Demonstration of a 1 TW peak power, joule-level ultrashort Tm:YLF laser.

We report on the demonstration of a diode-pumped, Tm:YLF-based, chirped pulse amplification laser system operating at λ ≈ 1.9 µm that produces amplified pulse energies exceeding 1.5 J using a single 8-pass power amplifier. The amplified pulses are subsequently compressed to sub-300 fs durations by a diffraction grating pair, producing record >1 TW peak power pulses. To the best of our knowledge, this is the highest peak power demonstrated for any solid-state, near-2 µm laser architecture and illustrates the potential of Tm:YLF for the next generation of high-power, diode-pumped ultrashort lasers.

Urinary Tract Infections: Pediatric Primary Care Curriculum Podcast.

INTRODUCTION: Demands on residents' time during training make it difficult for them to engage consistently with a primary care curriculum. In response to this, the emergency medicine and critical care fields have successfully utilized podcasting to the point where a recent study showed US emergency medicine residents ranked podcasts as the best use of their time for extracurricular education. METHODS: We produced a 30-minute podcast on urinary tract infections from a primary care perspective, based on descriptors from Entrustable Professional Activity 4, "Manage acute common illnesses in the ambulatory setting." A moderator, a primary care pediatrician, and a pediatric nephrologist used a loose script of salient points, allowing for a natural evolution of the dialogue. The podcast was distributed to residents via email, along with a 7-question survey. RESULTS: The survey was completed by 50 out of 84 residents. Ninety-two percent listened to all or part of the podcast, 98% found it educational, 93% enjoyed listening, and 74% felt more confident identifying and managing patients with possible urinary tract infections after listening. Ninety-six percent felt podcasts were a good alternative method for delivering this curriculum. One comment read, "This was great! It makes the information more accessible so that I can listen while working out or driving or just laying on the couch." DISCUSSION: Based on this success, we are producing additional podcasts and will strive to keep them under 20 minutes, provide key summary points at the end, and improve ease of access by utilizing an RSS (rich site summary) feed.

Hypoxia-regulated protein expression, patient characteristics, and preoperative imaging as predictors of survival in adults with glioblastoma multiforme.

BACKGROUND: Regions of hypoxia within glioblastoma multiforme (GBM) are common and may influence a tumor's aggressiveness, response to treatment, and the patient's overall survival. In this study, the authors examined 4 markers of hypoxia (hypoxia-inducible factor 1 [HIF-1alpha], glucose transporter 1 [GLUT-1], vascular endothelial growth factor [VEGF], and carbonic anhydrase 9 [CA IX]), cellular proliferation and microvascular density (MVD) indices, extent of surgical resection, and preoperative imaging characteristics and compared them with the overall survival rates of adults with GBM. METHODS: In this retrospective cohort study, patients who had lower grade astrocytomas were compared with patients who had GBM to verify that the methods used could establish differences between tumor grades. By using preoperative imaging, the amount of necrosis was established versus the overall tumor area. The authors also compared preoperative images with postoperative images to define the amount of tumor resected; and they compared molecular markers, proliferation, MVD, and imaging studies with survival among patients who had GBM. RESULTS: The hypoxia-regulated molecules (HRMs) and indices for MVD and cellular proliferation were associated significantly with tumor grade. Survival was improved when >or=95% of the tumor was resected. Although the total tumor area was associated with overall survival, no differences were observed when the amount of necrosis or a tumor necrosis index (area of necrosis/area of tumor) was compared with survival. The findings indicated that GLUT-1 and VEGF were correlated with survival after controlling for age. CONCLUSIONS: Tumor grade was differentiated with HRMs, MVD, and proliferation, but only GLUT-1 predicted survival in this group of patients with GBM. The results suggested that GLUT-1 may be an important independent prognostic indicator.

Partial-mouth assessment of periodontal disease in an adult population of the United States.

BACKGROUND: It has been previously demonstrated, using periodontal data from an untreated population, that half-mouth assessment of six sites/tooth provides an appropriate alternative to whole-mouth assessment of periodontal disease status. Since periodontal destruction exhibits left-right symmetry, it was hypothesized that this would be equally applicable to a population with access to routine dental care. METHODS: Adult subjects (N = 92) with a range of disease levels participated in the study. Probing depths (PDs) and recession (REC) were measured directly on six sites/tooth, on all teeth (excluding third molars), and clinical attachment levels (CALs) were derived. Partial-mouth assessments, i.e., assessment of limited sites and/or teeth, were compared with whole-mouth assessment as follows. Intraclass correlation coefficients (ICCs) were calculated for mean PD, CAL, and REC, and for percentage of sites with disease above a specified threshold, to determine the agreement between the whole- and partial-mouth assessment. The sensitivity of partial-mouth assessment of disease prevalence also was determined. RESULTS: For assessment of six sites per tooth in one upper and one lower quadrant, ICCs were consistently >0.80. Assessment of two sites per tooth or only Ramfjord teeth generally underestimated disease extent and severity, and prevalence, compared to half-mouth assessment. CONCLUSIONS: These results support the use of a half-mouth examination of six sites/tooth, to conserve time, limit cost, and reduce patient and examiner fatigue, while providing maximal clinical information. Assessment of only two sites per tooth or the Ramfjord teeth was not suitable for evaluation of either disease extent and severity or prevalence.