone and biased. The prior probabilities associated with an individual's genetics, pre-existing conditions, lifestyle and ongoing medical treatment all affect prediction and classification accuracy. In this paper, we describe some of the key problems and associated methods that hold promise for robust parameter extraction and data fusion for use in clinical decision support in the ICU.

Human teeth as historical biomonitors of environmental and dietary lead: some lessons from isotopic studies of 19th and 20th century archival material.

The lead isotopic composition of various sections (crown, crown base, root) of teeth was determined in specimens collected from 19th century skulls preserved in museum collections and, upon extraction or exfoliation, from humans of known ages residing in Scotland in the 1990s. For most 20th century samples, calculation of accurate crown-complete or root-complete dates of tooth formation ranging from the 1920s to the 1990s enabled comparison of (206)Pb/(207)Pb ratios for teeth sections (crown base root) with corresponding decadally averaged data for archival herbarium Sphagnum moss samples. This showed that the teeth sections had been significantly influenced by incorporation of non-contemporaneous (more recent) lead subsequent to the time of tooth formation, most probably via continuous uptake by dentine. This finding confirmed that separation of enamel from dentine is necessary for the potential of teeth sections as historical biomonitors of environmental (and dietary) lead exposure at the time of tooth formation to be realised. Nevertheless, the mean 19th century value of 1.172+/-0.007 for the (206)Pb/(207)Pb ratio in teeth was very similar to the corresponding mean value of 1.173+/-0.004 for 19th century archival moss, although relative contributions from environmental sources - whether direct, by inhalation/ingestion of dust contaminated by local lead smelting ((206)Pb/(207)Pb~1.17) and coal combustion ((206)Pb/(207)Pb~1.18) emissions, or indirect, through ingestion of similarly contaminated food - and drinking/cooking water contaminated by lead pipes of local origin, cannot readily be determined. In the 20th century, however, the much lower values of the (206)Pb/(207)Pb ratio (range 1.100-1.166, mean 1.126+/-0.013, median 1.124) for the teeth collected from various age groups in the 1990s reflect the significant influence of imported Australian lead of lower (206)Pb/(207)Pb ratio (~1.04) and released to the environment most notably through car-exhaust emissions arising from the use of alkyl lead additives ((206)Pb/(207)Pb~1.06-1.09) in petrol in the U.K. from ca. 1930 until the end of the 20th century.

Inhibition of 11beta-hydroxysteroid dehydrogenase type 1 reduces food intake and weight gain but maintains energy expenditure in diet-induced obese mice.

AIMS/HYPOTHESIS: The 11beta-hydroxysteroid dehydrogenase type-1 inhibitor BVT.2733 lowers blood glucose and insulin in mutant mouse models of obesity and diabetes. Its effects on energy balance and body composition, and their contribution to improved glucose homeostasis have received little attention. MATERIALS AND METHODS: BVT.2733 (100 mg/kg, orally) was given twice daily to lean and diet-induced obese mice for 16 or 17 days. A group of obese mice was pair-fed to the amounts consumed by BVT.2733-treated mice. RESULTS: In both obese and lean mice, BVT.2733 reduced food intake and weight gain, but increased water intake. Pair-feeding caused almost as great a decrease in body weight as BVT.2733. Energy expenditure was 38+/-8% higher in the BVT.2733-treated obese mice than in the pair-fed mice. Terminal plasma corticosterone was raised, lean body weight reduced and percentage fat unchanged in the pair-fed mice (control, 47.8+/-2.6%; pair-fed, 47.1+/-1.9%), whereas BVT.2733 did not reduce lean mass, but did reduce percentage fat (40.9+/-2.0%). BVT.2733 but not pair-feeding reduced both the glucose tolerance AUC and the plasma insulin concentration 30 min after giving glucose. CONCLUSIONS/INTERPRETATION: BVT.2733 reduced food intake but prevented a concomitant reduction in lean body mass and energy expenditure. The latter effects may have contributed to improved glucose tolerance.

Reduction of false arterial blood pressure alarms using signal quality assessment and relationships between the electrocardiogram and arterial blood pressure.

The paper presents an algorithm for reducing false alarms related to changes in arterial blood pressure (ABP) in intensive care unit (ICU) monitoring. The algorithm assesses the ABP signal quality, analyses the relationship between the electrocardiogram and ABP using a fuzzy logic approach and post-processes (accepts or rejects) ABP alarms produced by a commercial monitor. The algorithm was developed and evaluated using unrelated sets of data from the MIMIC database. By rejecting 98.2% (159 of 162) of the false ABP alarms produced by the monitor using the test set of data, the algorithm was able to reduce the false ABP alarm rate from 26.8% to 0.5% of ABP alarms, while accepting 99.8% (441 of 442) of true ABP alarms. The results show that the algorithm is effective and practical, and its use in future patient monitoring systems is feasible.

Long-term ST database: a reference for the development and evaluation of automated ischaemia detectors and for the study of the dynamics of myocardial ischaemia.

The long-term ST database is the result of a multinational research effort. The goal was to develop a challenging and realistic research resource for development and evaluation of automated systems to detect transient ST segment changes in electrocardiograms and for supporting basic research into the mechanisms and dynamics of transient myocardial ischaemia. Twenty-four hour ambulatory ECG records were selected from routine clinical practice settings in the USA and Europe, between 1994 and 2000, on the basis of occurrence of ischaemic and non-ischaemic ST segment changes. Human expert annotators used newly developed annotation protocols and a specially developed interactive graphic editor tool (SEMIA) that supported paperless editing of annotations and facilitated international co-operation via the Internet. The database contains 86 two- and three-channel 24 h annotated ambulatory records from 80 patients and is stored on DVD-ROMs. The database annotation files contain ST segment annotations of transient ischaemic (1155) and heart-rate related ST episodes and annotations of non-ischaemic ST segment events related to postural changes and conduction abnormalities. The database is intended to complement the European Society of Cardiology ST-T database and the MIT-BIH and AHA arrhythmia databases. It provides a comprehensive representation of 'real-world' data, with numerous examples of transient ischaemic and non-ischaemic ST segment changes, arrhythmias, conduction abnormalities, axis shifts, noise and artifacts.

Systematic comparison of different algorithms for apnoea detection based on electrocardiogram recordings.

Sleep apnoea is a common disorder that is usually diagnosed through expensive studies conducted in sleep laboratories. Sleep apnoea is accompanied by a characteristic cyclic variation in heart rate or other changes in the waveform of the electrocardiogram (ECG). If sleep apnoea could be diagnosed using only the ECG, it could be possible to diagnose sleep apnoea automatically and inexpensively from ECG recordings acquired in the patient's home. This study had two parts. The first was to assess the ability of an overnight ECG recording to distinguish between patients with and without apnoea. The second was to assess whether the ECG could detect apnoea during each minute of the recording. An expert, who used additional physiological signals, assessed each of the recordings for apnoea. Research groups were invited to access data via the world-wide web and submit algorithm results to an international challenge linked to a conference. A training set of 35 recordings was made available for algorithm development, and results from a test set of 35 different recordings were made available for independent scoring. Thirteen algorithms were compared. The best algorithms made use of frequency-domain features to estimate changes in heart rate and the effect of respiration on the ECG waveform. Four of these algorithms achieved perfect scores of 100% in the first part of the study, and two achieved an accuracy of over 90% in the second part of the study.

An automated, web-enabled and searchable database system for archiving electrogram and related data from implantable cardioverter defibrillators.

The advent of implantable cardioverter defibrillators (ICDs) has resulted in significant reductions in mortality in patients at high risk for sudden cardiac death. Extensive related basic research and clinical investigation continue. ICDs typically record intracardiac electrograms and inter-beat intervals along with device settings during episodes of device delivery of therapy. Researchers wishing to study these data further have until now been limited to viewing paper plots. In support of multi-center clinical studies of patients with ICDs, we have developed a web based searchable ICD data archiving system, which allows users to use a web browser to upload ICD data from diskettes to a server where the data are automatically processed and archived. Users can view and download the archived ICD data directly via the web. The entire system is built from open source software. At present more than 500 patient ICD data sets have been uploaded to and archived in the system. This project will be of value not only to those who wish to conduct research using ICD data, but also to clinicians who need to archive and review ICD data collected from their patients.

Evaluation of dental radiographic identification: an experimental study.

The object of this study was to assess the value of dental radiographs for the purposes of personal identification in the absence of tooth restorations. 198 periapical and bitewing radio graphs were taken of teeth contained in 22 dry skulls obtained from the skull collection of the Royal College of Surgeons of Edinburgh. Each selected view was taken three times: by a scientist, a dentist and a dental radiographer. Each operator independently positioned the films, selected the exposure times and positioned the cone of the X-ray machine. Three groups comprising forensic odontologists, dental vocational trainees and dental trainee hygienists attempted to match the randomly mixed radiographs into sets of three. Success rates for matching radio graphs ranged from 63.6 to 100%. The average for forensic odontologists was 93.3%, vocational trainees 85.2% and hygienists 89.7%. Where forensic odontologists had both formal training and experience, or extensive experience without formal training, the success rate was 100%. Where there was formal training but little experience the success rate was lower. Participants believed that root morphology and alignment had been the greatest aid to matching and not crown morphology. The depth of knowledge of the viewer correlated poorly with the number of correct results, although the forensic odontologists achieved the highest success rate. Formal training, although highly desirable, is no substitute for practical experience. Root morphology and alignment were cited most frequently as facilitating matching.

An action research approach to the development of a clinical pathway for women requiring Caesarean sections.

An action research framework was utilised to introduce a clinical pathway for women undergoing Caesarean section in the Maternity Unit at Westmead Hospital in 1998-1999. This style of research allowed the development of the clinical pathwayfor women having a Caesarean section to be progressively modified to adapt it to suit the needs of the multidisciplinary team and the clinical environment. The clinical pathway itself became a document that facilitated the education of the women, improving their preparation for discharge, aided the orientation and skill development of new staff and improved the continuity of care by enhancing the multidisciplinary approach to the women's care. It also identified the need for continuing staff education throughout the implementation and evaluation phases.

Introduction of computational models to PhysioNet.

PhysioNet is a national research resource that provides experimental data sets and open-source software for their analysis. Computational modeling can complement studies of these experimental data sets so as to facilitate the advancement of physiologic research. Thus, in order to introduce computational models to PhysioNet, we have developed and posted a cardiovascular model designed for research that generates reasonable human pulsatile hemodynamic waveforms, cardiac output and venous return curves, and beat-to-beat variability. Some of the key features of the software include: 1) compatibility with PhysioNet's open-source data analysis software; 2) online viewing and parameter updating as the data are being calculated; 3) off-line viewing after completion of the simulation; 4) pre-compiled Linux binaries; 5) open-source code that may be compiled on other platforms; and 6) an extensive user's manual and software guide.

Do nonlinearities play a significant role in short term, beat-to-beat variability?

Numerous studies of short-term beat-to-beat variability in cardiovascular signals have not resolved the debate about the completeness of linear analysis techniques. This aim of this paper is to evaluate further the role of nonlinearities in short-term, beat-to-beat variability. We compared linear autoregressive moving average (ARMA) and nonlinear neural network (NN) models for predicting instantaneous heart rate (HR) and mean arterial blood pressure (BP) from past HR and BP. To evaluate these models, we used HR and BP time series from the MIMIC database. Experimental results indicate that NN-based nonlinearities do not play a significant role and suggest that ARMA linear analysis techniques provide adequate characterization of the system dynamics responsible for generating short-term, beat-to-beat variability.