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Rudin CM, Pietanza MC, Bauer TM, Ready N, Morgensztern D, Glisson BS, Byers LA, Johnson ML, Burris HA, Robert F, Han TH, Bheddah S, Theiss N, Watson S, Mathur D, Vennapusa B, Zayed H, Lally S, Strickland DK, Govindan R, Dylla SJ, Peng SL, Spigel DR. Rovalpituzumab tesirine, a DLL3-targeted antibody-drug conjugate, in recurrent small-cell lung cancer: a first-in-human, first-in-class, open-label, phase 1 study. Lancet Oncol 2016; 18:42-51. [PMID: 27932068 DOI: 10.1016/s1470-2045(16)30565-4] [Citation(s) in RCA: 416] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/13/2016] [Accepted: 09/16/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Rovalpituzumab tesirine is a first-in-class antibody-drug conjugate directed against delta-like protein 3 (DLL3), a novel target identified in tumour-initiating cells and expressed in more than 80% of patients with small-cell lung cancer. We aimed to assess the safety and activity of rovalpituzumab tesirine in patients who progressed after one or more previous regimen. METHODS We conducted a phase 1 open-label study at ten cancer centres in the USA. Eligible patients were aged 18 years or older and had histologically or cytologically confirmed small-cell lung cancer or large-cell neuroendocrine tumours with progressive measurable disease (according to Response Evaluation Criteria in Solid Tumors [RECIST], version 1.1) previously treated with one or two chemotherapeutic regimens, including a platinum-based regimen. We assigned patients to dose-escalation or expansion cohorts, ranging from 0·05 mg/kg to 0·8 mg/kg rovalpituzumab tesirine intravenously every 3 weeks or every 6 weeks, followed by investigation of the dose schedules 0·3 mg/kg and 0·4 mg/kg every 6 weeks and 0·2 mg/kg every 3 weeks. Primary objectives were to assess the safety of rovalpituzumab tesirine, including the maximum tolerated dose and dose-limiting toxic effects. The primary activity endpoint was objective response by intention-to-treat analysis. This study is registered with ClinicalTrials.gov, number NCT01901653. The study is closed to enrolment; this report focuses on the cohort with small-cell lung cancer. FINDINGS Between July 22, 2013, and Aug 10, 2015, 82 patients were enrolled, including 74 patients with small-cell lung cancer and eight with large-cell neuroendocrine carcinoma, all of whom received at least one dose of rovalpituzumab tesirine. Dose-limiting toxic effects of rovalpituzumab tesirine occurred at a dose of 0·8 mg/kg every 3 weeks, including grade 4 thrombocytopenia (in two of two patients at that dose level) and grade 4 liver function test abnormalities (in one patient). The most frequent grade 3 or worse treatment-related adverse events in 74 patients with small-cell lung cancer were thrombocytopenia (eight [11%]), pleural effusion (six [8%]), and increased lipase (five [7%]). Drug-related serious adverse events occurred in 28 (38%) of 74 patients. The maximum tolerated dose of rovalpituzumab tesirine was 0·4 mg/kg every 3 weeks; the recommended phase 2 dose and schedule is 0·3 mg/kg every 6 weeks. At active doses of rovalpituzumab tesirine (0·2 mg/kg or 0·4 mg/kg every 3 weeks or 0·3 mg/kg or 0·4 mg/kg every 6 weeks), 11 (18%) of 60 assessable patients had a confirmed objective response. 11 (18%) of 60 assessable patients had a confirmed objective response, including ten (38%) of 26 patients confirmed to have high DLL3 expression (expression in 50% or more of tumour cells). INTERPRETATION Rovalpituzumab tesirine shows encouraging single-agent antitumour activity with a manageable safety profile. Further development of rovalpituzumab tesirine in DLL3-expressing malignant diseases is warranted. FUNDING Stemcentrx Inc.
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MESH Headings
- Aged
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antineoplastic Agents/therapeutic use
- Benzodiazepinones/therapeutic use
- Carcinoma, Large Cell/drug therapy
- Carcinoma, Large Cell/immunology
- Carcinoma, Large Cell/pathology
- Carcinoma, Neuroendocrine/drug therapy
- Carcinoma, Neuroendocrine/immunology
- Carcinoma, Neuroendocrine/pathology
- Dose-Response Relationship, Drug
- Female
- Follow-Up Studies
- Humans
- Immunoconjugates/pharmacology
- Immunoconjugates/therapeutic use
- Intracellular Signaling Peptides and Proteins/immunology
- Lung Neoplasms/drug therapy
- Lung Neoplasms/immunology
- Lung Neoplasms/pathology
- Male
- Maximum Tolerated Dose
- Membrane Proteins/immunology
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/immunology
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Prognosis
- Small Cell Lung Carcinoma/drug therapy
- Small Cell Lung Carcinoma/immunology
- Small Cell Lung Carcinoma/pathology
- Survival Rate
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Research Support, Non-U.S. Gov't |
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Brink C, Andersen L, Hvelplund P, Mathur D, Voldstad J. Laser photodetachment of C60− and C70− ions cooled in a storage ring. Chem Phys Lett 1995. [DOI: 10.1016/0009-2614(94)01413-p] [Citation(s) in RCA: 144] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kanaya AM, Wassel CL, Mathur D, Stewart A, Herrington D, Budoff MJ, Ranpura V, Liu K. Prevalence and correlates of diabetes in South asian indians in the United States: findings from the metabolic syndrome and atherosclerosis in South asians living in america study and the multi-ethnic study of atherosclerosis. Metab Syndr Relat Disord 2010; 8:157-64. [PMID: 19943798 DOI: 10.1089/met.2009.0062] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Individuals from South Asia have high diabetes prevalence despite low body weight. We compared the prevalence of diabetes among South Asian Indians with other U.S. ethnic groups and explored correlates of diabetes. METHODS This was a cross-sectional study of 150 South Asian Indians (ages 45-79) in California, using similar methods to the Multi-Ethnic Study of Atherosclerosis (MESA). Type 2 diabetes was classified by fasting plasma glucose (FPG) >or=126 mg/dL, 2-h postchallenge glucose >or=200 mg/dL, or use of hypoglycemic medication. RESULTS A total of 29% of Asian Indians had diabetes, 37% had prediabetes, and 34% had normal glucose tolerance. After full adjustment for covariates, Indians still had significantly higher odds of diabetes compared to whites and Latinos, but not significantly different from African Americans and Chinese Americans in MESA: Indians [odds ratio (OR), 1.0], whites [OR, 0.29; 95% confidence interval (CI), 0.17-0.49], Latinos (OR, 0.59; CI, 0.34-1.00) African Americans (OR, 0.77; CI 0.45-1.32), Chinese Americans (OR, 0.78, CI, 0.45-1.32). Variables associated with prediabetes or diabetes among Indians included hypertension, fatty liver, visceral adiposity, microalbuminuria, carotid intima media thickness, and stronger traditional Indian beliefs. CONCLUSIONS Indian immigrants may be more likely to have diabetes than other U.S. ethnic groups, and cultural factors may play a role, suggesting that this is a promising area of research.
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Research Support, N.I.H., Extramural |
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Buchholz TA, Tucker SL, Erwin J, Mathur D, Strom EA, McNeese MD, Hortobagyi GN, Cristofanilli M, Esteva FJ, Newman L, Singletary SE, Buzdar AU, Hunt KK. Impact of systemic treatment on local control for patients with lymph node-negative breast cancer treated with breast-conservation therapy. J Clin Oncol 2001; 19:2240-6. [PMID: 11304777 DOI: 10.1200/jco.2001.19.8.2240] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine the impact of tamoxifen and chemotherapy on local control for breast cancer patients treated with breast-conservation therapy. PATIENTS AND METHODS The data from 484 breast cancer patients who were treated with breast-conserving surgery and radiation were analyzed. Only patients with lymph node-negative disease were studied to provide comparative groups with a similar stage of disease and a similar competing risk for distant metastases. Actuarial local control rates of the 277 patients treated with systemic therapy (128, chemotherapy with or without tamoxifen; 149, tamoxifen alone) were compared with the rates for the 207 patients who received no systemic treatment. Only 10% of the patients had positive (2%), close (3%), or unknown margin status (5%). RESULTS Patients treated with systemic therapy had improved 5-year (97.5% v 89.8%) and 8-year (95.6% v 85.2%) local control rates compared with those that did not receive systemic treatment (P =.004, log-rank test). There was no statistical difference in local control between patients treated with chemotherapy and patients treated with tamoxifen alone (P =.219). Systemic treatment, margin status, young patient age, estrogen and progesterone receptor status, and primary tumor size were analyzed in a Cox regression analysis. The use of systemic treatment was the most powerful predictor of local control: patients who did not receive systemic treatment had a relative risk of local recurrence of 3.3 (95% confidence interval, 1.5 to 7.5; P =.004). CONCLUSION In this retrospective analysis, systemic therapy appears to contribute to long-term local control in patients with lymph node-negative breast cancer treated with breast-conservation therapy.
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Meehan TP, Weingarten SR, Holmboe ES, Mathur D, Wang Y, Petrillo MK, Tu GS, Fine JM. A statewide initiative to improve the care of hospitalized pneumonia patients: The Connecticut Pneumonia Pathway Project. Am J Med 2001; 111:203-10. [PMID: 11530031 DOI: 10.1016/s0002-9343(01)00803-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE A statewide quality improvement initiative was conducted in Connecticut to improve process-of-care performance and to decrease length of stay for patients hospitalized with community-acquired pneumonia. SETTING AND METHODS Data were collected on 1,242 elderly (> or =65 years) pneumonia patients hospitalized at 31 of 32 acute care hospitals between January 16, 1995, and March 15, 1996, and on 1,146 patients hospitalized between January 1, 1997, and June 30, 1997. Interventions included feedback of performance data (Qualidigm, the Connecticut Peer Review Organization), dissemination of an evidence-based pneumonia critical pathway (Connecticut Thoracic Society), and sharing of pathway implementation experiences (hospitals). Process and outcome measures included early antibiotic administration, blood culture collection, oxygenation assessment, length of stay, 30-day mortality, and 30-day readmission rates. Analyses were adjusted for severity of illness and hospital-specific practice patterns. RESULTS After the statewide initiative, improvements were noted in antibiotic administration within 8 hours of hospital arrival (improvement from 83.4% to 88.8%, relative risk [RR] = 1.21; 95% confidence interval [CI]: 1.10 to 1.32), oxygenation assessment within 24 hours of hospital arrival (93.6% to 95.4%; RR = 1.23, 95% CI: 1.11 to 1.38), and length of stay (7 days to 5 days, P <0.001). There were no significant changes in blood culture collection within 24 hours of hospital arrival, blood culture collection before antibiotic administration, 30-day mortality, or 30-day readmission rates. CONCLUSIONS Statewide improvements were demonstrated in the care of hospitalized pneumonia patients concurrent with a multifaceted quality improvement intervention. Further research is needed to separate the effects of the quality improvement interventions from secular trends.
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Brass LM, Krumholz HM, Scinto JD, Mathur D, Radford M. Warfarin use following ischemic stroke among Medicare patients with atrial fibrillation. ARCHIVES OF INTERNAL MEDICINE 1998; 158:2093-100. [PMID: 9801175 DOI: 10.1001/archinte.158.19.2093] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Elderly patients with ischemic stroke and atrial fibrillation are at especially increased risk for recurrent stroke. Warfarin sodium is highly effective in reducing this risk. OBJECTIVE To determine the use of warfarin among a population sample of elderly patients with atrial fibrillation hospitalized for ischemic stroke. METHODS The Connecticut Peer Review Organization conducted a chart review of Medicare patients, aged 65 years or older, hospitalized in 1994 with a diagnosis of atrial fibrillation. Patients with a principal diagnosis of acute myocardial infarction or another indication for anticoagulation were excluded. RESULTS Among 635 patients (402 women; 585 white; 218 > or =85 years old; 147 with a new diagnosis of atrial fibrillation), 334 had stroke as a principal diagnosis. Among those discharged alive after a stroke, only 147 (53%) of 278 were prescribed warfarin at discharge. Furthermore, among 130 (47%) of 278 patients not prescribed warfarin at discharge, 81 (62%) of 130 were also not prescribed aspirin. Increased potential benefit (additional vascular risk factors) was not associated with a higher rate of warfarin use. Low risk for anticoagulation (lack of risk factors for bleeding) was associated with a slightly higher rate of warfarin use. Among those with an increased risk of stroke and a low risk for bleeding (ideal candidates), 124 (62%) of 278 were discharged on a regimen of warfarin. CONCLUSION Anticoagulation of elderly stroke patients with atrial fibrillation, even among ideal candidates, is underused. The increased use of warfarin among these patients represents an excellent opportunity for reducing the risk of recurrent stroke in this high-risk population.
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Mathur D, Hasted JB. Resonant scattering of slow electrons from benzene and substituted benzene molecules. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0022-3700/9/3/003] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
The effects of acute alcohol consumption and abstinence on blood pressure were studied in normal healthy subjects and in non-drinking and regularly drinking hypertensive patients. All subjects drank alcohol (1 g/kg body weight daily) for 5 days then abstained for 5 days. There was no significant difference in blood pressure in normal subjects during and after alcohol ingestion. However, in hypertensive non-drinkers both systolic and diastolic pressures when standing were significantly higher during the period of alcohol intake; supine blood pressure was not significantly higher. In hypertensive patients who drank regularly, standing and supine systolic and diastolic blood pressures were significantly higher during the period of drinking.
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Mathur D, Badrinathan C, Rajgara F, Raheja U. Translational energy loss spectrometry of molecular dications from methane. Chem Phys 1986. [DOI: 10.1016/0301-0104(86)80046-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mathur D, Khan SU, Hasted JB. Dissociative recombination in low-energy e-H2+and e-H3+collisions. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0022-3700/11/20/021] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Rajgara FA, Krishnamurthy M, Mathur D. Electron rescattering and the dissociative ionization of alcohols in intense laser light. J Chem Phys 2003. [DOI: 10.1063/1.1625637] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Zachariah E, Bankapur A, Santhosh C, Valiathan M, Mathur D. Probing oxidative stress in single erythrocytes with Raman Tweezers. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2010; 100:113-6. [PMID: 20561796 DOI: 10.1016/j.jphotobiol.2010.05.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 05/22/2010] [Accepted: 05/25/2010] [Indexed: 02/05/2023]
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Rajgara FA, Dharmadhikari AK, Mathur D, Safvan CP. Strong fields induce ultrafast rearrangement of H atoms in H2O. J Chem Phys 2009; 130:231104. [DOI: 10.1063/1.3157234] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ghosh A, Sinha S, Dharmadhikari JA, Roy S, Dharmadhikari AK, Samuel J, Sharma S, Mathur D. Euler buckling-induced folding and rotation of red blood cells in an optical trap. Phys Biol 2006; 3:67-73. [PMID: 16582471 DOI: 10.1088/1478-3975/3/1/007] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We investigate the physics of an optically driven micromotor of biological origin. When a single, live red blood cell (RBC) is placed in an optical trap, the normal biconcave disc shape of the cell is observed to fold into a rod-like shape. If the trapping laser beam is circularly polarized, the folded RBC rotates. A model based on geometric considerations, using the concept of buckling instabilities, captures the folding phenomenon; the rotation of the cell is rationalized using the Poincaré sphere. Our model predicts that (i) at a critical power of the trapping laser beam the RBC shape undergoes large fluctuations, and (ii) the torque that is generated is proportional to the power of the laser beam. These predictions are verified experimentally. We suggest a possible mechanism for the emergence of birefringent properties in the RBC in the folded state.
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Mathur D. Collisions of slow electrons with methane: ionisation, fragmentation and resonances. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/13/23/026] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Krishnamurthy M, Rajgara FA, Mathur D. Strong light fields coax intramolecular reactions on femtosecond time scales. J Chem Phys 2004; 121:9765-8. [PMID: 15549849 DOI: 10.1063/1.1819895] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Energetic H(2) (+) ions are formed as a result of intramolecular rearrangement during fragmentation of linear alcohols (methanol, ethanol, propanol, hexanol, and dodecanol) induced by intense, pulsed optical fields. The laser intensity regime that is accessed in these experiments (peak intensity of 8 x 10(15) W cm(-2)) ensures multiple ionization of the irradiated alcohol molecules such that Coulomb explosions would be expected to dominate the overall fragmentation dynamics. Polarization dependent measurements show, counterintuitively, that rearrangement is induced by the strong optical field within a single, 100 fs long laser pulse, and that it occurs before Coulomb explosion of the field-ionized multiply charged alcohols.
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Okunishi M, Shimada K, Prümper G, Mathur D, Ueda K. Probing molecular symmetry effects in the ionization of N2 and O2 by intense laser fields. J Chem Phys 2007; 127:064310. [PMID: 17705599 DOI: 10.1063/1.2764029] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
High-resolution electron spectroscopy is used to explore the role played by molecular symmetry in determining the morphology of the energy spectra of electrons ejected when N2 and O2 are irradiated by intense laser fields. In O2, the low-energy part of the electron spectrum is curtailed due to the destructive interference brought about by the antibonding nature of the O2 valence orbital. The high-energy tail of the spectrum is also suppressed by virtue of electron rescattering being of little consequence in O2. In contrast, in N2, which has a bonding valence orbital, the electron dynamics follow the pattern that has been established for atomic ionization in strong optical fields.
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Mathur D, Kingston RG, Harris FM, Beynon JH. State-diagnosed electron capture collisions of CS2q+(q=2, 3) with atomic and molecular gases. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/19/17/006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Mathur D, Rajgara FA. Dissociative ionization of methane by chirped pulses of intense laser light. J Chem Phys 2004; 120:5616-23. [PMID: 15267438 DOI: 10.1063/1.1649723] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Measurements have been made of optical field-induced ionization and fragmentation of methane molecules at laser intensities in the 10(16) W cm(-2) range using near transform limited pulses of 100 fs duration as well as with chirped pulses whose temporal profiles extend up to 1500 fs. Data is taken both in constant-intensity and constant-energy modes. The temporal profile of the chirped laser pulse is found to affect the morphology of the fragmentation pattern that is measured. Besides, the sign of the chirp also affects the yield of fragments like C2+, H+, and H2+ that originate from methane dications that are formed by optical field-induced double ionization.
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Fhadil HA, Mathur D, Hasted JB. Mobilities of O+, O+* and O22+in He and Ar from ion energy distribution measurements in an injected-ion drift tube. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/15/9/019] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Mathur D, Khan SU, Hasted JB. Collision processes of electrons with molecular hydrogen ions. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0022-3700/12/12/022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ravindra Kumar G, Safvan C, Rajgara F, Mathur D. Intense laser field ionisation of CS2 at 532 nm. Does dissociation precede ionisation? Chem Phys Lett 1994. [DOI: 10.1016/0009-2614(93)e1435-j] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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