Picosecond laser filament-guided electrical discharges in air at 1 kHz repetition rate.

Laser-induced filaments have been shown to reduce the voltage necessary to initiate electrical discharges in atmospheric air and guide their propagation over long distances. Here we demonstrate the stable generation of laser filament-guided electrical discharge columns in air initiated by high energy (up to 250 mJ) 1030 nm wavelength laser pulses of 7 ps duration at repetition rates up to 1 kHz and we discuss the processes leading to breakdown. A current proportional to the laser pulse energy is observed to arise as soon as the laser pulse arrives, initiating a high impedance phase of the discharge.

Demonstration of a side-pumped cross-seeded thin-slab pre-amplifier for high-power Ti:Sa laser systems.

We demonstrate a room-temperature Ti:Sapphire (Ti:Sa) amplifier that uses a cross pump-seed geometry (cross-thin-slab) to generate 30-mJ output pulses at 0.5-kHz repetition rate, and 25 mJ at 1 kHz when pumped by 100-mJ, 515-nm pulses from a diode-pumped Yb:YAG laser. The geometry allows to maintain a crystal temperature of ∼30°C using cooling water at 10°C.

Difficulties Detecting Clinically Relevant Factor Xa Inhibitor Levels Prior to Reversal With Andexanet Alfa for Intracranial Hemorrhage.

Coagulation factor Xa (recombinant), inactivated-zhzo (andexanet alfa) is approved for reversal of life-threatening bleeding with rivaroxaban and apixaban use. Clinical decision-making to initiate reversal is reliant on dose taken and timing of last dose. In practice, timing of last dose may be unknown, and the turnaround time for drug-specific anti-factor Xa levels at some institutions may be prolonged, leaving clinicians balancing a difficult decision with limited tools.

Pentobarbital Coma Use in a Pregnant Patient With Refractory Intracranial Hypertension: A Case Report.

Objective: Intracranial hypertension is a life-threatening condition that requires emergent diagnosis and management. Although pentobarbital coma for refractory intracranial hypertension has been studied in the general population, this study is the first reported case of pentobarbital coma use in a pregnant patient.

Methods: We performed a retrospective chart review of a pregnant patient with refractory intracranial hypertension and reviewed the current literature on the role of pentobarbital coma.

Improved CRISPR genome editing using small highly active and specific engineered RNA-guided nucleases.

Streptococcus pyogenes (Spy) Cas9 has potential as a component of gene therapeutics for incurable diseases. One of its limitations is its large size, which impedes its formulation and delivery in therapeutic applications. Smaller Cas9s are an alternative, but lack robust activity or specificity and frequently recognize longer PAMs.

Automated, flow-based chemiluminescence microarray immunoassay for the rapid multiplex detection of IgG antibodies to SARS-CoV-2 in human serum and plasma (CoVRapid CL-MIA).

In the face of the COVID-19 pandemic, the need for rapid serological tests that allow multiplexing emerged, as antibody seropositivity can instruct about individual immunity after an infection with SARS-CoV-2 or after vaccination. As many commercial antibody tests are either time-consuming or tend to produce false negative or false positive results when only one antigen is considered, we developed an automated, flow-based chemiluminescence microarray immunoassay (CL-MIA) that allows for the detection of IgG antibodies to SARS-CoV-2 receptor-binding domain (RBD), spike protein (S1 fragment), and nucleocapsid protein (N) in human serum and plasma in less than 8 min. The CoVRapid CL-MIA was tested with a set of 65 SARS-CoV-2 serology positive or negative samples, resulting in 100% diagnostic specificity and 100% diagnostic sensitivity, thus even outcompeting commercial tests run on the same sample set.

1.1 J Yb:YAG picosecond laser at 1 kHz repetition rate.

We demonstrate the generation of 1.1 J pulses of picosecond duration at 1 kHz repetition rate (1.1 kW average power) from a diode-pumped chirped pulse amplification Yb:YAG laser.

Energy Expenditure in Critically Ill Adult Patients With Acute Brain Injury: Indirect Calorimetry vs. Predictive Equations.

Predictive equations (PE) are used in lieu of indirect calorimetry (IC) due to cost and limited resources; however, these equations may not be as accurate as IC in estimating resting energy expenditure (REE) in critically ill patients, putting them at risk of malnutrition. The purpose of this study is to compare predicted and measured energy expenditure (MEE) in critically ill adults with acute brain injury. This was a retrospective review of adult patients admitted to the Neurosciences ICU with acute brain injury between May 1st, 2014 and April 1st, 2016 who had IC performed.

Enhanced renal clearance and impact on vancomycin pharmacokinetic parameters in patients with hemorrhagic stroke.

Background: The majority of patients with hemorrhagic stroke experience enhanced renal clearance or augmented renal clearance (ARC). The purpose of this study was to determine the impact of enhanced renal clearance or ARC on vancomycin pharmacokinetic (PK) parameters.

Methods: This was a post hoc analysis of a prospective study of adult patients with aneurysmal subarachnoid hemorrhage (aSAH) or intracerebral hemorrhage (ICH) admitted to the neurosciences intensive care unit who received vancomycin.

Enhanced Renal Clearance in Patients With Hemorrhagic Stroke.

Objectives: To evaluate enhanced renal clearance over time in patients with aneurysmal subarachnoid hemorrhage or intracerebral hemorrhage via measured creatinine clearance and to compare measured creatinine clearance to creatinine clearance calculated by the Cockcroft-Gault equation and estimated glomerular filtration rate calculated by the Modification of Diet in Renal Diseases equation.

Design: Prospective, observational study.

Setting: Neurosciences ICU in a tertiary care academic medical center.

Correction to: Influence of Single-Dose Antibiotic Prophylaxis for Early-Onset Pneumonia in High-Risk Intubated Patients.

Due to an error introduced during the production process, J. Dedrick Jordan's name was improperly tagged in the original publication of this article. It is tagged correctly here.

In situ 3-D temperature mapping of high average power cryogenic laser amplifiers.

Heat generation is a key obstacle to scaling high energy solid-state lasers to the multi-kilowatt average powers required for several key applications. We demonstrate an accurate, in situ, noninvasive optical technique to that makes three-dimensional (3-D) temperature maps within cryogenic amplifiers operating at high average power. The temperature is determined by analyzing the fluorescence spectra with a neural network function.

Influence of Single-Dose Antibiotic Prophylaxis for Early-Onset Pneumonia in High-Risk Intubated Patients.

Background: Early-onset pneumonia (EOP) after endotracheal intubation is common among critically ill patients with a neurologic injury and is associated with worse clinical outcomes.

Methods: This retrospective cohort study observed outcomes pre- and post-implementation of an EOP prophylaxis protocol which involved the administration of a single dose of ceftriaxone 2 g around the time of intubation. The study included patients ≥ 18 years who were admitted to the University of North Carolina Medical Center (UNCMC) neuroscience intensive care unit (NSICU) between April 1, 2014, and October 26, 2016, and intubated for ≥ 72 h.

HIV Prevention 2020: a framework for delivery and a call for action.

Although effective programmes are available and several countries have seen substantial declines in new HIV infections, progress in the reduction of adult HIV incidence has been slower than expected worldwide and many countries have not had large decreases in new infections in adults despite large reductions in paediatric infections. Reasons for slow progress include inadequate commitment, investment, focus, scale, and quality of implementation of prevention and treatment interventions. The UNAIDS-Lancet Commission on Defeating AIDS-Advancing Global Health reported that the provision of large-scale, effective HIV prevention programmes has failed and called on stakeholders to "get serious about HIV prevention".

Getting the balance right: Scaling-up treatment and prevention.

The goals of the international response to control the HIV epidemic include high antiretroviral therapy (ART) coverage with HIV viral suppression, as well as reduction of new infections. ART use at individual and population levels reduces HIV morbidity and mortality and likely reduces HIV incidence. HIV viral suppression requires high levels of ART adherence, which necessitates support through behavioural and structural interventions to optimise effectiveness of the use of ART for prevention.

Is there scope for cost savings and efficiency gains in HIV services? A systematic review of the evidence from low- and middle-income countries.

Objective: To synthesize the data available--on costs, efficiency and economies of scale and scope--for the six basic programmes of the UNAIDS Strategic Investment Framework, to inform those planning the scale-up of human immunodeficiency virus (HIV) services in low- and middle-income countries.

Methods: The relevant peer-reviewed and "grey" literature from low- and middle-income countries was systematically reviewed. Search and analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

An action agenda for HIV and sex workers.

The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services.

Costs and efficiency of integrating HIV/AIDS services with other health services: a systematic review of evidence and experience.

Objectives: To review the literature on the potential efficiency gains of integrating HIV services with other health services.

Design: Systematic literature review. Search of electronic databases, manual searching and snowball sampling.

Understanding methods for estimating HIV-associated maternal mortality.

The impact of HIV on maternal mortality and more broadly on the health of women, remains poorly documented and understood. Two recent reports attempt to address the conceptual and methodological challenges that arise in estimating HIV-related maternal mortality and trends. This paper presents and compares the methods and discusses how they affect estimates at global and regional levels.

Local perceptions of the forms, timing and causes of behavior change in response to the AIDS epidemic in Zimbabwe.

Quantitative studies indicate that HIV incidence in Zimbabwe declined since the late 1990s, due in part to behavior change. This qualitative study, involving focus group discussions with 200 women and men, two dozen key informant interviews, and historical mapping of HIV prevention programs, found that exposure to relatives and close friends dying of AIDS, leading to increased perceived HIV risk, was the principal explanation for behavior change. Growing poverty, which reduced men's ability to afford multiple partners, was also commonly cited as contributing to reductions in casual, commercial and extra-marital sex.

HIV decline in Zimbabwe due to reductions in risky sex? Evidence from a comprehensive epidemiological review.

Background: Recent data from antenatal clinic (ANC) surveillance and general population surveys suggest substantial declines in human immunodeficiency virus (HIV) prevalence in Zimbabwe. We assessed the contributions of rising mortality, falling HIV incidence and sexual behaviour change to the decline in HIV prevalence.

Methods: Comprehensive review and secondary analysis of national and local sources on trends in HIV prevalence, HIV incidence, mortality and sexual behaviour covering the period 1985-2007.

Stromal regulation of vessel stability by MMP14 and TGFbeta.

Innate regulatory networks within organs maintain tissue homeostasis and facilitate rapid responses to damage. We identified a novel pathway regulating vessel stability in tissues that involves matrix metalloproteinase 14 (MMP14) and transforming growth factor beta 1 (TGFbeta(1)). Whereas plasma proteins rapidly extravasate out of vasculature in wild-type mice following acute damage, short-term treatment of mice in vivo with a broad-spectrum metalloproteinase inhibitor, neutralizing antibodies to TGFbeta(1), or an activin-like kinase 5 (ALK5) inhibitor significantly enhanced vessel leakage.

Healing of ungrafted bone defects of the talus after benign tumour removal.

Background: Curettage of benign tumours commonly results in significant bone defects that are reconstructed with autologous grafts, allografts, bone cement or bone substitute. We have treated such defects in the talus without reconstruction with bone or any other material. We now report the healing of these ungrafted defects in eight patients treated with curettage for benign talar tumours.