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The physical reason for the difference between the small-scale self-focusing of nanosecond and femtosecond pulses is that the typical intensity of the latter is three orders of magnitude higher, i.e., TW/cm2 versus GW/cm2. This causes a significant shift of the growth-rate maximum of the Bespalov–Talanov instability to the region of high spatial frequencies. During free propagation, a decrease in the spectral density of noise and the self-filtering of the beam lead to the noise-density decrease in the region of the maximum growth rate and, therefore, slowing of the self-focusing development. This is shown to shift the restriction on using the transmissive optical elements in the superpower lasers towards high powers.

The presented study examines and undertakes to overcome contradictions in modern enterprise management systems, providing a deeper insight into the new knowledge, skills, and role of an individual in business activities.Aim. The study aims to determine a range of problem situations in the people-oriented management of enterprises and organizations at the stages of building knowledge about the profession and accentuating knowledge, skills, and abilities relevant to the intended professionalization, and the resource potential of employees within the existing economic and organizational framework of personnel management.Tasks. The authors conduct comparative studies with allowance for the spatial and temporal transformations in the use of tools for improving the efficiency and quality of the operation of Russian enterprises, and make comparisons with data on the operation of modern foreign corporations, determining the dynamics, new value orientations, and motivation among the personnel.Methods. The theoretical and methodological basis of this study includes works of Russian and foreign scientists on improving the operation of enterprises and organizations through the principles of people-oriented management of educational potential, professionalization and motivation of employees, and interviews of different age and professional groups of employees.Results. The authors determine the primary causes of the low level of professionalization among young people within the system of disseminating family relations, spontaneous choice of profession by university students, inconsistency between new knowledge generated during education and its actual use in the operation of enterprises and organizations, lack of consideration among the management for the social expectations of employees and their ideas on improving the quality of life, inadequacy of employee motivation measures to the task of improving the efficiency and quality of work. The study also formulates directions for overcoming modern inconsistencies in the people-oriented activity of enterprises and organizations as well as systemic motivation mechanisms for different employee groups.Conclusions. Definition of the range of problem situations in the people-oriented management of enterprises and organizations combined with theoretical and empirical analysis of professionalization and employee motivation makes it possible not only to determine the scope of contradictions in the emerging social and labor relations, but also to develop a program of actions to resolve them.

The article presents the results of a theoretical study of the influence processes of the developed digital technologies and the activities of enterprises and organizations on the changing role of man in labor and their social improvement. The necessity of a balanced and consistent approach to create conditions for the use of digital technologies in practical activities and determining the con- sequences not only in enterprises and organizations, but also in the conscious behavior and social realities of all workers, without exception, is substantiated. The main directions of the development of digital technologies are determined, involving the wide participation of workers in their use in enterprises and organizations.

The presented study provides a theoretical interpretation of organizational processes associated with the collective activity of employees of enterprises and organizations during social, industrial, and economic transformations and substantiates measures to facilitate social action based on self-understanding and self-development. Aim . The study aims to determine the range of recurring and new challenges that limit the active engagement of employees in economic and social development and to substantiate directions for the development of social relations that form the socio-professional personality construct, which is creative at its core. Tasks . The authors use theoretical generalizations and determine cause-and-effect relationships in the activation of the collective activity of employees in solving socially important problems; advance arguments for the range of social actions that help employees establish an object-active stance on the transformation of social, industrial, and economic relations through self-understanding and self-development. Methods . The theoretical and methodological basis of the study draws on works of Russian and foreign scientists on the formation of social relations, development of the collective activity of employees in solving socially important problems, and formation of humanistic, social, and ethical principles of self-understanding and self-development. Results . This study identifies the restrictions and major directions of the development of collective activity in the system of social, industrial, and economic relations forming at modern enterprises and organizations and create conditions for the value-oriented activity of various professional, qualification, and status groups of employees. Conclusions . Determining the range of problem situations, object-active directions, and values of employees in the context of facilitating their engagement in collective activity associated with solving socially important problems makes it possible to implement measures aimed at shaping new economic thinking, modeling joint social actions, creating conditions for mutual trust between various professional and qualification groups of employees.

Background Infants with intestinal failure (IF) and IF-associated liver disease (IFALD) are at risk for poor somatic growth because of increased metabolic demands, inadequate intake, intestinal malabsorption, chronic liver disease and other comorbidities. There are limited data on the nutritional adequacy of intravenous fish oil lipid emulsion (FOLE) compared with standard soybean oil lipid emulsion (SOLE) in the setting of intestinal failure. Aims To describe growth patterns in a large cohort of infants with IFALD treated with FOLE. Methods We compared growth data from infants enrolled in a single-center, prospective FOLE study to published norms, as well as to a multicenter, historical cohort of infants with IF treated with SOLE. Results One hundred thirty-eight infants with IFALD were treated with FOLE and 108 with SOLE. Compared with normative growth curves from WHO and published preterm data, infants in both groups from 6 to 11 months postmenstrual age exhibited declines in mean weight- and length-for-age z scores. At 24 months postmenstrual age compared with WHO growth data, infants treated with FOLE had a mean (95% confidence interval [CI]) weight-for-age z-score of 0.13 (-0.18 to 0.45) and length-for-age z-score of 0.07 (-0.33 to 0.47). In comparison, at 24 months postmenstrual age, infants treated with SOLE had a mean weight for age z-score of -0.93 (-1.20 to -0.67) and mean length for age z-score of -2.33 (-2.75 to -1.91). Independent predictors of higher weight, length and head circumference z-scores included older postmenstrual age at baseline, fewer central line-associated blood stream infections, resolution of cholestasis, type of intravenous fat emulsion (FOLE vs SOLE) and female sex. Conclusions Infants with IFALD treated with FOLE showed comparable somatic growth to those treated with SOLE in early infancy, and improved somatic growth up to 24 months of age, supporting its wider use in this patient population.

Mainstreaming of the issue of resources in the implementation of enterprise development strategies makes it necessary to determine the extent of its impact on the efficiency and quality of labor, with a focus on the formation and use of a whole range of social resources. The presented study is based on a decade of comparative research that covers 19 industrial enterprises across Saint Petersburg to examine the effects of resources on the efficiency of an enterprise in pursuaing its strategic objectives.Aim. The study aims to substantiate the way resources increase performance and improve the efficiency of development strategy implementation in indusitral enterprises.Tasks. The authors perform a theoretical and empirical analysis of the problem of using the social resources of industrial enterprises, analyze risks of insufficient management support in a market economy, and develop a set of measures aimed at optimizing the use of internal resources to increase the performance of industrial enterprises.Methods. The theoretical and methodological basis of the study includes the interview method, expert assessment, content analysis, and findings of foreign and Russian scientists in the field of social and labor relations, development of labor potential, improvement of the enterprise management system, formation of behavioral practices among employees to improve labor efficiency.Results. This study provides a practical assessment of social resources at industrial enterprises in terms of the social expectations of employees, the level of trust between individuals and groups, commitment to the goals and values of the enterprise, opportunities for creative and professional fulfilment, perception of the fairness of compensation, social and psychological climate, etc. It is established that disregard for the resource component leads to social and psychological division, divergence of values, spiritual and moral positions, employee performance benchmarks, and impaired productivity in general. The study substantiates the importance of coordinated goals for each functional unit; procedures for continuous collection and analysis of enterprise performance data; development ofprofessional knowledge, skills, abilities, and experience; the need to identify, assess, and provide managerial support for the socially important qualities of employees.Conclusions. The obtained empirical data make it possible to develop a set of measures for industrial enterprises to identify, assess, and provide managerial support for the socially important qualities of employees, and to optimize the use of internal reserves that are the most significant resource for the enterprise development strategy.

BACKGROUND: Vitamin K is a fat-soluble compound that plays important roles in coagulation. In children with intestinal failure associated liver disease (IFALD), the disrupted enterohepatic circulation can lead to intestinal loss of vitamin K. Fish oil-based lipid emulsion (FOLE) has proven effective in treating IFALD. As biliary excretion is restored during cholestasis reversal, the accelerated vitamin K loss can pose a risk for deficiency. METHODS: Ten neonates with IFALD receiving FOLE monotherapy were prospectively enrolled in the study from 2016 to 2018. In addition to weekly measurements of international normalized ratio (INR) and direct bilirubin (DB), ostomy output was collected for determination of fecal concentrations of phylloquinone (PK) with mass spectrometry. Trends of DB, INR, and fecal PK concentrations were summarized with locally estimated scatterplot smoothing. RESULTS: The median time (interquartile range) from FOLE initiation to cholestasis reversal was 59 (19–78) days. During cholestasis reversal, INR remained relatively unchanged while the mean (95% confidence interval; CI) daily fecal excretion of PK increased from 25.1 (5.0, 158.5) ng at the time of FOLE initiation to 158.5 (31.6, 1000.0) ng at complete reversal. Examination of individual trends in fecal PK excretion and INR also revealed little correlation between the two measurements (r = −0.10; P=0.50). CONCLUSION: Children with IFALD are at risk for vitamin K deficiency during cholestasis reversal. Close monitoring and quantified supplementation of vitamin K may be warranted during this period. However, this should not be guided by INR alone as it is a poor indicator of vitamin K status.

A possibility of an implementation of Mach-Zehnder and Michelson interferometers for formation laser pulses with periodic intensity modulation is considered analytically.

Theoretical model of scanning cross-correlator used for diagnostic 3D profiled laser pulses was developed. The parameters of nonlinear crystals and the required accuracy of its alignment for correct measurements were determined with help of based on the model numerical simulations.

A prototype of a direct-current photoinjector (DC) with an electron energy of up to 400 keV is being developed at JINR for future electron accelerators (electron-positron colliders and free-electron lasers). This article describes the injector, one distinctive feature of which is the use of the transmission photocathode operation mode. A unique laser system is implemented on the photoinjector. The system makes it possible to synchronize the repetition rate and the phase of the laser pulses (of 10 ps duration, 262 nm wavelength, and 1.85 μJ energy) with the frequency of the accelerator RF system. The first experimental results of a DC photoinjector are presented and further plans for the development of the installation are discussed.

We consider the possibility of generating the second and fourth optical harmonics of laser pulses having a central wavelength of 1030 nm with retaining the three-dimensional quasi-ellipsoidal intensity distribution. The presented results of numerical simulation confirm that angular chirping allows one to retain the three-dimensional structure of the intensity distribution and enhance energy conversion. The proposed approach was tested experimentally using non-profiled laser beams. Energy conversion efficiency of 53% and 21% was achieved in the generation of the second and fourth harmonics, respectively.

The methods of shaping picosecond laser pulses with periodic intensity modulation tunable in frequency and depth are considered. Schemes for shaping modulated pulses “in-line” and with one output port are proposed. A picosecond modulation of the time envelope for IR laser pulses using a polarization interferometer is demonstrated experimentally. Shaping of modulated laser pulses of the UV range is shown by numerical modeling. The possibility to control the modulation depth of the fourth harmonic under the combined impact of material dispersion and nonlinear conversion in a classical collinear scheme of the fourth harmonic generation without distortion of the 3D pulse shape is demonstrated.

Intestinal failure-associated liver disease (IFALD) can be treated with parenteral fish oil (FO) monotherapy, but practitioners have raised concerns about a potential bleeding risk. This study aims to describe the incidence of clinically significant post-procedural bleeding (CSPPB) in children receiving FO monotherapy.A retrospective chart review was performed on patients at our institution treated with intravenous FO for IFALD. CSPPB was defined as bleeding leading to re-operation, transfer to the intensive care unit, re-admission, or death, up to one month after any invasive procedure.From 244 patients reviewed, 183 underwent ≥1 invasive procedure(s) (n = 732). Five (0.68%, 95% CI 0.22-1.59%) procedures resulted in CSPPB. FO therapy was never interrupted. No deaths due to bleeding occurred.Findings suggest that FO therapy is safe, with a CSPPB risk no greater than that reported in the general population. O3FA should not be held in preparation for procedures or in the event of bleeding.

Modern linacs are considered for generation of THz pulses with up to mJ energies at high repetition rates due to the capabilities of modern photo injectors. A Self-Amplified Spontaneous Emission (SASE) FEL is proposed for such a powerful THZ source [1]. In order to improve the Carrier-Envelope-Phase (CEP) stability of the THz SASE FEL a seeding option using temporally modulated electron bunches from the photo injector is under study. One of the methods is to generate electron beams with a sub-picosecond structure. Modern linac based FELs (like the European XFEL at DESY and LCLS at SLAC) start from photo injectors, where electron bunches are generated by laser pulses from a cathode surface. In this case, the phase space distribution of the electron bunches strongly depends on the 3D spatio-temporal intensity distribution of the photocathode laser pulses. So, it is necessary to modulate the temporal intensity distribution of the laser pulses to obtain rippled (or microbunched) electron beams. Spectral phase or spectral amplitude modulation of linearly chirped laser pulses can be used to obtain laser pulses with ∼1 ps modulation period. A spatial light modulator (SLM) placed inside the optical compressor with zero frequency dispersion is an attractive way to produce the modulation [3, 4].

Modern photoinjectros require to use 3D profiled laser pulses for irradiation of cathode surface. The pulses make it possible to control a space-charge distribution of generated electron bunches and, in paritcular, to form electron bunches with cylindrica and 3D ellipsoidal shapes. Spatial light modulators (SLM) [1,2] and profiled volume Bragg gratings [3] can be used for control 3D intensity distribution of linearly chirped broadband infrared laser pulses. But, the widely used in photoinjectors Cs 2 Te photocathodes have the highest efficiency in UV spectral range. So, the important task is to transform the profiled 3D (x,y,t) infrared pulses to visible and UV regions with high energy conversion efficiency and preserving 3D intensity distribution. It can be done with help of second, fourth and third harmonic generation (SHG, FHG, THG) processes at low group velocity mismatch of the interacted pulses. The control of the group velocities can be done by a creation of amplitude tilt or angular chirp. Here we present results of numerical simulations of SHG, FHG and noncollinear THG processes implemented for laser pulses with central wavelength 744 nm, 6 nm spectral width (FWHM) and pulse duration 15 ps (FWHM). The initial fundamental pulse has ellipsoidal 3D shape with linear grouth intensity in time.

A method for highly efficient fourth harmonic generation (FHG) retaining spatiotemporal intensity distribution of broadband chirped laser pulses is proposed. It is based on the use of pulses with linear frequency chirps of equal absolute magnitudes and opposite signs at the oo-e type noncollinear second harmonic generation. Fourth harmonic generation can by obtained by the classical method, since the second harmonic pulse is narrowband and spectrally limited. A possibility to retain the three-dimensional (3D) structure of the field at FHG with a conversion efficiency ∼ 60 % is demonstrated by the numerical simulation of 3D pulses with a quasi-ellipsoidal intensity distribution.

There are few evidence-based guidelines to inform optimal design of complex clinical trials, such as those assessing the safety and efficacy of intravenous drugs administered daily with infusion times over many hours per day and treatment durations that may span years. This study is a retrospective review of inpatient administration deviation reports for an investigational drug that is administered daily with infusion times of 8–24 h, and variable treatment durations for each patient. We report study design modifications made in 2007–2008 aimed at minimizing deviations from an investigational drug infusion protocol approved by an institutional review board and the United States Food and Drug Administration. Modifications were specifically aimed at minimizing errors of infusion rate, incorrect dose, incorrect patient, or wrong drug administered. We found that the rate of these types of administration errors of the study drug was significantly decreased following adoption of the specific study design changes. This report provides guidance in the design of clinical trials testing the safety and efficacy of study drugs administered via intravenous infusion in an inpatient setting so as to minimize drug administration protocol deviations and optimize patient safety.

The use of high brightness electron beams in Free Electron Laser (FEL) applications is of increasing importance. One of the most promising methods to generate such beams is the usage of shaped photocathode laser pulses. It has already demonstrated that temporal and transverse flat-top laser pulses can produce very low emittance beams [1] . Nevertheless, based on beam simulations further improvements can be achieved using quasi-ellipsoidal laser pulses, e.g. 30% reduction in transverse projected emittance at 1 nC bunch charge. In a collaboration between DESY, the Institute of Applied Physics of the Russian Academy of Science (IAP RAS) in Nizhny Novgorod and the Joint Institute of Nuclear Research (JINR) in Dubna such a laser system capable of producing trains of laser pulses with a quasi-ellipsoidal distribution, has been developed. The prototype of the system was installed at the Photo Injector Test facility at DESY in Zeuthen (PITZ) and is currently in the commissioning phase. In the following, the laser system will be introduced, the procedure of pulse shaping will be described and the last experimental results will be shown.

Background: Fish oil lipid emulsion (FOLE) and multidisciplinary care for infants with intestinal failure (IF) have been associated with reduced morbidity and mortality due to IF-associated liver disease (IFALD). With increased survival, a greater proportion of infants with IF are now able to remain on parenteral nutrition (PN) in the long term. The purpose of this study was to examine outcomes in children with IFALD who have required long-term PN and FOLE therapy due to chronic IF. Materials and Methods: A review of prospectively collected data was performed for children with IFALD who required at least 3 years of PN and FOLE therapy due to chronic IF. Outcomes examined include the incidence of death, transplantation, and essential fatty acid deficiency (EFAD), as well as growth parameters and the biochemical markers of liver disease. Results: Of 215 patients with IFALD treated from 2004–2015, 30 required PN and FOLE therapy for at least 3 years (median, 4.6 years). To date, no patients have died, requir...

Possibility of effective fourth harmonic generation with preserving of a shape of linearly chirped IR laser pulses with triangular temporal intensity profile has been demonstrated numerically.

While parenteral nutrition (PN) has revolutionized the management of patients with intestinal failure (IF), central line-associated bloodstream infections (CLABSIs) remain a leading cause of mortality and morbidity in this population. The objective of this study is to characterize the presentation of CLABSIs in pediatric IF and to determine the time to positivity of blood cultures.A retrospective cohort study of children with IF who presented to our institution for evaluation of a possible CLABSI from January 1, 2012, to December 31, 2012, was performed.Sixty patients with IF were identified. There were 33 cases of CLABSI in 16 patients, with a rate of 1.5 infections per 1000 catheter days. There were no significant differences in age, growth parameters, or catheter days between patients with or without CLABSI. Fever was documented in 85% of patients with CLABSI. These patients demonstrated an increased percentage of neutrophils and higher C-reactive protein levels compared with patients without CLABSI. The mean time to culture positivity was 13.2 hours, and 97% of cultures were positive within 24 hours.Our data suggest that most pediatric patients with IF who have CLABSI develop positive cultures within 24 hours, and the absence of fever and leukocytosis does not necessarily indicate the absence of infection. These findings may support clinical practice guidelines in favor of shorter hospital stay when CLABSI is suspected; however, a prospective analysis of CLABSI in this population is recommended to determine the safety and appropriate setting prior to any practice change.

BACKGROUND: Home parenteral nutrition (HPN) is a life-sustaining therapy for short bowel syndrome (SBS) and other severe digestive diseases, but complications are common. We aimed to evaluate an intensive pre-discharge HPN hands-on training course to reduce complications in children with SBS, including hospital readmissions. METHODS: We conducted a prospective, non-randomized controlled research study between April 1, 2014 and April 30, 2017. Eligible subjects were children age

Elevated serum alkaline phosphatase (ALP) in infants with intestinal failure (IF) can be due to parenteral nutrition-associated liver disease (PNALD) or metabolic bone disease (MBD). The purpose of the study was to determine the utility of serum ALP in the diagnostic criteria for PNALD by measuring tissue-specific levels in infants with IF and PNALD.A retrospective review of patient data for 15 infants diagnosed with PNALD between December 2012 and August 2013 was performed. PNALD was defined as the presence of 2 consecutive direct bilirubin (DB) levels2 mg/dL. Fractionated serum alkaline phosphatase was measured in each patient, while the DB was2 mg/dL. Parathyroid hormone (PTH), vitamin D3, calcium, and phosphate levels were recorded where available.In 15 infants with PNALD, elevation in total ALP was due to marked elevations in bone-specific ALP. The median liver-specific ALP remained within the normal range. PTH, vitamin D3, calcium, and phosphate levels were within normal limits.While elevated ALP can reflect biliary stasis, the ALP elevation observed in infants with IF and PNALD is predominantly of bone rather than hepatic origin. An elevated unfractionated ALP in infants with PNALD should therefore raise suspicion of underlying bone disease, rather than being attributed to liver disease alone.

The goal is to produce hot-rolled dual-phase steel of strength class DP 450–600 at OAO Novolipetskii Metallurgicheskii Kombinat (NLMK). The steel’s final structure and properties is greatly affected by single-stage strip cooling on the output roller conveyer of the 2000 continuous broad-strip mill. The influence of the hot-rolling parameters on the structure and mechanical properties of the hot-rolled SPRC440R steel from which cold-rolled dual-phase steel is produced at OAO NLMK is studied in the laboratory. The temperatures and rates for accelerated cooling on the output roller conveyer of the 2000 continuous broad-strip mill at OAO NLMK are calculated by means of a mathematical model. The laboratory data and simulation results are used in developing trial conditions for industrial rolling. Recommendations are made regarding the production of hot-rolled dual-phase steel corresponding to strength class DP 450–600.

The specific features of experimental implementation of a cross-correlator with a scan rate above 1600 cm s-1 and a spatial delay amplitude of more than 15 mm are considered. The possibility of measuring the width of femtosecond pulses propagating in a train 300 μs in duration with a repetition rate of 1 MHz is demonstrated. A time resolution of 300 fs for the maximum time window of 50 ps is attained. The cross-correlator is aimed at testing 3D pulses of a laser driver of an electron photo-injector.

Objective. To assess the safety and efficacy of a fish oil–based intravenous fat emulsion (FIFE) in reducing the incidence of cholestasis in neonates compared with the traditional soybean oil–based intravenous fat emulsion (SIFE). Methods. A double-blind randomized controlled trial was conducted. Nineteen neonates were enrolled (10 SIFE; 9 FIFE). Nutrition assessments and laboratory studies were serially obtained for the duration of PN support or until 6 months’ corrected gestational age. Neurodevelopmental outcomes were assessed at 6 and 24 months’ corrected age. Results. There were no differences between groups in demographic characteristics, with an overall median age of 2 days, gestational age of 36 weeks, and birth weight of 2410 g. There were no differences between groups in baseline laboratory values other than alkaline phosphatase (lower in the FIFE group) or in the duration of parenteral nutrition (PN), amount of enteral intake, or the number of operative procedures. The incidence of cholestasis ...

Intestinal failure-associated liver disease (IFALD) is complex and diagnosed by concurrent use of parenteral nutrition, clinical presentation, and alterations in hepatic biomarkers exclusive of other causes of liver disease. In comparison with individual measures, composite biomarkers may provide a more effective means for assessing disease progression and response to treatment than single parameters. Since IFALD is considered by some to be a type of drug-induced liver injury (DILI), those diagnostic criteria could potentially be used in this population. Using a preexisting database of children treated for IFALD, our aim was to determine if a similar composite biomarker could be applied to this population.Adult DILI criteria were applied at baseline, when treatment for IFALD (ie, direct bilirubin ≥2.0 mg/dL) was initiated.A total of 214 patients with IFALD treated at Boston Children's Hospital were identified; 168 patients were eligible for analysis. Most patients analyzed were male (61%) and preterm (87%). Alkaline phosphatase (ALP) ≥2× upper limit of normal (ULN) captured the least amount of DILI (11%), while γ-glutamyltransferase (GGT) ≥1× ULN accounted for the most (62%). Using adult DILI criteria, 60 (39%) patients with IFALD were found to have DILI. Substituting GGT ≥1× ULN for ALP ≥2× ULN improved the sensitivity, with 105 (69%) of patients meeting at least 1 criterion for DILI.Numerous challenges made it difficult to apply the DILI criteria to children with IFALD. Direct bilirubin, fractionated ALP, and perhaps GGT may be more suitable. Given its complex etiology and the age-based differences due to hepatic immaturity and growth, a more suitable composite marker needs to be developed to assess IFALD in this population.

With the use of spatial light modulators it became possible to implement in experiments the method of controlling the space-time intensity distribution of femtosecond laser pulses stretched to picosecond duration. Cylindrical and quasi-ellipsoidal intensity distributions were obtained and characterized by means of a 2D spectrograph and a cross-correlator.

Background Adhesions represent a major problem after abdominal and pelvic procedures. The purpose of the present study was to determine the effect of sunitinib (Sutent, SU11248), a Food and Drug Administration-approved receptor tyrosine kinase inhibitor, on recurrent pelvic adhesion formation after pelvic adhesiolysis in a rabbit model. Materials and methods A total of 20 New Zealand white rabbits underwent a uterine abrasion procedure, followed by an adhesiolysis procedure 4 weeks later. Before adhesiolysis, the rabbits were randomized to sunitinib at 10 mg/kg/d or placebo. These were administered as 1 dose preoperatively followed by 10 doses postoperatively. The rabbits were killed 30 d after the adhesiolysis procedure. At death, the adhesions were scored, and a total adhesion score (presented as the median and interquartile range [IQR]) was calculated according to the percentage of uterine involvement and the tenacity of the adhesions. Results All the rabbits survived the operative procedures without complications. The sunitinib-treated rabbits (n = 10) had a significantly lower uterine involvement score (median 2.0, IQR 1.0–3.0) than the placebo-treated rabbits (median 4.0, IQR 3.0–4.0; P = 0.02). The sunitinib-treated rabbits also had median tenacity score of 3.0 (IQR 3.0–4.0) compared with a median of 4.0 (IQR 4.0–4.0; P = 0.04) in the placebo-treated rabbits (n = 10). The median total score in the sunitinib-treated rabbits was 5.0 (IQR 4.0–6.25) compared with 8.0 (IQR 6.75, 8.0) in the placebo-treated rabbits (P = 0.01). Conclusions Sunitinib treatment might be an efficacious strategy to reduce recurrent adhesion formation after pelvic procedures.

Purpose The aim of this study was to determine the incidence of cholestasis and the correlation between cholestasis and weight-for-age z scores in parenteral nutrition–dependent neonates with gastroschisis. Methods A single-center retrospective review of 59 infants born with gastroschisis from January 2000 to June 2007 was conducted. Demographic and clinical data were collected and analyzed. Subjects were divided into cholestatic and noncholestatic groups. Statistical analyses included the Student t test, Wilcoxon rank sum test, Fisher exact test, and a general linear model. Results Fifty-nine neonates with gastroschisis were identified, and 16 (28%) of 58 patients developed cholestasis. Younger gestational age and cholestasis were found to be independently associated with weight-for-age z score in 30 of 58 patients with available long-term follow-up data. Conclusions Parenteral nutrition–dependent neonates with gastroschisis remain at considerable risk for the development of cholestasis. Both gestational age and cholestasis were found to be independent risk factors, predisposing these neonates to poor postnatal growth.

Background: Necrotizing enterocolitis (NEC) is one of the most devastating diseases in the neonatal population, with extremely low birth weight and extremely preterm infants at greatest risk. Method: A systematic review of the best available evidence to answer a series of questions regarding nutrition support of neonates at risk of NEC was undertaken and evaluated using concepts adopted from the Grading of Recommendations, Assessment, Development and Evaluation working group. A consensus process was used to develop the clinical guideline recommendations prior to external and internal review and approval by the A.S.P.E.N. Board of Directors. Results/Conclusions: (1) When and how should feeds be started in infants at high risk for NEC? We suggest that minimal enteral nutrition be initiated within the first 2 days of life and advanced by 30 mL/kg/d in infants ≥1000g. (Weak) (2) Does the provision of mother's milk reduce the risk of developing NEC? We suggest the exclusive use of mother's milk rather than bovine-based products or formula in infants at risk for NEC. (Weak) (3) Do probiotics reduce the risk of developing NEC? There are insufficient data to recommend the use of probiotics in infants at risk for NEC. (Further research needed.) (4) Do nutrients either prevent or predispose to the development of NEC? We do not recommend glutamine supplementation for infants at risk for NEC (Strong). There is insufficient evidence to recommend arginine and/or long chain polyunsaturated fatty acid supplementation for infants at risk for NEC. (Further research needed.) (5) When should feeds be reintroduced to infants with NEC? There are insufficient data to make a recommendation regarding time to reintroduce feedings to infants after NEC. (Further research needed.) (JPEN J Parenter Enteral Nutr. 2012;36:506-523)

Amplifiers based on neodymium phosphate glass rods 60 — 100 mm in diameter are experimentally studied. The amplifiers are pumped by INP-16/250 tubular flash lamps placed in a universal pump cavity with a two-section mirror reflector. A compact high-voltage capacitive energy storage with a preionisation circuit was developed to supply the lamps.

A laser system is designed for operation with a photocathode electron gun for a linear accelerator with the following parameters of radiation at a wavelength of 262 nm (the fourth harmonic of a Nd:YLF laser). The pulse trains (macropulses) with a repetition rate of 5 Hz and a duration of 900 μs consist of 8-ps micropulses with an energy of 1.4 μJ and a repetition rate of 2.708 MHz. This repetition rate is variable within ±32 kHz and is stabilised by an external signal with an accuracy of 10 Hz. Due to the use of a feedback-controlled acousto-optic modulator, the root-mean-square deviation of the micropulse energy in the first and second harmonics is 2.5% and 3.6%, respectively. Using the decaying branch of the dependence of the second-to-fourth harmonic conversion efficiency on the second harmonic intensity, we decreased the root-mean-square deviation of the energy of the fourth-harmonic micropulses to 2.3% at the first-to-fourth harmonic conversion efficiency of 27%.

The National Lung Screening Trial (NLST) is a randomized multicenter study comparing low-dose helical computed tomography (CT) with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer, which is the leading cause of cancer-related death in the United States. Five-year survival rates approach 70% with surgical resection of stage IA disease; however, more than 75% of individuals have incurable locally advanced or metastatic disease, the latter having a 5-year survival of less than 5%. It is plausible that treatment should be more effective and the likelihood of death decreased if asymptomatic lung cancer is detected through screening early enough in its preclinical phase. For these reasons, there is intense interest and intuitive appeal in lung cancer screening with low-dose CT. The use of survival as the determinant of screening effectiveness is, however, confounded by the well-described biases of lead time, length, and overdiagnosis. Despite previous attempts, no test has been shown to reduce lung cancer mortality, an endpoint that circumvents screening biases and provides a definitive measure of benefit when assessed in a randomized controlled trial that enables comparison of mortality rates between screened individuals and a control group that does not undergo the screening intervention of interest. The NLST is such a trial. The rationale for and design of the NLST are presented.

Purpose This study compares postoperative markers of liver injury in patients receiving intravenous fish oil (IFO) with parenteral nutrition (PN)–associated cholestasis (PNAC) to patients with resolved PNAC. Methods A retrospective review of all cholestatic-IFO patients undergoing abdominal laparotomy between March 1, 2007, and July 1, 2009, led to inclusion of 23 patients who collectively underwent 27 abdominal operations (13 pre-PNAC resolution and 14 post-PNAC resolution). Direct bilirubin (DB), total bilirubin, and alanine aminotransferase levels were examined over time in relation to operations. The time to resume presurgical trend of decreasing DB was calculated. Results Sixty-nine percent (9/13) of pre-PNAC resolution procedures were associated with postoperative increase in DB compared with 7% (1/14) of post-PNAC resolution procedures associated with a recurrence of cholestasis ( P = .02; odds ratio, 29.3; 95% confidence interval, 2.79-306.8). The median time to return to the preoperative downward trend of DB was 21 days. Conclusions Operations before PNAC resolution may be associated with an increased postoperative DB, possibly reflecting an exacerbation of liver injury. Operations post-PNAC resolution on IFO had a comparatively low incidence of postoperative cholestasis recurrence. Excepting clinical indication otherwise, it may be advisable to delay surgical intervention in the setting of PNAC in certain cases.

The step-by-step development in the production of HDT580X hot-rolled dual-phase steel (according to the EN 10338 standard) by means of the 2000 broad-strip hot-rolling mill at OAO Novolipetskii Metallurgicheskii Kombinat is considered. The analysis is based on theoretical and experimental results regarding topics such as the influence of alloying elements and the cooling parameters on structural and phase transformations in dual-phase steel for the auto industry. Physical modeling of the deformational parameters and the rolling and cooling temperatures and speeds on the broad-strip mill also proves helpful. Rolling and cooling rates are proposed for the 140 FGA semicontinuous hot-rolling mill.

To assess forced expiratory tracheal collapsibility in healthy volunteers by using multidetector computed tomography and to compare the results with the current diagnostic criterion for tracheomalacia.An institutional review board approved this HIPAA-compliant study. After informed consent was obtained, 51 healthy volunteers (age range, 25-75 years) with normal spirometry results and no history of smoking or risk factors for tracheomalacia were prospectively studied. Volunteers were imaged with a 64-detector row scanner, with spirometric monitoring at total lung capacity and during forced exhalation, with 40 mAs, 120 kVp, and 0.625-mm detector collimation. Cross-sectional area and sagittal and coronal diameters of the trachea were measured 1 cm above the aortic arch and 1 cm above the carina. The percentage of expiratory collapse, the reduction in sagittal and coronal diameters, and the number of participants exceeding the current diagnostic criterion (50% expiratory reduction in cross-sectional area) for tracheomalacia were calculated.The final study population included 25 men and 26 women (mean age, 50 years). The mean percentage of expiratory reduction in tracheal lumen cross-sectional area was 54.34% +/- 18.6 (standard deviation) in the upper trachea and 56.14% +/- 19.3 in the lower trachea. Forty (78%) participants exceeded the current diagnostic criterion for tracheomalacia in the upper and/or lower trachea. Decreases in cross-sectional area of the upper and lower trachea correlated well with decreases in sagittal (r = 0.807 and 0.688, respectively) and coronal (r = 0.779 and 0.751, respectively) diameters (P.001 for each correlation).Healthy volunteers demonstrate a wide range of forced expiratory tracheal collapse, frequently exceeding the current diagnostic criterion for tracheomalacia.

Small-scale self-focusing is the main cause of power limitation in nanosecond Nd:glass lasers. We report pioneer observation in experiment of laser beam noise amplification for B -integral (nonlinear phase) order of unity, i.e., without destruction of nonlinear medium. Analytical dependences of noise amplification coefficient on the B-integral have been obtained for one nonlinear medium as well as for two nonlinear media separated by an air gap with image relay. A simple analytical dependence has been found for an optimal distance between two nonlinear media for which the maximum allowable value of B -integral increases from 2.7 to 4.3. The maximum attainable energy in neodymium-phosphate glass lasers with rod amplifiers 10 cm in diameter is 400 J with a pulse duration of 1 ns.

It is shown that the time shifts of the intensity maximum and B-integral for an amplified laser pulse are proportional to the energy extraction from the amplifier normalised to the saturation energy, the proportionality coefficient being equal approximately to 1/7 and 1/14 of the pulse duration, respectively. Simple analytic expressions are obtained for the maximum values of the output intensity and B-integral. The results are experimentally confirmed by amplification observed in a Nd:YLF crystal.

The effect of various technological factors like the direction of crystal growth [(100) or (101)], acidity of the mother solution, growth rate, degree of filtration of the mother solution, purity of the starting raw material, specially introduced impurity (Pb), as well as after-growth thermal annealing, on the optical breakdown threshold of KDP crystals grown by the technique of rapid growth of profiled crystals is studied. It is shown that by using initial high-purity salts and fine filtration of solutions followed by after-growth annealing, it is possible to increase the optical breakdown threshold of profiled rapidly grown KDP crystals to values corresponding to the requirements of modern laser designs.

Objectives Intestinal failure-associated liver disease (IFALD) contributes to significant morbidity in pediatric patients with intestinal failure (IF); however, the use of parenteral nutrition (PN) with a fish oil-based intravenous (IV) emulsion (FO) has been associated with biochemical reversal of cholestasis and improved outcomes. Unfortunately, FO increases the complexity of care: because it can be administered only under Food and Drug Administration compassionate use protocols requiring special monitoring, it is not available as a 3-in-1 solution and is more expensive than comparable soy-based IV lipid emulsion (SO). Because of these pragmatic constraints, a series of patient families were switched to low-dose (1 g kg(-1) day(-1)) SO following biochemical resolution of cholestasis. The present study examines whether reversal of cholestasis and somatic growth are maintained following this transition. Methods The present study is a chart review of all children with IFALD who switched from FO to SO following resolution of cholestasis. Variables are presented as medians (interquartile ranges). Comparisons were performed using the Wilcoxon signed-rank test. Results Seven patients ages 25.9 (16.2-43.2) months were transitioned to SO following reversal of cholestasis using FO. At a median follow-up of 13.9 (4.3-50.1) months, there were no significant differences between pretransition and post-transition serum alanine and aspartate aminotransferases, direct bilirubin, and weight-for-age z scores. Because of recurrence of cholestasis, 1 patient was restarted on FO after 4 months on SO. Conclusions Biochemical reversal of IFALD and growth were preserved after transition from FO to SO in 6 of 7 (86%) patients. Given the challenges associated with the use of FO, SO may be a viable alternative in select patients with home PN.

A five-stage neodymium phosphate glass amplifier producing 1–1.5-ns radiation pulses of energy up to 110 J is described. The use of a multistage spatial filter based on an aperture line provides efficient extraction of the stored energy. The exit aperture filling factor is 0.65 and the output radiation divergence is equal to three times the diffraction-limited divergence. The energy efficiency of radiation conversion to the second harmonic is 60%. The amplifier is intended for pumping a chirped-pulse optical parametric amplifier.

We investigated a diode-pumped multipass disk Yb:KGW amplifier intended for amplifying a train of 3D ellipsoidal pulses of a laser driver for a photocathode of a linear electron accelerator. The multipass amplification geometry permitted increasing the energy of broadband (about 10 nm) pulses with a repetition rate of 1 MHz from 0.12 µJ to 39 µJ, despite large losses (two orders of magnitude) introduced by a beam shaper of 3D ellipsoidal beam. The distortions of the pulse train envelope were minimal due to optimal delay between the moment of pump switching on and arrival of the first pulse of the train.