Secondary Outcomes in a Clinical Trial of Carotenoids with Coantioxidants versus Placebo in Early Age-Related Macular Degeneration

Purpose: To report the secondary outcomes in the Carotenoids with Coantioxidants in Age-Related Maculopathy trial.

Design: Randomized double-masked placebo-controlled clinical trial (registered as ISRCTN 94557601).

Participants: Participants included 433 adults 55 years of age or older with early age-related macular degeneration (AMD) in 1 eye and late-stage disease in the fellow eye (group 1) or early AMD in both eyes (group 2).

Intervention: An oral preparation containing lutein (L), zeaxanthin (Z), vitamin C, vitamin E, copper, and zinc or placebo. Best-corrected visual acuity (BCVA), contrast sensitivity (CS), Raman spectroscopy, stereoscopic colour fundus photography, and serum sampling were performed every 6 months with a minimum follow-up time of 12 months.

Main Outcome Measures: Secondary outcomes included differences in BCVA (at 24 and 36 months), CS, Raman counts, serum antioxidant levels, and progression along the AMD severity scale (at 12, 24, and 36 months).

Results: The differential between active and placebo groups increased steadily, with average BCVA in the former being approximately 4.8 letters better than the latter for those who had 36 months of follow-up, and this difference was statistically significant (P = 0.04). In the longitudinal analysis, for a 1-log-unit increase in serum L, visual acuity was better by 1.4 letters (95% confidence interval, 0.3-2.5; P = 0.01), and a slower progression along a morphologic severity scale (P = 0.014) was observed.

Conclusions: Functional and morphologic benefits were observed in key secondary outcomes after supplementation with L, Z, and coantioxidants in persons with early AMD.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2012 American Academy of Ophthalmology.

Magnetic instability in a dilute circular rarefaction wave

The growth of magnetic fields in the density gradient of a rarefaction wave has been observed in simulations and in laboratory experiments. The thermal anisotropy of the electrons, which gives rise to the magnetic instability, is maintained by the ambipolar electric field. This simple mechanism could be important for the magnetic field amplification in astrophysical jets or in the interstellar medium ahead of supernova remnant shocks. The acceleration of protons and the generation of a magnetic field by the rarefaction wave, which is fed by an expanding circular plasma cloud, is examined here in form of a 2D particle-in-cell simulation. The core of the plasma cloud is modeled by immobile charges, and the mobile protons form a small ring close to the cloud's surface. The number density of mobile protons is thus less than that of the electrons. The protons of the rarefaction wave are accelerated to 1/10 of the electron thermal speed, and the acceleration results in a thermal anisotropy of the electron distribution in the entire plasma cloud. The instability in the rarefaction wave is outrun by a TM wave, which grows in the dense core distribution, and its magnetic field expands into the rarefaction wave. This expansion drives a secondary TE wave. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4769128]

Simulation of relativistically colliding laser-generated electron flows

The plasma dynamics resulting from the simultaneous impact, of two equal, ultra-intense laser pulses, in two spatially separated spots, onto a dense target is studied via particle-in-cell simulations. The simulations show that electrons accelerated to relativistic speeds cross the target and exit at its rear surface. Most energetic electrons are bound to the rear surface by the ambipolar electric field and expand along it. Their current is closed by a return current in the target, and this current configuration generates strong surface magnetic fields. The two electron sheaths collide at the midplane between the laser impact points. The magnetic repulsion between the counter-streaming electron beams separates them along the surface normal direction, before they can thermalize through other beam instabilities. This magnetic repulsion is also the driving mechanism for the beam-Weibel (filamentation) instability, which is thought to be responsible for magnetic field growth close to the internal shocks of gamma-ray burst jets. The relative strength of this repulsion compared to the competing electrostatic interactions, which is evidenced by the simulations, suggests that the filamentation instability can be examined in an experimental setting. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4768426]

Dynamics of Self-Generated, Large Amplitude Magnetic Fields Following High-Intensity Laser Matter Interaction

The dynamics of magnetic fields with an amplitude of several tens of megagauss, generated at both sides of a solid target irradiated with a high-intensity (~1019W/cm2) picosecond laser pulse, has been spatially and temporally resolved using a proton imaging technique. The amplitude of the magnetic fields is sufficiently large to have a constraining effect on the radial expansion of the plasma sheath at the target surfaces. These results, supported by numerical simulations and simple analytical modeling, may have implications for ion acceleration driven by the plasma sheath at the rear side of the target as well as for the laboratory study of self-collimated high-energy plasma jets. © 2012 American Physical Society.

Rayleigh-Taylor Instability of an Ultrathin Foil Accelerated by the Radiation Pressure of an Intense Laser

We report experimental evidence for a Rayleigh-Taylor-like instability driven by radiation pressure of an ultraintense (1021W/cm2) laser pulse. The instability is witnessed by the highly modulated profile of the accelerated proton beam produced when the laser irradiates a 5 nm diamondlike carbon (90% C, 10% H) target. Clear anticorrelation between bubblelike modulations of the proton beam and transmitted laser profile further demonstrate the role of the radiation pressure in modulating the foil. Measurements of the modulation wavelength, and of the acceleration from Doppler-broadening of back-reflected light, agree quantitatively with particle-in-cell simulations performed for our experimental parameters and which confirm the existence of this instability. © 2012 American Physical Society.

Identifying research priorities in long term care homes

Concerns about the quality of care in long term care (LTC) homes range from inadequate daily care to understaffing and insufficient funding. LTC decision makers are challenged to keep up with the changing demographics of residents admitted to LTC who have increasingly complex care needs. Decisions regarding LTC policies and procedures need to be informed by research that identifies the most effective and efficient care practices.This study solicited feedback from LTC decision makers in Ontario, Canada, regarding research priorities to guide improvement in the quality of care in LTC homes. Representatives from 134 LTC homes responded (53.6% response rate). Nine thematic areas of research were identified: delivery of care; staffing; organization and structure of homes; funding; indicators, standards, policies, and procedures; managing difficult behaviors; education; safety; and infectious disease control. It is anticipated that these themes will steer research down a path that is responsive to the information needs of practitioners in LTC homes. © 2012 American Medical Directors Association, Inc.

A Family Booklet About Comfort Care in Advanced Dementia:Three-Country Evaluation

Objectives: To evaluate a booklet on comfort care in dementia from the perspective of family with relevant experience, and assess nursing home resident and family factors associated with evaluations. Design: Retrospective study. Setting: Long term care facilities in French-speaking Canada, and the Netherlands and Italy.
Participants: Bereaved family (n = 138).
Measurements: An 8-item scale assessed the booklet's acceptability. Usefulness was rated on a 0 to 10 scale, and perceived usefulness referred to usefulness if family had had the booklet during the resident's stay. Families indicated preferred ways of obtaining, and the most appropriate time to get the booklet.
Results: Almost all families (94%) perceived the booklet as useful. Canadian and Dutch families evaluated the booklet's contents and format favorably, whereas Italian families' evaluations were less favorable. Almost all families endorsed roles for physicians or nurses and about half additionally accepted availability through own initiative, in print or through the Internet. Preference of timing was highly variable. Better acceptability, usefulness, and availability through own initiative were independently associated with non-Italian nationality, presence of more physical signs discussed in the booklet, feeling ill-prepared, and higher satisfaction with care. A preference of receiving the booklet early was more likely in Italian families, those without university education, and those involved with older residents.
Conclusion: The booklet is suitable to inform Dutch and Canadian families on comfort care in dementia, but implementation in Italy requires further consideration. The booklet may be integrated in advance care planning in long term care, and made available outside long term care settings to serve families who wish to be informed early. © 2012 American Medical Directors Association, Inc.
Keywords: Decision aid; decision making; advance care planning; palliative care; nursing homes; dementia.

Direct assembly of three-dimensional mesh plasmonic rolls

A direct-assembly method to construct three-dimensional (3D) plasmonic nanostructures yields porous plasmonic rolls through the strain-induced self-rolling up of two-dimensional metallic nanopore films. This route is scalable to different hole sizes and film thicknesses, and applicable to a variety of materials, providing general routes towards a diverse family of 3D metamaterials with nano-engineerable optical properties. These plasmonic rolls can be dynamically driven by light irradiation, rolling or unrolling with increasing or decreasing light intensity. Such dynamically controllable 3D plasmonic nanostructures offer opportunities both for sensing and feedback in active nano-actuators. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4711923]

Stretch-induced plasmonic anisotropy of self-assembled gold nanoparticle mats

Close-packed monolayers of 20 nm Au nanoparticles are self-assembled at hexane/water interfaces and transferred to elastic substrates. Stretching the resulting nanoparticle mats provides active and reversible tuning of their plasmonic properties, with a clear polarization dependance. Both uniaxial and biaxial strains induce strong blue shifts in the plasmonic resonances. This matches theoretical simulations and indicates that plasmonic coupling at nanometer scale distances is responsible for the observed spectral tuning. Such stretch-tunable metal nanoparticle mats can be exploited for the development of optical devices, such as flexible colour filters and molecular sensors. (C) 2012 American Institute of Physics. [doi:10.1063/1.3683535]

Unusual photoresponse of indium doped ZnO/organic thin film heterojunction

Photoresponse of n-type indium-doped ZnO and a p-type polymer (PEDOT:PSS) heterojunction devices are studied, juxtaposed with the photoluminescence of the In-ZnO samples. In addition to the expected photoresponse in the ultraviolet, the heterojunctions exhibit significant photoresponse to the visible (532 nm). However, neither the doped ZnO nor PEDOT: PSS individually show any photoresponse to visible light. The sub-bandgap photoresponse of the heterojunction originates from visible photon mediated e-h generation between the In-ZnO valence band and localized states lying within the band gap. Though increased doping of In-ZnO has limited effect on the photoluminescence, it significantly diminishes the photoresponse. The study indicates that optimally doped devices are promising for the detection of wavelengths in selected windows in the visible. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4704655]

Dynamics of intense laser propagation in underdense plasma: Polarization dependence

We present a comprehensive numerical study of the dynamics of an intense laser pulse as it propagates through an underdense plasma in two and three dimensions. By varying the background plasma density and the polarization of the laser beam, significant differences are found in terms of energy transport and dissipation, in agreement with recently reported experimental results. Below the threshold for relativistic self-focusing, the plasma and laser dynamics are observed to be substantially insensitive to the initial laser polarization, since laser transport is dominated by ponderomotive effects. Above this threshold, relativistic effects become important, and laser energy is dissipated either by plasma heating (p-polarization) or by trapping of electromagnetic energy into plasma cavities (s-polarization) or by a combination of both (circular polarization). Besides the fundamental interest of this study, the results presented are relevant to applications such as plasma-based accelerators, x-ray lasers, and fast-ignition inertial confinement fusion. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4737151]

Cold atmospheric pressure plasma jets:Interaction with plasmid DNA and tailored electron heating using dual-frequency excitation

Recent progress in plasma science and technology has enabled the development of a new generation of stable cold non-equilibrium plasmas operating at ambient atmospheric pressure. This opens horizons for new plasma technologies, in particular in the emerging field of plasma medicine. These non-equilibrium plasmas are very efficient sources for energy transport through reactive neutral particles (radicals and metastables), charged particles (ions and electrons), UV radiation, and electro-magnetic fields. The effect of a cold radio frequency-driven atmospheric pressure plasma jet on plasmid DNA has been investigated. The formation of double strand breaks correlates well with the atomic oxygen density. Taken with other measurements, this indicates that neutral components in the jet are effective in inducing double strand breaks. Plasma manipulation techniques for controlled energy delivery are highly desirable. Numerical simulations are employed for detailed investigations of the electron dynamics, which determines the generation of reactive species. New concepts based on nonlinear power dissipation promise superior strategies to control energy transport for tailored technological exploitations. © 2012 American Institute of Physics.

Effect of geosynthetic reinforcement creep on the long term performance of an embankment

Geo-synthetic reinforcements are often used to enhance the stability of geotechnical structures such as embankments. These geosynthetic polymers often show significant creep deformational behaviour. In the short-term performance of a geotechnical structure, it may not play a significant role. However, while dealing with the long term behaviour, it is necessary to investigate its effect. In this paper two plane strain fully coupled finite element analysis have been conducted; one with and the other without taking into account of the creep behaviour of geosynthetics. A well documented field case of Leneghans embankment (Geogrid improved wide embankment constructed near Sydney, Australia in 1990s) have been used for this purpose. It is evident from the analyses that though the geosynthetic reinforcements may play a vital role in the performance/stability of an embankment in the early days (during and after construction), its contribution may become insignificant with time and the creep of geo-synthetic may not play a significant role in the long term stability. © 2012 American Society of Civil Engineers.

Multiferroic PbZrxTi1-xO3/Fe3O4 epitaxial sub-micron sized structures

Large range well ordered epitaxial ferrimagnetic nominally Fe3O4 structures were fabricated by pulsed-laser deposition and embedded in ferroelectric PbZrxTi1-xO3 (x = 0.2, 0.52) epitaxial films. Magnetite dots were investigated by magnetic force microscopy and exhibited magnetic domain contrast at room temperature (RT). Embedding ferroelectric PbZrxTi1-xO3 layers exhibit remnant polarization values close to the values of single epitaxial layers. Transmission electron microscopy demonstrated the epitaxial growth of the composites and the formation of the ferrimagnetic and ferroelectric phases. Physical and structural properties of these composites recommend them for investigations of stress mediated magneto-electric coupling at room temperature. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.3692583]

On transition rates in surface hopping

Trajectory surface hopping (TSH) is one of the most widely used quantum-classical algorithms for nonadiabatic molecular dynamics. Despite its empirical effectiveness and popularity, a rigorous derivation of TSH as the classical limit of a combined quantum electron-nuclear dynamics is still missing. In this work, we aim to elucidate the theoretical basis for the widely used hopping rules. Naturally, we concentrate thereby on the formal aspects of the TSH. Using a Gaussian wave packet limit, we derive the transition rates governing the hopping process at a simple avoided level crossing. In this derivation, which gives insight into the physics underlying the hopping process, some essential features of the standard TSH algorithm are retrieved, namely (i) non-zero electronic transition rate ("hopping probability") at avoided crossings; (ii) rescaling of the nuclear velocities to conserve total energy; (iii) electronic transition rates linear in the nonadiabatic coupling vectors. The well-known Landau-Zener model is then used for illustration. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4770280]