Experience of Anti-VEGF Treatment and Clinical Levels of Depression and Anxiety in Patients With Wet Age-Related Macular Degeneration

PURPOSE: To investigate detailed patient experiences specific to receiving vascular endothelial growth factor inhibitors (anti-VEGF) for wet age-related macular degeneration (wAMD), and to acquire a snapshot of the frequency of clinically significant levels of depression, anxiety, and posttraumatic stress among patients and levels of burden in patients’ carers. DESIGN: Observational cross-sectional mixed-methods study. METHODS: Three hundred patients with wAMD receiving anti-VEGF treatment and 100 patient carers were recruited. Qualitative data on patients’ experience of treatment were collected using a structured survey. Standardized validated questionnaires were used to quantify clinically significant levels of anxiety, depression, and posttraumatic stress, as well as cognitive function and carers’ burden. RESULTS: Qualitative data showed that 56% of patients (n =132) reported anxiety related to antiVEGF treatment. The main sources of anxiety were fear of going blind owing to intravitreal injections and concerns about treatment effectiveness, rather than around pain. From validated questionnaires, 17% of patients (n= 52) showed clinical levels of anxiety and 12% (n =36) showed clinical levels of depression. Depression levels, but not anxiety, were significantly higher in patients who received up to 3 injections compared with patients who received from 4 to 12 injections (analysis of variance [ANOVA] P = .027) and compared with patients who received more than 12 injections (ANOVA P = .001). CONCLUSIONS: Anti-VEGF treatment is often experienced with some anxiety related to treatment, regardless of the number of injections received. Clinical levels of depression seem to be more frequent in patients at early stages of anti-VEGF treatment. Strategies to improve patient experience of treatment and minimize morbidity are suggested

Multifractal patterns formed by laser irradiation in GeAl thin multilayer films

Structures induced in GeAl thin multilayer films by laser irradiation are studied. We compute their multifractal spectra from digitized transmission-electron micrographs. The results show that the patterns, which arise from a diffusion process followed by rapid solidification, are fractal, and that they cannot be described by a unique scaling exponent. © 1992 The American Physical Society.This work was partially supported by the Comision Interrninisterial de Ciencia y Tecnologia (CICyT) of Spain under Project Nos. MAT88-0437 and MAT90-0544.Peer Reviewe

Multifractal patterns formed by laser irradiation in GeAl thin multilayer films

Structures induced in GeA1 thin multilayer films by laser irradiation are studied. We compute their multifractal spectra from digitized transmission-electron micrographs. The results show that the patterns, which arise from a diH'usion process followed by rapid solidification, are fractal, and that they cannot be described by a unique scaling exponentThis work was partially supported by the Comision Interrninisterial de Ciencia y Tecnologia (CICyT) of Spain under Project Nos. MAT88-0437 and MAT90-0544.Publicad

Nanocrystal size dependence of the third-order nonlinear optical response of Cu:Al2O3 thin films

3 pages, 3 figures.Metal nanocomposite thin films formed by Cu nanocrystals embedded in an amorphous Al2O3 host have been synthesized by pulsed laser deposition. The mean nanocrystal diameter d was varied in the range 3.0 ± 0.6 to 6 ± 1 nm. The linear and nonlinear optical properties of the films were studied in the vicinity of the surface plasmon resonance and the size dependence of the third-order nonlinear optical susceptibility of the metal nanocrystals has been determined. The observed dependence (1/d3) indicates that in the studied diameter interval, the nonlinear response is due to quantum confinement effects in which the major contribution is associated with electronic intraband transitions.This work has been partially supported by CICYT (Spain) under TIC 96-0467 project and by the EU under BRPR-CT98-0616 project. We acknowledge Dr. I. Vickridge (University of Paris VI et VII, France) for his assistance with RBS techniques.Peer reviewe

Interaction of ballistic quasiparticles and vortex configurations in superfluid He3-B

The vortex line density of turbulent superfluid He3-B at very low temperature is deduced by detecting the shadow of ballistic quasiparticles which are Andreev reflected by quantized vortices. Until now the measured total shadow has been interpreted as the sum of shadows arising from interactions of a single quasiparticle with a single vortex. By integrating numerically the quasi-classical Hamiltonian equations of motion of ballistic quasiparticles in the presence of nontrivial but relatively simple vortex systems (such as vortex-vortex and vortex-antivortex pairs and small clusters of vortices) we show that partial screening can take place, and the total shadow is not necessarily the sum of the shadows. We have also found that it is possible that, upon impinging on complex vortex configurations, quasiparticles experience multiple reflections, which can be classical, Andreev, or both.Comment: To appear in Phys Rev

Two-Temperature Intracluster Medium in Merging Clusters of Galaxies

We investigate the evolution of intracluster medium during a cluster merger, explicitly considering the relaxation process between the ions and electrons by N-body and hydrodynamical simulations. When two subclusters collide each other, a bow shock is formed between the centers of two substructures and propagate in both directions along the collision axis. The shock primarily heats the ions because the kinetic energy of an ion entering the shock is larger than that of an electron by the ratio of masses. In the post-shock region the energy is transported from the ions to electrons via Coulomb coupling. However, since the energy exchange timescale depends both on the gas density and temperature, distribution of electron temperature becomes more complex than that of the plasma mean temperature, especially in the expanding phase. After the collision of two subclusters, gas outflow occurs not only along the collision axis but also in its perpendicular direction. The gas which is originally located in the central part of the subclusters moves both in the parallel and perpendicular directions. Since the equilibrium timescale of the gas along these directions is relatively short, temperature difference between ions and electrons is larger in the directions tilted by the angles of $\pm 45^\circ$ with respect to the collision axis. The electron temperature could be significantly lower that the plasma mean temperature by $\sim 50$ at most. The significance of our results in the interpretation of X-ray observations is briefly discussed.Comment: 20 pages, 11 figures, Accepted for publication in Ap

Spectroscopic ellipsometry of composite thin films with embedded Bi nanocrystals

8 pages, 6 figures, 1 table.-- PACS: 78.66.Jg; 78.66.Nk; 78.20.Ci; 68.55.Ln; 07.60.Fs; 81.05.Ys; 68.55.JkSpectroscopic ellipsometry together with an effective medium model is used to determine simultaneously the effective refractive index, thickness, and metal volume fraction of thin nanocomposite films. The films are formed by Bi nanocrystals embedded in amorphous matrices, either semiconducting (Ge) or dielectric (Al2O3). For the Bi:Ge films (metal in an absorbing host), the values obtained for both the real and imaginary parts of the refractive index vary continuously from that of Ge to that of Bi. The metal contents determined from the ellipsometry analysis are in excellent agreement with those obtained from direct measurements of the composition. For the Bi:Al2O3 films (metal in a nonabsorbing host), the extinction coefficient (k) exhibits a maximum around 360 nm which is related to the metal plasmon resonance frequency of Bi nanocrystals. The metal content determined from the ellipsometry analysis in this case is underestimated, probably due to interaction of the Bi crystals with the Al2O3 host.This work has been partially supported by CICYT (Spain) under TIC96-0467 project. The authors are grateful to the GPS (Université de Paris VI et VII, France) for provision and assistance of Rutherford backscattering facilities. One of the authors (J.M.B.) greatly acknowledges a FPI grant from the Spanish Ministry of Education and Culture.Peer reviewe

OptEEmAL: Decision-Support Tool for the Design of Energy Retrofitting Projects at District Level

Designing energy retrofitting actions poses an elevated number of problems, as the definition of the baseline, selection of indicators to measure performance, modelling, setting objectives, etc. This is time-consuming and it can result in a number of inaccuracies, leading to inadequate decisions. While these problems are present at building level, they are multiplied at district level, where there are complex interactions to analyse, simulate and improve. OptEEmAL proposes a solution as a decision-support tool for the design of energy retrofitting projects at district level. Based on specific input data (IFC(s), CityGML, etc.), the platform will automatically simulate the baseline scenario and launch an optimisation process where a series of Energy Conservation Measures (ECMs) will be applied to this scenario. Its performance will be evaluated through a holistic set of indicators to obtain the best combination of ECMs that complies with user's objectives. A great reduction in time and higher accuracy in the models are experienced, since they are automatically created and checked. A subjective problem is transformed into a mathematical problem; it simplifies it and ensures a more robust decision-making. This paper will present a case where the platform has been tested.This research work has been partially funded by the European Commission though the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement No 680676. All related information to the project is available at https://www.opteemal-project.eu