The safety and feasibility of telemedicine in intensive care units (ICU) are well established. However, whether tele-ICU exerts a measurable impact on clinically relevant outcomes remains uncertain. To evaluate whether a multifaceted Tele-ICU intervention, integrating intensivist-led daily multidisciplinary rounds (DMRs), coordinated care from a multidisciplinary team, and a quality and safety management strategy focused on quality improvement can reduce ICU length of stay among patients in Brazil. Design, setting, participants, and intervention: The TELESCOPE 2 study is a multicentre, open-label, stepped-wedge cluster randomized controlled trial including 25 ICUs in Brazil from January 2024 to January 2026. In a stepped-wedge assignment, ICUs will be randomized and allocated to one of five sequences. All ICUs will receive the interventions in a staggered manner at different times. All adult patients admitted in participant ICUs will be eligible for inclusion in the study. Admissions to the ICU due to justice-related issues (since in such circumstances the ICU admission or discharge may be determined by the law rather than by medical reasons), and patients previously included in the TELESCOPE 2 study will be excluded. The trial intervention is multifaceted, comprising three components delivered in combination, via telemedicine: I) daily multidisciplinary rounds led by board-certified intensive care physicians; II) coordinated care by a multidisciplinary team, including nurses, physiotherapists, and clinical pharmacists); III) a management strategy focused on quality improvement and patient safety. The primary outcome is ICU length of stay. Secondary outcomes include ICU mortality, in-hospital mortality, ventilator-free days during the first 28 days, ICU readmission within 48 h, early reintubation, ventilator-associated events, and accidental extubation rate. The TELESCOPE 2 study will assess whether a muiltifaceted Tele-ICU intervention can reduce ICU lenght of stay among critically ill patients in Brazil. We describe the study protocol for the TELESCOPE 2 trial, finalized prior to database lock. TELESCOPE 2 will evaluate the clinical impact of a structured Tele-ICU intervention in resource-variable ICUs and may provide robust evidence regarding the optimal model for delivering Tele-ICU.
Ground-based optical telescopes necessitate prompt and spatially detailed information regarding dome-scale cloud coverage to facilitate target-specific shuttering and scheduling decisions. When only coarse or delayed atmospheric data are available, observatories risk inefficient use of scarce dark time and the irreversible loss of scientific exposures. To address this, we introduce the WOANC dataset, a pixel-annotated nighttime full-dome dataset acquired at an operational observatory, alongside NightCloudSegNet, a fisheye-aware segmentation framework specifically designed for low-light astronomical imaging. Evaluated on the WOANC test set, NightCloudSegNet achieves a mean intersection-over-union (mIoU) of 86.6% and a pixel-level F1 score of 92.8%. Furthermore, when tested on the external SWINSEG dataset, the model attains an mIoU of 86.2% and an F1 score of 92.6%, thereby demonstrating robust performance under conditions of fisheye distortion and low illumination. By translating pixel-level segmentation masks into per-target observability indicators, this approach has the potential to support informed shuttering and scheduling decisions, which is expected to enhance observational efficiency in automated telescope operations.
Moderate and high hyperopia is a common clinical refractive error that severely affects distant and near visual functions. Traditional correction relies on high-power positive spherical lenses, which are prone to problems such as thick lens thickness, heavy weight, poor wearing comfort, and limited visual correction effect, resulting in low wearing compliance and reduced life quality of patients. Existing telescopic correction devices have the defects of large volume and narrow imaging field of view, which cannot meet the needs of daily clinical correction. This study aims to construct an improved optical correction system based on the Galilean telescope principle, and explore a low-burden, high-efficiency novel correction scheme for moderate and high hyperopia. Based on the afocal imaging theory of Galilean telescopes, a novel diopter-splitting optical structure was constructed with a zero-diopter air lens as the core component. The total diopter of hyperopic refractive error was decomposed and redistributed optically. A low-power positive lens was adopted to undertake the major correction of hyperopia, while the residual refractive diopter was matched with a negative eyepiece corresponding to the hyperopic degree. Combined with a positive spherical objective lens, the optical interval between lens groups was precisely optimized to form a compact Galilean telescopic correction system with the magnification limited within 2.0 × . Optical simulation was conducted to explore the quantitative relationships among optical magnification, system structural size, imaging distortion and field of view, so as to determine the optimal wearable structural parameters for clinical application. The proposed novel optical system can effectively correct moderate and high hyperopia merely by using low-power positive lenses, which completely eliminates the clinical drawbacks of traditional high-power lenses such as excessive thickness and heavy weight. When the magnification is controlled within the range of 1.2 × -1.5 ×, the system features an ultra-compact structure, excellent wearability, wide imaging field of view and negligible optical distortion. Excessively high magnification (over 2.0 ×) will greatly narrow the peripheral visual field, reduce the effective imaging area, and significantly weaken the practical wearable value of the device. Reasonable low magnification can effectively magnify retinal images, relieve blurred vision caused by refractive defocus, and alleviate long-term visual fatigue in hyperopic patients. The improved Galilean telescopic correction system realizes innovative diopter-splitting correction for moderate and high hyperopia, breaking the limitations of traditional hyperopia correction lenses and conventional telescopic optical devices. The optimized low-magnification optical structure has the advantages of compact volume, wide field of view, low distortion and good wearing adaptability. It can effectively improve visual acuity and daily visual quality of patients with moderate and high hyperopia, and greatly enhance life satisfaction. This system has broad application prospects in clinical optometric correction and low-vision rehabilitation.
Diffractive optical elements can be manufactured as ultra-thin planar segmented structures, enabling beam focusing while significantly reducing the volume and weight of optical systems. In this paper, a segmented reflective-diffractive hybrid infrared telescope is proposed. This configuration effectively shortens the total system length, realizes a lightweight design, and improves system integration. The correlation between the phase coefficients of diffractive optical elements and their aberrations is investigated, laying an analytical foundation for system design. Based on the axial chromatic aberration formulas of the diffractive primary and secondary mirrors, quantitative chromatic aberration analysis of the system is performed. Furthermore, the suppression effect of pupil aberrations on the achromatic mechanism is revealed. Comparative analyses verify that the system configuration with eliminated pupil aberrations exhibits superior optical performance. Taking an optical system with a 1000-mm aperture and an operating wavelength range of 3.8-4.2 μm as an example, the proposed system achieves a spatial resolution of 33 cy/mm with a shorter overall length and higher integration, which validating the effectiveness of the proposed design method.
Efficient, selective, and sustainable synthetic platforms are increasingly important in modern chemical manufacturing, yet chemical flexibility often remains limited. In this study, we develop a modular biocatalytic system for the divergent and continuous transformation of ethyl acetoacetate (EAA) into either enantiomerically pure (R)-3-hydroxybutyric acid ((R)-3HBA) or oligomers of (R)-poly(3-hydroxybutyrate) (PHB). The cascade combines two telescoped packed-bed reactors containing an immobilized, self-sufficient Lactobacillus kefir ketoreductase (LkKRED) and commercial immobilized Candida antarctica lipase B (N435). By simply tuning the reaction conditions, the system selectively directs the substrate toward either product. Under aqueous conditions, it achieves quantitative conversion to (R)-3HBA with >99% enantiomeric excess and maintains excellent stability over 7 days of continuous operation. It also reaches a maximum space-time yield of 105 g L-1 h-1, which is 33 times higher than the volumetric productivity of the sequential two-pot process. Under anhydrous conditions, the same setup promotes polycondensation into PHB oligomers, as confirmed by matrix-assisted laser desorption/ionization time-of-flight analysis. Overall, this platform combines productivity, stereoselectivity, and flexibility for the integrated synthesis of chiral building blocks or oligomers.
The EXoplanet Climate Infrared TElescope (EXCITE) is a balloon-borne mission dedicated to measuring spectroscopic phase curves of hot Jupiter-type exoplanets. Phase curve measurements can be used to characterize an exoplanet's longitude-dependent atmospheric composition and energy circulation patterns. EXCITE carries a 0.5 m primary mirror and a moderate resolution diffraction-limited spectrograph with spectral coverage from 0.8 to 3.5 μm. EXCITE is designed to fly from a long-duration balloon. EXCITE will observe through the peak of a target's spectral energy distribution and through spectral signatures of hydrogen and carbon-containing molecules. In this paper, we present the science goals of EXCITE, detail the as-built instrument, and discuss its performance during a 2024 engineering flight from Fort Sumner, New Mexico.
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Quantum networks and remote quantum entanglement serve as vital future quantum communication resources with broad applicability. A key direction lies in extending the baseline of optical interferometers to enhance angular resolution in interferometric imaging. Here, by measuring a simulated thermal light field, we report the demonstration of a memory-assisted nonlocal interferometer achieving a fiber-link baseline up to 20 km while simultaneously showing its capability to compensate for a geometric delay equivalent to 1.5 km. This result demonstrates potential for enhancing the angular resolution of interferometric imaging in the optical band with delocalized single-photon entanglement, and paves the way for future application of quantum memories in astronomical observation.
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Giant camera will repeatedly scan the sky, spotting transients while building deep map of billions of galaxies.
The geosynchronous (GSO) debris environment is continually evolving. Regular monitoring of the region is consequently of great importance, though the trade-off between coverage and sensitivity makes this challenging for the population of optically faint debris, where collecting area becomes a pivotal factor. Surveys conducted with large-aperture telescopes have provided crucial insights into the nature of this largely uncharacterised population. In this paper, we revisit a survey conducted with the 2.54 m Isaac Newton Telescope (INT), presenting an overhaul of the astrometric calibration and object detection stages of the original analysis pipeline. We apply a blind stacking technique to boost target recovery, unearthing 25 tracklets previously missed by single-frame extraction methods, and pushing the sensitivity limit fainter by 1 magnitude. The same algorithm is applied to a contemporaneous dataset, captured with a 36 cm astrograph, enabling performance benchmarking through the attempted recovery of INT detections from commercial-off-the-shelf observations. We achieve sub-arcsecond astrometric accuracy through a combination of improved star trail centroiding and iterative distortion fitting, allowing short arc initial orbit solutions to be obtained. High-cadence light curves extracted for trailing detections indicate that faint fragments are proportionally more variable than bright derelicts, with many exhibiting photometric signatures of rapid tumbling, often straddling the image noise floor. Lastly, we present preliminary findings from a follow-up multi-national observation campaign, utilising telescopes in Australia, Japan and La Palma. As space traffic management concerns begin to extend beyond GSO altitudes, scientifically-driven surveys of high-altitude orbits have an important role to play in characterising the faint debris environment.
As a key component of space telescopes, the rational structure of the mirror is a crucial factor affecting the telescope's environmental adaptability and imaging performance. To address the technical challenges of simultaneously achieving lightweight, environmental adaptability, and surface accuracy in large-aperture ultrathin mirrors, this paper proposes a mirror optimization method based on multiphysics coupling. Based on the finite element method and thermoelasticity theory, the interaction relationship between the temperature physical field and the force physical field was established. The P-norm was used to solve the problems of non-smoothness and inability to solve the sensitivity of the max(·) function. An optimized model for the mirror was determined using a combination of topology optimization and parameter optimization. Compared to a solid mirror, the optimized mirror achieved a mass reduction rate of 82.04%. Under temperature and gravity conditions, the surface accuracy of the optimized mirror met the requirements. In terms of response dynamics, the optimized mirror performs better, with a maximum response amplification factor of 4.39, below the threshold of 4.5 required to maintain structural stability, which is crucial for maintaining the structural integrity of the mirror. This method will provide a feasible approach for the optimized design of lightweight mirrors with strong environmental adaptability.
Using a combination of Hubble Space Telescope and James Webb Space Telescope imaging, a runaway supermassive black hole was recently identified with an inferred velocity of 954_{-126}^{+110}  km s^{-1}, likely ejected from a compact star-forming galaxy at z≈0.96. Assuming the runaway black hole originated from a gravitational-wave-driven merger of two supermassive black holes (SMBHs), we combine its measured recoil velocity with gravitational-wave recoil predictions from numerical relativity and black-hole perturbation theory to constrain the mass ratio and spin configuration of the progenitor binary that overcame the final-parsec problem and merged ∼70  Myr ago. We find that the progenitor binary must have been precessing, with a mass ratio m_{1}/m_{2}≲6, and that the more massive SMBH likely possessed a high dimensionless spin magnitude (∼0.75) in order to generate a recoil of this magnitude. Such SMBH mergers could represent an interesting source population for the upcoming Laser Interferometer Space Antenna mission, with characteristic signal-to-noise ratios of order ≳10^{3}. Furthermore, the inferred progenitor SMBH properties suggest that the compact galaxy likely originated from a major, gas-rich ("wet") merger between two galaxies of comparable mass, with a mass ratio ≲4.
The interaction between the magnetic field and turbulent convection in the Sun's photosphere drives the dynamics, evolution and structuring of its magnetized atmosphere. This interaction often takes place at or below the spatial resolution of modern-day observations. Here we report on high-spatial-resolution observations of the solar photosphere acquired using the world's first 4-m class solar telescope, the US National Science Foundation's Daniel K. Inouye Solar Telescope. Time sequence images reveal a far more complex and dynamic solar scene than previously observed. We identify ubiquitous magnetized Kelvin-Helmholtz instabilities at the edges of magnetic flux concentrations and provide experimental confirmation of a long-standing theoretical prediction1,2. The discovery of small-scale magnetized Kelvin-Helmholtz instabilities in the solar photosphere, which can be reproduced by high-resolution numerical simulations, has far-reaching implications for our understanding of the creation and dissipation of magnetic fields exhibiting vortex motion, which can lead to flux braiding. Our results support the picture of disjoint magnetic field concentrations in layers below the visible solar surface that connect to monolithic flux regions visible as facular concentrations and pores in the solar photosphere. Kelvin-Helmholtz instabilities are an efficient mechanism for transporting mass, energy, momentum and magnetic flux in magnetohydrodynamic systems, and they offer transformative insights into processes in magnetically active regions such as the one observed here.
Clonidine•HCl is a clinically important imidazoline derivative whose manufacturing routes have seen little innovation since their development in the mid-to-late 20th century. Its widespread use as an antihypertensive and neuroactive agent underscores the need for more efficient, modern production strategies. Herein, we report the first continuous flow strategy for the synthesis of clonidine. By integrating telescoped multistep sequences, inline liquid-liquid workup, advanced solid handling, and machine learning, we developed an intensified process that delivers clonidine•HCl in only 24 min total residence time across 5 continuous transformations, achieving an overall yield of 54%. This approach significantly outperforms conventional batch protocols, which typically require more than 18 h. The platform enables efficient and precisely controlled isothiocyanate formation, thiourea hydrolysis, S-methylation, and imidazoline cyclisation, while reducing intermediate isolations, minimising reagent handling, and eliminating hazardous materials associated with legacy routes. These advances provide a scalable, data-driven manufacturing solution and establish a foundation for intensified production of clonidine and related APIs under continuous flow conditions.
Hypopharyngeal venous malformations are rare and may mimic malignancy on imaging, creating diagnostic and management challenges, particularly when tissue diagnosis is required. A 61-year-old woman presented with progressive dysphagia and odynophagia. Contrast-enhanced computed tomography (CT) of the neck demonstrated an enhancing lesion involving the left tongue base, aryepiglottic fold, and hypopharynx, with associated coarse calcifications, raising concern for neoplasia. Flexible laryngoscopy revealed a compressible, purplish, vascular-appearing lesion. The patient underwent direct laryngoscopy with biopsy using a Lindholm laryngoscope with rigid telescope assistance, during which bleeding was successfully controlled with epinephrine-soaked pledgets. Histopathological analysis confirmed a venous malformation with phleboliths and features of a chronic low-flow vascular lesion, including positive immunohistochemical staining for CD34, CD31, and smooth muscle actin. Hypopharyngeal venous malformations can closely resemble malignancy on imaging. Recognition of characteristic features, including calcifications and compressibility on endoscopy, is essential to guide diagnosis. This case demonstrates that biopsy can be performed safely in selected patients with appropriate airway planning and hemostatic precautions.
Hydrocarbons are partly responsible for the opacity of warm Jupiters' atmospheres in the infrared. Laboratory high-resolution spectroscopic data, including hot band rovibrational transitions, are crucial to model and interpret telescope observations. In this work, a set of six hot bands and 11 cold bands of ethylene (12C2H4) is observed using cavity ringdown spectroscopy between 5880 and 6200 cm-1. The ethylene sample is preheated to 650 and 850 K before being expanded through a Laval nozzle to produce a high Mach number expansion. The rotational temperature drops to ∼12-13 K in the jet, while the vibrational population accumulates in the first excited vibrational state ν10, from which all the observed hot bands originate. The observed transitions are assigned using the lower state combination difference approach; a set of A, B, and C rotational constants, along with the energy of the upper state, is determined using PGOPHER software for the 17 observed vibrational bands. The TheoReTS (Theoretical Reims-Tomsk Spectral data) model, employed to identify the upper vibrational states, will benefit from these newly identified transitions.
Dispersed fringe sensing (DFS) is an efficient co-phasing method for segmented mirrors, though conventionally limited to one-dimensional piston measurement. We propose a two-stage orthogonal decoupling method based on the multi-trace Hilbert transform. By combining frequency-domain carrier isolation with spatially robust fitting, this approach enables full-dimensional pose error retrieval using a standard DFS. Simulations show that under a signal-to-noise ratio (SNR) of 5 dB, the piston retrieval error is below 0.6 nm, and the tip-tilt error is within 0.5 μrad. Experimental validations yield an average piston retrieval error of 50.67 nm, with absolute tip and tilt errors below 0.63 μrad and 0.70 μrad, respectively. This extends traditional DFS into a three-dimensional coarse co-phasing solution for large-aperture telescopes.
The suggested detection of sulfur-based biomarkers in the atmosphere of exoplanet K2-18b has triggered intensive discussions about the use of observational data from the James Webb Space Telescope (JWST) to search for life on exoplanets. This methodology, however, requires precise infrared spectroscopic data of biomarker molecules, ideally without the influence of pressure broadening or contaminants. In this work, we use the light of the free-electron laser FELIX to record the infrared spectrum of three sulfur-based biomarkers, dimethyl sulfide (DMS), dimethyl disulfide (DMDS), and dimethyl sulfoxide (DMSO), in the isolated conditions of a molecular beam. The use of FELIX allows the sampling of a wide spectral range, spanning from 650 to 3300 cm-1, where JWST is most sensitive. In addition, separate spectra of the (DMS)2, (DMDS)2 and (DMSO)2 dimers are recorded, allowing for a clear assessment of the effect of complexation on the infrared spectra of the molecules. Density functional theory calculations and Born-Oppenheimer molecular dynamics simulations are performed to interpret the measured infrared spectra and to estimate absolute cross sections.
This paper proposes a freeform optical design method based on collaborative optimization of point clouds and normals. The method represents the freeform surface as a discrete point cloud with local normal information, and realizes collaborative optimization of point position updating and normal reconstruction under the guidance of system image quality evaluation. This method avoids dependence on a preset analytical form of the target freeform surface, as well as repeated complex ray intersection calculations with the analytical target freeform surface during optimization. To ensure the stability of the optimization process, the sensitivity of local normal reconstruction parameters and sampled ray density is further analyzed. The method is then applied to the design of an off-axis three mirror telescope with a wide field of view of 30∘×5∘, in which the third mirror is selected as the freeform surface to be optimized. After optimization, the system merit function decreases significantly from 0.3923 to 0.002789. The final design achieves an average RMS spot radius of 5.939µm, and the full field MTF remains above 0.6 at 56 lp/mm. The results show that the proposed method can effectively obtain a discrete freeform surface solution that satisfies the imaging quality requirements of the system.