An optical coupling method with high alignment tolerance by self-written waveguide (SWW) formation is a promising candidate for co-packaged optics (CPO) by silicon photonics (SiPh). However, conventional SWWs cannot be used with Si waveguides because visible light for SWW formation cannot radiate from the waveguide facet. Here, we devised a new, to the best of our knowledge, optical circuit with SiOxNy waveguides for SWW formation from an SiPh chip. With our circuit, we achieved optical coupling between an SiPh chip and a standard single-mode fiber (SSMF) with a tapered SWW (TSWW). The lowest excess coupling loss compared to butt coupling with a high-numerical aperture (NA) fiber is approximately 0.6 dB over the C-band with the TSWW. In addition, our coupling method has higher alignment tolerances than butt coupling with a high-NA fiber (HNF).We show here that light polarization of a beam propagating through a heliconical cholesteric cell can be controlled by tuning the Bragg resonance of the structure. We demonstrate that this control is achieved by varying either the low-frequency electric field or the intensity of a pump beam impinging on the sample. The study confirms the recently reported phenomenon of optical tuning of the heliconical cholesterics and opens the door for the development of simple and efficient polarization modulators controlled electrically or optically.Spatial division multiplexing (SDM) is one of the most important technologies that may help to solve the future capacity crisis. However, to date, SDM optical amplification is still a challenge for its application. Herein, we numerically and experimentally demonstrated a few-mode Er/Yb co-doped fiber amplifier (FM-EYDFA) for extended L-band operation. A double cladding Er/Yb co-doped fiber was fabricated to expand the L-band bandwidth and a novel, to the best of our knowledge, cladding-pumped pseudo-two-stage amplification configuration was proposed to enhance the L-band gain. With an initial signal power of -16.8 dBm and an injected pump power of 8.8 W at 940 nm, the 20-dB gain range was covered to 1620 nm for two-mode groups of LP01 and LP11. Importantly, the average gain of 25 dB and average differential modal gain (DMG) of less then 1 dB were obtained in the wavelength range of 1570-1620 nm for all modes. Our results suggest that the cladding-pumped pseudo-two-stage amplifier based on Er/Yb co-doped fiber providing low DMG, and broad bandwidth has a great potential for increasing the future SDM capacity.Focal plane array (FPA) detectors have escalated Fourier transform infrared (FTIR) microspectroscopy to a potent hyperspectral imaging method. Yet, despite the instrumental multiplex/multichannel advantages, the fidelity of the hyperspectral images relies on the throughput as the total flux of the source is divided among each FPA pixel. Additionally, maintaining the spectral resolution requires a certain level of collimation of the beam which adversely affect the flux of high étendue source. To this end, we propose an implementation of two deformable mirror (DM) sensorless adaptive optics system for infrared (IR) source coupling. The deflection shape of each DM membrane is optimized individually to deal with the beam intensity and the rays' direction in a separate manner, while preserving the spectral quality across the entire mid-IR range. This paper contemplates the choice of metrics in sequential optimization in conjunction with two variations of stochastic parallel gradient descent optimization algorithm. We discuss this approach with respect to a state-of-the-art FTIR microscope.Realizing a densely packed waveguide antenna array is of great importance in light detection and ranging (LIDAR), owing to its suppressed grating lobes. In this work, a low-cross-talk half-wavelength pitch silicon waveguide array is proposed and experimentally demonstrated. It has a periodic arrangement of silicon strip nanophotonic waveguides, between which deep-subwavelength silicon strips are placed. Our experimental results show that this array's cross talk suppression is nearly 20 dB and has a bandwidth covering a wavelength range from 1500 nm to 1560 nm. Our realization of a half-wavelength pitch waveguide array may offer a promising platform for studying integrated optical phased arrays for solid-state LIDAR with a very low grating lobe and thus potentially a large field of view.In non-Hermitian quasicrystals, mobility edges (ME) separating localized and extended states in the complex energy plane can arise as a result of non-Hermitian terms in the Hamiltonian. Such ME are of topological nature, i.e., the energies of localized and extended states exhibit distinct topological structures in the complex energy plane. However, depending on the origin of non-Hermiticity, i.e., asymmetry of hopping amplitudes or complexification of the incommensurate potential phase, different winding numbers are introduced, corresponding to different transport features in the bulk of the lattice while ballistic transport is allowed in the former case, pseudo-dynamical localization is observed in the latter case. The results are illustrated by considering non-Hermitian photonic quantum walks in synthetic mesh lattices.We systematically demonstrated the angular and temperature acceptances of noncritical phase-matching (NCPM) fourth- and fifth-harmonic generation (FHG and FiHG) of a 1077 nm laser in NH4H2PO4 (ADP), KH2PO4 (KDP), and KD2PO4 (DKDP) crystals. In this work, a new, to the best of our knowledge, laser frequency with a wavelength of 1077 nm was generated by optical parametric amplification, in which the pump light (526.3 nm) was generated by the frequency doubling of a NdYLF laser (1052.7 nm), and the signal light was a YbYAG laser (1029.5 nm). Subsequently, the 1077 nm laser was used as the fundamental wave for FHG and FiHG to obtain a deep-ultraviolet laser source. For ADP and DKDP crystals, NCPM FHG of a 1077 nm laser was realized at 74.0∘C and 132.5∘C, respectively, and large angular acceptances of 59.8 and 61.6 mrad were measured. For the FiHG, NCPM was realized in a KDP crystal at 48.5∘C with an angular acceptance of 56.4 mrad. The results pave the way for high-energy and high-power deep-ultraviolet laser generation using KDP-family crystals under noncryogenic conditions.A binary-lens-embedded photonic crystal (B-LEPC) was designed for operation at 1550 nm and fabricated by multiphoton lithography. The lens is binary in the sense that optical path difference is generated using unit cells having just two distinct fill factors. The unit cells have a "rod-in-wall" structure that exhibits three-dimensional self-collimation. Simulations show that self-collimation forces light to move through the device without diffracting or focusing, even as the wavefront is reshaped by the lensing region. Upon exiting the device, the curved wavefront causes the light to focus. The thickness of a B-LEPC was reduced threefold by wrapping phase in the style of a Fresnel lens. Embedding a faster-varying phase profile enables tighter focusing, and numerical aperture NA = 0.59 was demonstrated experimentally.Continuous-variable quantum key distribution (CV-QKD) is a protocol that uses quantum mechanics to ensure that the distribution of an encryption key is secure even in the presence of eavesdroppers. The wide application of CV-QKD requires low cost, system simplicity, and system stability. However, owing to the particularity of Gaussian modulation in CV-QKD, an amplitude modulator (AM) and a bias controller are required, making the system structure complex and unstable. In this Letter, we achieve two-dimensional Gaussian modulation with only one phase modulator (PM) and a Sagnac ring structure, which significantly reduces the complexity of the system. We test the Gaussian modulation stability for 10 h, and the result shows that the expected secure key rate can be maintained at 80 kbit/s under a transmission distance of 50 km. This scheme opens up new, to the best of our knowledge, possibilities for a new generation of highly stable and simple CV-QKD systems.
Intravenous fluids are recommended for the treatment of patients who are in septic shock, but higher fluid volumes have been associated with harm in patients who are in the intensive care unit (ICU).

In this international, randomized trial, we assigned patients with septic shock in the ICU who had received at least 1 liter of intravenous fluid to receive restricted intravenous fluid or standard intravenous fluid therapy; patients were included if the onset of shock had been within 12 hours before screening. https://www.selleckchem.com/products/bozitinib.html The primary outcome was death from any cause within 90 days after randomization.

We enrolled 1554 patients; 770 were assigned to the restrictive-fluid group and 784 to the standard-fluid group. Primary outcome data were available for 1545 patients (99.4%). In the ICU, the restrictive-fluid group received a median of 1798 ml of intravenous fluid (interquartile range, 500 to 4366); the standard-fluid group received a median of 3811 ml (interquartile range, 1861 to 6762). At 90 days, death had occurred r deaths at 90 days than standard intravenous fluid therapy. (Funded by the Novo Nordisk Foundation and others; CLASSIC ClinicalTrials.gov number, NCT03668236.).
In primary care, general practitioners (GPs) unavoidably reach a clinical judgement about a patient as part of their encounter with patients, and so clinical judgement can be an important part of the diagnostic evaluation. Typically clinical decision making about what to do next for a patient incorporates clinical judgement about the diagnosis with severity of symptoms and patient factors, such as their ideas and expectations for treatment. When evaluating patients for dementia, many GPs report using their own judgement to evaluate cognition, using information that is immediately available at the point of care, to decide whether someone has or does not have dementia, rather than more formal tests.

To determine the diagnostic accuracy of GPs' clinical judgement for diagnosing cognitive impairment and dementia in symptomatic people presenting to primary care. To investigate the heterogeneity of test accuracy in the included studies.

We searched MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP), Web depression - may suffer delayed intervention for an alternative treatable pathology.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with late complications that can impair the quality of life (QoL) of patients for years after transplant. The purpose of the present study was to determine the difference in the QoL of adults that underwent allo-HSCT in childhood and adolescence compared with not transplanted adults.

In this prospective case-control cross-sectional study, we included patients aged ≥18 years that received an allo-HSCT during childhood or adolescence and subsequently survived at least 2 years after transplantation. The control group consisted of blood donors matched for age and sex. QoL assessment was performed using the Short Form-36 (SF-36) Health Survey, Portuguese version 2.

Thirty-four transplanted patients and controls were included. 58.8% were male, and the median age at transplant was 13.5 years (range, 4-17 years). The median follow-up was 11.5 years (range, 2.0-23.0 years). The most common late effect was skeletally followed by endocrine complications.