Neonatal Opioid Withdrawal Syndrome Following Prenatal Use of Supplements Containing Tianeptine.

Tianeptine is an opioid receptor agonist that is prescribed as an antidepressant in many countries. In the United States, tianeptine is not approved for medical use because of its potential for abuse and addiction. Nonetheless, products containing tianeptine are easily obtainable and are marketed as dietary supplements. There are increasing reports of adverse effects and fatal toxicities resulting from tianeptine use among adolescents and adults. This emerging public health threat could escalate the opioid epidemic and drive increased newborn perinatal exposure. The impact of in utero exposure to tianeptine has not been studied, and to our knowledge, the authors of only 1 report have documented possible neonatal effects. Here, we describe a case of chronic prenatal exposure to tianeptine in the setting of maternal dependence on dietary supplements. This infant developed signs of severe withdrawal shortly after birth that were refractory to treatment with oral phenobarbital but responded to subsequent oral morphine therapy. On further questioning, the mother revealed the use of a tianeptine-containing dietary supplement. We did not perform confirmatory toxicology testing because tianeptine is not assayed by usual urine drug screening tests. For infants with clinical signs of opioid withdrawal without known etiology, we suggest that the maternal interview should inquire about the use of neurotropic over-the-counter drugs.

Close to transform-limited, few-cycle 12 µJ pulses at 400 kHz for applications in ultrafast spectroscopy.

Non-collinear optical parametric amplification has become the leading technology for amplifying few-cycle carrier-envelope phase (CEP) stable pulses to high energy at extreme repetition rates. In this work, a parametric amplifier system devoted to ultrafast photoionization experiments with coincidence detection is reported. The amplifier delivers CEP-stable few-cycle pulses with an average power of 5 W, and operates at repetition rates between 400 and 800 kHz. Close to transform-limited compression of the few-cycle pulses is achieved with minimized spatio-temporal distortions. Potential limitations introduced by spatio-temporal couplings to applications in attosecond science are analyzed. In particular, it is shown that pulse front tilt resulting from non-collinear amplification can considerably reduce the asymmetry in stereo above threshold ionization (stereo-ATI) experiments.

Efforts at the Frontlines: Implementing a Hepatitis C Testing and Linkage-to-Care Program at the Local Public Health Level.

OBJECTIVES: The national Viral Hepatitis Action Plan recommends strengthening partnerships among health departments, community-based organizations, and health-care providers for hepatitis services. We implemented a hepatitis C virus (HCV) testing and linkage-to-care program through a local health department using similar strategies reported for HIV care. METHODS: The Durham County Department of Public Health received federal funding to conduct HCV testing and linkage to care in Durham, North Carolina. HCV antibody testing with reflex RNA was offered through a sexually transmitted disease clinic, a county jail, community testing sites (including a residential substance abuse recovery program), and a homeless clinic. People with evidence of HCV infection were linked to care through an HCV bridge counselor who provided education, incentives, and transportation, and scheduled appointments with HCV specialists at nearby academic centers and on-site clinics. RESULTS: From December 2012 through February 2014, we conducted 2,004 HCV tests, of which 326 (16.3%) were HCV antibody positive and 241 (12.0%) had detectable HCV RNA. Among the 241 people with HCV infection, 178 (73.9%) were men, and 133 (55.2%) were born between 1945 and 1965. Of 241 people with chronic HCV infection, 150 (62.2%) reported ever injecting drugs, eight (2.5%) were coinfected with HIV, and 123 (51.0%) were linked to care. CONCLUSION: At the local public health level, HCV testing and linkage to care can be facilitated with additional funding and by leveraging existing programs and provider networks to deliver a coordinated system of care.

Carrier-envelope phase stable few-cycle pulses at 400 kHz for electron-ion coincidence experiments.

Coincident electron-ion detection after photoionization in a "reaction microscope" is a very powerful tool to study atomic and molecular dynamics. However, the implementation of this tool in the field of attosecond science has so far been rather limited, due to the lack of high repetition rate laser sources capable of delivering few-cycle pulses with sufficient energy per pulse. In this article, the development of a Non-collinear Optical Parametric Amplifier (NOPA) capable of delivering Carrier-Envelope Phase (CEP) stable pulses with sub-6 fs duration and pulse energies in the few-µJ range is presented. The potential of combining the high repetition rate source and a reaction microscope operating at this high frequency is demonstrated in a proof-of-principle experiment on strong field ionization of Ar atoms.

Few-femtosecond plasmon dephasing of a single metallic nanostructure from optical response function reconstruction by interferometric frequency resolved optical gating.

The precise characterization of the ultrafast optical response of metals and metallic nanostructures has remained an experimental challenge. We probe the few-femtosecond electronic dephasing of a local surface plasmon polariton excitation using symmetry-selective second-harmonic (SH) Rayleigh scattering of a nanoscopic conical gold tip as an individual plasmonic nanostructure. The full reconstruction of the optical response function of the plasmon excitation with phase and amplitude without any model assumptions is demonstrated from the analysis of the two-dimensional spectrogram obtained by simultaneous time- and frequency-domain SH measurements, using interferometric frequency resolved optical gating. The measured dephasing time of T(2) = 18 +/- 5 fs indicates the plasmon damping is dominated by nonradiative decay, consistent with a Drude-Sommerfeld dielectric response for gold. Even for the nominally homogeneous localized plasmon response, deviations are observed from the ideal harmonic oscillator phase behavior, which may reflect the underlying inhomogeneous electronic response with its different scattering channels. The presented technique is generally applicable for the reconstruction of the plasmon dynamics of complex nanostructures: information that cannot be obtained by conventional dark-field scattering.