Predicting Vaginal Delivery in Nulliparous Women Undergoing Induction of Labor at Term.

OBJECTIVE: We sought to develop a model to calculate the likelihood of vaginal delivery in nulliparous women undergoing induction at term. STUDY DESIGN: We obtained data from the Consortium on Safe Labor by including nulliparous women with term singleton pregnancies undergoing induction of labor at term. Women with contraindications for vaginal delivery were excluded. A stepwise logistic regression analysis was used to identify the predictors associated with vaginal delivery by considering maternal characteristics and comorbidities and fetal conditions. The receiver operating characteristic curve, with an area under the curve (AUC) was used to assess the accuracy of the model. RESULTS: Of 10,591 nulliparous women who underwent induction of labor, 8,202 (77.4%) women had vaginal delivery. Our model identified maternal age, gestational age at delivery, race, maternal height, prepregnancy weight, gestational weight gain, cervical exam on admission (dilation, effacement, and station), chronic hypertension, gestational diabetes, pregestational diabetes, and abruption as significant predictors for successful vaginal delivery. The overall predictive ability of the final model, as measured by the AUC was 0.759 (95% confidence interval, 0.749-0.770). CONCLUSION: We identified independent risk factors that can be used to predict vaginal delivery among nulliparas undergoing induction at term. Our predictor provides women with additional information when considering induction.

Synthesis and characterization of attosecond light vortices in the extreme ultraviolet.

Infrared and visible light beams carrying orbital angular momentum (OAM) are currently thoroughly studied for their extremely broad applicative prospects, among which are quantum information, micromachining and diagnostic tools. Here we extend these prospects, presenting a comprehensive study for the synthesis and full characterization of optical vortices carrying OAM in the extreme ultraviolet (XUV) domain. We confirm the upconversion rules of a femtosecond infrared helically phased beam into its high-order harmonics, showing that each harmonic order carries the total number of OAM units absorbed in the process up to very high orders (57). This allows us to synthesize and characterize helically shaped XUV trains of attosecond pulses. To demonstrate a typical use of these new XUV light beams, we show our ability to generate and control, through photoionization, attosecond electron beams carrying OAM. These breakthroughs pave the route for the study of a series of fundamental phenomena and the development of new ultrafast diagnosis tools using either photonic or electronic vortices.

Spatial fingerprint of quantum path interferences in high order harmonic generation.

We have spatially and spectrally resolved the high order harmonic emission from an argon gas target. Under proper phase matching conditions we were able to observe for the first time the spatial fine structure originating from the interference of the two shortest quantum paths in the harmonic beam. The structure can be explained by the intensity-dependent harmonic phase of the contributions from the two paths. The spatially and spectrally resolved measurements are consistent with previous spatially integrated results. Our measurement method represents a new tool to clearly distinguish between different interference effects and to potentially observe higher order trajectories in the future with improved detection sensitivity. Here, we demonstrate additional experimental evidence that the observed interference pattern is only due to quantum-path interferences and cannot be explained by a phase modulation effect. Our experimental results are fully supported by simulations using the strong field approximation and including propagation.

Ionization effects on spectral signatures of quantum-path interference in high-harmonic generation.

The interference between the emission originating from the short and long electron quantum paths is intrinsic to the high harmonic generation process. We investigate the universal properties of these quantum-path interferences in various generation media and discuss how ionization effects influence the observed interference structures. Our comparison of quantum-path interferences observed in xenon, argon, and neon demonstrates that our experimental tools are generally applicable and should also allow investigating more complex systems such as molecules or clusters.

[Omental infarct after a gastric by-pass]. / Infarctus épiploïque après by-pass gastrique.

The authors describe the case of a 56 year old woman 25 days status post laparoscopic gastric bypass who presented with an acute onset of severe epigastric pain with signs of inflammation and localized peritoneal irritation. Although her findings suggested a late anastomotic leak, an abdominal CT scan revealed only necrosis of the greater omentum beneath the left hepatic lobe. This finding permitted a non-surgical approach; after observation over several days, the patient's symptoms resolved completely.

Quantum path interferences in high-order harmonic generation.

We have investigated the intensity dependence of high-order harmonic generation in argon when the two shortest quantum paths contribute to the harmonic emission. For the first time to our knowledge, experimental conditions were found to clearly observe interference between these two quantum paths that are in excellent agreement with theoretical predictions. This result is a first step towards the direct experimental characterization of the full single-atom dipole moment and demonstrates an unprecedented accuracy of quantum path control on an attosecond time scale.

Scaling of wave-packet dynamics in an intense midinfrared field.

A theoretical investigation is presented that examines the wavelength scaling from near-visible (0.8 micro m) to midinfrared (2 micro m) of the photoelectron distribution and high harmonics generated by a "single" atom in an intense electromagnetic field. The calculations use a numerical solution of the time-dependent Schrödinger equation (TDSE) in argon and the strong-field approximation in helium. The scaling of electron energies (lambda2), harmonic cutoff (lambda2), and attochirp (lambda -1) agree with classical mechanics, but it is found that, surprisingly, the harmonic yield follows a lambda -(5-6) scaling at constant intensity. In addition, the TDSE results reveal an unexpected contribution from higher-order returns of the rescattering electron wave packet.

Transient phase masks in high-harmonic generation.

We present a method for controlling the spatial properties of high-harmonic beams with high efficiency. The high nonlinearity of harmonic generation allows weak control beams to induce a phase mask for the extreme UV light as it is formed. We fabricate a phase grating and demonstrate efficient diffraction in the far field. Diffractive elements formed in this way are transient. Since they are induced by the subcycle interaction of the medium with the fundamental and control fields, they can be extended to the attosecond time scale.

Optimization of attosecond pulse generation.

The generation of attosecond pulses by superposition of high harmonics relies on their synchronization in the emission. Our experiments in the low-order, plateau, and cutoff regions of the spectrum reveal different regimes in the electron dynamics determining the synchronization quality. The shortest pulses are obtained by combining a spectral filtering of harmonics from the end of the plateau and the cutoff, and a far-field spatial filtering that selects a single electron quantum path contribution to the emission. This method applies to isolated pulses as well as pulse trains.

Influence of optical thickness and hot electrons on Rydberg spectra of Ne-like and F-like copper ions.

Spectra in the 7.10 to 8.60 A range from highly charged copper ions are observed from three different laser-produced plasmas (LPPs). The LPPs are formed by a 15-ns Nd:glass laser pulse (type I: E(pulse)=1-8 J, lambda=1.064 microm), a 1-ps Nd:glass laser pulse (type II: E(pulse)=1 J, lambda=1.055 microm), and a 60-fs Ti:sapphire laser pulse (type III: E(pulse)=800 mJ, lambda=790 nm). The spectra of high-n (n

Hot-electron influence on L-shell spectra of multicharged Kr ions generated in clusters irradiated by femtosecond laser pulses.

Strong L-shell x-ray emission has been obtained from Kr clusters formed in gas jets and irradiated by 60-500-fs laser pulses. Spectral lines from the F-, Ne- Na-, and Mg-like charge states of Kr have been identified from highly resolved x-ray spectra. Spectral line intensities are used in conjunction with a detailed time-dependent collisional-radiative model to diagnose the electron distribution functions of plasmas formed in various gas jet nozzles with various laser pulse durations. It is shown that L-shell spectra formed by relatively long nanosecond-laser pulses can be well described by a steady-state model without hot electrons when opacity effects are included. In contrast, adequate modeling of L-shell spectra from highly transient and inhomogeneous femtosecond-laser plasmas requires including the influence of hot electrons. It is shown that femtosecond-laser interaction with gas jets from conical nozzles produces plasmas with higher ionization balances than plasmas formed by gas jets from Laval nozzles, in agreement with previous work for femtosecond laser interaction with Ar clusters.

Space- and time-resolved density measurements of a high-intensity laser-produced plasma for x-ray laser studies.

We present a detailed study on the spatiotemporal density evolution of a plasma created by optical-field ionization of a high-pressure pulsed gas jet by a 10-TW, 60-fs Ti:sapphire laser. The plasma dynamics has been studied on a 17-ns time scale with a 60-fs time resolution and a 5-microm space resolution using a Mach-Zehnder interferometer. The density profile and the plasma radial expansion were accurately measured for conditions relevant to x-ray laser schemes in H-like nitrogen which were recently proposed [S. Hulin et al., Phys. Rev. E 61, 5693 (2000)]. The results were reproduced well by hydrocode simulations that allowed to infer the plasma temperature.

Spatially resolved x-ray spectroscopy investigation of femtosecond laser irradiated Ar clusters.

High temperature plasmas have been created by irradiating Ar clusters with high intensity 60-fs laser pulses. Detailed spectroscopic analysis of spatially resolved, high resolution x-ray data near the He(alpha) line of Ar is consistent with a two-temperature collisional-radiative model incorporating the effects of highly energetic electrons. The results of the spectral analysis are compared with a theoretical hydrodynamic model of cluster production, as well as interferometric data. The plasma parameters are notably uniform over one Rayleigh length (600 microm).

Soft-x-ray laser scheme in a plasma created by optical-field-induced ionization of nitrogen

An x-ray laser scheme based on the recombination of a fully stripped nitrogen plasma is presented. Plasma is assumed to be created by the optical-field ionization of a nitrogen gas jet of 10(19) cm-3 atomic density by an ultrashort (60 fs), high-intensity (3 x 10(19) W/cm2) Ti:sapphire laser. Results of two-dimensional particle-in-cell simulations, modeling laser-plasma interaction, parametric heating, and ponderomotive effects are presented. Hydrodynamic and kinetics calculations are performed and predict important local gain for H-like nitrogen transitions at 25 and 134 A, following fast collisional recombination for specific plasma conditions.

Direct spectroscopic observation of multiple-charged-ion acceleration by an intense femtosecond-pulse laser.

We have observed evidence of the emission of energetic He-and H-like ions of fluorine more than 1 MeV produced via the optical field ionization (OFI) from a solid target irradiated by an intense I=(2-4)x10(18) W/cm(2) (60 fs, lambda=800 nm), obliquely incident p-polarized pulse laser. The measured blue wing of He(alpha), He(beta), and Ly(alpha) lines of fluorine shows a feature of the Doppler-shifted spectrum due to the self-similar ion expansion dominated by superthermal electrons with the temperature T(h) approximately 100 keV. Using a collisional particle-in-cell simulation, which incorporates the nonlocal-thermodynamic-equilibrium ionization including OFI, we have obtained the plasma temperature, line shape, and maximal energy of accelerated ions, which agree well with those determined from the experimental spectra. The red wing of ion spectra gives the temperature of bulk plasma electrons.