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Abstract Indirect Drive Inertial Confinement Fusion Experiments on the National Ignition Facility (NIF) have achieved a burning plasma state with neutron yields exceeding 170 kJ, roughly 3 times the prior record and a necessary stage for igniting plasmas. The results are achieved despite multiple sources of degradations that lead to high variability in performance. Results shown here, for the first time, include an empirical correction factor for mode-2 asymmetry in the burning plasma regime in addition to previously determined corrections for radiative mix and mode-1. Analysis shows that including these three corrections alone accounts for the measured fusion performance variability in the two highest performing experimental campaigns on the NIF to within error. Here we quantify the performance sensitivity to mode-2 symmetry in the burning plasma regime and apply the results, in the form of an empirical correction to a 1D performance model. Furthermore, we find the sensitivity to mode-2 determined through a series of integrated 2D radiation hydrodynamic simulations to be consistent with the experimentally determined sensitivity only when including alpha-heating.

Objectives: Knowledge on mental health consultations in immigration detention and characteristics of people receiving consultations is scarce. Based on a sample of 230 adult men in immigration detention in Switzerland, we aimed to: (1) Quantify the proportion of persons receiving mental health consultations during detention; and (2) Identify socio-demographic and clinical characteristics associated with mental health consultations.Methods: Retrospective observational study with a cross-sectional design. Prevalence estimates, logistic regressions, and contingency tables were used to analyse the data.Results: A total of 30% of the sample received mental health consultations during detention. Time spent in immigration detention, mental health problems during detention, use of psychotropic medication, and self-harm were associated with mental health consultations. Although mental health consultations are provided to people with more severe mental health problems, 41% of persons with assessed mental health needs during the initial screening and 26% of those who self-harmed during detention did not receive mental health consultations.Conclusion: Mental health resources and screening procedures could be improved to ensure that mental health consultations are matched to clinical need in immigration detention settings.

Compression is an essential component of achieving high gain in inertial confinement fusion. However, increasing compression with crystalline ablator-based implosions had not succeeded up to now, attributed to increased hydrodynamic instability growth. We present experimental results demonstrating record high compression of stagnated fuel in indirectly driven implosions that use a high-density carbon ablator at the National Ignition Facility (NIF) [Spaeth et al., Fusion Sci. Technol. 69, 25 (2016)]1536-105510.13182/FST15-144 by the use of a modified drive pulse (and capsule design). Specifically, the SQ-n design [Clark et al., Phys. Plasmas 29, 052710 (2022)1070-664X10.1063/5.0087052] replaces the second and the third shock phase with a more gently ramped rise designed to reduce in-flight fuel adiabat and instability growth at both the ablation front and the ablator-DT fuel interface and hence promote increased compression. Comparing the results from a large set of experiments, we show that SQ-n achieves ≈15%–30% higher compression than prior designs, a finding that may chart a path toward increased compression and higher gain at the NIF [Abu-Shawareb et al., Phys. Rev. Lett. 129, 075001 (2022)0031-900710.1103/PhysRevLett.129.075001.].

Fusion ignition by inertial confinement requires compression and heating of the fusion fuel to temperatures in excess of 5 keV and densities exceeding hundreds of g/cc. In August 2021, this scientific milestone was surpassed at the National Ignition Facility (NIF), when the Lawson criterion for ignition was exceeded generating 1.37MJ of fusion energy (Abu-Shawareb et al 2022 Phys. Rev. Lett. 129 075001), and then in December 2022 target gain >1 was realized with the production of 3.1MJ of fusion energy from a target driven by 2.0MJ of laser energy (Abu-Shawareb et al 2024 Phys. Rev. Lett. 132 065102). At the NIF, inertial confinement fusion research primarily uses a laser indirect drive in which the fusion capsule is surrounded by a high-Z enclosure (‘hohlraum’) used to convert the directed laser energy into a symmetric x-ray drive on the capsule. Precise measurements of the plasma conditions, x-rays, γ -rays and neutrons produced are key to understanding the pathway to higher performance. This paper discusses the diagnostics and measurement techniques developed to understand these experiments, focusing on three main topics: (1) key diagnostic developments for achieving igniting plasmas, (2) novel signatures related to thermonuclear burn and (3) advances to diagnostic capabilities in the igniting regime with a perspective toward developments for intertial fusion energy.

In this work, we describe a microfluidic three-dimensional (3D) chondrocyte culture mimicking in vivo articular chondrocyte morphology, cell distribution, metabolism, and gene expression. This has been accomplished by establishing a physiologic nutrient diffusion gradient across the simulated matrix, while geometric design constraints of the microchambers drive native-like cellular behavior. Primary equine chondrocytes remained viable for the extended culture time of 3 weeks and maintained the low metabolic activity and high Sox9, aggrecan, and Col2 expression typical of articular chondrocytes. Our microfluidic 3D chondrocyte microtissues were further exposed to inflammatory cytokines to establish an animal-free, in vitro osteoarthritis model. Results of our study indicate that our microtissue model emulates the basic characteristics of native cartilage and responds to biochemical injury, thus providing a new foundation for exploration of osteoarthritis pathophysiology in both human and veterinary patients. Keywords: Organ-on-a-Chip, Cartilage, Primary cells, Tissue-on-a-Chip

Summary: Lymphatic vessels (LVs) are important in the regulation of tissue fluid homeostasis and the pathogenesis of tumor progression. We investigated the innervation of LVs and the response to agonists and antagonists of the autonomic nervous system in vivo. While skin-draining collecting LVs express muscarinic, α1- and β2-adrenergic receptors on lymphatic endothelial cells and smooth muscle cells, intestinal lacteals express only β-adrenergic receptors and muscarinic receptors on their smooth muscle cells. Quantitative in vivo near-infrared imaging of the exposed flank-collecting LV revealed that muscarinic and α1-adrenergic agonists increased LV contractility, whereas activation of β2-adrenergic receptors inhibited contractility and initiated nitric oxide (NO)-dependent vasodilation. Tumor-draining LVs were expanded and showed a higher innervation density and contractility that was reduced by treatment with atropine, phentolamine, and, most potently, isoproterenol. These findings likely have clinical implications given the impact of lymphatic fluid drainage on intratumoral fluid pressure and thus drug delivery. : Bachmann et al. use in vivo imaging to demonstrate that muscarinic and α1-adrenergic agonists increase lymphatic contractility, whereas activation of β2-adrenergic receptors inhibits contractility and mediates NO-dependent vasodilation. Tumor-draining lymphatics have a denser innervation and increased contractility, which can be diminished by β2-adrenergic agonists. Keywords: lymphatic vessels, contractility, autonomic nervous system, Ca2+ imaging, tumor-draining lymphatics

The lymphatic vascular system plays important roles in the control of tissue fluid homeostasis and immune responses. While VEGF-A-induced angiogenesis promotes hair follicle (HF) growth, the potential role of lymphatic vessels (LVs) in HF cycling has remained unknown. In this study, we found that LVs are localized in close proximity to the HF bulge area throughout the postnatal and depilation-induced hair cycle in mice and that a network of LVs directly connects the individual HFs. Increased LV density in the skin of K14-VEGF-C transgenic mice was associated with prolongation of anagen HF growth. Conversely, HF entry into the catagen phase was accelerated in K14-sVEGFR3 transgenic mice that lack cutaneous LVs. Importantly, repeated intradermal injections of VEGF-C promoted hair growth in mice. Conditioned media from lymphatic endothelial cells promoted human dermal papilla cell (DPC) growth and expression of IGF-1 and alkaline phosphatase, both activators of DPCs. Our results reveal an unexpected role of LVs in coordinating and promoting HF growth and identify potential new therapeutic strategies for hair loss-associated conditions.

Shock synthesis of diamond and even harder carbon polymorphs from graphite is of great interest for science and technology. Here, the authors present unprecedented in situmeasurements of the structural changes, showing ultrafast formation of diamond and, at higher pressures, evidence for a pure lonsdaleite structure.

This paper is aimed at listing environmental attributes, according to the degree of importance of disclosure, to compose a truly Brazilian indicator that assesses the quality of environmental information disclosure. “Environmental accounting/sustainability” experts and environmental disclosure attributes were selected, based on Brazilian and international studies. Through Delphi rounds, the experts outlined the list of the most relevant attributes to compose the indicator. The Environmental Disclosure Indicator – EDI consists of ten attributes than combine practicality and representativeness of the quality of environmental information disclosure. The results revealed a high degree of importance and, therefore, a greater weight of qualitative attributes, such as “Environmental Impacts of Products and Processes” and “Information about Residues”. The study contributes by revealing “what” should be disclosed prioritarily, that is, which are the essential environmental attributes. It contributes to verify whether the amount of environmental information companies have disclosed have necessarily meant disclosure quality. As it provides an instrument to quantify the quality of environmental disclosure, the study permits further research about the association between this disclosure and other company aspects, such as performance and corporate governance.O artigo tem por objetivo elencar atributos ambientais, conforme o grau de importância de disclosure, para composição de um indicador genuinamente brasileiro que avalie qualidade de evidenciação de informações ambientais. Selecionaram-se especialistas da área “contabilidade ambiental/sustentabilidade” e atributos de evidenciação ambiental subsidiados por estudos nacionais e internacionais. Por meio de rodadas Delphi, os especialistas delinearam o rol de atributos mais relevantes para a composição do indicador. O Indicador de Disclosure Ambiental – IDA é composto por dez atributos que combinam praticidade e representatividade da qualidade de evidenciação de informações ambientais. Os resultados revelaram alto grau de importância e, portanto, maior peso para atributos qualitativos, como “Impactos Ambientais de Produtos e Processos” e “Informações sobre Resíduos”. A contribuição do estudo consiste em revelar “o que” se deve evidenciar prioritariamente, ou seja, quais são os atributos ambientais essenciais. Contribui para que verifique se a quantidade de informações ambientais evidenciadas pelas companhias tem significado necessariamente qualidade de disclosure. Por fornecer um instrumento para quantificação da qualidade do disclosure ambiental, o estudo possibilita pesquisas posteriores sobre a associação entre esta evidenciação e demais aspectos das companhias, como desempenho e governança corporativa

O artigo tem por objetivo elencar atributos ambientais, conforme o grau de importância de disclosure, para composição de um indicador genuinamente brasileiro que avalie qualidade de evidenciação de informações ambientais. Selecionaram-se especialistas da área “contabilidade ambiental/sustentabilidade” e atributos de evidenciação ambiental subsidiados por estudos nacionais e internacionais. Por meio de rodadas Delphi, os especialistas delinearam o rol de atributos mais relevantes para a composição do indicador. O Indicador de Disclosure Ambiental – IDA é composto por dez atributos que combinam praticidade e representatividade da qualidade de evidenciação de informações ambientais. Os resultados revelaram alto grau de importância e, portanto, maior peso para atributos qualitativos, como “Impactos Ambientais de Produtos e Processos” e “Informações sobre Resíduos”. A contribuição do estudo consiste em revelar “o que” se deve evidenciar prioritariamente, ou seja, quais são os atributos ambientais essenciais. Contribui para que verifique se a quantidade de informações ambientais evidenciadas pelas companhias tem significado necessariamente qualidade de disclosure. Por fornecer um instrumento para quantificação da qualidade do disclosure ambiental, o estudo possibilita pesquisas posteriores sobre a associação entre esta evidenciação e demais aspectos das companhias, como desempenho e governança corporativa

Zusammenfassung Das spontane Liquorunterdrucksyndrom (SLUDS) ist ein noch seltenes Krankheitsbild mit allerdings zunehmender Tendenz. Die klinischen Symptome sind mit denen des postspinalen Punktionssyndroms vergleichbar. Leitsymptom ist der lageabhängige Kopfschmerz. Die Ursache des SLUDS ist eine Liquorleckage, die zumeist zervikal oder zervikothorakal lokalisiert ist. Seine Ãtiologie ist noch weit gehend unbekannt. Als mögliche Komplikation treten kraniale subdurale Hämatome auf. Magnetresonanztomographien des Schädels zeigen häufig typische diffuse Kontrastmittelanreicherungen der Dura, oft auch in Verbindung mit Kaudalverlagerungen des Hirnstamms. Kenntnis dieser radiologischen Befundkonstellation kann sehr hilfreich bei der Diagnosefindung sein. Obwohl konservative Behandlungsmaßnahmen häufig zuerst durchgeführt werden, ist die Anlage eines epiduralen Blutpatches die Therapie der Wahl. Aufgrund der klinischen Symptomatik mit der Ãhnlichkeit zum postspinalen Punktionssyndrom werden zunehmend Anästhesisten und Schmerztherapeuten in Diagnosefindung und Behandlung miteinbezogen. Wir berichten über 2 Patienten mit dem Krankheitsbild eines SLUDS, die neben dem Leitsymptom des lageabhängigen Kopfschmerzes auch magnetresonanztomographisch nachgewiesene kraniale epidurale Flüssigkeitsansammlungen aufweisen. [ABSTRACT FROM AUTHOR]

Zusammenfassung Ziel der Untersuchung war es zu prüfen, welche Auswirkungen Veränderungen der Nachlast auf den intrazellulären Calciumstoffwechsel des isolierten menschlichen Vorhofmyokards haben. Das Verhalten von atrialen Trabekeln von Herzen mit chronischem Vorhofflimmern (cVF) wurde mit Präparaten von Patienten mit Sinusrhythmus (SR) verglichen. Material und Methoden Myokardtrabekel aus dem Vorhof von Patienten mit chronischem Vorhofflimmern (n=15) und mit Sinusrhythmus (n=12) wurden entnommen, mit dem Fluoreszenzindikator für Calcium FURA 2-AM geladen und auf optimale Länge (LMax) vorgedehnt. Bei konstanter Frequenz (1 Hz) wurden unter isometrischen Bedingungen Ruhekraft, maximale Kraft, systolische und diastolische Calciumkonzentration und unter isotonen Bedingungen die Änderung des Calciumtransienten ermittelt (Messbedingungen: 37 °C, oxygenierte Krebs-Henseleit-Lösung, 10% supramaximale Stimulation). Ergebnisse Die maximale, aktiv von dem Präparat entwickelte isometrische Kraft war bei Herzen mit cVF gegenüber SR um 20,3% erniedrigt (p<0,0006). Gleichzeitig wurde bei cVF eine signifikant erhöhte diastolische Calciumkonzentration gemessen (p<0,004). Unter isotonen Messbedingungen konnte bei minimaler Nachlast eine um 35% verminderte Verkürzungsamplitude bei cVF nachgewiesen werden (p<0,0005). Im Vergleich mit der isometrischen Kontraktion zeigte sich eine Zunahme der Amplitude des intrazellulären Calciumtransienten und vor allem eine deutliche Zunahme des Calcium-Zeit-Integrals (p<0,0004). Schlussfolgerung Die Befunde sprechen für erhebliche Veränderungen des Kontraktionsverhaltens und des intrazellulären Calciumstoffwechsels zwischen cVF und SR, die besonders deutlich werden, sobald isotone Messbedingungen hergestellt werden. Eine veränderte Expression Calcium transportierender Proteine bei cVF könnte ursächlich an den beobachteten Veränderungen des Calciumstoffwechsels und der Kontraktionskinetik beteiligt sein. Summary The aim of the study was to analyze the effects of afterload variation on intracellular calcium metabolism. Atrial trabecula were obtained from patients with chronic atrial fibrillation (cAF, n=15) and patients in sinus rhythm (SR, n=12). Materials and methods The muscle specimen were excised during the cannulation procedure of the right atrium and allowed to equilibrate in 37 °C warm oxygenated Krebs Henseleit solution. The fibers were loaded with FURA 2-AM, a calciumbinding fluorescence dye, and adjusted to the length with optimal isometric force output (optimal length, Lmax) at constant electrical stimulation frequency (1 Hz, amplitude 10% above threshold). Passive diastolic resting force, maximal developed force, systolic and diastolic intracellular calcium concentrations were recorded simultaneously using isometric conditions. The changes of the calcium transient and shortening amplitudes were monitored under isotonic conditions. Results The maximal isometric force developed by a specimen was 20.3% lower in cAF than in SR (p<0.0006). The simultaneously recorded diastolic calcium concentration was significantly higher in cAF (p<0.004). Shortening amplitudes were significantly reduced (35%) in cAF (p<0.0005). As compared to the isometric contractions, a retardation of the time course of the intracellular calcium transient and a significant prolongation of the calcium-time integral appeared in cAF (p<0.0004). Conclusion The data suggest a considerable alteration of the mechanical performance of muscle shortening and the intracellular calcium metabolism in cAF as compared to SR. Under isotonic measurement conditions, these changes appear to be most pronounced. Alterations of the expression of calcium-transporting proteins in cAF could be one reason to explain these changes in the intracellular calcium metabolism and the kinetics of muscle shortening. [ABSTRACT FROM AUTHOR]

Hydrodynamic instabilities are a major factor in degradation of inertial confinement fusion (ICF) implosions. In the highest performing implosions on National Ignition Facility, yield amplification (YA) due to alpha particle heating approached ∼3, while YA of ∼15–30 is needed for ignition. Understanding and mitigation of the instabilities are critical to achieving ignition. This article reviews several experimental platforms that have been developed to directly measure these instabilities in all phases of ICF implosions. Measurements of ripple-shock propagation at OMEGA laser has provided results on initial seeds for the instabilities in three ablators—plastic (CH), beryllium, and high-density carbon. At the ablation front, instability growth of pre-imposed modulations was measured in the linear regime using the hydrodynamic growth radiography platform. This platform was extended for modulation growth of 'native roughness' modulations and engineering features (fill tubes and capsule support membranes or 'tents'). Several new experimental platforms have or are being developed to measure instability growth at the ablator–ice interface. In the deceleration phase of implosions, complementary 'self-emission' and 'self-backlighting' platforms were developed to measure low-mode asymmetries and high-mode perturbations near peak compression. [ABSTRACT FROM AUTHOR]

We discuss the possibility of obtaining highly precise measurements of the ionization potential depression in dense plasmas with spectrally resolved x-ray scattering, while simultaneously determining the electron temperature and the free electron density. A proof-of-principle experiment at the Linac Coherent Light Source, probing isochorically heated carbon samples, demonstrates the capabilities of this method and motivates future experiments at x-ray free electron laser facilities. [ABSTRACT FROM AUTHOR]

Objective of Surgery: The aim of this surgical technique is the implantation of a glaucoma drainage device (GDD) in eyes with aphakic glaucoma following injector-assisted implantation of an artificial iris into the ciliary sulcus., Indications: This atraumatic tube insertion technique can be performed during GDD implantation after implantation of an artificial iris into the ciliary sulcus., Surgical Technique: Following injector-assisted implantation of an artificial iris into the ciliary sulcus of eyes, the iris can shift into the chamber angle. The GDD should be positioned in the quadrant in which the iridectomy is located. Otherwise, GDD implantation is not possible due to the resistance of the artificial iris. Alternatively, the artificial iris can be easily and non-traumatically rotated in the ciliary sulcus by flushing the anterior chamber with balanced salt solution (BSS) to move the iridectomy into the desired area and position the GDD tube in the anterior chamber. A surgical video, which is available online, shows the surgical technique in detail., Follow-Up: After GDD, dexamethasone eye drops should be applied 8 times daily for 1 week tapering down by 1 drop per week thereafter. Antibiotic eye drops, e.g., ofloxacin eye drops, are prescribed 4 times daily for 1 week and might be discontinued thereafter., Evidence: To date, this is the first description of a rotation of an artificial iris located in the ciliary sulcus by irrigation of the anterior chamber during GDD implantation., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Purpose: The novel endothelial keratoprosthesis EndoArt improves corneal edema by reducing the inflow of aqueous humor into the cornea. We assessed the early outcome after EndoArt implantation in patients at a high risk of graft failure after keratoplasty., Methods: This retrospective study included 14 patients with high-risk eyes owing to at least one of the following risk factors for graft failure after keratoplasty: multiple previous surgeries (glaucoma surgery, keratoplasty) and recurrent intraocular inflammation because of uveitis, aniridia, or anterior synechia. After descemetorhexis, the EndoArt keratoprosthesis was placed on the posterior stroma, secured with a gas bubble and 1 to 3 transcorneal holding sutures. Best spectacle-corrected visual acuity and central corneal thickness were calculated preoperatively and postoperatively. In addition, detachment of the keratoprosthesis and the need for additional gas injections (rebubbling) were analyzed., Results: Octafluoropropane (C3F8) 12% in 11 patients and sulfur hexafluoride 20% in 3 patients were used to attach EndoArt. Detachments requiring at least 1 rebubbling occurred in 8 eyes. Preoperative best spectacle-corrected visual acuity was 1.6 (±0.6) logarithm of the minimal angle of resolution and improved to 1.3 (±0.6) after 12 weeks. Preoperative central corneal thickness (771.8 μm ± 157) significantly decreased postoperatively in all patients (622.1 μm ± 184.7 [P = 0.025] and 562.8 μm ± 183.6 [P = 0.012] after 6 and 12 weeks, respectively)., Conclusions: EndoArt improved visual acuity and significantly reduced corneal thickness within 3 months postoperatively, subjectively, but not statistically significantly. The rebubbling rates in this cohort with an altered anterior segment anatomy were relatively high. Patients at a high risk of graft failure may benefit from this novel endothelial keratoprosthesis., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: EndoArt® (Eye Yon Medical, Ness Ziona, Israel) is a novel artificial corneal inner layer transplant and an innovative treatment alternative for patients at high risk for graft failure after posterior lamellar corneal transplantation (EK)., Aim of the Study: We present the initial results of the EndoArt® implantation in patients with glaucoma drainage devices (GDD)., Patients and Surgical Procedure: In this study 12 eyes with GDD were retrospectively evaluated. All had a high risk of transplant rejection in cases of EK (previous other glaucoma surgery in addition to GDD, n = 8, condition following Descemet membrane endothelial keratoplasty, DMEK, n = 9, uveitis, n = 2, or synechiae, n = 2). The EndoArt® was secured with a gas bubble and one to three holding sutures. The preoperative and postoperative best spectacle-corrected visual acuity (BSCVA) and central corneal thickness (CCT) were determined. The need for additional gas injections (rebubbling) was analyzed., Results: Octafluoropropane (C3F8) 12% was used in nine patients and sulfur hexafluoride (SF6) 20% in three patients as anterior chamber tamponade to ensure adhesion of the EndoArt®. At least one rebubbling was necessary in four eyes. The preoperative BSCVA was 1.6 (± 0.5) logMAR and significantly improved to 1.1 (± 0.6) logMAR after 12 weeks (p = 0.028). The preoperative CCT was 719 µm ± 145.7, which significantly decreased to 622.4 µm ± 174.9 after six weeks (p = 0.004) and to 591.7 µm ± 190.8 after 12 weeks (p = 0.096). In one eye, the prosthesis was explanted due to a suspected fibrotic remodelling of the cornea following multiple previous DMEKs., Discussion: EndoArt® led to a significant improvement in BSCVA and reduction in CCT; however, there was a high rebubbling rate in patients with GDD. In high-risk patients, the use of EndoArt® may be advantageous in avoiding graft failure after EK., (© 2024. The Author(s).)

Background: Currently, the push-in technique through the corneal tunnel using a blunt-tip spatula is used to insert an artificial corneal endothelium (EndoArt) into the anterior chamber (AC). The device is useful for patients with bullous keratopathy; however, it may be difficult to manipulate the very thin implant through hazy cornea. Unlike DMEK graft, it cannot be stained and the F-mark is faint. So, visualizing and orienting the implant is a real challenge especially through a hazy cornea and inadequate AC visualization. Therefore, alternative EndoArt implantation techniques are needed in patients with advanced endothelial dysfunction to avoid complications., Purpose: To report an alternative technique for EndoArt implantation using a Busin glide., Technique: The EndoArt was loaded onto the Busin glide with the concave side of the EndoArt facing upward and was then pulled/pushed into the Busin glide opening. After the Descemet's membrane and endothelium were detached and removed in a circular fashion in a patient with advanced corneal endothelial decompensation, the Busin glide was inserted into the corneal incision, and the EndoArt was slowly pulled into the AC using retractor forceps. Finally, the air was injected into the AC., Conclusion: The Busin glide-assisted pull-through technique smoothly and securely inserted the EndoArt into the AC without upside-down attachment. This alternative technique can be useful for patients with a history of repeat intraocular surgeries or trauma with severe corneal edema to avoid potential complications such as epithelial implantation cysts or downgrowth., Competing Interests: The authors have no conflicts of interest to disclose regarding any of the products mentioned in this article., (© 2024 Kobayashi et al.)

Bayesian inference applied to x-ray spectroscopy data analysis enables uncertainty quantification necessary to rigorously test theoretical models. However, when comparing to data, detailed atomic physics and radiation transfer calculations of x-ray emission from non-uniform plasma conditions are typically too slow to be performed in line with statistical sampling methods, such as Markov Chain Monte Carlo sampling. Furthermore, differences in transition energies and x-ray opacities often make direct comparisons between simulated and measured spectra unreliable. We present a spectral decomposition method that allows for corrections to line positions and bound-bound opacities to best fit experimental data, with the goal of providing quantitative feedback to improve the underlying theoretical models and guide future experiments. In this work, we use a neural network (NN) surrogate model to replace spectral calculations of isobaric hot-spots created in Kr-doped implosions at the National Ignition Facility. The NN was trained on calculations of x-ray spectra using an isobaric hot-spot model post-processed with Cretin, a multi-species atomic kinetics and radiation code. The speedup provided by the NN model to generate x-ray emission spectra enables statistical analysis of parameterized models with sufficient detail to accurately represent the physical system and extract the plasma parameters of interest., (© 2024 Author(s). Published under an exclusive license by AIP Publishing.)

Indirect Drive Inertial Confinement Fusion Experiments on the National Ignition Facility (NIF) have achieved a burning plasma state with neutron yields exceeding 170 kJ, roughly 3 times the prior record and a necessary stage for igniting plasmas. The results are achieved despite multiple sources of degradations that lead to high variability in performance. Results shown here, for the first time, include an empirical correction factor for mode-2 asymmetry in the burning plasma regime in addition to previously determined corrections for radiative mix and mode-1. Analysis shows that including these three corrections alone accounts for the measured fusion performance variability in the two highest performing experimental campaigns on the NIF to within error. Here we quantify the performance sensitivity to mode-2 symmetry in the burning plasma regime and apply the results, in the form of an empirical correction to a 1D performance model. Furthermore, we find the sensitivity to mode-2 determined through a series of integrated 2D radiation hydrodynamic simulations to be consistent with the experimentally determined sensitivity only when including alpha-heating., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Purpose: To determine which donor characteristics, like previous diseases and surgeries, influence the severity of the DM/endothelial lamella preparation prior to DMEK-surgery., Patients and Methods: Retrospective cross-sectional single-center study is presented. Eight hundred and forty-six eyes with DMEK-surgery between 01/2018 and 01/2021 performed at the University Hospital Cologne, Germany, were included. Information regarding the donors' previous diseases and surgeries were provided by a large database of a cornea bank (Multi Tissue Bank Mecklenburg-Vorpommern) and merged with the Cologne DMEK database, which contains information regarding preparation characteristics of the surgeon-prepared graft directly preoperatively. Three preparation groups (easy, difficult and very difficult) were correlated to the donors' previous diseases and surgeries. The following characteristics were used for the assignment in one of the three groups: stripping difficulty, rolling and staining behavior, central and peripheral adherences, tissue fragility and DM-splitting., Results: Significant risk factors for DM-splitting were diabetes mellitus (DMel) type II, heart failure, chronic kidney disease and previous cataract surgery (p=0.022, p=0.012; p=0.047 and p<0.001 respectively). Previous DMel (especially type 2) was significantly associated with the occurrence of central adherences (p=0.009). Several cardiovascular diseases (p-values between <0.001 and p=0.038), DMel type II, chronic kidney disease and previous cataract-surgery were associated with peripheral adherences (p=0.004; p=0.020 and p<0.001 respectively). Furthermore, pseudophakic donor eyes presented a higher degree of fragility of the graft (p<0.001). Age was a significant risk factor for difficult preparation (p<0.001). The staining of the graft was poorer in donors with chronic kidney disease (p=0.037)., Conclusion: Donor diabetes mellitus type 2, heart failure, previous cataract surgery, chronic kidney disease and age are associated with a difficult DMEK graft preparation. For every one-year increment in donor age, the odds of having very difficult preparation were increased by 3%. Also, chronic kidney disease predisposes to a poor tissue staining with trypan blue during preparation., Competing Interests: Professor Björn Bachmann reports personal fees from Heidelberg Engineering, outside the submitted work; In addition, Professor Björn Bachmann has a patent DMEK shooter system issued (EP3474776 B1, US 10,874,504, PCT/EP2020/055687, PCT/EP2020/072701). The authors report no other conflicts of interest in this work., (© 2024 Schrittenlocher et al.)

Background: Good vision highly depends on the transparency of the cornea, which is the "windscreen" of the eye. In fact, corneal blindness due to transparency loss is the second most common cause of blindness worldwide, and corneal transplantation is the main cure. Importantly, the cornea is normally avascular but can secondarily be invaded by pathological (blood and lymphatic) vessels due to severe inflammation, and the survival prognosis of a corneal graft mainly depends on the preoperative vascular condition of the recipient's cornea. Whereas transplants placed into avascular recipient beds enjoy long-term survival rates of > 90%, survival rates significantly decrease in pathologically pre-vascularized, so-called high-risk recipients, which account for around 10% of all performed transplants in Germany and > 75% in lower and middle-income countries worldwide., Methods: This parallel-grouped, open-randomized, multicenter, prospective controlled exploratory investigator-initiated trial (IIT) intends to improve graft survival by preconditioning pathologically vascularized recipient corneas by (lymph)angioregressive treatment before high-risk corneal transplantation. For this purpose, corneal crosslinking (CXL) will be used, which has been shown to potently regress corneal blood and lymphatic vessels. Prior to transplantation, patients will be randomized into 2 groups: (1) CXL (intervention) or (2) no pretreatment (control). CXL will be repeated once if insufficient reduction of corneal neovascularization should be observed. All patients (both groups) will then undergo corneal transplantation. In the intervention group, remaining blood vessels will be additionally regressed using fine needle diathermy (on the day of transplantation). Afterwards, the incidence of graft rejection episodes will be evaluated for 24 months (primary endpoint). Overall graft survival, as well as regression of corneal vessels and/or recurrence, among other factors, will be analyzed (secondary endpoints)., Discussion: Based on preclinical and early pilot clinical evidence, we want to test the novel concept of temporary (lymph)angioregressive pretreatment of high-risk eyes by CXL to promote subsequent corneal graft survival. So far, there is no evidence-based approach to reliably improve graft survival in the high-risk corneal transplantation setting available in clinical routine. If successful, this approach will be the first to promote graft survival in high-risk transplants. It will significantly improve vision and quality of life in patients suffering from corneal blindness., Trial Registration: ClinicalTrials.gov NCT05870566. Registered on 22 May 2023., (© 2024. The Author(s).)

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G&#95;{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G&#95;{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

In this work we present the design of the first controlled fusion laboratory experiment to reach target gain G>1 N221204 (5 December 2022) [Phys. Rev. Lett. 132, 065102 (2024)10.1103/PhysRevLett.132.065102], performed at the National Ignition Facility, where the fusion energy produced (3.15 MJ) exceeded the amount of laser energy required to drive the target (2.05 MJ). Following the demonstration of ignition according to the Lawson criterion N210808, experiments were impacted by nonideal experimental fielding conditions, such as increased (known) target defects that seeded hydrodynamic instabilities or unintentional low-mode asymmetries from nonuniformities in the target or laser delivery, which led to reduced fusion yields less than 1 MJ. This Letter details design changes, including using an extended higher-energy laser pulse to drive a thicker high-density carbon (also known as diamond) capsule, that led to increased fusion energy output compared to N210808 as well as improved robustness for achieving high fusion energies (greater than 1 MJ) in the presence of significant low-mode asymmetries. For this design, the burnup fraction of the deuterium and tritium (DT) fuel was increased (approximately 4% fuel burnup and a target gain of approximately 1.5 compared to approximately 2% fuel burnup and target gain approximately 0.7 for N210808) as a result of increased total (DT plus capsule) areal density at maximum compression compared to N210808. Radiation-hydrodynamic simulations of this design predicted achieving target gain greater than 1 and also the magnitude of increase in fusion energy produced compared to N210808. The plasma conditions and hotspot power balance (fusion power produced vs input power and power losses) using these simulations are presented. Since the drafting of this manuscript, the results of this paper have been replicated and exceeded (N230729) in this design, together with a higher-quality diamond capsule, setting a new record of approximately 3.88MJ of fusion energy and fusion energy target gain of approximately 1.9.

To compare the outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed after phacoemulsification and intraocular lens (IOL) implantation (sequential DMEK) and DMEK combined with phacoemulsification and IOL implantation (combined DMEK) in patients with Fuchs endothelial corneal dystrophy (FECD) and cataract. Systematic literature review and meta-analysis performed according to the PRISMA guidelines and registered in PROSPERO. Literature searches were conducted in Medline and Scopus. Comparative studies reporting sequential DMEK and combined DMEK in FECD patients were included. The main outcome measure of the study was the corrected distance visual acuity (CDVA) improvement. Secondary outcomes were postoperative endothelial cell density (ECD), rebubbling rate and primary graft failure rate. Bias risk was assessed and a quality appraisal of the body of evidence was completed using the Cochrane Robin-I tool. A total of 667 eyes (5 studies) were included in this review, 292 eyes (43.77%) underwent a combined DMEK, while 375 (56.22%) eyes underwent a sequential DMEK surgery. We found no evidence of a difference between the two groups (mean difference, 95% CI) regarding: (1) CDVA improvement (-0.06; -0.14, 0.03 LogMAR; 3 studies, I 2 : 0%; p = 0.86); (2) postoperative ECD (-62; -190, 67 cells/mm 2 ; 4 studies, I 2 : 67%; p = 0.35); (3) rebubbling (risks ratio: 1.04; 0.59, 1.85; 4 studies, I 2 : 48%; p = 0.89); and primary graft failure rate (risks ratio: 0.91; 0.32, 2.57; 3 studies, I 2 : 0%; p = 0.86). Of all the 5 non-randomized studies, all (100%) were graded as low quality. The overall quality of the analysed studies was low. Randomized controlled trials are needed to confirm no difference or superiority of one approach in terms of CDVA, endothelial cell count and postoperative complication rate between the two arms., (© 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

An indirect-drive inertial fusion experiment on the National Ignition Facility was driven using 2.05 MJ of laser light at a wavelength of 351 nm and produced 3.1±0.16 MJ of total fusion yield, producing a target gain G=1.5±0.1 exceeding unity for the first time in a laboratory experiment [Phys. Rev. E 109, 025204 (2024)10.1103/PhysRevE.109.025204]. Herein we describe the experimental evidence for the increased drive on the capsule using additional laser energy and control over known degradation mechanisms, which are critical to achieving high performance. Improved fuel compression relative to previous megajoule-yield experiments is observed. Novel signatures of the ignition and burn propagation to high yield can now be studied in the laboratory for the first time.

Purpose: The aim of this study was to assess the long-term outcome of excimer laser phototherapeutic keratectomy (PTK) for treating remaining anterior corneal opacities after Descemet membrane endothelial keratoplasty (DMEK)., Methods: This cohort study analyzed 67 eyes of 66 patients undergoing PTK in addition to and after DMEK between 2012 and 2021 at the Department of Ophthalmology, University of Cologne. Patients who were treated by PTK after previous DMEK on the same eye were included. The outcome parameters were best corrected visual acuity (BCVA), changes in refraction, endothelial cell density, corneal densitometry, central corneal thickness, and total corneal higher order aberrations. Patients with visual limitations in addition to anterior opacification were analyzed separately for their visual outcome. Eyes with severe visual limitations that have a very limited visual potential were excluded from the study. In addition, patients with not at least 1 postoperative follow-up examination were excluded from the study., Results: In this study, 67 eyes of 66 patients met all inclusion criteria. The median follow-up period was 13.1 (quartiles: 4.1; 30.7; interquartile range 26.6) months. The mean (±SD) BCVA improved from (logarithm of the minimum angle of resolution) 0.54 (±0.32) to 0.38 (±0.27) at the first postoperative visit ( P < 0.001) and remained significantly improved at all follow-up examinations compared with preoperative BCVA. Refraction and endothelial cell density did not change significantly after PTK. There was a significant decrease in corneal backscatter in the anterior corneal layer ( P < 0.001), and the total higher order aberration ( P = 0.02) and central corneal thickness were significantly reduced at the most recent postoperative visit ( P < 0.001). No immune reactions were observed., Conclusions: Excimer laser PTK after DMEK for persisting anterior corneal opacities has the potential to significantly improve patients' vision without affecting refractive parameters or endothelial cell density., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Patients undergoing corneal abrasion as part of Descemet membrane endothelial keratoplasty (DMEK) under general anesthesia suffer from early burning pain postoperatively. This pain appears to be poorly treatable with systemic analgesics. This study aims to evaluate postoperative pain management using topical lidocaine gel after DMEK with iatrogenic corneal abrasion., Methods: Retrospective analysis of 28 consecutive patients undergoing DMEK with corneal abrasion from October 19, 2021, to November 12, 2021, at a German university hospital. Patients during week 1 and 2 received peri-operative standard pain treatment (cohort S) and additional local lidocaine gel during week 3 and 4 immediately postoperatively (cohort L)., Results: 13 patients were included in cohort S and 15 patients in cohort L. At awakening all patients (100%) in cohort S reported burning pain, and six of 15 patients (40%) in cohort L reported burning pain. Burning pain scores were significantly lower in cohort L (p < 0.001 at awakening, p < 0.001 at 10 min, p < 0.001 at 20 min, p < 0.001 at 30 min, p = 0.007 at 40 min after awakening, and p < 0.001 at leaving recovery room). No significant differences between cohort S and cohort L were detected concerning surgical outcome during 1-month-follow-up (p = 0.901 for best corrected visual acuity)., Conclusion: Patients undergoing DMEK with corneal abrasion suffer significant pain in the recovery room. A single dose of topic lidocaine gel reduces the early postoperative burning pain sufficiently and does not affect the surgical outcome., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: The success of keratoplasty strongly depends on the health status of the transplanted endothelial cells. Donor corneal tissues are routinely screened for endothelial damage before shipment; however, surgical teams have currently no means of assessing the overall viability of corneal endothelium immediately prior to transplantation. The aim of this study is to validate a preoperative method of evaluating the endothelial health of donor corneal tissues, to assess the proportion of tissues deemed suitable for transplantation by the surgeons and to prospectively record the clinical outcomes of a cohort of patients undergoing keratoplasty in relation to preoperatively defined endothelial viability., Methods and Analysis: In this multicentre cohort study, consecutive patients undergoing keratoplasty (perforating keratoplasty, Descemet stripping automated endothelial keratoplasty (DSAEK), ultra-thin DSAEK (UT-DSAEK) or Descemet membrane endothelial keratoplasty) will be enrolled and followed-up for 1 year. Before transplantation, the endothelial viability of the donor corneal tissue will be evaluated preoperatively through trypan blue staining and custom image analysis to estimate the overall percentage of trypan blue-positive areas (TBPAs), a proxy of endothelial damage. Functional and structural outcomes at the end of the follow-up will be correlated with preoperatively assessed TBPA values., Ethics and Dissemination: The protocol will be reviewed by the ethical committees of participating centres, with the sponsor centre issuing the final definitive approval. The results will be disseminated on ClinicalTrials.gov, at national and international conferences, by partner patient groups and in open access, peer-reviewed journals., Trial Registration Number: NCT05847387., Competing Interests: Competing interests: YZ, SK and VR are editors of BMJ Open Ophthalmology., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The out-of-hospital cardiac arrest (OHCA) in the young may be associated with a genetic predisposition which is relevant even for genetic counseling of relatives. The identification of genetic variants depends on the availability of intact genomic DNA. DNA from autopsy may be not available due to low autopsy frequencies or not suitable for high-throughput DNA sequencing (NGS). The emergency medical service (EMS) plays an important role to save biomaterial for subsequent molecular autopsy. It is not known whether the DNA integrity of samples collected by the EMS is better suited for NGS than autopsy specimens., Material and Methods: DNA integrity was analyzed by standardized protocols. Fourteen blood samples collected by the EMS and biomaterials from autopsy were compared. We collected 172 autopsy samples from different tissues and blood with postmortem intervals of 14-168 h. For comparison, DNA integrity derived from blood stored under experimental conditions was checked against autopsy blood after different time intervals., Results: DNA integrity and extraction yield were higher in EMS blood compared to any autopsy tissue. DNA stability in autopsy specimens was highly variable and had unpredictable quality. In contrast, collecting blood samples by the EMS is feasible and delivered comparably the highest DNA integrity., Conclusions: Isolation yield and DNA integrity from blood samples collected by the EMS is superior in comparison to autopsy specimens. DNA from blood samples collected by the EMS on scene is stable at room temperature or even for days at 4 °C. We conclude that the EMS personnel should always save a blood sample of young fatal OHCA cases died on scene to enable subsequent genetic analysis., (© 2023. The Author(s).)

Historically, the eye has been considered as an organ free of lymphatic vessels. In recent years, however, it became evident, that lymphatic vessels or lymphatic-like vessels contribute to several ocular pathologies at various peri- and intraocular locations. The aim of this review is to outline the pathogenetic role of ocular lymphatics, the respective molecular mechanisms and to discuss current and future therapeutic options based thereon. We will give an overview on the vascular anatomy of the healthy ocular surface and the molecular mechanisms contributing to corneal (lymph)angiogenic privilege. In addition, we present (i) current insights into the cellular and molecular mechanisms occurring during pathological neovascularization of the cornea triggered e.g. by inflammation or trauma, (ii) the role of lymphatic vessels in different ocular surface pathologies such as dry eye disease, corneal graft rejection, ocular graft versus host disease, allergy, and pterygium, (iii) the involvement of lymphatic vessels in ocular tumors and metastasis, and (iv) the novel role of the lymphatic-like structure of Schlemm's canal in glaucoma. Identification of the underlying molecular mechanisms and of novel modulators of lymphangiogenesis will contribute to the development of new therapeutic targets for the treatment of ocular diseases associated with pathological lymphangiogenesis in the future. The preclinical data presented here outline novel therapeutic concepts for promoting transplant survival, inhibiting metastasis of ocular tumors, reducing inflammation of the ocular surface, and treating glaucoma. Initial data from clinical trials suggest first success of novel treatment strategies to promote transplant survival based on pretransplant corneal lymphangioregression., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The change in the power balance, temporal dynamics, emission weighted size, temperature, mass, and areal density of inertially confined fusion plasmas have been quantified for experiments that reach target gains up to 0.72. It is observed that as the target gain rises, increased rates of self-heating initially overcome expansion power losses. This leads to reacting plasmas that reach peak fusion production at later times with increased size, temperature, mass and with lower emission weighted areal densities. Analytic models are consistent with the observations and inferences for how these quantities evolve as the rate of fusion self-heating, fusion yield, and target gain increase. At peak fusion production, it is found that as temperatures and target gains rise, the expansion power loss increases to a near constant ratio of the fusion self-heating power. This is consistent with models that indicate that the expansion losses dominate the dynamics in this regime.

Purpose: The aim of this study was to quantify preparation difficulties and complications during DMEK graft preparation and their influence on clinical outcome., Methods: A retrospective evaluation of 214 consecutive DMEK surgeries from the prospective Cologne DMEK database was performed between July 2018 and December 2019. Preparation conditions (such as central and peripheral adherences, tissue fragility, and Descemet membrane splitting) were quantified and divided into 3 groups: easy, difficult, and very difficult preparation. At follow-up (3, 6, and 12 months after DMEK), best spectacle-corrected visual acuity, endothelial cell count (ECC), and rebubbling rates were evaluated and compared between groups., Results: An easy preparation was possible in 41.6% of cases (group 1, n = 89), a difficult preparation of the DMEK graft occurred in 30.8% (group 2, n = 66), and a very difficult preparation occurred in 27.6% (group 3, n = 59). There was no difference between groups for best spectacle-corrected visual acuity at 3, 6, and 12 months ( P = 0.179, P = 0.325, and P = 0.682, respectively) or for ECC at 3 and 6 months ( P = 0.537 and P = 0.606, respectively). Only at 12 months, the ECC was slightly significant between groups ( P = 0.045). Regarding the rebubbling rate, there was no difference ( P = 0.585). 17.9% of eyes from group 1, 25.7% of eyes from group 2, and 23.7% of eyes from group 3 received at least 1 rebubbling., Conclusions: These data suggest that difficult preparation conditions do not lead to any worsening of visual acuity or rebubbling rate in the 1-year outcome after DMEK. The endothelial cell density at 12 months showed slightly poorer results in the cases of very difficult preparation., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

The spatial boundaries of tissue response to wounding are unknown. Here, we show that in mammals, the ribosomal protein S6 (rpS6) is phosphorylated in response to skin injury, forming a zone of activation surrounding the region of the initial insult. This p-rpS6-zone forms within minutes after wounding and is present until healing is complete. The zone is a robust marker of healing as it encapsulates features of the healing process, including proliferation, growth, cellular senescence, and angiogenesis. A mouse model that is unable to phosphorylate rpS6 shows an initial acceleration of wound closure, but results in impaired healing, identifying p-rpS6 as a modulator but not a driver of healing. Finally, the p-rpS6-zone accurately reports on the status of dermal vasculature and the effectiveness of healing, visually dividing an otherwise homogeneous tissue into regions with distinct properties., Competing Interests: Declaration of interests M.O., N.A.R.R., H.D., B.S., and H.R. have submitted a patent application based on the application of p-rpS6 as a clinical diagnostic tool in the assessment of wound healing., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

The gravitational pressure in many astrophysical objects exceeds one gigabar (one billion atmospheres) 1-3 , creating extreme conditions where the distance between nuclei approaches the size of the K shell. This close proximity modifies these tightly bound states and, above a certain pressure, drives them into a delocalized state 4 . Both processes substantially affect the equation of state and radiation transport and, therefore, the structure and evolution of these objects. Still, our understanding of this transition is far from satisfactory and experimental data are sparse. Here we report on experiments that create and diagnose matter at pressures exceeding three gigabars at the National Ignition Facility 5 where 184 laser beams imploded a beryllium shell. Bright X-ray flashes enable precision radiography and X-ray Thomson scattering that reveal both the macroscopic conditions and the microscopic states. The data show clear signs of quantum-degenerate electrons in states reaching 30 times compression, and a temperature of around two million kelvins. At the most extreme conditions, we observe strongly reduced elastic scattering, which mainly originates from K-shell electrons. We attribute this reduction to the onset of delocalization of the remaining K-shell electron. With this interpretation, the ion charge inferred from the scattering data agrees well with ab initio simulations, but it is significantly higher than widely used analytical models predict 6 ., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Purpose: To develop an artificial intelligence (AI) algorithm enabling corneal surgeons to predict the probability of rebubbling after Descemet membrane endothelial keratoplasty (DMEK) from images obtained using optical coherence tomography (OCT)., Methods: Anterior segment OCT data of patients undergoing DMEK by 2 different DMEK surgeons (C.C. and B.B.; University of Cologne, Cologne, Germany) were extracted from the prospective Cologne DMEK database. An AI algorithm was trained by using a data set of C.C. to detect graft detachments and predict the probability of a rebubbling. The architecture of the AI model used in this study was called EfficientNet. This algorithm was applied to OCT scans of patients, which were operated by B.B. The transferability of this algorithm was analyzed to predict a rebubbling after DMEK., Results: The algorithm reached an area under the curve of 0.875 (95% confidence interval: 0.880-0.929). The cutoff value based on the Youden index was 0.214, and the sensitivity and specificity for this value were 78.9% (67.6%-87.7%) and 78.6% (69.5%-86.1%)., Conclusions: The development of AI algorithms allows good transferability to other surgeons reaching a high accuracy in predicting rebubbling after DMEK based on OCT image data., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Large scale high-energy density science facilities continue to grow in scale and complexity worldwide. The increase in driver capabilities, including pulsed-power and lasers, continue to push the boundaries of temperature, pressure, and densities, opening up new physics regimes. X-ray imaging is one of the many diagnostic techniques that are used to probe states of matter in these extreme conditions. Improved fabrication and polishing methods have provided improved x-ray microscope performance, while improving detector and x-ray sources now enable pico-second imaging with few micron resolutions. This Review will cover x-ray imaging methods, primarily absorption imaging, and their improvements over the last few decades., (© 2023 Author(s). Published under an exclusive license by AIP Publishing.)

Purpose: The purpose of this study was to analyze the influence of patient positioning on intraocular pressure (IOP) after Descemet membrane endothelial keratoplasty (DMEK) in pseudophakic patients treated for Fuchs endothelial corneal dystrophy., Methods: Forty patients were included in this prospective, single-blinded, randomized controlled clinical trial. Patients received a YAG iridotomy 1 day before surgery and an 80% anterior chamber tamponade [20% concentration of sulfur hexafluoride (SF6)]. Postoperative positioning was either supine (group 1) or seated (group 2, at least 30 degrees upper-body high position). IOP was measured with iCare., Results: There was no statistically significant difference in IOP postoperatively [group 1 vs. group 2-after 1h: 13.9 mm Hg (±4.2 mm Hg) versus 13.6 mm Hg (±4.1 mm Hg) ( P = 1.00); after 2h: 13.9 mm Hg (±5.4 mm Hg) versus 15.3 mm Hg (±4.6 mm Hg) ( P = 0.370); after 4h: 13.8 mm Hg (±4.2 mm Hg) versus 15.2 mm Hg (±4.2 mm Hg) ( P = 0.401]. In group 1, 10% of patients showed IOP decompensations well above 30 mm Hg, and in group 2, there were no IOP decompensations. Seated position led to relative risk reduction of 100% and absolute risk reduction of 10% regarding IOP decompensations. The number of patients needed to position seated to prevent 1 additional IOP decompensation was 10. Rebubbling rates, best spectacle-corrected visual acuity, and reduction of corneal thickness were comparable between the 2 groups in the follow-up period up to 1 month., Conclusions: After DMEK in pseudophakic eyes with 80% anterior chamber tamponade, positioning patients with at least 30 degrees elevation of the upper body up immediately after surgery until bedtime prevents IOP decompensations., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: Descemet membrane endothelial keratoplasty (DMEK) accounts for >50% of all corneal transplants in Germany. So far, no data from such a large multicenter study have been published., Methods: This retrospective study included 3200 DMEKs at seven departments performed for Fuchs endothelial corneal dystrophy (FECD) or bullous keratopathy (BK). We evaluated best corrected visual acuity (BCVA, logMAR), endothelial cell density (ECD, cells/mm 2 ), minimal corneal thickness (CT, μm), rebubbling-, primary transplant failure- and immune reaction-rate. Changes over time were evaluated by linear mixed models for repeated measures and correlation with case number by center by weighted linear regression., Results: For patients without vision-limiting comorbidities (74% of all analysed eyes, n = 2270), mean BCVA improved from 0.6 ± 0.4 logMAR to 0.2 ± 0.2 logMAR 6 months (p < 0.001, n = 1441) and 0.1 ± 0.2 logMAR 12 months (p = 0.001, n = 1402) postoperatively. BK- had a worse BCVA compared to FECD-patients (0.3 ± 0.5 vs. 0.1 ± 0.2 logMAR [p < 0.001] at 1 year). ECD declined from 2465 ± 259 cells/mm 2 (n = 2876 preoperatively) to 1587 ± 433 cells/mm 2 after 12 months (p < 0.001, n = 1237). Mean rebubbling rate was 0.4 ± 0.7/eye. 784 eyes (25%) received at least one rebubbling. More rebubblings correlated with a lower ECD, a worse BCVA, a higher CT, and higher transplant failure and rejection rates (p < 0.001, p = 0.013 for BCVA at 12 months). A single rebubbling did not influence the BCVA (p = 0.785). Graft failure rate was 3% (n = 67), rejection rate 1.5% (n = 48)., Conclusion: Descemet membrane endothelial keratoplasty increases visual acuity with low transplant failure- and rejection-rates. FECD has a better outcome than BK. Since a quarter of all patients need a rebubbling, this should be included in the informed consent. Remarkably, one rebubbling has no influence on the outcome., (© 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

In order to understand how close current layered implosions in indirect-drive inertial confinement fusion are to ignition, it is necessary to measure the level of alpha heating present. To this end, pairs of experiments were performed that consisted of a low-yield tritium-hydrogen-deuterium (THD) layered implosion and a high-yield deuterium-tritium (DT) layered implosion to validate experimentally current simulation-based methods of determining yield amplification. The THD capsules were designed to reduce simultaneously DT neutron yield (alpha heating) and maintain hydrodynamic similarity with the higher yield DT capsules. The ratio of the yields measured in these experiments then allowed the alpha heating level of the DT layered implosions to be determined. The level of alpha heating inferred is consistent with fits to simulations expressed in terms of experimentally measurable quantities and enables us to infer the level of alpha heating in recent high-performing implosions.

Purpose: The purpose of the study was to evaluate the feasibility of mini-descemet membrane endothelial keratoplasty ("Mini-DMEK," graft diameter <5 mm) for the treatment of chronic focal corneal endothelial decompensation for reasons other than acute hydrops in patients with keratoconus., Methods: Of the 3010 patients registered in the prospective Cologne DMEK database, 16 patients with focal corneal endothelial decompensation treated with Mini-DMEK were identified. After exclusion of patients with acute hydrops in keratoconus (n = 9), indications for focal corneal endothelial decompensation were either defects in Descemet membrane after intraocular surgeries (n = 5) or corneal edema in the area of Haab striae in buphthalmus (n = 2). Best spectacle-corrected visual acuity, corneal thickness in the affected area, and rebubbling rates served as main outcome measures., Results: All patients showed a postoperative increase in the best spectacle-corrected visual acuity from preoperative logarithm of the minimum angle of resolution (logMAR) 1.1 (±0.7) to logMAR 0.3 (±0.2) after the first month (P = 0.046) and to logMAR 0.3 (±0.2) after half a year (5-7 months) (P = 0.025). The corneal thickness decreased from preoperative 757 μm (±125) to 603 μm (±121) after the first month (P = 0.031) and to 593 μm (±131) after half a year (5-7 months) (P = 0.031). Rebubbling was necessary in 43% of patients (3 of 7 eyes). In 2 patients, Mini-DMEK was performed as triple Mini-DMEK including cataract surgery., Conclusions: Mini-DMEK is an effective treatment option for focal chronic corneal endothelial decompensation caused by tears in Descemet membrane or other defects such as Haab striae. Mini-DMEK can also be performed as a triple procedure including cataract surgery (triple Mini-DMEK)., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

We present measurements of ice-ablator mix at stagnation of inertially confined, cryogenically layered capsule implosions. An ice layer thickness scan with layers significantly thinner than used in ignition experiments enables us to investigate mix near the inner ablator interface. Our experiments reveal for the first time that the majority of atomically mixed ablator material is "dark" mix. It is seeded by the ice-ablator interface instability and located in the relatively cooler, denser region of the fuel assembly surrounding the fusion hot spot. The amount of dark mix is an important quantity as it is thought to affect both fusion fuel compression and burn propagation when it turns into hot mix as the burn wave propagates through the initially colder fuel region surrounding an igniting hot spot. We demonstrate a significant reduction in ice-ablator mix in the hot-spot boundary region when we increase the initial ice layer thickness.

The application of an external 26 Tesla axial magnetic field to a D&#95;{2} gas-filled capsule indirectly driven on the National Ignition Facility is observed to increase the ion temperature by 40% and the neutron yield by a factor of 3.2 in a hot spot with areal density and temperature approaching what is required for fusion ignition [1]. The improvements are determined from energy spectral measurements of the 2.45 MeV neutrons from the D(d,n)^{3}He reaction, and the compressed central core B field is estimated to be ∼4.9  kT using the 14.1 MeV secondary neutrons from the D(T,n)^{4}He reactions. The experiments use a 30 kV pulsed-power system to deliver a ∼3  μs current pulse to a solenoidal coil wrapped around a novel high-electrical-resistivity AuTa&#95;{4} hohlraum. Radiation magnetohydrodynamic simulations are consistent with the experiment.

We report on measurements of the ion-electron energy-transfer cross section utilizing low-velocity ion stopping in high-energy-density plasmas at the OMEGA laser facility. These measurements utilize a technique that leverages the close relationship between low-velocity ion stopping and ion-electron equilibration. Shock-driven implosions of capsules filled with D^{3}He gas doped with a trace amount of argon are used to generate densities and temperatures in ranges from 1×10^{23} to 2×10^{24} cm^{-3} and from 1.4 to 2.5 keV, respectively. The energy loss of 1-MeV DD tritons and 3.7-MeV D^{3}He alphas that have velocities lower than the average velocity of the thermal electrons is measured. The energy loss of these ions is used to determine the ion-electron energy-transfer cross section, which is found to be in excellent agreement with quantum-mechanical calculations in the first Born approximation. This result provides an experimental constraint on ion-electron energy transfer in high-energy-density plasmas, which impacts the modeling of alpha heating in inertial confinement fusion implosions, magnetic-field advection in stellar atmospheres, and energy balance in supernova shocks.

A system of x-ray imaging spectrometer (XRIS) has been implemented at the OMEGA Laser Facility and is capable of spatially and spectrally resolving x-ray self-emission from 5 to 40 keV. The system consists of three independent imagers with nearly orthogonal lines of sight for 3D reconstructions of the x-ray emission region. The distinct advantage of the XRIS system is its large dynamic range, which is enabled by the use of tantalum apertures with radii ranging from 50 μm to 1 mm, magnifications of 4 to 35×, and image plates with any filtration level. In addition, XRIS is capable of recording 1-100's images along a single line of sight, facilitating advanced statistical inference on the detailed structure of the x-ray emitting regions. Properties such as P0 and P2 of an implosion are measured to 1% and 10% precision, respectively. Furthermore, T e can be determined with 5% accuracy.

Target preheat by superthermal electrons from laser-plasma instabilities is a major obstacle to achieving thermonuclear ignition via direct-drive inertial confinement fusion at the National Ignition Facility (NIF). Polar-direct-drive surrogate plastic implosion experiments were performed on the NIF to quantify preheat levels at an ignition-relevant scale and develop mitigation strategies. The experiments were used to infer the hot-electron temperature, energy fraction, and divergence, and to directly measure the spatial hot-electron energy deposition profile inside the imploding shell. Silicon layers buried in the ablator are shown to mitigate the growth of laser-plasma instabilities and reduce preheat, providing a promising path forward for ignition designs at an on-target intensity of about 10^{15}W/cm^{2}.