The ongoing improvement in laser technology and target fabrication is opening new possibilities for diagnostic development. An example is x-ray phase-contrast imaging (XPCI), which serves as an advanced x-ray imaging diagnostic in laser-driven experiments. In this work, we present the results of the XPCI platform that was developed at the OMEGA EP Laser-Facility to study multi-Mbar single and double shocks produced using a kilojoule laser driver. Two-dimensional radiation-hydrodynamic simulations agree well with the shock progression and the spherical curvature of the shock fronts. It is demonstrated that XPCI is an excellent method to determine with high accuracy the front position of a trailing shock wave propagating through an expanding CH plasma that was heated by a precursor Mbar shock wave. The interaction between the rarefaction wave and the shock wave results in a clear signature in the radiograph that is well reproduced by radiation-hydrodynamic simulations.

In an experiment carried out at the Prague Asterix Laser System at laser intensities relevant to shock ignition conditions (I > 1016 W/cm2), the heating and transport of hot electrons were studied by using several complementary diagnostics, i.e., Kα time-resolved imaging, hard x-ray filtering (a bremsstrahlung cannon), and electron spectroscopy. Ablators with differing composition from low Z (parylene N) to high Z (nickel) were used in multilayer planar targets to produce plasmas with different coronal temperature and collisionality and modify the conditions of hot-electron generation. The variety of available diagnostics allowed full characterization of the population of hot electrons, retrieving their conversion efficiency, time generation and duration, temperature, and angular divergence. The obtained results are shown to be consistent with those from detailed simulations and similar inertial confinement fusion experiments. Based on the measured data, the advantages, reliability, and complementarity of the experimental diagnostics are discussed.

We describe the direct measurement of the expulsion of a magnetic field from a plasma driven by heat flow. Using a laser to heat a column of gas within an applied magnetic field, we isolate Nernst advection and show how it changes the field over a nanosecond timescale. Reconstruction of the magnetic field map from proton radiographs demonstrates that the field is advected by heat flow in advance of the plasma expansion with a velocity v_{N}=(6±2)×10^{5}  m/s. Kinetic and extended magnetohydrodynamic simulations agree well in this regime due to the buildup of a magnetic transport barrier.

Shock Ignition is a two-step scheme to reach Inertial Confinement Fusion, where the precompressed fuel capsule is ignited by a strong shock driven by a laser pulse at an intensity in the order of 10^16 W/cm ^2 . In this report we describe the results of an experiment carried out at PALS laser facility designed to investigate the origin of hot electrons in laser-plasma interaction at intensities and plasma temperatures expected for Shock Ignition. A detailed time- and spectrally-resolved characterization of Stimulated Raman Scattering and Two Plasmon Decay instabilities, as well as of the generated hot electrons, suggest that Stimulated Raman Scattering is the dominant source of hot electrons via the damping of daughter plasma waves. The temperature dependence of laser plasma instabilities was also investigated, enabled by the use of different ablator materials, suggesting that Two Plasmon Decay is damped at earlier times for higher plasma temperatures, accompanied by an earlier ignition of SRS. The identification of the predominant hot electron source and the effect of plasma temperature on laser plasma interaction, here investigated, are extremely useful for developing the mitigation strategies for reducing the impact of hot electrons on the fuel ignition.

Purpose/Objective(s) Recent systematic reviews suggested that hemoglobin (Hgb) level may play a role as biomarker for survival outcome among patients with head and neck cancer. However, the optimal threshold for anemia and its role in a current human papillomavirus (HPV) era remain unclear. To address this knowledge gap, we performed an observational cohort study to investigate pre-treatment Hgb and its association with survival outcomes in patients with head and neck cancer treated with radiation therapy. Materials/Methods A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent radiation therapy from January 2005 to April 2021. Pre-radiation Hgb was evaluated as a continuous variable using restricted cubic splines (RCS), and the model-derived threshold was used to stratify patients into low and high Hgb. Cox multivariable analysis (MVA) and Kaplan-Meier method were used to analyze overall survival (OS) and disease-specific survival (DSS). Logistic MVA was performed to identify variables associated with low Hgb level. Propensity score matching was used to construct matched pairs. A subgroup analysis was also performed among patients with available HPV data. Results Among a total of 753 patients, median follow up was 29.7 months (interquartile range 17.8-57.8). Cox MVA based on RCS showed a threshold of Hgb at 12.96, with worsening survival in a continuous fashion without plateau as Hgb decreases. Low Hgb was associated with worse OS (aHR 1.55, 95% CI 1.17-2.05, p=0.002) and DSS (aHR 1.79, 95% CI 1.28-2.51, p<0.001). Similar findings were observed in 178 matched pairs (OS: HR 1.47, 95% CI 1.05-2.06, p=0.03; DSS: HR 1.82, 95% CI 1.19-2.78, p=0.006). On logistic MVA, patients were more likely to have low Hgb if they were female, had a higher T staging, underwent induction chemotherapy or surgery prior to radiation therapy, and had feeding tubes placed. They were less likely to have low Hgb if they had a good performance status and HPV-associated head and neck cancer. Among 466 patients with available HPV data, low Hgb was associated with DSS (aHR 1.84, 95% CI 1.30-2.61, p<0.001), but not OS (aHR 1.32, 95% CI 0.89-1.95, p=0.16). Conclusion In this study, low Hgb was associated with worse survival outcomes even among those with available HPV data. Patients with significant primary disease burden, feeding tube placement, and poor performance status who underwent either induction chemotherapy or surgery were more likely to have low Hgb. Further studies would be warranted to investigate the role of Hgb to identify patients early with poor prognosis and tailor treatments based on their risk factors. Recent systematic reviews suggested that hemoglobin (Hgb) level may play a role as biomarker for survival outcome among patients with head and neck cancer. However, the optimal threshold for anemia and its role in a current human papillomavirus (HPV) era remain unclear. To address this knowledge gap, we performed an observational cohort study to investigate pre-treatment Hgb and its association with survival outcomes in patients with head and neck cancer treated with radiation therapy. A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent radiation therapy from January 2005 to April 2021. Pre-radiation Hgb was evaluated as a continuous variable using restricted cubic splines (RCS), and the model-derived threshold was used to stratify patients into low and high Hgb. Cox multivariable analysis (MVA) and Kaplan-Meier method were used to analyze overall survival (OS) and disease-specific survival (DSS). Logistic MVA was performed to identify variables associated with low Hgb level. Propensity score matching was used to construct matched pairs. A subgroup analysis was also performed among patients with available HPV data. Among a total of 753 patients, median follow up was 29.7 months (interquartile range 17.8-57.8). Cox MVA based on RCS showed a threshold of Hgb at 12.96, with worsening survival in a continuous fashion without plateau as Hgb decreases. Low Hgb was associated with worse OS (aHR 1.55, 95% CI 1.17-2.05, p=0.002) and DSS (aHR 1.79, 95% CI 1.28-2.51, p<0.001). Similar findings were observed in 178 matched pairs (OS: HR 1.47, 95% CI 1.05-2.06, p=0.03; DSS: HR 1.82, 95% CI 1.19-2.78, p=0.006). On logistic MVA, patients were more likely to have low Hgb if they were female, had a higher T staging, underwent induction chemotherapy or surgery prior to radiation therapy, and had feeding tubes placed. They were less likely to have low Hgb if they had a good performance status and HPV-associated head and neck cancer. Among 466 patients with available HPV data, low Hgb was associated with DSS (aHR 1.84, 95% CI 1.30-2.61, p<0.001), but not OS (aHR 1.32, 95% CI 0.89-1.95, p=0.16). In this study, low Hgb was associated with worse survival outcomes even among those with available HPV data. Patients with significant primary disease burden, feeding tube placement, and poor performance status who underwent either induction chemotherapy or surgery were more likely to have low Hgb. Further studies would be warranted to investigate the role of Hgb to identify patients early with poor prognosis and tailor treatments based on their risk factors.

IMPORTANCE Given the role of inflammation in cancer progression, neutrophil-lymphocyte ratio (NLR) from peripheral blood has been suggested as a readout of systemic inflammation and a prognostic marker in several solid malignant neoplasms. However, optimal threshold for NLR in US patients with head and neck cancer remains unclear. OBJECTIVE To evaluate the optimal NLR threshold as a potential prognostic biomarker for survival outcomes. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study was conducted at a single institution. Participants included 496 patients with nonmetastatic head and neck cancer who underwent chemoradiation from April 2007 to March 2021. Statistical analysis was performed from September to December 2021. EXPOSURES High vs low NLR. MAIN OUTCOMES AND MEASURES Overall survival (OS) and cancer-specific survival (CSS). RESULTS A total of 496 patients (411 male patients [82.9%]; 432 White patients [87.1%]; 64 patients with other race or ethnicity [12.9%]; median [IQR] age, 61 [55-67] years) were identified. Median (IQR) follow-up was 44.4 (22.8-74.0) months. Thresholds of NLR for both OS and CSS were 5.71. High NLR above 5.71 was associated with worse OS (adjusted hazard ratio [aHR], 1.97; 95% CI, 1.26-3.09; P = .003) and CSS (aHR, 2.33; 95% CI, 1.38-3.95; P = .002). On logistic multivariable analysis, patients were more likely to have high NLR if they had higher T and N staging (T3-4: aOR, 4.07; 95% CI, 1.92-9.16; P < .001; N2: aOR, 2.97; 95% CI, 1.04-9.17; P = .049; N3: aOR, 11.21; 95% CI, 224-46.97; P < .001), but less likely if they had a good performance status (Karnofsky Performance Status 90-100: aOR, 0.29; 95% CI, 0.14-0.59; P < .001). Among 331 patients (66.7%) with available human pa pilloma virus (HPV) data, high NLR was not associated with OS (HPV-negative: aHR, 2.46; 95% CI. 0.96-6.31; P = .06; HPV-positive: aHR, 1.17; 95% CI, 0.38-3.56; P = .78) and CSS (HPV-negative: aHR, 2.55; 95% CI, 0.81-7.99; P = .11; HPV-positive: aHR, 1.45; 95% CI, 0.44-4.76; P = .54). CONCLUSIONS AND RELEVANCE High NLR was associated with worse survival. Patients with substantial disease burden and poor performance status were more likely to have high NLR. These findings suggest that further studies would be warranted to investigate the role of such prognostic marker to identify patients at risk to tailor interventions.

Shock ignition enables high gain at low implosion velocity, reducing ablative Rayleigh-Taylor instability growth, which can degrade conventional direct drive. With this method, driving a strong shock requires high laser power and intensity, resulting in inefficiencies in the drive and the generation of hot electrons that can preheat the fuel. A new "shock-augmented ignition" pulse shape is described that, by preconditioning the ablation plasma before launching a strong shock, enables the shock ignition of thermonuclear fuel, but importantly, with substantially reduced laser power and intensity requirements. The reduced intensity requirement with respect to shock ignition limits laser-plasma instabilities, such as stimulated Raman and Brillouin scatter, reducing the risk of hot-electron preheat and restoring the laser coupling advantages of conventional direct drive. Simulations indicate that, due to the reduced power requirements, high gain (∼100) ignition of large-scale direct drive implosions (outer radius ∼1750  μm, deuterium-tritium ice thickness ∼165  μm) may be possible within the power and energy limits of existing facilities such as the National Ignition Facility. Moreover, this concept extends to indirect drive implosions, which exhibit substantial yield increases at reduced implosion velocity. Shock-augmented ignition expands the viable design space of laser inertial fusion.

Purpose/Objective(s) A secondary analysis of RTOG 0129 established 10 pack-years of smoking as a threshold of risk stratification for survival among patients treated with chemoradiation for oropharyngeal cancer. We performed a single-institution, observational cohort study to evaluate the optimal threshold of pack-years of smoking and validate 10 pack-years as a prognostic factor. Materials/Methods A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent definitive-intent chemoradiation from January 2005 to April 2021. An optimal threshold of pack-years of smoking was evaluated based on maximizing log-rank test statistic, and heavy smokers were defined as those with above the threshold. Cox multivariable analysis (MVA) and Kaplan-Meier method were performed to analyze overall survival (OS) and progression-free survival (PFS). Multivariable Fine-Gray competing risk analysis was performed for locoregional (LRF) and distant failure (DF) outcomes with death as a competing event. Propensity score matching was performed to construct matched pairs based on nearest neighbor method in a 1:1 ratio with no replacement. Multivariable analyses were repeated using 10 pack-years of smoking as a threshold. Results A total of 518 patients were identified for analysis. Median follow up was 44.1 months (interquartile range 22.3-72.8). The threshold of smoking in pack-years was determined to be 22. On Cox MVA, heavy smokers were associated with worse OS (adjusted hazards ratio [aHR] 1.64, 95% confidence interval [CI] 1.17-2.30, p=0.004) and PFS (aHR 1.42, 95% CI 1.04-1.93, p=0.03). On multivariable Fine-Gray competing risk model, heavy smokers were associated with worse DF (aHR 1.70, 95% CI 1.03-2.83, p=0.04), but not LRF (aHR 1.03, 95% CI 0.59-1.78, p=0.92). Similar findings were noted among 141 matched pairs (OS: HR 1.93, 95% CI 1.29-2.88, p=0.001; PFS: HR 1.50, 95% CI 1.04-2.16, p=0.03; LRF: HR 0.92, 95% CI 0.49-1.71, p=0.78; DF: HR 1.94, 95% CI 1.02-3.68, p=0.04). However, heavy smokers defined using 10 pack-years of smoking as a threshold were not associated with OS (aHR 1.41, 95% CI 0.97-2.06, p=0.07), PFS (aHR 1.21, 95% CI 0.87-1.70, p=0.26), LRF (aHR 1.19, 95% CI 0.66-2.16, p=0.56), or DF (aHR 1.51, 95% CI 0.88-2.58, p=0.13). Conclusion In our study, heavy smoking based on 22 pack-years of smoking as a threshold was an independent adverse prognostic factor for survival and distant metastasis. However, using 10 pack-year of smoking as a threshold was not associated with such outcomes. Further studies are warranted to optimize the role of smoking in pack-years for risk stratification.

Purpose/Objective(s) Combined modality therapy with surgery, chemotherapy, and/or radiation often results in significant morbidity among patients with head and neck cancer, including dysphagia and weight loss. Given extensive side effect profiles, body mass index (BMI) has been shown to play a role in the clinical outcome of such patients. To validate this finding, we performed an observational cohort study to investigate BMI and its association with survival outcomes in patients with head and neck cancer treated with multimodal therapies. Materials/Methods A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent either definitive-intent chemoradiation or postoperative radiation therapy from 1/2005 to 4/2021. BMI was stratified by underweight, normal, overweight, and obese by <18.5, 18.5-24.9, 25.0-29.9, and 30.0 or above, respectively. Cox multivariable analysis (MVA) and Kaplan-Meier method were used to analyze overall survival (OS) and cancer-specific survival (CSS) outcomes. Logistic MVA was performed to identify variables associated with post-treatment responses. Propensity score matching was used to construct matched pairs based on nearest neighbor method in a 1:1 ratio with no replacement. Results A total of 738 patients (n=206 with normal BMI, n=27 with underweight, n=274 with overweight, and n=231 with obese BMI) were included for analysis. Median follow up was 31.0 months (interquartile range 18.5-58.0). On Cox MVA, being overweight was associated with improved OS (aHR 0.70, 95% CI 0.51-0.97, p=0.03), but not CSS (aHR 0.82, 95% CI 0.55-1.22, p=0.34). Similar findings were noted in 163 matched pairs of patients with normal BMI and overweight (OS: HR 0.69, 95% CI 0.48-0.99, p=0.04; CSS: HR 0.80, 95% CI 0.51-1.24, p=0.32). Among 683 patients with available treatment response, being overweight was associated with complete response after treatments (aOR 0.52, 95% CI 0.30-0.90, p=0.02). Being underweight (OS: aHR 0.84, 95% CI 0.49-1.44, p=0.53; CSS: aHR 1.83, 95% CI 0.98-3.41, p=0.06) or obese (OS: aHR 0.77, 95% CI 0.53-1.11, p=0.16; CSS: aHR 0.92, 95% CI 0.58-1.46, p=0.73) was not associated with survival outcomes. Conclusion In this study, being overweight was associated with improved OS and increased likelihood of complete response after treatments, while it had no association with CSS. However, having normal BMI or obesity were not associated with improved survival outcomes. Further studies would be warranted to investigate the role of BMI as a prognostic marker among patients who underwent multimodal therapies. Combined modality therapy with surgery, chemotherapy, and/or radiation often results in significant morbidity among patients with head and neck cancer, including dysphagia and weight loss. Given extensive side effect profiles, body mass index (BMI) has been shown to play a role in the clinical outcome of such patients. To validate this finding, we performed an observational cohort study to investigate BMI and its association with survival outcomes in patients with head and neck cancer treated with multimodal therapies. A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent either definitive-intent chemoradiation or postoperative radiation therapy from 1/2005 to 4/2021. BMI was stratified by underweight, normal, overweight, and obese by <18.5, 18.5-24.9, 25.0-29.9, and 30.0 or above, respectively. Cox multivariable analysis (MVA) and Kaplan-Meier method were used to analyze overall survival (OS) and cancer-specific survival (CSS) outcomes. Logistic MVA was performed to identify variables associated with post-treatment responses. Propensity score matching was used to construct matched pairs based on nearest neighbor method in a 1:1 ratio with no replacement. A total of 738 patients (n=206 with normal BMI, n=27 with underweight, n=274 with overweight, and n=231 with obese BMI) were included for analysis. Median follow up was 31.0 months (interquartile range 18.5-58.0). On Cox MVA, being overweight was associated with improved OS (aHR 0.70, 95% CI 0.51-0.97, p=0.03), but not CSS (aHR 0.82, 95% CI 0.55-1.22, p=0.34). Similar findings were noted in 163 matched pairs of patients with normal BMI and overweight (OS: HR 0.69, 95% CI 0.48-0.99, p=0.04; CSS: HR 0.80, 95% CI 0.51-1.24, p=0.32). Among 683 patients with available treatment response, being overweight was associated with complete response after treatments (aOR 0.52, 95% CI 0.30-0.90, p=0.02). Being underweight (OS: aHR 0.84, 95% CI 0.49-1.44, p=0.53; CSS: aHR 1.83, 95% CI 0.98-3.41, p=0.06) or obese (OS: aHR 0.77, 95% CI 0.53-1.11, p=0.16; CSS: aHR 0.92, 95% CI 0.58-1.46, p=0.73) was not associated with survival outcomes. In this study, being overweight was associated with improved OS and increased likelihood of complete response after treatments, while it had no association with CSS. However, having normal BMI or obesity were not associated with improved survival outcomes. Further studies would be warranted to investigate the role of BMI as a prognostic marker among patients who underwent multimodal therapies.

Shock ignition is a scheme for direct drive inertial confinement fusion that offers the potential for high gain with the current generation of laser facility; however, the benefits are thought to be dependent on the use of low adiabat implosions without laser–plasma instabilities reducing drive and generating hot electrons. A National Ignition Facility direct drive solid target experiment was used to calibrate a 3D Monte Carlo hot-electron model for 2D radiation-hydrodynamic simulations of a shock ignition implosion. The α=2.5 adiabat implosion was calculated to suffer a 35% peak areal density decrease when the hot electron population with temperature Th=55 keV and energy Eh=13 kJ was added to the simulation. Optimizing the pulse shape can recover ∼1/3 of the peak areal density lost due to a change in shock timing. Despite the harmful impact of laser–plasma instabilities, the simulations indicate shock ignition as a viable method to improve performance and broaden the design space of near ignition high adiabat implosions.

Increase platelet count can accompany various cancers including lung cancer. This finding has recently been suggested to indicate poor prognosis. In patients with malignancies, thrombocytosis has previously been related disease stage, histological type and survival. In this study, the prevalence of thrombocytosis and the prognostic information provided by platelet count were analyzed in patients with stage IV Non-Small Cell Lung Cancer (NSCLC) with an aim to assess elevated platelet count as a prognostic factor in patients with stage IV NSCLC and to investigate whether there is relationship between thrombocytosis, other clinico-pathologic factors and median survival. This prospective observational study was conducted in National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh from September 2019 to August 2020. A total of 108 patients were enrolled purposively. Detail history taking, thorough physical examination was done along with relevant investigations. Data were collected by semi structured questionnaire and analysis was done with the help of Statistical Package for Social Science (SPSS), version 21.0. The mean age of the patients was found 56.4±12.2 years with range from 35 to 75 years. Majority (79.6%) patients were male, 52.8% patients came from low income and 36.1% were farmer. Majority (40.7%) were symptomatic; in bed >50.0% of day. Almost two third (59.3%) had <5.0% weight loss. Almost three fourth (69.4%) had squamous cell carcinoma. At the time of first assessment 75(69.4%) patients had normal and 33(30.6%) had elevated platelet count level. Age, sex and histological type were statistically not significant between normal and elevated platelet count level groups. But performance status, weight loss were statistically significant (p<0.05) between two groups. According to univariate analysis, age, performance status at presentation, weight loss more than 10.0% for 3 months and platelet count prior the start of treatment were all significant predictors for the overall survival. In multivariate analysis age, performance status at presentation and initial thrombocytosis were independent prognostic determinants for overall survival. Median survival time was significantly higher for the normal platelet count group and elevated platelet count group (7.5 months versus 5.5 months) respectively (95% CI, 5.5-7.5), p<0.001. The frequency of thrombocytosis in patients with stage-IV NSCLC at first presentation was 30.6% and median survival time in these patients was significantly shorter compared in patients without thrombocytosis. These results concluded that an elevated platelet count could be a useful prognostic factor for survival in patients with stage-IV NSCLC.

We report on planar target experiments conducted on the OMEGA-EP laser facility performed in the context of the shock ignition (SI) approach to inertial confinement fusion. The experiment aimed at characterizing the propagation of strong shock in matter and the generation of hot electrons (HEs), with laser parameters relevant to SI (1-ns UV laser beams with I similar to 10(16) W/cm(2)). Time-resolved radiographs of the propagating shock front were performed in order to study the hydrodynamic evolution. The hot-electron source was characterized in terms of Maxwellian temperature, T-h, and laser to hot-electron energy conversion efficiency ? using data from different x-ray spectrometers. The post-processing of these data gives a range of the possible values for T-h and ? [i.e., T h [ keV ] (sic)& nbsp;(20, 50) and ? (sic)& nbsp; (2%, 13%)]. These values are used as input in hydrodynamic simulations to reproduce the results obtained in radiographs, thus constraining the range for the HE measurements. According to this procedure, we found that the laser converts similar to 10% +/-& nbsp;4% of energy into hot electrons with T-h = 27 +/-& nbsp;8 keV. The paper shows how the coupling of different diagnostics and numerical tools is required to sufficiently constrain the problem, solving the large ambiguity coming from the post-processing of spectrometers data. The effect of the hot electrons on the shock dynamics is then discussed, showing an increase in the pressure around the shock front. The low temperature found in this experiment without pre-compression laser pulses could be advantageous for the SI scheme, but the high conversion efficiency may lead to an increase in the shell adiabat, with detrimental effects on the implosion.

Explore Medical Nutrition Therapy through telehealth services as a viable option to reduce HbA1c in a low-income ethnic minority community. Baylor Scott and White Health and Wellness Center (HWC) transitioned Medical Nutrition Therapy (MNT) from in-person to telehealth services, in response to COVID-19 restrictions. MNT had effectively been used to improve HbA1c in a low-income ethnic minority population. However, efficacy of MNT through telehealth compared to in-person delivery for improving HbA1c in low-income populations had not been examined. During 2019 and 2020, patients (N = 79) received MNT either in-person (N = 51) or via telehealth (N=28). HbA1c measurements were taken at baseline and at least 3 months after MNT. Paired t-tests and ANOVA were used for within and between-group pre-post comparisons, respectively. The in-person group had an average HbA1c (SD) of 9.2 (2.4) at baseline and 8.2 (1.7) at post. The telehealth group pre-post HbA1c was 9.4 (1.9) and 8.8 (2.2), respectively. In-person participants had significant reduction of HbA1c of 1.0 (1.9) (p = 0.0003). The telehealth group had no significant reduction of HbA1c (p = 0.09). The in-person group had an additional reduction of 0.6 (SE= 0.4) HbA1c compared to the telehealth group; however, it was not statistically significant (p = 0.09). Most in-person visits occurred before the pandemic’s onset. During the pandemic, telehealth became the predominant method for MNT. Although HbA1c reduction was insignificant, telehealth remains a viable option. Because low-income ethnic minority communities are especially impacted by Covid -19, other factors may contribute to lack of reduction in HbA1c. Further investigation to improve the effectiveness of telehealth for this population is needed. DSRIP CMS Waiver

Abstract We report results and modelling of an experiment performed at the Target Area West Vulcan laser facility, aimed at investigating laser–plasma interaction in conditions that are of interest for the shock ignition scheme in inertial confinement fusion (ICF), that is, laser intensity higher than ${10}^{16}$ $\mathrm{W}/{\mathrm{cm}}^2$ impinging on a hot ($T>1$ keV), inhomogeneous and long scalelength pre-formed plasma. Measurements show a significant stimulated Raman scattering (SRS) backscattering ($\sim 4\%{-}20\%$ of laser energy) driven at low plasma densities and no signatures of two-plasmon decay (TPD)/SRS driven at the quarter critical density region. Results are satisfactorily reproduced by an analytical model accounting for the convective SRS growth in independent laser speckles, in conditions where the reflectivity is dominated by the contribution from the most intense speckles, where SRS becomes saturated. Analytical and kinetic simulations well reproduce the onset of SRS at low plasma densities in a regime strongly affected by non-linear Landau damping and by filamentation of the most intense laser speckles. The absence of TPD/SRS at higher densities is explained by pump depletion and plasma smoothing driven by filamentation. The prevalence of laser coupling in the low-density profile justifies the low temperature measured for hot electrons ($7\!{-}\!12$ keV), which is well reproduced by numerical simulations.

We use a subignition scale laser, the 30 kJ Omega, and a novel shallow-cone target to study laser-plasma interactions at the ablation-plasma density scale lengths and laser intensities anticipated for direct drive shock-ignition implosions at National Ignition Facility scale. Our results show that, under these conditions, the dominant instability is convective stimulated Raman scatter with experimental evidence of two plasmon decay (TPD) only when the density scale length is reduced. Particle-in-cell simulations indicate this is due to TPD being shifted to lower densities, removing the experimental back-scatter signature and reducing the hot-electron temperature. The experimental laser energy-coupling to hot electrons was found to be 1%-2.5%, with electron temperatures between 35 and 45 keV. Radiation-hydrodynamics simulations employing these hot-electron characteristics indicate that they should not preheat the fuel in MJ-scale shock ignition experiments.

By driving hot electrons between two metal plates connected by a wire loop, high power lasers can generate multi-tesla, quasi-static magnetic fields in miniature coil targets. Many experiments involving laser-coil targets rely on proton deflectometry directed perpendicular to the coil axis to extract a measurement of the magnetic field. In this paper, we show that quantitative measurements using perpendicular probing are complicated by the presence of GV m(-1) electric fields in the target that develop on sub-ns timescales. Probing parallel to the coil axis with fiducial grids is shown to reliably separate the electric and magnetic field measurements, giving current estimates of I approximate to 5 kA in 1 mm- and 2 mm-diameter wire loops. An analytic model of proton deflection in electric and magnetic fields is used to benchmark results from the particle-in-cell code and help deconvolve the magnetic and electric field deflections. Results are used to motivate a new experimental scheme that combines a single-plate target with axial proton probing and direct current measurements. This scheme has several important advantages over the traditional target and diagnostic set-up, enabling the robust measurement of coil magnetic fields and plasma properties, as well as making it easier to validate different theoretical models at a range of laser intensities.

The dynamical behavior of weakly nonlinear Alfvén waves is investigated in positive ion—negative ion (PINI) magnetized plasmas. The dynamics of the nonlinear wave is shown to be governed by a higher-order dispersion modified derivative nonlinear Schrödinger equation (DNLSE). The dispersive modification arises due to the inertial effect of both the ions. Analytical and numerical (for the experimental parameters) solutions predict the existence of solitary wave structures in positive ion—negative ion plasmas.

Considering the dark matter as self-gravitating Bose-Einstein condensate in a gravito-chemical equilibrium state, we have studied the light trajectory through the halo. Found that depending on the initial direction cosine of the light ray, there are three types of trajectories: (a) the refracted light i.e. light which can refracts away from the halo to the out side, (b) the trapped light i.e. light that is trapped into the halo i.e. an observer, situated outside of the halo, can not observe it and (c) the reflected light: in this case the halo behaves as a perfect reflector to the outside light. The light trapping can introduce asymmetry in the observed spectrum and modify the apparent number of stars in a dark matter dominated galaxy.

Background and study aims: The pathogenesis of functional dyspepsia (FD) is complex and still remains to be established. Recent studies support duodenal inflammation with increased infiltration of eosinophils and a higher level of systemic cytokines among patients with FD. These findings may help to understand the underlying pathophysiology of FD. The aim of this study was to evaluate the association between duodenal eosinophilia and FD. Patients and methods: A total of 84 patients (42 cases of FD and 42 subjects without dyspepsia as control, mean age 31 years, 56% female) were recruited for this prospective observational study. FD was diagnosed by validated Bangla version of the ROME III criteria. Patients with no symptoms of FD who were referred for upper gastrointestinal endoscopy for other reasons were included as control. Biopsy specimens were taken from the second part (D2) of the duodenum of all participants. The eosinophil count was quantitatively evaluated by hematoxylin and eosin staining and expressed in numbers per 5 HPF. The association between duodenal eosinophilia (defined as >= 22/5HPF a priori) and FD was assessed. Result: Significantly increased duodenal eosinophil count was found in patients with FD than patients without dyspepsia (p = 0.001). 57.1% of patients with FD had duodenal eosinophilia. A significant positive association was found between duodenal eosinophilia and FD (OR = 5.67, 95% CI 1.92-17.2, p = 0.001). A positive association was also observed between duodenal eosinophilia and postprandial distress syndrome (OR = 5.54, 95% CI 0.86-45.24, p = 0.036). A higher odds ratio was noticed among those who complain of early satiety. Conclusion: A significant positive association was found between duodenal eosinophilia and FD especially among those with postprandial distress syndrome. It requires further large scale multicenter studies to establish duodenal eosinophilia as a biomarker of FD. (C) 2020 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

A developing application of laser-driven currents is the generation of magnetic fields of picosecond–nanosecond duration with magnitudes exceeding $B=10~\text{T}$ . Single-loop and helical coil targets can direct laser-driven discharge currents along wires to generate spatially uniform, quasi-static magnetic fields on the millimetre scale. Here, we present proton deflectometry across two axes of a single-loop coil ranging from 1 to 2 mm in diameter. Comparison with proton tracking simulations shows that measured magnetic fields are the result of kiloampere currents in the coil and electric charges distributed around the coil target. Using this dual-axis platform for proton deflectometry, robust measurements can be made of the evolution of magnetic fields in a capacitor coil target.