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The non-linear optical process of laser harmonic generation (HG) enables the creation of high quality pulses of UV or even X-ray radiation, which have many potential uses at the frontiers of experimental science, ranging from lensless microscopy to ultrafast metrology and chiral science. Although many of the promising applications are enabled by generating harmonic modes with orbital angular momentum (OAM), independent control of the harmonic frequency and OAM level remains elusive. Here we show, through a theoretical approach, validated with 3D simulations, how unique 2-D harmonic progressions can be obtained, with both frequency and OAM level tuned independently, from tailored structured targets in both reflective and transmissive configurations. Through preferential selection of a subset of harmonic modes with a specific OAM value, a controlled frequency comb of circularly polarised harmonics can be produced. Our approach to describe HG, which simplifies both the theoretical predictions and the analysis of the harmonic spectrum, is directly applicable across the full range of HG mechanisms and can be readily applied to investigations of OAM harmonics in other processes, such as OAM cascades in Raman amplification, or the analysis of harmonic progressions in nonlinear optics.
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Mass loss of the Antarctic Ice Sheet has been driven primarily by the thinning of the floating ice shelves that fringe the ice sheet1, reducing their buttressing potential and causing land ice to accelerate into the ocean2. Observations of ice-shelf thickness change by satellite altimetry stretch back only to 1992 (refs. 1,3-5) and previous information about thinning remains unquantified. However, extending the record of ice-shelf thickness change is possible by proxy, by measuring the change in area of the surface expression of pinning points-local bathymetric highs on which ice shelves are anchored6. Here we measure pinning-point change over three epochs spanning the periods 1973-1989, 1989-2000 and 2000-2022, and thus by proxy infer changes to ice-shelf thickness back to 1973-1989. We show that only small localized pockets of ice shelves were thinning between 1973 and 1989, located primarily in the Amundsen Sea Embayment and the Wilkes Land coastline. Ice-shelf thinning spreads rapidly into the 1990s and 2000s and is best characterized by the proportion of pinning points reducing in extent. Only 15% of pinning points reduced from 1973 to 1989, before increasing to 25% from 1989 to 2000 and 37% from 2000 to 2022. A continuation of this trend would further reduce the buttressing potential of ice shelves, enhancing ice discharge and accelerating the contribution of Antarctica to sea-level rise.
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West Antarctica has experienced dramatic ice losses contributing to global sea-level rise in recent decades, particularly from Pine Island and Thwaites glaciers. Although these ice losses manifest an ongoing Marine Ice Sheet Instability, projections of their future rate are confounded by limited observations along West Antarctica's coastal perimeter with respect to how the pace of retreat can be modulated by variations in climate forcing. Here, we derive a comprehensive, 12-year record of glacier retreat around West Antarctica's Pacific-facing margin and compare this dataset to contemporaneous estimates of ice flow, mass loss, the state of the Southern Ocean and the atmosphere. Between 2003 and 2015, rates of glacier retreat and acceleration were extensive along the Bellingshausen Sea coastline, but slowed along the Amundsen Sea. We attribute this to an interdecadal suppression of westerly winds in the Amundsen Sea, which reduced warm water inflow to the Amundsen Sea Embayment. Our results provide direct observations that the pace, magnitude and extent of ice destabilization around West Antarctica vary by location, with the Amundsen Sea response most sensitive to interdecadal atmosphere-ocean variability. Thus, model projections accounting for regionally resolved ice-ocean-atmosphere interactions will be important for predicting accurately the short-term evolution of the Antarctic Ice Sheet.
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The Antarctic continent reached its current polar location ~83 Ma and became shrouded by ice sheets ~34 Ma, coincident with dramatic global cooling at the Eocene-Oligocene boundary. However, it is not known whether the first Antarctic glaciers formed immediately prior to this or were present significantly earlier. Here we show that mountain glaciers were likely present in the Transantarctic Mountains during the Late Palaeocene (~60-56 Ma) and middle Eocene (~48-40 Ma). Temperate (warm-based) glaciers were prevalent during the Late Eocene (~40-34 Ma) and, in reduced numbers, during the Oligocene (~34-23 Ma), before larger, likely cold-based, ice masses (including ice sheets) dominated. Some temperate mountain glaciers were present during the Miocene Climatic Optimum (~15 Ma), before a widespread switch to cold-based glaciation. Our findings highlight the longevity of glaciation in Antarctica and suggest that glaciers were present even during the Early-Cenozoic greenhouse world.
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Cubierta de Hielo , Regiones AntárticasRESUMEN
In conventional gases and plasmas, it is known that heat fluxes are proportional to temperature gradients, with collisions between particles mediating energy flow from hotter to colder regions and the coefficient of thermal conduction given by Spitzer's theory. However, this theory breaks down in magnetized, turbulent, weakly collisional plasmas, although modifications are difficult to predict from first principles due to the complex, multiscale nature of the problem. Understanding heat transport is important in astrophysical plasmas such as those in galaxy clusters, where observed temperature profiles are explicable only in the presence of a strong suppression of heat conduction compared to Spitzer's theory. To address this problem, we have created a replica of such a system in a laser laboratory experiment. Our data show a reduction of heat transport by two orders of magnitude or more, leading to large temperature variations on small spatial scales (as is seen in cluster plasmas).
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The European Resuscitation Council (ERC) Paediatric Life Support (PLS) guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations of the International Liaison Committee on Resuscitation (ILCOR). This section provides guidelines on the management of critically ill or injured infants, children and adolescents before, during and after respiratory/cardiac arrest.
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These European Resuscitation Council Paediatric Life Support (PLS) guidelines, are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the management of critically ill infants and children, before, during and after cardiac arrest.
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Reanimación Cardiopulmonar , Paro Cardíaco , Niño , Cardioversión Eléctrica , Paro Cardíaco/terapia , Humanos , LactanteRESUMEN
Understanding magnetic-field generation and amplification in turbulent plasma is essential to account for observations of magnetic fields in the universe. A theoretical framework attributing the origin and sustainment of these fields to the so-called fluctuation dynamo was recently validated by experiments on laser facilities in low-magnetic-Prandtl-number plasmas ([Formula: see text]). However, the same framework proposes that the fluctuation dynamo should operate differently when [Formula: see text], the regime relevant to many astrophysical environments such as the intracluster medium of galaxy clusters. This paper reports an experiment that creates a laboratory [Formula: see text] plasma dynamo. We provide a time-resolved characterization of the plasma's evolution, measuring temperatures, densities, flow velocities, and magnetic fields, which allows us to explore various stages of the fluctuation dynamo's operation on seed magnetic fields generated by the action of the Biermann-battery mechanism during the initial drive-laser target interaction. The magnetic energy in structures with characteristic scales close to the driving scale of the stochastic motions is found to increase by almost three orders of magnitude and saturate dynamically. It is shown that the initial growth of these fields occurs at a much greater rate than the turnover rate of the driving-scale stochastic motions. Our results point to the possibility that plasma turbulence produced by strong shear can generate fields more efficiently at the driving scale than anticipated by idealized magnetohydrodynamics (MHD) simulations of the nonhelical fluctuation dynamo; this finding could help explain the large-scale fields inferred from observations of astrophysical systems.
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AIM: To evaluate the optimal timing and doses of epinephrine for Infants and children suffering in-hospital or out-of-hospital cardiac arrest. METHODS: We searched Medline, EMBASE, and Cochrane Controlled Register of Trials (CENTRAL) for human randomized clinical trials and observational studies including comparative cohorts. Two investigators reviewed relevance of studies, extracted the data, conducted meta-analyses and assessed the risk of bias using the GRADE and CLARITY frameworks. Authors of the eligible studies were contacted to obtain additional data. Critically important outcomes included return of spontaneous circulation, survival to hospital discharge and survival with good neurological outcome. RESULTS: We identified 7 observational studies suitable for meta-analysis and no randomized clinical trials. The overall certainty of evidence was very low. For the critically important outcomes, the earlier administration of epinephrine was favorable for both in-hospital and out-of-hospital cardiac arrest. Because of a limited number of eligible studies and the presence of severe confounding factors, we could not determine the optimal interval of epinephrine administration. CONCLUSIONS: Earlier administration of the first epinephrine dose could be more favorable in non-shockable pediatric cardiac arrest. The optimal interval for epinephrine administration remains unclear.
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Epinefrina , Paro Cardíaco Extrahospitalario , Niño , Humanos , Lactante , Paro Cardíaco Extrahospitalario/tratamiento farmacológico , Alta del PacienteRESUMEN
This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) for pediatric life support is based on the most extensive evidence evaluation ever performed by the Pediatric Life Support Task Force. Three types of evidence evaluation were used in this review: systematic reviews, scoping reviews, and evidence updates. Per agreement with the evidence evaluation recommendations of the International Liaison Committee on Resuscitation, only systematic reviews could result in a new or revised treatment recommendation.Systematic reviews performed for this 2020 CoSTR for pediatric life support included the topics of sequencing of airway-breaths-compressions versus compressions-airway-breaths in the delivery of pediatric basic life support, the initial timing and dose intervals for epinephrine administration during resuscitation, and the targets for oxygen and carbon dioxide levels in pediatric patients after return of spontaneous circulation. The most controversial topics included the initial timing and dose intervals of epinephrine administration (new treatment recommendations were made) and the administration of fluid for infants and children with septic shock (this latter topic was evaluated by evidence update). All evidence reviews identified the paucity of pediatric data and the need for more research involving resuscitation of infants and children.
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Reanimación Cardiopulmonar/normas , Consenso , Servicios Médicos de Urgencia/normas , Servicio de Urgencia en Hospital/normas , Paro Cardíaco Extrahospitalario/terapia , American Heart Association , Humanos , Estados UnidosRESUMEN
This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) for pediatric life support is based on the most extensive evidence evaluation ever performed by the Pediatric Life Support Task Force. Three types of evidence evaluation were used in this review: systematic reviews, scoping reviews, and evidence updates. Per agreement with the evidence evaluation recommendations of the International Liaison Committee on Resuscitation, only systematic reviews could result in a new or revised treatment recommendation. Systematic reviews performed for this 2020 CoSTR for pediatric life support included the topics of sequencing of airway-breaths-compressions versus compressions-airway-breaths in the delivery of pediatric basic life support, the initial timing and dose intervals for epinephrine administration during resuscitation, and the targets for oxygen and carbon dioxide levels in pediatric patients after return of spontaneous circulation. The most controversial topics included the initial timing and dose intervals of epinephrine administration (new treatment recommendations were made) and the administration of fluid for infants and children with septic shock (this latter topic was evaluated by evidence update). All evidence reviews identified the paucity of pediatric data and the need for more research involving resuscitation of infants and children.
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Reanimación Cardiopulmonar , Servicios Médicos de Urgencia , Paro Cardíaco Extrahospitalario , Niño , Consenso , Tratamiento de Urgencia , Humanos , LactanteRESUMEN
This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) for pediatric life support is based on the most extensive evidence evaluation ever performed by the Pediatric Life Support Task Force. Three types of evidence evaluation were used in this review: systematic reviews, scoping reviews, and evidence updates. Per agreement with the evidence evaluation recommendations of the International Liaison Committee on Resuscitation, only systematic reviews could result in a new or revised treatment recommendation. Systematic reviews performed for this 2020 CoSTR for pediatric life support included the topics of sequencing of airway-breaths-compressions versus compressions-airway-breaths in the delivery of pediatric basic life support, the initial timing and dose intervals for epinephrine administration during resuscitation, and the targets for oxygen and carbon dioxide levels in pediatric patients after return of spontaneous circulation. The most controversial topics included the initial timing and dose intervals of epinephrine administration (new treatment recommendations were made) and the administration of fluid for infants and children with septic shock (this latter topic was evaluated by evidence update). All evidence reviews identified the paucity of pediatric data and the need for more research involving resuscitation of infants and children.
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Reanimación Cardiopulmonar/normas , Enfermedades Cardiovasculares/terapia , Servicios Médicos de Urgencia/normas , Cuidados para Prolongación de la Vida/normas , Corticoesteroides/administración & dosificación , Arritmias Cardíacas/tratamiento farmacológico , Atropina/administración & dosificación , Reanimación Cardiopulmonar/métodos , Niño , Humanos , Choque Séptico/tratamiento farmacológicoRESUMEN
OBJECTIVE: To summarise in a systematic review the effectiveness of interventions to treat foreign body airway obstructions (FBAO). METHODS: We searched MEDLINE, EMBASE, and the Cochrane library from inception on 30th September 2019 for studies that described the effectiveness of interventions to treat FBAO in adults and children. We included randomised controlled trials, observational studies and case series (≥5 cases) that described evidence of benefit. For evidence of harm/complications, we included case reports. Two reviewers independently assessed study eligibility, extracted study data, and assessed risk of bias. Data are summarised in a narrative synthesis. The GRADE system is used to assess evidence certainty. RESULTS: We included 69 publications, comprising three cross-sectional studies (557 patients); eight case series (755 patients), and 59 were case reports (64 patients). One paper was included as a case series and cross-sectional study. For all interventions and associated outcomes, evidence certainty was very low. Early removal of FBAO by bystanders was associated with improved neurological survival (odds ratio 6.0, 95% confidence interval 1.5 to 23.4). Identified evidence showed that key interventions (back blows, abdominal thrusts, chest thrusts/compressions, Magill forceps, manual removal of obstructions from the mouth, suction-based airway clearance devices) are effective in relieving FBAO. We identified reports of harm in relation to back blows, abdominal thrusts, chest thrusts/compressions, and blind finger sweeps. CONCLUSIONS: Key interventions successfully relieve FBAO, but may be associated with important harms. Guidelines for FBAO management should balance the benefits and harms of interventions.
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Obstrucción de las Vías Aéreas , Cuerpos Extraños , Adulto , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/terapia , Sesgo , Niño , Estudios Transversales , Cuerpos Extraños/complicaciones , Cuerpos Extraños/terapia , HumanosRESUMEN
The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.
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Reanimación Cardiopulmonar/normas , Paro Cardíaco Extrahospitalario/terapia , Adolescente , Adulto , Anciano , Reanimación Cardiopulmonar/métodos , Niño , Preescolar , Epinefrina/uso terapéutico , Circulación Extracorporea/métodos , Circulación Extracorporea/normas , Humanos , Hipertermia Inducida/métodos , Hipertermia Inducida/normas , Lactante , Intubación Intratraqueal/métodos , Intubación Intratraqueal/normas , Persona de Mediana Edad , Respiración Artificial/métodos , Respiración Artificial/normas , Vasoconstrictores/uso terapéutico , Adulto JovenRESUMEN
The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.
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Reanimación Cardiopulmonar/normas , Servicios Médicos de Urgencia/normas , Tratamiento de Urgencia , Hipotermia Inducida/normas , Niño , Servicio de Urgencia en Hospital/normas , Tratamiento de Urgencia/normas , Humanos , Paro Cardíaco Extrahospitalario/terapiaRESUMEN
Inertial confinement fusion fuel suffers increased x-ray radiation losses when carbon from the capsule ablator mixes into the hot-spot. Here, we present one- and two-dimensional ion Vlasov-Fokker-Planck simulations that resolve hot-spot self-heating in the presence of a localized spike of carbon mix, totalling 1.9% of the hot-spot mass. The mix region cools and contracts over tens of picoseconds, increasing its α particle stopping power and radiative losses. This makes a localized mix region more severe than an equal amount of uniformly distributed mix. There is also a purely kinetic effect that reduces fusion reactivity by several percent, since faster ions in the tail of the distribution are absorbed by the mix region. Radiative cooling and contraction of the spike induces fluid motion, causing neutron spectrum broadening. This artificially increases the inferred experimental ion temperatures and gives line of sight variations.
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Airborne radar sounding can measure conditions within and beneath polar ice sheets. In Antarctica, most digital radar-sounding data have been collected in the last 2 decades, limiting our ability to understand processes that govern longer-term ice-sheet behavior. Here, we demonstrate how analog radar data collected over 40 y ago in Antarctica can be combined with modern records to quantify multidecadal changes. Specifically, we digitize over 400,000 line kilometers of exploratory Antarctic radar data originally recorded on 35-mm optical film between 1971 and 1979. We leverage the increased geometric and radiometric resolution of our digitization process to show how these data can be used to identify and investigate hydrologic, geologic, and topographic features beneath and within the ice sheet. To highlight their scientific potential, we compare the digitized data with contemporary radar measurements to reveal that the remnant eastern ice shelf of Thwaites Glacier in West Antarctica had thinned between 10 and 33% between 1978 and 2009. We also release the collection of scanned radargrams in their entirety in a persistent public archive along with updated geolocation data for a subset of the data that reduces the mean positioning error from 5 to 2.5 km. Together, these data represent a unique and renewed extensive, multidecadal historical baseline, critical for observing and modeling ice-sheet change on societally relevant timescales.
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The Canadian Arctic Archipelago contains >300 glaciers that terminate in the ocean, but little is known about changes in their frontal positions in response to recent changes in the ocean-climate system. Here, we examine changes in glacier frontal positions since the 1950s and investigate the relative influence of oceanic temperature versus atmospheric temperature. Over 94% of glaciers retreated between 1958 and 2015, with a region-wide trend of gradual retreat before ~2000, followed by a fivefold increase in retreat rates up to 2015. Retreat patterns show no correlation with changes in subsurface ocean temperatures, in clear contrast to the dominance of ocean forcing in western Greenland and elsewhere. Rather, significant correlations with surface melt indicate that increased atmospheric temperature has been the primary driver of the acceleration in marine-terminating glacier frontal retreat in this region.
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The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the second annual summary of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations that includes the most recent cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation. This summary addresses the role of antiarrhythmic drugs in adults and children and includes the Advanced Life Support Task Force and Pediatric Task Force consensus statements, which summarize the most recent published evidence and an assessment of the quality of the evidence based on Grading of Recommendations, Assessment, Development, and Evaluation criteria. The statements include consensus treatment recommendations approved by members of the relevant task forces. Insights into the deliberations of each task force are provided in the Values and Preferences and Task Force Insights sections. Finally, the task force members have listed the top knowledge gaps for further research.
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Reanimación Cardiopulmonar , Paro Cardíaco Extrahospitalario/terapia , Amiodarona/uso terapéutico , Antiarrítmicos/uso terapéutico , Consenso , Servicios Médicos de Urgencia , Humanos , Lidocaína/uso terapéutico , Magnesio/uso terapéutico , Paro Cardíaco Extrahospitalario/tratamiento farmacológicoRESUMEN
The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the second annual summary of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations that includes the most recent cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation. This summary addresses the role of antiarrhythmic drugs in adults and children and includes the Advanced Life Support Task Force and Pediatric Task Force consensus statements, which summarize the most recent published evidence and an assessment of the quality of the evidence based on Grading of Recommendations, Assessment, Development, and Evaluation criteria. The statements include consensus treatment recommendations approved by members of the relevant task forces. Insights into the deliberations of each task force are provided in the Values and Preferences and Task Force Insights sections. Finally, the task force members have listed the top knowledge gaps for further research.