Sum frequency generation from touching wires: a transformation optics approach.

We employ transformation optics to study analytically nonlinear wave mixing from a singular geometry of touching plasmonic wires. We obtain the analytic solution of the near field and complement it with a solution of far-field properties. We find, somewhat surprisingly, that optimal efficiency (in both regimes) is obtained for the degenerate case of second-harmonic generation. We exploit the analytic solution obtained to trace this behavior to the spatial overlap of input fields near the geometric singularity.

Tracking ultrafast hot-electron diffusion in space and time by ultrafast thermomodulation microscopy.

The ultrafast response of metals to light is governed by intriguing nonequilibrium dynamics involving the interplay of excited electrons and phonons. The coupling between them leads to nonlinear diffusion behavior on ultrashort time scales. Here, we use scanning ultrafast thermomodulation microscopy to image the spatiotemporal hot-electron diffusion in thin gold films. By tracking local transient reflectivity with 20-nm spatial precision and 0.25-ps temporal resolution, we reveal two distinct diffusion regimes: an initial rapid diffusion during the first few picoseconds, followed by about 100-fold slower diffusion at longer times. We find a slower initial diffusion than previously predicted for purely electronic diffusion. We develop a comprehensive three-dimensional model based on a two-temperature model and evaluation of the thermo-optical response, taking into account the delaying effect of electron-phonon coupling. Our simulations describe well the observed diffusion dynamics and let us identify the two diffusion regimes as hot-electron and phonon-limited thermal diffusion, respectively.

Metal nanospheres under intense continuous-wave illumination: A unique case of nonperturbative nonlinear nanophotonics.

We show that the standard perturbative (i.e., cubic) description of the thermal nonlinear response of a single metal nanosphere to intense continuous-wave (CW) illumination is sufficient only for a temperature rise of up to 100 degrees above room temperature. Beyond this regime, the slowing down of the temperature rise requires a nonperturbative description of the nonlinear response, even though the permittivity is linearly dependent on the temperature and despite the deep subwavelength effective propagation distances involved. Using experimental data, we show that, generically, the increase of the imaginary part of the metal permittivity dominates the increase of the host permittivity as well as the resonance shift due to the joint changes to the real parts of the metal and host. Thus, the main nonlinear effect is a decrease of the quality factor of the resonance. We further analyze the relative importance of the various contributions to the temperature rise and thermal nonlinearity, compare the nonlinearity of Au and Ag, demonstrate the potential effect of the nanoparticle morphology, and show that although the thermo-optical nonlinearity of the host typically plays a minor role, its thermal conductivity and its temperature dependence is important. Finally, we discuss the differences between CW and ultrafast thermal nonlinearities.

Publisher's Note: Metal nanospheres under intense continuous-wave illumination: A unique case of nonperturbative nonlinear nanophotonics [Phys. Rev. E 96, 012212 (2017)].

This corrects the article DOI: 10.1103/PhysRevE.96.012212.

Nonlinear wave interactions between short pulses of different spatio-temporal extents.

We study the nonlinear wave interactions between short pulses of different spatio-temporal extents. Unlike the well-understood mixing of quasi-monochromatic waves, this configuration is highly non-intuitive due to the complex coupling between the spatial and temporal degrees of freedom of the interacting pulses. We illustrate the process intuitively with transitions between different branches of the dispersion curves and interpret it in terms of spectral exchange between the interacting pulses. We verify our interpretation with an example whereby a spectrally-narrow pulse "inherits" the wide spectrum of a pump pulse centered at a different wavelength, using exact numerical simulations, as well as a simplified coupled mode analysis and an asymptotic analytical solution. The latter also provides a simple and intuitive quantitative interpretation. The complex wave mixing process studied here may enable flexible spatio-temporal shaping of short pulses and is the starting point of the study of more complicated systems.

Femtosecond-scale switching based on excited free-carriers.

We describe novel optical switching schemes operating at femtosecond time scales by employing free carrier (FC) excitation. Such unprecedented switching times are made possible by spatially patterning the density of the excited FCs. In the first realization, we rely on diffusion, i.e., on the nonlocality of the FC nonlinear response of the semiconductor, to erase the initial FC pattern and, thereby, eliminate the reflectivity of the system. In the second realization, we erase the FC pattern by launching a second pump pulse at a controlled delay. We discuss the advantages and limitations of the proposed approaches and demonstrate their potential applicability for switching ultrashort pulses propagating in silicon waveguides. We show switching efficiencies of up to 50% for 100 fs pump pulses, which is an unusually high level of efficiency for such a short interaction time, a result of the use of the strong FC nonlinearity. Due to limitations of saturation and pattern effects, these schemes can be employed for switching applications that require femtosecond features but standard repetition rates. Such applications include switching of ultrashort pulses, femtosecond spectroscopy (gating), time-reversal of short pulses for aberration compensation, and many more. This approach is also the starting point for ultrafast amplitude modulations and a new route toward the spatio-temporal shaping of short optical pulses.

Congenital tuberculosis and management of exposure in neonatal and pediatric intensive care units.

SETTING: This report describes the management and outcome of neonatal intensive care unit (NICU) and paediatric ICU (PICU) exposure to a 26-day-old premature infant with congenital tuberculosis (TB). DESIGN: The infant's mother underwent chest X-ray (CXR) and sputum culture. Contacts of the infant were identified. Tuberculin skin tests (TSTs) were performed on 97 infants and children, 156 NICU and PICU visitors and 115 health care workers. RESULTS: The mother's sputum culture was positive for Mycobacterium tuberculosis. No TST conversion occurred in the exposed NICU infants. All neonates received prophylactic isoniazid (INH). One exposed child in the PICU had TST conversion with normal CXR and completed 9 months of INH without developing active disease; 22 (14%) PICU and NICU visitors and 3 NICU personnel had TST conversion without evidence of disease. CONCLUSIONS: The sequence of events described here demonstrates the difficulty in diagnosis and management of TB in this age group. Transmission of TB in NICU and PICUs is unusual but can occur, and calls for a systematic approach to investigation of the exposed infants, family members and health care providers.

Innovations in monitoring of adverse drug reactions: the role of a technical advisor.

Adverse drug reactions (ADRs) have ethical implications. These include assessment of the risk-benefit ratio and re-administering informed consent based on the new ADRs identified. The Indian Council of Medical Research ethical guidelines mandate the scrutiny of ADR; and the standard operating procedures of the ethics committee of the authors' medical school endorse this line. However, institutional review board members are often hardpressed for time and are unable to analyse all the reported ADRs as thoroughly as required. This calls for a dedicated system for the scrutiny of ADRs. This paper seeks to share the experience of development and implementation of a review mechanism for ADR monitoring. The authors report an innovation in ADR monitoring by appointing a technical advisor on ADR (TA-ADR). During routine assessment, an unusual occurrence of ADRs was noticed from internal and external sites which were related to the study drug, which in turn resulted in the trial being put on hold. This system is being reported here for possible adoption by others.

Appendicitis in adults with incidental midgut malrotation: CT findings.

AIM: To report the computed tomography (CT) findings of acute and complicated appendicitis in adults with incidental midgut malrotation. MATERIALS AND METHODS: The medical records and CT studies of eight patients with appendicitis and incidental midgut malrotation who presented to two medical centres between 1998 and 2009 were reviewed. RESULTS: All patients presented with 1-5 days of acute abdominal pain, which was diffuse in two, left-sided in two, lower abdominal in two, and in the right lower quadrant in two patients. The inflamed appendix was right-sided in three, left-sided in three, and in the midline in two patients. Three cases were complicated by a peri-appendicular abscess, and one patient also had a small bowel obstruction. All patients had a complete non-rotation with right-sided duodenum and jejunum, and left-sided colon. All eight patients had an abnormal superior mesenteric artery-superior mesenteric vein (SMA/SMV) relationship and a dysplastic uncinate process of the pancreas. Urgent surgery was performed in six patients and the remaining two were treated conservatively. CONCLUSION: Altered anatomy in malrotation affects the typical clinical and CT findings of acute appendicitis, therefore delaying diagnosis. When CT shows focal inflammation anywhere within the abdomen, along with an abnormal SMA/SMV relationship, the position of the caecum should be ascertained and acute appendicitis ruled out.

Qualitative and quantitative analysis of stability and instability dynamics of positive lattice solitons.

We present a unified approach for qualitative and quantitative analysis of stability and instability dynamics of positive bright solitons in multidimensional focusing nonlinear media with a potential (lattice), which can be periodic, periodic with defects, quasiperiodic, single waveguide, etc. We show that when the soliton is unstable, the type of instability dynamic that develops depends on which of two stability conditions is violated. Specifically, violation of the slope condition leads to a focusing instability, whereas violation of the spectral condition leads to a drift instability. We also present a quantitative approach that allows one to predict the stability and instability strength.

Drift instability and tunneling of lattice solitons.

We derive an analytic formula for the lateral dynamics of solitons in a general inhomogeneous nonlinear media, and show that it can be valid over tens of diffraction lengths. In particular, we show that solitons centered at a lattice maximum can be "mathematically unstable" but "physically stable." We also derive an analytic upper bound for the critical velocity for tunneling, which is valid even when the standard Peierls-Nabarro potential approach fails.

Interaction-induced localization of anomalously diffracting nonlinear waves.

We study experimentally the interactions between normal solitons and tilted beams in glass waveguide arrays. We find that as a tilted beam, traversing away from a normally propagating soliton, coincides with the self-defocusing regime of the array, it can be refocused and routed back into any of the intermediate sites due to the interaction, as a function of the initial phase difference. Numerically, distinct parameter regimes exhibiting this behavior of the interaction are identified.

Waves in nonlinear lattices: ultrashort optical pulses and Bose-Einstein condensates.

The nonlinear Schrödinger equation i (partial differential)(z)A(z,x,t)+(inverted Delta)(2)(x,t)A+[1+m(kappax)]|A|2A=0 models the propagation of ultrashort laser pulses in a planar waveguide for which the Kerr nonlinearity varies along the transverse coordinate x, and also the evolution of 2D Bose-Einstein condensates in which the scattering length varies in one dimension. Stability of bound states depends on the value of kappa=beamwidth/lattice period. Wide (kappa>>1) and kappa=O(1) bound states centered at a maximum of m(x) are unstable, as they violate the slope condition. Bound states centered at a minimum of m(x) violate the spectral condition, resulting in a drift instability. Thus, a nonlinear lattice can only stabilize narrow bound states centered at a maximum of m(x). Even in that case, the stability region is so small that these bound states are "mathematically stable" but "physically unstable."

Effect of religious observance on infants' sleep position in the Jewish population.

OBJECTIVES: To describe the effect of the level of religiousness on infants' sleep position in the Jewish population. METHODS: A longitudinal telephone survey of randomly selected 608 2-month-old Jewish infants repeated at 4 and 6 months. Results were analyzed versus the four levels of Jewish religion observance. RESULTS: A significant correlation was found between the level of religious practice and sleep position (P < or = 0.002). 56.8% (50/88) of ultra-orthodox parents put their babies to sleep in the non-prone position, compared with 79% (411/520) in the other three groups (P < 0.001). Non-prone sleeping decreased when infants grew. Higher parity correlated with the level of religiousness and with prone sleeping in religious families (OR = 1.15, 95% CI 1.00-1.33, P < 0.001). CONCLUSIONS: Jews and especially the ultra-orthodox families comply significantly less with recommendations to avoid prone sleeping. Specific measures may be required in this population that rely more on personal experience and belief than on health care provider advice.

Impact of vitamin A supplementation through different dosages of red palm oil and retinol palmitate on preschool children.

Red palm oil (5 ml and 10 ml), ground nut oil fortified with 400 and 800 retinol equivalent retinol palmitate, and ground nut oil (5 and 10 ml), were administered to six groups of preschool children (four experimental and two control groups) in randomly assigned balwadis of Ramanathapuram District of Tamil Nadu for a period of 7 months, to monitor the difference in the efficacy of the mode of supplementation and the optimum dose for improving vitamin A status. Results show that red palm oil groups recorded more gain in retinol and beta-carotene levels compared to other dosage groups, and that administration of 10 ml did not offer any substantial improvement over the 5-ml daily dose.

Impact of beta-carotene supplementation through red palm.

A 10-month long feeding trial was conducted to assess the impact of beta-carotene supplementation through red palm oil (RPO) with the focus on vitamin A status, morbidity status and acceptability of an RPO-incorporated noon-meal as a dietary supplement among two cohorts of 409 (experimental) and 346 (control) preschool children in two southern districts of rural Tamil Nadu, selected by stratified random sampling. Information was gathered on ocular symptoms of vitamin A deficiency and anthropometry, and blood samples were drawn at baseline and final rounds for estimation of serum beta-carotene, retinol and tocopherol. Data about Socioeconomic Status (SES) were collected once during the study period, while information on attendance, consumption and morbidity was recorded by preschool teachers. The results showed the following. 1. Significant improvement in the vitamin A status of children in terms of disappearance of Bitot's spots (50.0 per cent) in the experimental group vs. 28.0 per cent in the control group. 2. After feeding of RPO, incidence rate of new Bitot's spots cases was low at 2.13 in the experimental children vs. 4.78 in control children. 3. Marked improvement in the serum beta-carotene levels after 10 months of feeding. 4. RPO is acceptable to children as an edible grade oil as there is no perceptible difference in the consumption pattern between experimental and control children.

Melatonin production in healthy infants: evidence for seasonal variations.

The objective of this study was to determine the normal range of nocturnal urinary excretion of the major melatonin metabolite, 6-sulfatoxymelatonin (6SMT) in a large sample of healthy full-term infants (8 and 16 wk old) and assess whether the endogenous production of melatonin changes with season. 6SMT was assessed in urine samples extracted from disposable diapers removed from full-term, 8- (n = 317) and 16-wk-old (n = 93) infants over the nocturnal period (19:00-08:00 h). In addition, 6SMT was assessed in 8-wk-old (n = 35) healthy infants over the entire 24-h period. 6SMT was determined by an ELISA assay. 6SMT excretion at 8 wk of age exhibited diurnal variations with (mean +/- SD) 61 +/- 18% of the daily production excreted during the nocturnal period regardless of season. The nocturnal 6SMT values in the entire cohort (at 8 as well as 16 wk of age) were found to significantly depart from normal distribution (Kolmogorov-Smirnov test). A normal distribution was obtained using a natural base logarithmic (ln) transformation of the data. The normal range (2.5-97.5 percentile of the ln 6SMT excretion per night) was thus defined as 4.66-8.64 (106-5646 ng/night) for 8-wk-old and 5.19-9.67 (180-15,820 ng/night) for 16-wk-old infants. A significant effect of the month of birth on 6SMT production at the age of 8 wk was found (ANOVA, p < 0.002) with maximal levels produced by infants born in June (summer solstice) and minimal excretion in infants born in December (winter solstice). Short-photoperiod-born infants excreted on average about threefold less 6SMT compared with long-photoperiod-born infants (t test, p = 0. 01). The seasonal variations were no longer present at 16 wk of age. No effect of breast-feeding at the time of sampling on seasonality of 6SMT was found. Normal ranges for the nocturnal urinary excretion of 6SMT in full-term infants at 8 and 16 wk of age are defined. This enables the evaluation of nocturnal 6SMT excretion as a prognostic and diagnostic factor for child development. The strong effect of season on the normal excretion of nocturnal 6SMT at 8 but not 16 wk of age suggests prenatal influence of the photoperiod on the ontogeny of melatonin.

Duration of home monitoring for infants discharged with apnea of prematurity.

Sixty-four preterm infants with apnea of prematurity (AOP) discharged with cardiorespiratory home monitoring (HM) were prospectively followed. For each monitor alarm the parents recorded the occurrence of apnea, bradycardia or color change, and the type of assistance provided. The mean gestational age at birth was 28.8 (26-34) weeks, and the mean birth weight was 1,180 (730-2,390) g. The parents of 61/64 infants (95%) reported a total of 185 true AOPs with a mean of 3 (1-12) events/infant. The mean postconceptional age (PCA) at the last apnea was 41.0 (37-44) weeks. In 80%, AOP terminated between 40 and 44 weeks PCA. There was no correlation between the degree of prematurity and the PCA of the last apnea. We conclude that in preterm infants with AOP discharged with HM, HM may be discontinued at 45 weeks PCA.

Low melatonin production in infants with a life-threatening event.

This study compares the urinary excretion of the main melatonin metabolite, 6-sulfatoxymelatonin (6SMT), in infants who have and have not experienced a life-threatening event (ALTE). 6SMT was assessed in the following groups of infants: 15 infants with ALTE for whom home monitoring had been recommended, 15 infants who had had an abrupt cyanotic apneic event but did not require mouth-to-mouth resuscitation, 15 siblings of those who had died from sudden infant death syndrome (SIDS), and 35 age-matched healthy comparison infants. All 80 infants were between 48 and 58 weeks of postconceptional age. On a double-blind basis, the total amount of 6SMT excreted over 24 hours and the diurnal rhythm in the rate of 6SMT excretion were assessed using urine samples taken from disposable diapers (nappies). The mean daily excretion of 6SMT was significantly lower in the ALTE (1,588 ng/24 hour) than in the comparison infants (3,961 ng/24 hour). No such difference was found between the infants with a cyanotic apneic event (3,268 ng/24 hour) and the SIDS siblings (2,962 ng/24 hour). The diurnal 6SMT rhythms in the ALTE infants were characterized by lower 24-hour mean and amplitude values, whereas the time of peak and nadir excretion rates (07:15 to 08:45 hours and 14:45 to 16:15 hours respectively) was similar in all four infant groups. Follow-up of the ALTE infants, performed 6 to 8 weeks later (59 to 66 weeks of postconceptional age), revealed that 6SMT excretion increased in all of them, suggesting a delayed ontogeny rather than permanent deficiency of melatonin production in ALTE.

Immunologic response to a single dose of tetanus toxoid in older people.

OBJECTIVES: Several studies have demonstrated that a large percentage of older people are inadequately immunized against tetanus. The aim of this study was to assess the immunity against tetanus in a group of individuals aged 69 and older and to examine the immune response to a single dose of tetanus toxoid. DESIGN: A convenience sample of 115 residents of a large retirement home, aged 69 and older, was studied. After a blood sample for anti-tetanus antibody titer, a single dose of tetanus toxoid vaccine was administered. Repeat titers were obtained 6 weeks after the vaccination and analyzed by ELISA assay. Antibody levels equal to or greater than 0.1 IU/mL were considered protective. RESULTS: Sixty-seven of 115 (58.3%) individuals had adequate antibody titers. Those individuals who reported having been vaccinated with tetanus toxoid in the past were more likely to be immunized adequately compared with those who reported having never been vaccinated (66.7% vs 39.3%, P = .02). After vaccination, 34 of 46 (73.9%) individuals with inadequate antibody titers became seropositive. Those who remained seronegative had mean prevaccination antibody titers significantly lower than those who seroconverted. Sixteen of 17 (94.1%) persons who reported having been vaccinated in the past and were found to be seronegative developed adequate antibody titers following vaccination, compared with only nine of 16 (56.2%) who reported never having been vaccinated (P = .04). There was no association between seroconversion rate and age, sex, underlying diseases, and army service. CONCLUSIONS: Most individuals will develop an adequate anti-tetanus antibody titer following administration of a single dose of tetanus vaccine. A history of past immunization is a good predictor of becoming adequately immunized. It is important that physicians follow the current recommendations for adult immunization and initiate campaigns to ensure that the older population is protected against tetanus.