In the 2015 review paper‘Petawatt Class Lasers Worldwide’a comprehensive overview of the current status of highpower facilities of>200 TW was presented.This was largely based on facility specifications,with some ...In the 2015 review paper‘Petawatt Class Lasers Worldwide’a comprehensive overview of the current status of highpower facilities of>200 TW was presented.This was largely based on facility specifications,with some description of their uses,for instance in fundamental ultra-high-intensity interactions,secondary source generation,and inertial confinement fusion(ICF).With the 2018 Nobel Prize in Physics being awarded to Professors Donna Strickland and Gerard Mourou for the development of the technique of chirped pulse amplification(CPA),which made these lasers possible,we celebrate by providing a comprehensive update of the current status of ultra-high-power lasers and demonstrate how the technology has developed.We are now in the era of multi-petawatt facilities coming online,with 100 PW lasers being proposed and even under construction.In addition to this there is a pull towards development of industrial and multi-disciplinary applications,which demands much higher repetition rates,delivering high-average powers with higher efficiencies and the use of alternative wavelengths:mid-IR facilities.So apart from a comprehensive update of the current global status,we want to look at what technologies are to be deployed to get to these new regimes,and some of the critical issues facing their development.展开更多
Background To compare the efficacy of two different concepts of cisternal therapy—PREVENTIVE fibrinolysis plus on-demand spasmolysis versus RESCUE spasmolysis—for the prevention of cerebral vasospasm(CVS)and delayed...Background To compare the efficacy of two different concepts of cisternal therapy—PREVENTIVE fibrinolysis plus on-demand spasmolysis versus RESCUE spasmolysis—for the prevention of cerebral vasospasm(CVS)and delayed cerebral infarction(DCI)in patients with aneurysmal subarachnoid haemorrhage(aSAH).Methods Retrospective analysis of 84 aSAH patients selected for cisternal therapy for DCI prevention.66 high-risk patients received PREVENTIVE cisternal therapy to enhance blood clearance.Either stereotactic catheter ventriculocisternostomy(STX-VCS)or intraoperative placement of a cisterno-ventriculostomy catheter(CVC),followed by fibrinolytic cisternal lavage using urokinase was performed.In case of vasospasm,nimodipine was applied intrathecally.22 low-risk patients who developed CVS against expectations were selected for STX-VCS as RESCUE intervention for cisternal spasmolysis with nimodipine.Rates of DCI and mean flow velocities of daily transcranial Doppler(TCD)ultrasonographies were evaluated.Results Despite a higher prespecified DCI risk,patients selected for PREVENTIVE intervention primarily aiming at blood clearance had a lower DCI rate compared with patients selected for intrathecal spasmolysis as a RESCUE therapy(11.3%vs 18.2%).After intrathecal treatment onset,CVS(TCD>160 cm/s)occurred in 45%of patients with PREVENTIVE and 77%of patients with RESCUE therapy(p=0.013).A stronger response of CVS to intrathecal nimodipine was observed in patients with PREVENTIVE intervention as the mean CVS duration after start of intrathecal nimodipine was 3.2 days compared with 5.8 days in patients with RESCUE therapy(p=0.026).Conclusions PREVENTIVE cisternal therapy directed at blood clearance is more effective for the prevention of CVS and delayed infarction compared with cisternal RESCUE spasmolysis.展开更多
文摘In the 2015 review paper‘Petawatt Class Lasers Worldwide’a comprehensive overview of the current status of highpower facilities of>200 TW was presented.This was largely based on facility specifications,with some description of their uses,for instance in fundamental ultra-high-intensity interactions,secondary source generation,and inertial confinement fusion(ICF).With the 2018 Nobel Prize in Physics being awarded to Professors Donna Strickland and Gerard Mourou for the development of the technique of chirped pulse amplification(CPA),which made these lasers possible,we celebrate by providing a comprehensive update of the current status of ultra-high-power lasers and demonstrate how the technology has developed.We are now in the era of multi-petawatt facilities coming online,with 100 PW lasers being proposed and even under construction.In addition to this there is a pull towards development of industrial and multi-disciplinary applications,which demands much higher repetition rates,delivering high-average powers with higher efficiencies and the use of alternative wavelengths:mid-IR facilities.So apart from a comprehensive update of the current global status,we want to look at what technologies are to be deployed to get to these new regimes,and some of the critical issues facing their development.
基金funded by the Berta-Ottenstein-Programme for Advanced Clinician Scientists,Faculty of Medicine,University of Freiburg.
文摘Background To compare the efficacy of two different concepts of cisternal therapy—PREVENTIVE fibrinolysis plus on-demand spasmolysis versus RESCUE spasmolysis—for the prevention of cerebral vasospasm(CVS)and delayed cerebral infarction(DCI)in patients with aneurysmal subarachnoid haemorrhage(aSAH).Methods Retrospective analysis of 84 aSAH patients selected for cisternal therapy for DCI prevention.66 high-risk patients received PREVENTIVE cisternal therapy to enhance blood clearance.Either stereotactic catheter ventriculocisternostomy(STX-VCS)or intraoperative placement of a cisterno-ventriculostomy catheter(CVC),followed by fibrinolytic cisternal lavage using urokinase was performed.In case of vasospasm,nimodipine was applied intrathecally.22 low-risk patients who developed CVS against expectations were selected for STX-VCS as RESCUE intervention for cisternal spasmolysis with nimodipine.Rates of DCI and mean flow velocities of daily transcranial Doppler(TCD)ultrasonographies were evaluated.Results Despite a higher prespecified DCI risk,patients selected for PREVENTIVE intervention primarily aiming at blood clearance had a lower DCI rate compared with patients selected for intrathecal spasmolysis as a RESCUE therapy(11.3%vs 18.2%).After intrathecal treatment onset,CVS(TCD>160 cm/s)occurred in 45%of patients with PREVENTIVE and 77%of patients with RESCUE therapy(p=0.013).A stronger response of CVS to intrathecal nimodipine was observed in patients with PREVENTIVE intervention as the mean CVS duration after start of intrathecal nimodipine was 3.2 days compared with 5.8 days in patients with RESCUE therapy(p=0.026).Conclusions PREVENTIVE cisternal therapy directed at blood clearance is more effective for the prevention of CVS and delayed infarction compared with cisternal RESCUE spasmolysis.
