The legacy of immigration policies and employment exclusion: Assessing the relationship between employment exclusions and immigrant health.

Restrictive federal and state immigration policies create conditions of employment exclusion that may negatively influence the health of immigrants. In particular, these policy effects are reflected in labor market and workplace experiences that determine the types of work and employment opportunities that immigrants are able to access and pursue. This study examines the relationship between both cumulative and individual measures of employment exclusion and self-rated health and psychological distress among Asian and Latino immigrants in California, and whether this relationship is modified by legal status. We used data from the Research on Immigrant Health and State Policy (RIGHTS) study (n = 2010). We used both multivariable logistic regression and linear regression models for our analyses. For cumulative models, labor market exclusion was associated with poor health (OR = 1.21, 95% CI: 1.01, 1.46). Workplace exclusion was also associated with poor self-rated health (OR = 1.45, 95% CI: 1.15, 1.82) and increased psychological distress (ß = 0.69, 95% CI: 0.31, 1.07). For individual measures of employment exclusion, settling for a job - a labor market exclusion - and working in a dangerous job and experiencing wage theft - workplace exclusions - were associated with poor health and increased psychological distress. There was no evidence that the association between employment exclusions and health varied by legal status. These findings demonstrate that the combined effect of employment exclusions is detrimental to immigrant health. To improve population health, public health researchers should continue to interrogate the policy conditions at the federal, state, and local level that exclude immigrants from employment opportunities and workplace protections.

Cerebral autoregulation-based mean arterial pressure targets and delirium in critically ill adults without brain injury: a retrospective cohort study.

PURPOSE: Cerebral autoregulation (CA) is a mechanism that acts to maintain consistent cerebral perfusion across a range of blood pressures, and impaired CA is associated with delirium. Individualized CA-derived blood pressure targets are poorly characterized in critically ill patients and the association with intensive care unit (ICU) delirium is unknown. Our objectives were to characterize optimal mean arterial pressure (MAPopt) ranges in critically ill adults without brain injury and determine whether deviations from these targets contribute to ICU delirium. METHODS: We performed a retrospective cohort analysis of patients with shock of any etiology and/or respiratory failure requiring invasive mechanical ventilation, without a neurologic admitting diagnosis. Patients were screened daily for delirium. Cerebral oximetry and mean arterial pressure data were captured for the first 24 hr from enrolment. RESULTS: Forty-two patients with invasive blood pressure monitoring data were analyzed. Optimal mean arterial pressure targets ranged from 55 to 100 mm Hg. Optimal mean arterial pressure values were not significantly different based on history of hypertension or delirium status, and delirium was not associated with deviations from MAPopt. Nevertheless, the majority (69%) of blood pressure targets exceeded the current 65 mm Hg Surviving Sepsis guidelines. CONCLUSION: We observed that MAPopt targets across patients were highly variable, but did not observe an association with the incidence of delirium. Studies designed to evaluate the impact on neurologic outcomes are needed to understand the association with individualized mean arterial pressure targets in the ICU. STUDY REGISTRATION: ClinicalTrials.gov (NCT02344043); first submitted 22 January 2015.

RéSUMé: OBJECTIF: L'autorégulation cérébrale (AC) est un mécanisme qui agit pour maintenir une perfusion cérébrale constante pour une gamme de tensions artérielles, et une altération de l'AC est associée au delirium. Les cibles de tension artérielle individualisées dérivées de l'AC sont mal caractérisées chez les patient·es gravement malades et l'association avec le delirium à l'unité de soins intensifs (USI) est inconnue. Nos objectifs étaient de caractériser la tension artérielle moyenne optimale (TAMopt) chez les adultes gravement malades sans lésion cérébrale et de déterminer si les écarts par rapport à ces cibles contribuaient au delirium à l'USI. MéTHODE: Nous avons réalisé une analyse de cohorte rétrospective de patient·es présentant un choc de toute étiologie et/ou une insuffisance respiratoire nécessitant une ventilation mécanique invasive, et n'ayant pas reçu de diagnostic d'atteinte neurologique à l'admission. Les patients ont été dépistés quotidiennement pour le delirium. Les données d'oxymétrie cérébrale et de tension artérielle moyenne ont été saisies pendant les 24 premières heures suivant le recrutement. RéSULTATS: Quarante-deux patient·es pour qui des données de monitorage invasif de la tension artérielle étaient disponibles ont été analysé·es. Les cibles optimales de tension artérielle moyenne variaient de 55 à 100 mm Hg. Les valeurs optimales de tension artérielle moyenne n'étaient pas significativement différentes en fonction des antécédents d'hypertension ou de delirium, et le delirium n'était pas associé à des écarts par rapport à la TAMopt. Néanmoins, la majorité (69 %) des cibles de tension artérielle dépassaient celle de 65 mm Hg préconisée par les lignes directrices Surviving Sepsis. CONCLUSION: Nous avons observé que les cibles de TAMopt étaient très variables chez les patient·es, mais nous n'avons pas observé d'association avec l'incidence de delirium. Des études conçues pour évaluer l'impact sur les issues neurologiques sont nécessaires pour comprendre l'association avec les cibles de tension artérielle moyenne individualisées à l'USI. ENREGISTREMENT DE L'éTUDE: ClinicalTrials.gov (NCT02344043); soumis pour la première fois le 22 janvier 2015.

Compact Yb fiber few-cycle pulse source based on precision pulse compression and shaping with an adaptive fiber Bragg grating.

We generate bandwidth limited 10 µJ pulses of 92 fs pulse width using an adaptive fiber Bragg grating stretcher (FBG) in conjunction with a Lyot filter. The temperature controlled FBG is used to optimize the group delay, whereas the Lyot filter counteracts gain narrowing in the amplifier chain. Soliton compression in a hollow core fiber (HCF) allows for access to the few-cycle pulse regime. Adaptive control further enables the generation of nontrivial pulse shapes.

Coherent supercontinuum shaping for multiple wavelength optimization over an octave.

We shape the spectrum of an octave spanning supercontinuum from an erbium fiber laser. The group delay dispersion is controlled through the temperature profile of a chirped fiber Bragg grating. We demonstrate control of spectral broadening, switching in spectral windows, and optimizing power at six wavelengths corresponding to Yb, Ca, and Sr clock transitions, an f-2f pair, and a C-band reference for frequency transfer applications. We verify locking of the shaped f-2f beat note, and the coherence of the shaped supercontinuum by interference with an unshaped supercontinuum branch with relative frequency deviation of 10-17 at 1 s averaging time.

Delirium, Cerebral Perfusion, and High-Frequency Vital-Sign Monitoring in the Critically Ill. The CONFOCAL-2 Feasibility Study.

Rationale: Studies suggest that reduced cerebral perfusion may contribute to delirium development in the intensive care unit (ICU). However, evidence is limited because of factors including small sample size and limited inclusion of covariates.Objectives: To assess the feasibility of a multicenter prospective observational study using a multimodal data collection platform. Feasibility was assessed by enrollment, data-capture, and follow-up rates. The full study will aim to assess the association between noninvasively derived surrogate markers of cerebral perfusion, delirium development, and long-term cognitive outcomes in critically ill patients.Methods: Adult patients in the ICU were enrolled if they had shock and/or respiratory failure requiring invasive mechanical ventilation for >24 hours. For the first 72 hours, a near-infrared spectroscopic sensor was placed on the forehead to continuously monitor regional cerebral oxygenation (rSo2) and high-frequency (1 Hz) vital signs were concurrently captured via an arterial line. Cerebral perfusion was estimated using three variables, including mean rSo2, duration of disturbed autoregulation, and time/magnitude away from optimal mean arterial pressure (MAP). Patients were screened for delirium in the ICU and ward daily for up to 30 days. Cognitive function was assessed 3 and 12 months after ICU admission to identify cognitive impairment.Results: Fifty-nine patients were enrolled across four sites in 1 year. Data-capture rates varied across modalities but exceeded 80% for rSo2, blood gas, and delirium data capture. Vital-sign capture and 3-month follow-up rates were lower at 53% and 55%, respectively. Eighty-three percent (49 of 59) of patients experienced delirium, with a median severity of 0.56 in the ICU. Mean physiological (±standard deviation) values were: rSo2 (70.4% ± 7.0%), heart rate (83.9 ± 16.45 beats/min), MAP (76.4 ± 12.8 mm Hg), peripheral oxygenation saturation (96.5% ± 2.1%), proportion of recording time spent with disturbed autoregulation (10.1% ± 7.3%) and proportion of area under the curve outside optimal MAP (39.6% ± 22.4%). Thirty-two (54%) individuals had cerebral autoregulation curves where a targeted optimal MAP was identified. Barriers to data collection included missing vital-sign data and low follow-up rates.Conclusions: Given our current protocol, a multicenter study examining the association between cerebral oxygenation, delirium, and long-term cognitive impairment is not feasible. However, by performing an early assessment of feasibility, we identified strategies to increase capture rates to ensure success as the study begins the next phase of study recruitment.Clinical trial registered with clinicaltrials.gov (NCT03141619).

A Synthetic Likelihood Solution to the Silent Synapse Estimation Problem.

Functional features of synaptic populations are typically inferred from random electrophysiological sampling of small subsets of synapses. Are these samples unbiased? Here, we develop a biophysically constrained statistical framework to address this question and apply it to assess the performance of a widely used method based on a failure-rate analysis to quantify the occurrence of silent (AMPAR-lacking) synapses. We simulate this method in silico and find that it is characterized by strong and systematic biases, poor reliability, and weak statistical power. Key conclusions are validated by whole-cell recordings from hippocampal neurons. To address these shortcomings, we develop a simulator of the experimental protocol and use it to compute a synthetic likelihood. By maximizing the likelihood, we infer silent synapse fraction with no bias, low variance, and superior statistical power over alternatives. Together, this generalizable approach highlights how a simulator of experimental methodologies can substantially improve the estimation of physiological properties.

Threshold photodissociation dynamics of NO2 studied by time-resolved cold target recoil ion momentum spectroscopy.

We study the near-threshold photodissociation dynamics of NO2 by a kinematically complete femtosecond pump-probe scheme using a cold target recoil ion momentum spectrometer. We excite NO2 to the optically bright Ã2B2 state with a 400 nm pulse and probe the ensuing dynamics via strong field single and double ionization with a 25 fs, 800 nm pulse. The pump spectrum spans the NO(X2Π) + O(3P) dissociation channel threshold, and therefore, following internal conversion, excited NO2 is energetically prepared both "above threshold" (dissociating) and "below threshold" (nondissociating). Experimentally, we can clearly discriminate a weak two-photon pump channel from the dominant single-photon data. In the single ionization channel, we observe NO+ fragments with nonzero momentum at 200 fs delay and an increasing yield of NO+ fragments with near-zero momentum at 3.0 ps delay. For double ionization events, we observe a time-varying Coulombic kinetic energy release between the NO+ and O+ fragments impulsively created from the evolving "hot" neutral ground state. Supported by classical trajectory calculations, we assign the decreasing Coulombic kinetic energy release at longer time delays to the increasing average NO-O distances in the ground electronic state during its large amplitude phase space evolution toward free products. The time-resolved kinetic energy release in the double ionization channel probes the large amplitude ground state evolution from a strongly coupled "inner region" to a loosely coupled "outer region" where one O atom is on average much further away from the NO. Both the time evolution of the kinetic energy release and the NO+ angular distributions support our assignments.

Assessing the relationship between near-infrared spectroscopy-derived regional cerebral oxygenation and neurological dysfunction in critically ill adults: a prospective observational multicentre protocol, on behalf of the Canadian Critical Care Trials Group.

INTRODUCTION: Survivors of critical illness frequently exhibit acute and chronic neurological complications. The underlying aetiology of this dysfunction remains unknown but may be associated with cerebral ischaemia. This study will use near-infrared spectroscopy to non-invasively quantify regional cerebral oxygenation (rSO2) to assess the association between poor rSO2 during the first 72 hours of critical illness with delirium severity, as well as long-term sensorimotor and cognitive impairment among intensive care unit (ICU) survivors. Further, the physiological determinants of rSO2 will be examined. METHODS AND ANALYSIS: This multicentre prospective observational study will consider adult patients (≥18 years old) eligible for enrolment if within 24 hours of ICU admission, they require mechanical ventilation and/or vasopressor support. For 72 hours, rSO2 will be continuously recorded, while vital signs (eg, heart rate) and peripheral oxygenation saturation will be concurrently captured with data monitoring software. Arterial and central venous gases will be sampled every 12 hours for the 72 hours recording period and will include: pH, PaO2, PaCO2, and haemoglobin concentration. Participants will be screened daily for delirium with the confusion assessment method (CAM)-ICU, whereas the brief-CAM will be used on the ward. At 3 and 12 months post-ICU discharge, neurological function will be assessed with the Repeatable Battery for the Assessment of Neuropsychological Status and KINARM sensorimotor and cognitive robot-based behavioural tasks. ETHICS AND DISSEMINATION: The study protocol has been approved in Ontario by a central research ethics board (Clinical Trials Ontario); non-Ontario sites will obtain local ethics approval. The study will be conducted under the guidance of the Canadian Critical Care Trials Group (CCCTG) and the results of this study will be presented at national meetings of the CCCTG for internal peer review. Results will also be presented at national/international scientific conferences. On completion, the study findings will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03141619.

Rovibrational quantum state resolution of the C60 fullerene.

The unique physical properties of buckminsterfullerene, C60, have attracted intense research activity since its original discovery. Total quantum state-resolved spectroscopy of isolated C60 molecules has been of particularly long-standing interest. Such observations have, to date, been unsuccessful owing to the difficulty in preparing cold, gas-phase C60 in sufficiently high densities. Here we report high-resolution infrared absorption spectroscopy of C60 in the 8.5-micron spectral region (1180 to 1190 wave number). A combination of cryogenic buffer-gas cooling and cavity-enhanced direct frequency comb spectroscopy has enabled the observation of quantum state-resolved rovibrational transitions. Characteristic nuclear spin statistical intensity patterns confirm the indistinguishability of the 60 carbon-12 atoms, while rovibrational fine structure encodes further details of the molecule's rare icosahedral symmetry.

Metaplasticity at CA1 Synapses by Homeostatic Control of Presynaptic Release Dynamics.

Hebbian and homeostatic forms of plasticity operate on different timescales to regulate synaptic strength. The degree of mechanistic overlap between these processes and their mutual influence are still incompletely understood. Here, we report that homeostatic synaptic strengthening induced by prolonged network inactivity compromised the ability of CA1 synapses to exhibit LTP. This effect could not be accounted for by an obvious deficit in the postsynaptic capacity for LTP expression, since neither the fraction of silent synapses nor the ability to induce LTP by two-photon glutamate uncaging were reduced by the homeostatic process. Rather, optical quantal analysis reveals that homeostatically strengthened synapses display a reduced capacity to maintain glutamate release fidelity during repetitive stimulation, ultimately impeding the induction, and thus expression, of LTP. By regulating the short-term dynamics of glutamate release, the homeostatic process thus influences key aspects of dynamic network function and exhibits features of metaplasticity.

Midinfrared frequency comb by difference frequency of erbium and thulium fiber lasers in orientation-patterned gallium phosphide.

We generate over 60 mW of pulses with wavelengths from 6 to 11 micrometers by difference frequency mixing between erbium and thulium fiber amplifiers in orientation-patterned GaP with a photon conversion efficiency of 0.2. By stabilizing the repetition rate of the shared oscillator and adding a frequency shifter to one arm, the output becomes a frequency comb with tunable carrier envelope offset.

Harmonic generation in solids with direct fiber laser pumping.

High harmonic generation in solids presents the possibility for bringing attosecond techniques to semiconductors and a simple source for frequency comb spectroscopy in the vacuum ultraviolet. We generate up to the seventh harmonic of a Tm fiber laser by focusing in silicon or zinc oxide. The harmonics are strong and stable, with no indication of material damage. Calculations show the potential for generating nineteenth harmonic photons at 12 eV photons of energy.

Three-photon absorption in optical parametric oscillators based on OP-GaAs.

We report on, to the best of our knowledge, the first singly resonant (SR), synchronously pumped optical parametric oscillator (OPO) based on orientation-patterned gallium arsenide (OP-GaAs). Together with a doubly resonant (DR) degenerate OPO based on the same OP-GaAs material, the output spectra cover 3 to 6 µm within ∼3 dB of relative power. The DR-OPO has the highest output power reported to date from a femtosecond, synchronously pumped OPO based on OP-GaAs. We observed strong three-photon absorption with a coefficient of 0.35±0.08 cm3/GW2 for our OP-GaAs sample, which limits the output power of these OPOs as mid-IR light sources. We present a detailed study of the three-photon loss on the performance of both the SR- and DR-OPOs, and compare them to those without this loss mechanism.

Fourier transform and Vernier spectroscopy using an optical frequency comb at 3-5.4 µm.

We present a versatile mid-infrared frequency comb spectroscopy system based on a doubly resonant optical parametric oscillator tunable in the 3-5.4 µm range and two detection methods: a Fourier transform spectrometer (FTS) and a continuous-filtering Vernier spectrometer (CF-VS). Using the FTS with a multipass cell, we measure high precision broadband absorption spectra of CH4 at 3.3 µm and NO at 5.25 µm, the latter for the first time with comb spectroscopy, and we detect atmospheric species (CH4, CO, CO2, and H2O) in air in the signal and idler ranges. Multiline fitting yields minimum detectable concentrations of 10-20 ppb Hz-1/2 for CH4, NO, and CO. For the first time in the mid-infrared, we perform CF-VS using an enhancement cavity, a grating, and a single detector, and we measure the absorption spectrum of CH4 and H2O in ambient air at ∼3.3 µm, reaching a 40 ppb concentration detection limit for CH4 in 2 ms.

Self-referenced, accurate and sensitive optical frequency comb spectroscopy with a virtually imaged phased array spectrometer.

We present a cavity-enhanced direct optical frequency comb spectroscopy system with a virtually imaged phased array (VIPA) spectrometer and either a dither or a Pound-Drever-Hall (PDH) locking scheme used for stable transmission of the comb through the cavity. A self-referenced scheme for frequency axis calibration is shown along with an analysis of its accuracy. A careful comparison between both locking schemes is performed based on near-IR measurements of the carbon monoxide ν=3←0 band P branch transitions in a gas sample with known composition. The noise-equivalent absorptions (NEA) for the PDH and dither schemes are 9.9×10(-10) cm(-1) and 5.3×10(-9) cm(-1), respectively.

Correlated Synaptic Inputs Drive Dendritic Calcium Amplification and Cooperative Plasticity during Clustered Synapse Development.

The mechanisms that instruct the assembly of fine-scale features of synaptic connectivity in neural circuits are only beginning to be understood. Using whole-cell electrophysiology, two-photon calcium imaging, and glutamate uncaging in hippocampal slices, we discovered a functional coupling between NMDA receptor activation and ryanodine-sensitive intracellular calcium release that dominates the spatiotemporal dynamics of activity-dependent calcium signals during synaptogenesis. This developmentally regulated calcium amplification mechanism was tuned to detect and bind spatially clustered and temporally correlated synaptic inputs and enacted a local cooperative plasticity rule between coactive neighboring synapses. Consistent with the hypothesis that synapse maturation is spatially regulated, we observed clustering of synaptic weights in developing dendritic arbors. These results reveal developmental features of NMDA receptor-dependent calcium dynamics and local plasticity rules that are suited to spatially guide synaptic connectivity patterns in emerging neural networks.

Midinfrared frequency comb from self-stable degenerate GaAs optical parametric oscillator.

We pump a degenerate frequency-divide-by-two optical parametric oscillator (OPO) based on orientation-patterned GaAs with a stable Tm frequency comb at 2 micrometer wavelength and measure the OPO comb offset frequency and linewidth. We show frequency division by two with sub-Hz relative linewidth of the comb teeth. The OPO thermally self-stabilizes and oscillates for nearly an hour without any active control.

A cost-effective method for preparing, maintaining, and transfecting neurons in organotypic slices.

The cellular and molecular mechanisms that underlie brain function are challenging to study in the living brain. The development of organotypic slices has provided a welcomed addition to our arsenal of experimental brain preparations by allowing both genetic and prolonged pharmacological manipulations in a system that, much like the acute slice preparation, retains several core features of the cellular and network architecture found in situ. Neurons in organotypic slices can survive in culture for several weeks, can be molecularly manipulated by transfection procedures and their function can be interrogated by traditional cellular electrophysiological or imaging techniques. Here, we describe a cost-effective protocol for the preparation and maintenance of organotypic slices and also describe a protocol for biolistic transfection that can be used to introduce plasmids in a small subset of neurons living in an otherwise molecularly unperturbed network. The implementation of these techniques offers a flexible experimental paradigm that can be used to study a multitude of neuronal mechanisms.

Midinfrared frequency combs from coherent supercontinuum in chalcogenide and optical parametric oscillation.

We observe the coherence of the supercontinuum generated in a nanospike chalcogenide-silica hybrid waveguide pumped at 2 µm. The supercontinuum is shown to be coherent with the pump by interfering it with a doubly resonant optical parametric oscillator (OPO) that is itself coherent with the shared pump laser. This enables coherent locking of the OPO to the optically referenced pump frequency comb, resulting in a composite frequency comb with wavelengths from 1 to 6 µm.