OBJECTIVES/GOALS: Studies to improve uptake of Chronic Obstructive Pulmonary Disease Clinical Practice Guidelines (COPD CPG) have yielded inconsistent results. We hypothesized that using implementation science would facilitate rigorous site ‘diagnosis’, and promote effective contextual tailoring of COPD CPG, while piloting the use of telehealth for this. METHODS/STUDY POPULATION: The study was conducted in two Veterans Affairs primary care clinics located in a small sized city. A detailed formative evaluation was conducted using key informant interviews (with VA staff and veterans with COPD who received care at this location) and quantitative data. Multidisciplinary stakeholder group was engaged and strategies to address the determinants identified through the previous step were identified. Telehealth was strongly encouraged as the primary modality for implementing the COPD CPG and we are collecting pilot data on this. Tele-Facilitation, used as the meta-strategy was employed in conjunction with other strategies such as develop/distribute educational materials, tailor strategies, change record systems and revise professional roles. RESULTS/ANTICIPATED RESULTS: Primary Care at the VA is provided by Patient Aligned Care Teams (PACT-teams), where each team consists of multiple health professionals to provide collaborative care to the patient. Discussions with the multidisciplinary stakeholder team suggested that any implementation effort primarily focused on physician and nursing efforts was unlikely to succeed due to competing demands. A pharmacy-centric model that allowed for the PACT-team clinical pharmacist to address most of the COPD CPG (inhaler technique education/assessment, inhaler choice optimization, COPD-specific patient education, spirometry use, smoking and immunization) was developed and implemented with incorporation of telehealth (video visits and telephone). We will present pilot implementation outcomes using RE-AIM framework elements. DISCUSSION/SIGNIFICANCE: This use of implementation science to implement COPD CPG and novel use of telehealth has enormous potential for impact. Increasing reach/adoption by targeting primary care practices can help permeate quality care to the underserved population. This data will allow us to explore generalizability through wider scale implementation studies.

Interaction of extreme ultraviolet (EUV) pulses of high intensity with gases results in the creation of non-thermalized plasmas. Energies of the driving photons and photoelectrons are sufficient for creation of excited states, followed by emission of the EUV photons. In most cases, decay times of these states are short comparing to the driving EUV pulse. It means that just after stopping of the driving pulse, the EUV emission corresponding to the excited states should also stop. From our earlier measurements in the optical range, however, it can be concluded that lifetimes of such plasmas exceed a time duration of the driving pulse even two orders of magnitude. Hence, it can be expected that the time duration of the EUV emission can be also significantly longer than the irradiation time. In this work, EUV-induced, low-temperature helium (He), krypton, and xenon plasmas were investigated. EUV emission from these plasmas was studied, using a specially prepared detection system, allowing for time-resolved measurements, in selected spectral ranges. The detection system was based on a paraboloidal collector and a semiconductor photodiode, sensitive for the EUV photons. For spectral selection, the corresponding filters or multilayer mirrors were employed. In most cases, the time duration of the EUV emission was significantly longer than the driving EUV pulse. In case of He plasmas, the emission corresponding to excited atoms was detected even hundreds of nanoseconds after the irradiation. It was also shown that the corresponding time profiles depended on densities of gases to be ionized.

Irradiation of gases with intense pulses of extreme ultraviolet (EUV) can result in the formation of low-temperature plasmas. During the time of irradiation, various non-thermal processes driven by the EUV photons and photoelectrons take place, leading to the creation of excited states of atoms and ions. Fast relaxation of these states should result in EUV emission within a time comparable to the driving EUV pulse. On the other hand, from our earlier works, a time duration of the emission in an optical range is over an order of magnitude longer. It can be thus expected that the time of EUV emission can be also relatively long. In this work, time-resolved measurements of the EUV emission from low-temperature plasmas induced in He, Ne, and Ar gases were performed. Due to a low intensity of the emitted radiation, a specially prepared detection system, based on an EUV collector and an EUV sensitive photodiode, was employed. In all cases, a time duration of the EUV emission was much longer compared with the driving EUV pulse. Time profiles of the corresponding signals were specific for particular gases. In case of He and Ne plasmas, these time profiles varied with initial densities of gases to be ionized. The corresponding dependence was especially visible in case of plasmas induced in helium. In case of Ar plasmas, such dependence was not revealed.

In this work, extreme ultraviolet (EUV) emission, from EUV induced, low-temperature microplasmas, were investigated. To perform temporal measurements of the EUV pulses of low intensity, in a medium vacuum, under the pressure of the order of 0.1–0.01 mbar a special detection system was prepared. The system was based on an EUV collector and a semiconductor detector, sensitive for the EUV photons. The collector consisted of two identical grazing incidence, paraboloidal mirrors, and allowed to focus a part of the radiation emitted from the microplasma onto the detector surface. An absorption filter, mounted between the collector and the detector, allowed for selection of an interesting wavelength range. Plasmas were created by irradiation of small portions of gases, injected into the vacuum chamber, using a laser produced plasma EUV source. Three gases were used for the EUV induced plasma formation: neon, krypton, and xenon. Low-temperature plasmas, created in these gases, contained multiply charged ions, emitting radiation in similar wavelength ranges. Two detectors, AXUV20HS1 and AXUVHS5, were used for the measurements. It was shown that differences between the corresponding signal profiles, obtained using both detectors, were not very significant. Moreover, it was demonstrated that the duration of the EUV emission from plasmas, created in different gases, were comparable with the duration of the driving EUV pulse. The longest EUV emission was observed for Kr plasmas, approximately 1.5 times the full width half maximum of the driving EUV pulse.

In this work, a comparative study of low-temperature plasmas, induced in a gaseous nitrogen by photoionization of the gas using two different irradiation systems, was performed. Both systems were based on laser-produced Xe plasmas, emitting intense extreme ultraviolet (EUV) radiation pulses in a wide wavelength range. The essential difference between the systems concerned formation of the EUV beam. The first one utilized a dedicated ellipsoidal mirror for collecting and focusing of the EUV radiation. This way a high radiation fluence could be obtained for ionization of the N2 gas injected into the vacuum chamber. The second system did not contain any EUV collector. In this case, the nitrogen to be ionized was injected into the vicinity of the Xe plasma. In both cases, energies of emitted photons were sufficient for dissociative ionization, ionization of atoms or even ions. The resulting photoelectrons had also sufficiently high energy for further ionizations or excitations. Low-temperature plasmas, created this way, were investigated by spectral measurements in the EUV, ultraviolet (UV) and visible (VIS) spectral ranges. Time-resolved UV/VIS spectra, corresponding to single-charged ions, molecules, and molecular ions, were recorded. Numerical simulations of the molecular spectra were performed allowing one to estimate vibrational and rotational temperatures of plasmas created using both irradiation systems.

In this paper, we present the application of partially spatially coherent extreme ultraviolet (EUV) radiation from xenon plasma from a laser-plasma source, based on a double stream gas puff target, in coherent imaging. The radiation at the wavelength of 13.5 ± 0.5 nm was employed to record Gabor-type holograms. An iterative algorithm, based on a phase retrieval technique, was developed and used to remove the twin image from the reconstructed EUV image of test objects. Using partially coherent radiation from a compact, laser-plasma source based on a double stream gas puff target, which is intrinsically incoherent, a Gabor EUV holography was successfully demonstrated.

Identification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007–2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45% were among reported MSM and an anorectal swab was performed in 40% of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87%, specificity = 99%, positive predictive value = 98·6%, negative predictive value = 90·3%). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.

In this work, a laser-produced plasma source was used to create xenon (Xe) photoionized plasmas. An extreme ultraviolet (EUV) radiation beam was focused onto a gas stream, injected into a vacuum chamber synchronously with the EUV pulse. Energies of photons exceeding 100 eV allowed for inner-shell ionization of Xe atoms. Creation of N-shell vacancies resulted in N-shell fluorescence and was followed by multiple ionization. Time-integrated EUV spectra, corresponding to excited states in Xe II–V ions, were recorded. Several emission lines detected in the 39–65 nm wavelength range were not reported earlier. They were not identified due to lack of a corresponding information in published databases. Except spectral measurements in the EUV range, time resolved ultraviolet and visible spectra, originating from Xe II and III ions, were recorded. For spectral lines, corresponding to radiative transitions in Xe II ions, electron temperature was calculated based on a Boltzmann plot method. Based on this method the temperature was measured for different time delays according to the driving EUV pulses.

Twin gestation is known to be a risk factor for hypertensive disorders of pregnancy. However, the relationship between hypertensive disorders (pre-eclampsia (PE) and gestational hypertension (GH)) and chorionicity of twin pregnancy is unclear, and published data is conflicting. We decided to analyze the relationship between placentation and prevalence of hypertensive disorders. It was a retrospective cohort study. 312 twin pregnancies delivered between 2009 and 2014 were analyzed, 79 of which were monochorionic and 233 dichorionic. The occurrence of PE and GH was established according to American College of Obstetricians and Gynecologists’ (ACOG) guidelines. Hypertensive disorders were diagnosed significantly more often in dichorionic than in monochorionic twin pregnancies (19.7% vs. 8.9%; OR = 2.53 95% CI 1.04–6.45; p = .03). PE occurred more frequently in DCP (13.3% vs. 3.8%; OR = 3.88 95% CI 1.09–16.46; p = .02). There were no differences between those two groups in the prevalence of GH (6.4% vs. 5.1%; p = .79). The logistic regression model for the occurrence of PE included chorionicity, mother's age lower than 18 or higher than 40, pre-gestational obesity, in vitro fertilization, primiparity, gestational age at delivery, gestational diabetes, and active smoking. It showed that dichorionicity remained an independent risk factor for PE (adjusted OR = 4.97.0 95% CI 1.06–23.38; p = .04). Dichorionicity seems to be a risk factor for PE but not for GH development.

Short illumination wavelength allows an extension of the diffraction limit toward nanometer scale; thus, improving spatial resolution in optical systems. Soft X-ray (SXR) radiation, from “water window” spectral range, λ=2.3–4.4 nm wavelength, which is particularly suitable for biological imaging due to natural optical contrast provides better spatial resolution than one obtained with visible light microscopes. The high contrast in the “water window” is obtained because of selective radiation absorption by carbon and water, which are constituents of the biological samples. The development of SXR microscopes permits the visualization of features on the nanometer scale, but often with a tradeoff, which can be seen between the exposure time and the size and complexity of the microscopes. Thus, herein, we present a desk-top system, which overcomes the already mentioned limitations and is capable of resolving 60 nm features with very short exposure time. Even though the system is in its initial stage of development, we present different applications of the system for biology and nanotechnology. Construction of the microscope with recently acquired images of various samples will be presented and discussed. Such a high resolution imaging system represents an interesting solution for biomedical, material science, and nanotechnology applications.

The results of formation of elongated krypton/helium plasma channels are presented. Two laser pulses were used: one to produce plasma channels and the second one for conversion to soft X rays. The soft X-ray radiation was in turn used for backlighting the channels and their visualization. The study of their formation and uniformity was performed using a combination of soft X-ray shadowgraphy and pinhole camera imaging. The plasma channels, with various lengths and various densities, were visualized and the results of their characterization are presented. Using moderate laser pulse energy quite uniform channels, up to 9 mm in length, were demonstrated.

In this work, two laser-produced plasma (LPP) sources – extreme ultraviolet (EUV) and a LPP soft X-ray (SXR) source were used to create Ne photoionized plasmas. A radiation beam was focused onto a gas stream, injected into a vacuum chamber synchronously with the radiation pulse. EUV radiation spanned a wide spectral range with pronounced maximum centered at λ≈11 nm, while in case of the SXR source spectral maximum was at λ≈1.4 nm. Emission spectra of photoionized plasmas created this way were measured in a wide spectral range λ = 10–100 nm. The dominating spectral lines originated from singly charged ions (Ne II) and neutral atoms (Ne I). For the highest radiation fluence, spectral lines originating from Ne III and even Ne IV species were detected. Differences between the experimental spectra, obtained for all irradiation conditions, were analyzed. They were attributed either to different fluence or spectral distribution of driving photons.

Characterization measurements and modes of operation of a novel, dual-gas multi-jet target, developed for experiments on high-order harmonic generation, are presented. The target has been formed by pulsed injection of argon through a nozzle in a form of linearly oriented small orifices. The argon jets were separated with the helium jets formed by injection of helium through alternate orifices in the nozzle. The targets have been characterized by extreme ultraviolet backlighting at 13.5 nm wavelength. Density profiles for this type of targets have been obtained, to our knowledge, for the first time.

In this work, a laser-produced plasma extreme ultraviolet source and a free electron laser were used to create Ne photo-ionized plasmas. In both cases, a radiation beam was focused onto a gas stream injected into a vacuum chamber synchronously with the radiation pulse. Extreme ultraviolet radiation from the plasma spanned a wide spectral range with pronounced maximum centered at λ = 11 ± 1 nm while the free electron laser pulses were emitted at a wavelength of 32 nm. The power density of the focused plasma radiation was approximately 2 × 107 W/cm2 and was seven orders of magnitude lower compared with the focused free electron laser beam. Radiation fluences in both experimental conditions were comparable. Despite quite different spectral characteristics and extremely different power densities, emission spectra of both photo-ionized plasmas consist of the same spectral lines within a wavelength range of 20 to 50 nm, however, with different relative intensities of the corresponding lines. The dominating spectral lines originated from singly charged ions (Ne II); however, Ne III lines were also detected. Additionally, computer simulations of the emission spectra, obtained for photo-ionized plasmas, driven by the plasma extreme ultraviolet source, were performed. The corresponding measured and calculated spectra are presented. An electron temperature and ionic composition were estimated. Differences between the experimental spectra, obtained for both irradiation conditions, were analyzed. The differences were attributed mainly to different energies of driving photons.

Record-brightness infrared LEDs based on colloidal quantum-dots have been achieved through control of the spacing between adjacent quantum-dots. By tuning the size of quantum-dots, the emission wavelengths can be tuned between 900nm and 1650nm.

We report an interesting property of carbon dots: they emit light under charge injection. We synthesized carbon dots in diameter about 20 nm using wet chemistry methods. The photoluminescence quantum efficiency of the carbon dots dissolved in water was about 11%. We observed strong electrogenerated chemiluminescence (ECL) from the sample. This observation of ECL from carbon dots indicates that they could be a good candidate material for carbon-based electroluminescent devices.

A considerable improvement in the selection of haploids in Aspergillus nidulans is described. Haploidization is used to assign genes to linkage groups (chromosomes) in fungi. The differential effect of a polyene antibiotic, N-glycosyl-polifungin, in respect to haploids and diploids, was utilized. In minimal medium only diploids (constructed from a ‘Master Strain’ and the investigated strain), which are fully heterozygous and thus have no growth requirements, germinate and are killed by the antibiotic. However, auxotrophic haploids, either induced or spontaneously formed, survive. These can then be used for linkage studies.

We report the first studies on the formation of an elongated plasma column suitable for X-ray laser experiments, using a gas puff target irradiated with a high-power laser. The gas puff targets, produced by pulsed injection of a small amount of gas from a high-pressure solenoid valve through a nozzle in the form of a slit, have been characterized by optical interferometry and X-ray backlighting. The formation of a hot plasma column up to 30-mm-long is demonstrated. The spatial uniformity of the column was monitored by means of an X-ray pinhole camera. XUV spectra measurements for SF6 gas puff targets show predominant 3–2 line of hydrogenic fluorine (λ = 8.1 nm), however, only linear increasing of its intensity with the target length was observed.

A new method of generation of nanosecond soft X-ray pulses with a photon energy around 1 keV is presented. X-rays are generated in a high-temperature plasma, which is created as a result of the interaction of Nd:glass laser radiation with a gas puff target. The target was obtained by puffing a small amount of gas through the nozzle into the vacuum chamber by means of a pressure electromagnetic valve. The pulses of laser radiation, with pulse duration of 1 ns and energy up to 15 J, generated in the system of a high-power Nd:glass laser were used for the target heating. Spatial, spectral, and temporal measurements of X-ray emission have shown that the high-intensity soft X rays are generated as a result of the interaction of nanosecond pulses of Nd:glass laser radiation with the gas puff target. A high efficiency of X-ray generation is suggested to be related to the effect of condensation of the gas outflowing from the valve nozzle and, in effect, to the interaction of laser radiation with matter in a form of aerosol.