Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

A qualitative analysis of rural syringe service program fidelity in Appalachian Kentucky: Staff and participant perspectives

PURPOSE

As drug-related epidemics have expanded from cities to rural areas, syringe service programs (SSPs) and other harm reduction programs have been slow to follow. The recent implementation of SSPs in rural areas demands attention to program fidelity based on core components of SSP success.

METHODS

Semistructured interviews conducted with clients and staff at 5 SSPs in 5 counties within 2 Central Appalachian health districts. Interviews covered fidelity of SSP implementation to 6 core components: (1) meet needs for harm reduction supplies; (2) education and counseling for sexual, injection, and overdose risks; (3) cooperation between SSPs and local law enforcement; (4) provide other health and social services; (5) ensure low threshold access to services; and (6) promote dignity, the impact of poor fidelity on vulnerability to drug-related harms, and the risk environment's influence on program fidelity. We applied thematic methods to analyze the data.

FINDINGS

Rural SSPs were mostly faithful to the 6 core components. Deviations from core components can be attributed to certain characteristics of the local rural risk environment outlined in the risk environment model, including geographic remoteness, lack of resources and underdeveloped infrastructure, and stigma against people who inject drugs (PWID) CONCLUSIONS: As drug-related epidemics continue to expand outside cities, scaling up SSPs to serve rural PWID is essential. Future research should explore whether the risk environment features identified also influence SSP fidelity in other rural areas and develop and test strategies to strengthen core components in these vulnerable areas.

Impact of inflammatory phenotype on prognostic discrimination for the novel biomarker cellular communication network factor 1 (CCN1) in patients with dilated cardiomyopathy

Objective

Circulating cellular communication network factor 1 (CCN1) improves risk stratification in ACS patients and, as we have recently shown, predicts all-cause mortality in patients with dilated cardiomyopathy (DCM). It was the aim of this study to evaluate whether the prognostic role of CCN1 is influenced by an inflammatory phenotype.

Methods

Patients with a primary diagnosis of DCM, defined as LVEF <45% and an increased LVEDD (according to HENRY >117%), were included in this single-center study. Exclusion criteria comprised primary valvular diseases (≥second degree), acute myocarditis, active infectious diseases, pulmonary diseases, cancer, chronic alcoholism, and heart failure of other origins. CCN1 levels were determined in serum at study inclusion using an enzyme-linked immunosorbent assay. The primary endpoint was all-cause mortality during follow-up. An adjusted multivariable cox regression model was used to assess the association between CCN1 and all-cause mortality. We further analysed potential effect modifications by adding either an interaction term between CCN1 and DCMi diagnosis (DCMi vs. DCM). The Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score to predict all-cause mortality in HF patients was used as a reference model. The performance of CCN1 in combination with the MAGGIC score and NT-proBNP to predict all-cause mortality was assessed using Cox's proportional-hazards models

Results

A total of 283 predominantly male DCM patients (78.5% males) with a median age of 55.7 (interquartile range [IQR 48.2, 65.7]) years and predominantly recent onset of disease (3.8 [IQR 1.1, 20.5] months) with a severely reduced LVEF (31 [IQR 25, 37] %), increased LVEDD (67.0 [IQR 62.8, 72.0] mm), and normal eGFR (CKD-EPI) (90.9 [IQR73.9, 102.4] ml/min) were analyzed. During a median follow-up of 12.4 [IQR 10.5, 14.0] years, a total of 107 (37.8%) patients died. Patients in the highest CCN1 tertile had a significantly higher mortality risk than those in the lower tertile (HR 1.82; 95% CI 1.06, 3.14; P=0.030) in adjusted multivariable Cox regression models. Adding CCN1 to the MAGGIC risk score improved c-statistics for prognostic accuracy of all-cause mortality at 6 years (0.624 to 0.645, p=0.012), unlike NT-proBNP (0.624 to 0.630, p=0.123). Patients classified as DCMi (n=128) had significantly lower CCN1 levels compared with classical DCM (n=155) (154.9 (115.4–191.7) vs. 174.7 (130.0–241.0) pg/ml, P=0.022). Inflammation status (DCMi vs DCM) had no significant impact (P interaction = 0.28) on the association of CCN1 and all-cause mortality (Fig. 1).

Conclusion

CCN1 independently predicts all-cause mortality in DCM patients and improves risk stratification beyond the MAGGIC score. In this pilot cohort, the inflammatory phenotype had no impact on prognostic discrimination. Data are currently analyzed in a validation cohort.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Kerckhoff Research Foundation

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

Cardiorespiratory fitness but not physical activity are associated with pulse wave velocity and arterial stiffness in the general population

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): BMBF

Background

Higher cardiorespiratory fitness (CRF) and physical activity (PA) are associated with lower cardiovascular morbidity and all-cause mortality. Pulse wave velocity (PWV) and augmentation index (AIx) are vascular parameters associated with aging and end-organ damage and provide reliable information about arterial stiffness. Therefore, PWV and AIx could represent attractive parameters for cardiovascular risk stratification.

Purpose

To improve our understanding of the relationship between CRF/PA and PWV and arterial stiffness, we associated CRF and PA with central and peripheral PWVs and AIx as outcomes using multivariable regression analysis using data from the population-based Study of Health in Pomerania (SHIP Trend 1).

Methods

CRF was assessed using cardiopulmonary exercise testing (CPET) on a bicycle ergometer. CRF was defined as peak oxygen uptake (VO2peak), VO2peak per kg fat free mass (VO2peak_ffm) and metabolic equivalent tasks (METs). PA was measured using the Baecke questionnaire. Aortic PWV (aoPWV), carotid-femoral PWV (cfPWV) and brachial-ankle PWV (baPWV) in m/s were determined non-invasively using the Vascular Explorer. Aortic AIx (aoAIx), aortic AIx at a heart rate of 75 bpm (aoAIx@75) and brachial-ankle AIx (brAIx) were measured using the same device. We used linear regression models adjusted for age, sex, smoking status, mean arterial pressure, antihypertensive medication, diabetic medication, HbA1c, fat mass, fat-free-mass and height. Fat-free mass was not included when VO2peak_ffm was the exposure. Fat-free mass and fat mass were not used in models with METs.

Results

We analysed data of 1,677 individuals which included 840 men (median age 56 years; inter-quartile range [IQR] 47 to 65) and 837 women (median age 54 years; IQR 46 to 65). A one l/min greater VO2peak was related to lower aoPWV (β - 0.22; 95% confidence interval (CI) -0.37 to -0.06, p < 0.01), cfPWV (β - 0.32; 95%CI -0.55 to -0.09; p < 0.01), baPWV (β -0.02; 95%CI -0.03 to 0.00, p < 0.05) and brAIx (β -3.49; 95%CI -6.95 to -0.03, p < 0.01). VO2peak was not related to aoAIx and aoAIx@75. VO2peak_ffm was associated with lower aoPWV (β -0.01; 95%CI -0.02 to -0.00, p < 0.05) and cfPWV (β -0.02; 95%CI -0.03 to -0.00, p < 0.05). VO2peak_ffm was not associated with baPWV, aoAIx, aoAIx@75 or brAIx. METs were positively associated with aoAIx@75 (β 0.30; 95%CI 0.02 to 0.59, p < 0.01). Sport and work related PA were not related to PWV or AIx. Sensitivity analysis with further adjustment for heart rate did not significantly change the results.

Conclusions

We found an association between CRF and central as well as peripheral PWV and AIx values in the adult general population. Interestingly, body composition had an impact on the relationship between CRF and peripheral but not central parameters. Further, PA was not related to these vascular markers which highlights the important difference between CRF and PA.

Sex-specific associations of ceramides with cardiopulmonary fitness in the general population

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Federal Ministry of Education & Research (BMBF)

Introduction

According to the WHO 17.9 million people die because of cardiovascular diseases (CVD) each year, being the 3rd leading cause of death worldwide. Low cardiorespiratory fitness (CRF) is an important risk factor for CVD. Recent research showed that long-chain unsaturated ceramides are associated with higher risk of cardiovascular events, thus identifying ceramides as a potential novel and independent risk factor. However, not all ceramides are equal. We previously showed beneficial effects of very-long-chain ceramides (i.e. C24:0 and C24:0/C16:0 ratio) with higher concentrations being inversely associated with all-cause mortality and CVD events.

Purpose

We would like to investigate, if ceramides mediated their effects on developing CVD by affecting CRF. Therefore, we explored the association of three specific ceramides (C16:0, C22:0 and C24:0) and their ratios with different parameters of CRF.

Methods

We used data of the population-based Study of Health in Pomerania (SHIP-1) from North Germany (N: 1,247/men: 583, median age: 50.8 years/women: 664, median age: 50.2 years). Ceramides and CRF were assessed by LC/MS assay and symptom-limited cardiopulmonary exercise testing, respectively. VO2peak, VO2@AT, Wmax and respective indexing per kg body weight were used as outcomes. We used sex-stratified, multiple adjusted linear regression models. Participants with asthma, chronic lung disease, LVEF < 40% and cancer were excluded.

Results

In men, a 1-unit higher C24:0/C16:0 ratio was associated with higher VO2peak/kg (0.199 ml/min/kg [95% CI: 0.032, 0.365], P = 0.019), Wmax (1.368 W [0.033, 2.404], P = 0.010) and Wmax/kg (0.018 W/kg [0.007, 0.029], P = 0.002). In addition, a 1 µg/ml higher C24:0 concentration was related to greater Wmax/kg (0.054 W/kg [0.009, 0.099], P = 0.018).

In women, a 1-unit greater C24:0/C16:0 ratio was associated with greater VO2peak (8.603 ml/min [0.019, 17.013], P = 0.045), VO2peak/kg (0.186 ml/min/kg [0.054, 0.319], P = 0.006), VO2@AT/kg (0.136 ml/min/kg [0.040, 0.231], P = 0.005) as well as higher Wmax/kg (0.015 W/kg [0.004, 0.026], P = 0.007). Furthermore, a 1 µg/ml higher C16:0 concentration was related to lower Wmax (-55.447 W [-101.775, -9.119], P = 0.019) and Wmax/kg (-0.736 W/kg [-1.341, -0.130], P = 0.017).

Conclusions

We report sex-specific associations between ceramides and CRF. In women, C24:0/C16:0 ratio was associated with more CRF parameters than in men. Furthermore, the single species C16:0 was significantly associated with lower maximal power in women only, whereas in men the single species C24:0 was significantly associated with higher maximal power. The positive association of the C24:0/C16:0 ratio with maximal CRF capacity is in agreement with previous findings of beneficial effects on the risk for CVD events and mortality.

Future studies should explore the reason for different sex-specific ceramide profiles and whether ceramides are causally mediating their effects on CVD through CRF.

s-VCAM-1 is an independent predictor of all-cause mortality in patients with dilated cardiomyopathy and hypokinetic non-dilated cardiomyopathy

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): University Medicine Munich University Medicine Greifswald

Introduction

The vascular cell adhesion molecule-1 (VCAM-1) is overexpressed in a number of different inflammatory processes on activated endothelium. This could be shown in both a mouse model for autoimmune myocarditis and in human heart tissue from patients with lymphocytic myocarditis.

In addition to the tissue-bound one, a soluble isoform of VCAM-1 (s-VCAM-1) can also be detected in the blood. Higher levels have been associated with worse clinical outcome in chronic heart failure patients of different etiology and other patient groups.

Purpose

Since both inflammation and fibrosis are key processes involved in the pathogenesis of dilated cardiomyopathy (DCM) and hypokinetic non-dilated cardiomyopathy (HNDC), we aimed to investigate the prognostic value of s-VCAM-1 plasma levels for survival in a large cohort of DCM and HNDC patients.

Methods

The cohort comprised of patients with a primary diagnosis of DCM, defined as reduced left ventricular ejection fraction (LVEF <45%), increased left ventricular enddiastolic diameter according to HENRY score (LVEDD >117%) at time of diagnosis as well as HNDC, defined as a reduced left ventricular ejection fraction (LVEF <45%) but no increased LVEDD according to HENRY score (LVEDD < =117%). Exclusion criteria were primary valvular diseases (≥ second degree), acute myocarditis, cancer, chronic alcoholism, coronary artery disease with epicardial stenosis >50%, peripheral artery occlusive disease, known auto-immune disease and heart failure of other origins. Levels of s-VCAM-1 were measured in human plasma using an enzyme-linked immunosorbent assay (R&D Systems, USA). A Cox proportional hazard model for the association between s-VCAM-1 and all-cause mortality was adjusted for age, sex, time since symptom-onset, LVEF, kidney function (eGFR-CKDEPI), CRP and NT-proBNP.

Results

A total of 334 DCM patients were included in this single-center cohort (78.4 % males) with a mean age of 54.0 years [interquartile range [IQR] 47.0, 63.2). On average time since symptom onset was 1.5 years (IQR 0.1, 1.1), LVEF 30.7 % (IQR 25, 37), LVEDD 67.1 mm (IQR 62, 72). During a median follow-up of 12.4 years (IQR 10.1, 13.9), a total of 118 (35.3 %) patients died. Multivariable-adjusted cox regression model revealed a significantly increased all-cause mortality risk with increasing levels of s-VCAM-1 (p for trend =0.039), (hazard ratio [HR] 1.00045 (Conf. Interval 1.00002, 1.00087) for VCAM increase of 1 ng/mL, for increase of 100 ng/ml HR 1.046 (Conf- interval 1.002, 1.091), for increase of 1000ng/ml HR 1.57 (Conf_interval 1.02-2.41) (Kaplan Meier survival estimates see Figure 1, median s-VCAM-1 = 664 ng/ml, IQR 515,874).

Conclusions

s-VCAM-1 predicts long-term survival in DCM patients independent of NT-pro-BNP and other risk determinants. Further research needs to evaluate whether this biomarker proves useful in monitoring and planning management of DCM and HNDC patients (e.g. more intensive management in high-risk patients).

Abstract Figure. Kaplan-Meier survival estimates

Ceramides are related to subclinical atherogenesis in the general population

Introduction

Biomarkers for risk stratification of patients with cardiovascular disease are essential for disease prevention. Ceramides play an important role during atherogenesis. For the C24:0/C16:0 ratio an inverse association with incident coronary artery disease and heart failure has been shown. Hence, ceramides may be a new predictive biomarker for cardiovascular disease.

Purpose

We explored the relation of three specific ceramides (i.e. C16:0, C22:0 and C24:0) and their ratios with subclinical atherosclerosis, assessed by carotid intima media thickness (cIMT), carotid lumen diameter (LD), brachial artery flow mediated dilation (FMD), nitroglyceride mediated brachial artery dilation (NMD) as well as with the presence of atherosclerotic plaques in the common carotid artery, the carotid bifurcation, and the internal as well as external carotid artery.

Methods

We used data from the population-based Study of Health in Pomerania (SHIP-1) from North-East Germany (n=2,506, 47% male, 53 median age, 25th and 75th inter-quartile range 41–64 years). Ceramides were quantified by liquid chromatography/tandem mass spectrometry assay. Extracranial carotid arteries were measured with B-mode ultrasound and used to assess plaque presence, LD, NMD, FMD and cIMT with standard procedures. Subjects with missing data were excluded. The relationship between ceramides and log LD, log cIMT, NMD, FMD as well as plaque score were modelled using multivariable regression models adjusted for sex, age, body mass index, diabetes mellitus, dyslipidaemia, hypertension and smoking status.

Results

A 1 μg/ml higher C22:0 and C24:0 were associated with a 3% (95% confidence interval [CI] 1% - 5%, p<0.01) and 1% (95% CI 0% - 1%, p=0.01) smaller LD, respectively. Furthermore, an increased C22:0/C16:0 and C24:0/C16:0 ratio were related to a 1.2% (95% CI 0.6% - 1.8%) and 0.2% (95% CI 0.009% - 0.37%, p<0.01) narrower LD, respectively. A one point higher C22:0/C16:0 ratio was associated with a 0.04 mm (95% CI 0 – 0.08 mm, p=0.04) greater absolute FMD. Moreover, a 1 μg/ml higher C16:0 or C22:0 concentration increased the odds for the presence of plaque by 13.6% (95% CI 2.33–79.0, p<0.01) and 1.68% (95% CI 1.08–2.61, p=0.02). Neither C24:0 nor the C22:0/C16:0 or C24:0/C16:0 ratios were related to the presence of atherosclerotic plaques and did not find any significant associations between ceramides and cIMT or NDM.

Conclusions

We found significant associations of ceramides with various markers of subclinical atherosclerosis. Hence, our findings further support the investigation of ceramides as biomarkers of vascular disease. However, our results indicate that not all ceramides are equal with regards to atherosclerosis. For example, C22:0 is related with vasoprotective effects (high HDL-C, low triglycerides) and intriguingly, more atherosclerotic plaques. Future studies should explore the role of ceramides during the different stages of atherosclerosis.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): BMBF

Giving blood: providing treatment, providing knowledge

Background

In France, 1,6 million donors contribute 3 million blood donations / year collected and tested by the French public transfusion service (Etablissement Français du Sang - EFS). At each donation, 2 ml plasma of are stored for 3 years for further testing if needed. In addition to providing life-saving blood products, blood donors may also provide knowledge through the sharing of their health data and bioresource collected at time of donation.

Objective

To describe how blood donors can provide knowledge in addition to blood products.

Results

Over the last 10 years, blood donors in France have enabled several studies performed by EFS in collaboration with research and reference laboratories as well as public health authorities. A linked assessment of Ab titers (+ clinical history) in donors having given blood before and after the 2009 H1N1 flu epidemic, as well as measles, rubella and hepatitis E virus seroprevalence studies (+ specific health questionnaires) have generated high value epidemiological data. Screening for arboviruses (such as Zika virus) and hepatitis A virus in donors during epidemics have increased knowledge of infectious spread and disease characteristics. Testing of plasma samples collected before variant Creutzfeldt-Jakob disease occurrence in two donors revealed the presence of circulating prion more than 1 year before diagnosis. A project to further take advantage of such a bio resource is underway. Upon occurrence and notification of a disease (or any pre-defined health event) in one of the 1,4 million repeat blood donors, all samples from prior donations would be gathered in a cohort of samples of all donors having notified an identical health event. Such cohorts would provide valuable samples to assess disease-specific biomarkers at pre-symptomatic phases.

Conclusions

Providing the opportunity to donors to give knowledge in addition to blood can result in production of high value biomedical data. Giving blood, being a public health actor.

Key messages

Blood donors may provide knowledge and bioresources in addition to blood products. Blood donors in France have enabled several large-scale epidemiological studies.

P4409Cardiorespiratory fitness is inversely associated with the inflammatory status in the general population

Background/Introduction

Low-grade systemic chronic inflammation is a major risk factor for cardiometabolic diseases. Higher physical activity has athero- and cardioprotective effects, potentially through its anti-inflammatory properties. However, the relation between resting inflammatory status and cardiorespiratory fitness (CRF) in population-based settings remains to be elucidated. While previous research has shown inverse associations between CRF and high-sensitive C-reactive protein (hs-CRP) levels, relations with other inflammatory markers are not yet well examined.

Purpose

We assessed the relation between markers of CRF (i.e. maximal oxygen uptake [VO2peak], oxygen uptake at the anaerobic threshold [VO2@AT], oxygen pulse [O2HRmax] and maximal workload [max. Watt]) and hs-CRP as well as total white blood cell (WBC), monocyte, neutrophil, lymphocyte, eosinophil and basophil counts.

Methods

Data of the population-based cohort Study of Health in Pomerania (SHIP) was used (n=1,481; 51% male; age range 20–81 years). CRF was assessed using standardized cardio-pulmonary exercise testing (CPET) according to a modified Jones protocol. The Dimension Vista 500 analytical system was used to measure hs-CRP concentrations. Fluorescence-activated cell sorting was used to assess total as well as subpopulation WBC count. We excluded subjects with missing data, anti-rheumatic/steroid/anti-inflammatory medication as well as chronic inflammatory and hepatic diseases, gastritis, hepatitis infection, severe renal disease, chronic lung disease, asthma, chronic bronchitis, previous myocardial infarction, left ventricular ejection fraction <40% and previous cancer. Linear regression models, adjusted for age, sex, current smoking and lean-mass, were used to assess the relation between CPET and inflammatory parameters.

Results

A 14 ml/min (95%-confidence interval [CI] −23 to −6, p=0.004) lower VO2peak was associated with a one mg/L higher hs-CRP. A lower VO2peak was also related with a one Gpt/L greater WBC (β: −42. 95% CI: −55 to −27 ml/min, p<0.001) as well as neutrophil (β: −57, 95% CI: −77 to −36 ml/min, p<0.001), lymphocyte (β: −63, 95% CI: −107 to 19 ml/min, p=0.005) and monocyte count (β: −204, 95% CI: −360 to −47 ml/min, p=0.011). No significant associations were found for eosinophil and basophil count. Similar results were found for VO2@AT, O2HRmax and max. Watt.

Conclusion

Results suggest an inverse association between CRF and resting inflammatory status. Our non-significant findings with regards to eosinophils and basophils may be expected since these cell types are generally involved in type 2 immune responses related to allergic skin and airway inflammation as well as immunity against parasites. Overall, our results imply that potential biological mechanisms underlying the athero- and cardioprotective effects of high CRF may be related to lower chronic inflammation in fitter individuals.

[Preparation of pooled granulocytes concentrates from whole blood buffy coats (PGC) as an alternative to apheresis]

BACKGROUND

The collection of granulocytes by apheresis requires volunteer donor stimulation by corticoids and the use of HES, a compound which is currently challenged by potential safety issues. Preparation of pooled granulocytes concentrates from whole blood buffy coats (PGC) represent an alternative to apheresis with a better benefit/risk for the donors.

METHOD

Whole blood is collected in a bottom and top blood bag for buffy coat preparation. After centrifugation and separation, buffy coat are obtained. Twenty ABO matched buffy coats are selected for processing into one PGC. Four pools of five buffy coats were made, platelet additive solution is added to each pool, mixed gently and centrifuged. The red cell residue, supernatant and granulocyte rich layer are separated. Two granulocyte rich layers are pooled and added with 70mL of ABO matched plasma from the initial donations (=PGC10). The final PGC (=PGC20) is obtained by pooling two PGC10 into a platelet storage bag. Neutrophil content and in-vitro functionality are assessed at day of preparation (D1) and at expiry hour, 48 hours after collection (D2).

RESULTS

On N=18, mean: Volume=408±4mL, 2.2*1010±0.24 neutrophils, Hematocrit=18%±3%, 4.7*1011platelets. Viability is well preserved: 95%±6% day of PGC preparation, 85%±7% after 24h of storage (D2). Functionality (ROS production measurement) is well preserved: 1.36±0.25 at D1 and 1.38±0.18 at D2. Expression and modulation of adhesion molecules after stimulation are normal at D1 and slightly decreased at D2 but still normal.

CONCLUSIONS

PGC20 in vitro characteristics are in conformance with the EDQM guide (V19) and similar to apheresis for granulocytes content and hematocrit. The viability and two mean indicators which explore neutrophil function are well maintained during PGC preparation and after 24 hours of storage.

[Comparative study on platelet transfusion in Lorraine-Champagne and Alsace in 2015]

OBJECTIVES

To find explanations for the observed differences of platelets concentrates (PC) deliveries between 2 French regions, Lorraine-Champagne (LOCH) and Alsace (ALSA).

METHODS

This is a non-interventional prospective study, performed during 30 days in 2015 in intensive care, cardiovascular surgery and onco-hematological wards of 8 LOCH and ALSA hospitals. Questionnaires listing clinical and biological parameters were attached to the prescription forms and filled in at each PC prescription.

RESULTS

In all, 290 patients, 1093 prescriptions and 1093 deliveries of PC were analyzed. The pre-transfusional context (patient weight, prophylactic or curative situation, pre-transfusional platelet count) were homogenous. The phasing of the prescription forms wording had a direct impact on the doses' formulation : 100 % of the LOCH forms were expressed in platelet quantity (PQ), vs 22 % in ALSA. The mean interval between 2 transfusions was 2.9 days in ALSA vs 4.9 days in LOCH. The mean PQ/delivery was higher in ALSA (5.6.10¹¹ vs 4.0.10¹¹ in LOCH). The delivered PQs were compared to the 2003 French recommendations that were in force in 2015. Twenty-seven percent of the LOCH delivered PQs were in the recommended interval, vs Forty-nine percent in ALSA. Due to the systematic delivery of a single PC unit, including weights>80Kg, LOCH presented 63 % insufficient PQ deliveries. Twenty-two percent of the deliveries in ALSA were over the recommended interval, mostly linked with the simultaneous delivery of a second PC.

CONCLUSION

This study identifies disparities in terms of prescription and delivery between LOCH and ALSA, which may explain their respective PC consumption levels.

Novel concept for visible and near infrared spectro-interferometry: laser-written layered arrayed waveguide gratings

With the growing complexity of astronomical instruments devoted to interferometry, such as MATISSE (a 4 telescope beam combiner) or FIRST (a 9 sub-apertures beam combiner), and the rebirth of space projects such as LIFE (a mid-infrared interferometer), integrated optics devices can be an interesting and complementary approach for beam combination of a large number of apertures. Moreover, one of the approaches for beam combination is pairwise combination of the inputs (either from individual telescopes or from aperture masking on a single telescope), which scales as N(N-1)/2 for an N input system. Astrophotonics devices are attractive to reduce mass and system complexity, while achieving all the beam combination in a single chip, even for a high number of inputs. The aim of this work is to develop a compact photonic device for astronomical applications and demonstrate a proof-of-concept of a spectro-interferometer. In this paper ultrafast laser inscription is used to fabricate three arrayed waveguide gratings (AWGs) stacked vertically. This arrangement enables spectral dispersion and interferometry to be measured simultaneously. Individual AWGs were designed for operation at 633 nm, and demonstrated at 633nm and 830nm. A scan between 790 and 830nm was also achieved to study the wavelength behavior of the AWG. Using a segmented mirror, light at 633nm or 830nm was injected simultaneously into three AWGs layered 40 µm apart, showing analogous behavior for all three layers and no unexpected crosstalk. Finally the three outputs were vertically combined to obtain interference fringes, showing the feasibility of spectro-interferometry and opening the way for compact astrophotonic devices devoted to phase closure studies, used in astronomy to reduce the effect of atmospheric turbulence.

Femtosecond laser written arrayed waveguide gratings with integrated photonic lanterns

We demonstrate for the first time functional arrayed waveguide gratings (AWGs) fabricated using the femtosecond laser direct-write technique. This fabrication technique is a mask-less alternative to lithography enabling design flexibility and rapid prototyping. It is ideal for customized small scale production for new applications. The devices were demonstrated in the visible region at 632.8 nm with a measured free spectral range (FSR) of 22.2 nm, and 1.35 nm resolution. To highlight the advantages of using a 3-dimensional fabrication technique, a 3-port photonic lantern was integrated with an AWG in a single monolithic chip. Integration of this type is not feasible with lithography-based AWG fabrication and can increase the functionality of AWGs for sensing applications.

Modal noise in an integrated photonic lantern fed diffraction-limited spectrograph

In an attempt to develop a streamlined astrophotonic instrument, we demonstrate the realization of an all-photonic device capable of both multimode to single mode conversion and spectral dispersion on an 8-m class telescope with efficient coupling. The device was a monolithic photonic spectrograph which combined an integrated photonic lantern and an efficient arrayed waveguide grating device. During on-sky testing, we discovered a previously unreported type of noise that made spectral extraction and calibration extremely difficult. The source of the noise was traced to a wavelength-dependent loss mechanism between the feed fiber's multimode near-field pattern and the modal acceptance profile of the integrated photonic lantern. Extensive modeling of the photonic components replicates the wavelength-dependent loss, and demonstrates an identical effect on the final spectral output. We outline that this could be mitigated by directly injecting into the integrated photonic lantern.

Demonstration of an efficient, photonic-based astronomical spectrograph on an 8-m telescope

We demonstrate for the first time an efficient, photonic-based astronomical spectrograph on the 8-m Subaru Telescope. An extreme adaptive optics system is combined with pupil apodiziation optics to efficiently inject light directly into a single-mode fiber, which feeds a compact cross-dispersed spectrograph based on array waveguide grating technology. The instrument currently offers a throughput of 5% from sky-to-detector which we outline could easily be upgraded to ∼ 13% (assuming a coupling efficiency of 50%). The isolated spectrograph throughput from the single-mode fiber to detector was 42% at 1550 nm. The coupling efficiency into the single-mode fiber was limited by the achievable Strehl ratio on a given night. A coupling efficiency of 47% has been achieved with ∼ 60% Strehl ratio on-sky to date. Improvements to the adaptive optics system will enable 90% Strehl ratio and a coupling of up to 67% eventually. This work demonstrates that the unique combination of advanced technologies enables the realization of a compact and highly efficient spectrograph, setting a precedent for future instrument design on very-large and extremely-large telescopes.

[Prevention of anemia in blood donors]

The prevention of anemia of blood donor is a main issue for donor safety and self-supplying. This prevention is done in one hand by donor deferral whose haemoglobin level is under defined threshold and in other hand by preventing iron deficiency. Some subgroups of donors are at increased risk for developing iron deficiency and adverse effects of iron deficiency: premenopausal females; donors with haemoglobin values near the minimum for eligibility and frequent donors. Different interventions could be used: lengthening the inter-donational interval and/or decreasing the number of donations per year; donor ferritin testing to evaluate iron store and at least donor iron supplementation.

Grand challenges for catalysis in the Science and Technology Roadmap on Catalysis for Europe: moving ahead for a sustainable future

This perspective discusses the general concepts that will guide future catalysis and related grand challenges based on the Science and Technology Roadmap on Catalysis for Europe prepared by the European Cluster on Catalysis.

Least absolute deviation estimates in autoregression with infinite variance

We consider an L1 analogue of the least squares estimator for the parameters of stationary, finite-order autoregressions. This estimator, the least absolute deviation (LAD), is shown to be strongly consistent via a result that may have independent interest. The striking feature is that the conditions are so mild as to include processes with infinite variance, notably the stationary, finite autoregressions driven by stable increments in Lα, α > 1. Finally, sampling properties of LAD are compared to those of least squares. Together with a known convergence rate result for least squares, the Monte Carlo study provides evidence for a conjecture on the convergence rate of LAD.

In-depth mesocrystal formation analysis of microwave-assisted synthesis of LiMnPO4 nanostructures in organic solution

Formation of LiMnPO₄ mesocrystals via self-assembled subunits employing microwave-assisted synthesis in rac-1-phenylethanol.

Holmium-doped 2.1 μm waveguide chip laser with an output power > 1 W

We demonstrate the increasing applicability of compact ultra-fast laser inscribed glass guided-wave lasers and report the highest-power glass waveguide laser with over 1.1 W of output power in monolithic operation in the short-infrared near 2070 nm achieved (51% incident slope efficiency). The holmium doped ZBLAN chip laser is in-band pumped by a 1945 nm thulium fiber laser. When operated in an extended-cavity configuration, over 1 W of output power is realized in a linearly polarized beam. Broad and continuous tunability of the extended-cavity laser is demonstrated from 2004 nm to 2099 nm. Considering its excellent beam quality of M² = 1.08, this laser shows potential as a flexible master oscillator for single frequency and mode-locking applications.

Towards femtosecond laser written arrayed waveguide gratings

The fabrication of arrayed waveguide gratings (AWGs) using the femtosecond laser direct-write technique is investigated. We successfully demonstrate the fabrication of large planar waveguides that act as 2D free propagation zones. These slabs were found to have a highly uniform refractive index with a standard deviation of 1.97% relative to the total index contrast. The incorporation of low loss linear adiabatic tapers resulted in an increase of transmission by 90%. Strategies for manufacturing integrated laser written AWGs using continuous contouring to avoid lossy defects are discussed and demonstrated.

Spectral narrowing of Yb:YAG waveguide lasers through hybrid integration with ultrafast laser written Bragg gratings

Laser written waveguides in crystalline materials can be used to make highly efficient, high gain lasers. The bi-directional emission from such lasers however is typically broadband with poor spectral control. Hybridizing a tapered, mode matched laser written Bragg grating with a broadband Yb:YAG crystalline waveguide laser, we demonstrate single longitudinal mode output from one end of the device. Careful control of the grating characteristics led to laser thresholds below 90 mW, slope efficiencies greater than 42% and output powers greater than 20 mW.

Competition of Faraday rotation and birefringence in femtosecond laser direct written waveguides in magneto-optical glass

We consider the process of Faraday rotation in femtosecond laser direct-write waveguides. The birefringence commonly associated with such waveguides may be expected to impact the observable Faraday rotation. Here, we theoretically calculate and experimentally verify the competition between Faraday rotation and birefringence in two waveguides created by laser writing in a commercial magneto-optic glass. The magnetic field applied to induce Faraday rotation is nonuniform, and as a result, we find that the two effects can be clearly separated and used to accurately determine even weak birefringence. The birefringence in the waveguides was determined to be on the scale of Δn = 10(-6) to 10(-5). The reduction in Faraday rotation caused by birefringence of order Δn = 10(-6) was moderate and we obtained approximately 9° rotation in an 11 mm waveguide. In contrast, for birefringence of order 10(-5), a significant reduction in the polarization azimuth change was found and only 6° rotation was observed.

Widely tunable short-infrared thulium and holmium doped fluorozirconate waveguide chip lasers

We report widely tunable (≈ 260 nm) Tm(3+) and Ho(3+) doped fluorozirconate (ZBLAN) glass waveguide extended cavity lasers with close to diffraction limited beam quality (M(2) ≈ 1.3). The waveguides are based on ultrafast laser inscribed depressed claddings. A Ti:sapphire laser pumped Tm(3+)-doped chip laser continuously tunes from 1725 nm to 1975 nm, and a Tm(3+)-sensitized Tm(3+):Ho(3+) chip laser displays tuning across both ions evidenced by a red enhanced tuning range of 1810 to 2053 nm. We also demonstrate a compact 790 nm diode laser pumped Tm(3+)-doped chip laser which tunes from 1750 nm to 1998 nm at a 14% incident slope efficiency, and a beam quality of M(2) ≈ 1.2 for a large mode-area waveguide with 70 µm core diameter.

[Batch release of immunoglobulin and monoclonal antibody products]

The Paul-Ehrlich Institute (PEI) is an independent institution of the Federal Republic of Germany responsible for performing official experimental batch testing of sera. The institute decides about the release of each batch and performs experimental research in the field. The experimental quality control ensures the potency of the product and also the absence of harmful impurities. For release of an immunoglobulin batch the marketing authorization holder has to submit the documentation of the manufacture and the results of quality control measures together with samples of the batch to the PEI. Experimental testing is performed according to the approved specifications regarding the efficacy and safety. Since implementation of the 15th German drug law amendment, the source of antibody is not defined anymore. According to § 32 German drug law, all batches of sera need to be released by an official control laboratory. Sera are medicinal products, which contain antibodies, antibody fragments or fusion proteins with a functional antibody portion. Therefore, all batches of monoclonal antibodies and derivatives must also be released by the PEI and the marketing authorization holder has to submit a batch release application. Under certain circumstances a waiver for certain products can be issued with regard to batch release. The conditions for such a waiver apply to the majority of monoclonal antibodies.

Analysis of risk factors for long-term glaucomatous damage development

PURPOSE

The aim of this study was to analyze predictors of long-term glaucoma progression.

PATIENTS AND METHODS

We followed 17 primary open angle glaucoma patients (POAG) and 25 ocular hypertensives (OHT) over three years, with regular follow-up examinations of both eyes every 6 months. Glaucoma damage was quantified by optical coherence tomography (retinal nerve fiber layer - OCT RNFL) and by perimetry. Corneal and hand temperature (infrared thermometer), corneal hysteresis, pachymetry and ocular pulse amplitude (OPA) readings were taken at baseline, and applanatory intraocular pressure and retinal vessel analysis recordings were made at baseline and follow-up visits. Forward-stepwise multiple regression analysis was performed.

RESULTS

With OCT-RNFL progression as the dependent variable, the model selected initial diagnosis (OHT less probable of progressing), baseline RNFL thickness, retinal arterial and venous diameter and arterial flicker response as significant damage predictors. For visual field damage progression, these were: corneal temperature, OPA, initial diagnosis and venous flicker response (all p<0.05).

CONCLUSION

Initial damage and vascular factors are strong predictors of future glaucoma progression.