High-peak-power optically pumped passively mode-locked semiconductor laser with minimal components

A high-peak-power sub-500-fs mode-locked optically pumped semiconductor laser is innovatively developed with only three components of a semiconductor gain chip, a semiconductor saturable absorber, and a focusing lens. The developed laser near the threshold pump power of 3.9 W can be operated with stable fundamental mode locking. The laser output can be naturally turned into the stable harmonic mode locking (HML) with the order gradually changing from 2nd to 8th by increasing the pump power from 4.0 W to 5.0 W. Due to the onset of the high-order transverse modes, the order of HML is fixed at 8th for a pump power greater than 5.0 W. For the HML with order less than 8th, the overall peak power and pulse width in the HML are approximately 0.36 kW and 550 fs, respectively. In the operation of 8th-order HML, the minimum pulse width and maximum peak power can reach 480 fs and 0.95 kW, respectively.

Structured transverse modes governed by maximum entropy principle

Based on the birefringent effect of the gain medium, a diode-pumped Nd-doped vanadate laser with nearly hemispherical cavity is exploited to emulate the quantum Green functions of two-dimensional commensurate harmonic oscillators. By matching the theoretical calculations to the far-field patterns of lasing modes, the resonant transverse frequencies can be accurately determined up to extremely high orders. The Shannon entropy is further employed to calculate the spatial entanglement of the quantum Green function as a function the transverse frequency. From the resonant transverse frequencies, all lasing modes are confirmed to be in excellent agreement with the maximum entropy states. This discovery implies that the formation of lasing modes is relevant to the coupling interaction between the pump source and the laser cavity.

Quantum entanglement by a beam splitter analogous to laser mode transformation by a cylindrical lens

Quantum entanglement by a beam splitter (BS) is shown to be analogous to laser mode transformation by an astigmatic mode converter (AMC). Schmidt decomposition is used to characterize the entanglement by an AMC for generating orbital angular momentum and by a BS for creating quantum photon interference. The probability distributions of Schmidt decomposition are calculated to manifest the sameness and difference between AMC and BS in generating entanglement. Finally, the theoretical patterns of mode transformations by an AMC are confirmed with experimental results to validate the present analysis.

Effect of a Novel Macrophage-Regulating Drug on Wound Healing in Patients With Diabetic Foot Ulcers: A Randomized Clinical Trial

IMPORTANCE

Delayed healing of diabetic foot ulcers (DFUs) is known to be caused by dysregulated M1/M2-type macrophages, and restoring the balance between these macrophage types plays a critical role in healing. However, drugs used to regulate M1/M2 macrophages have not yet been studied in large randomized clinical trials.

OBJECTIVE

To compare the topical application of ON101 cream with use of an absorbent dressing (Hydrofiber; ConvaTec Ltd) when treating DFUs.

DESIGN, SETTING, AND PARTICIPANTS

This multicenter, evaluator-blinded, phase 3 randomized clinical trial was performed in 21 clinical and medical centers across the US, China, and Taiwan from November 23, 2012, to May 11, 2020. Eligible patients with debrided DFUs of 1 to 25 cm2 present for at least 4 weeks and with Wagner grade 1 or 2 were randomized 1:1 to receive ON101 or control absorbent dressings.

INTERVENTIONS

Twice-daily applications of ON101 or a absorbent dressing changed once daily or 2 to 3 times a week for 16 weeks, with a 12-week follow-up.

MAIN OUTCOMES AND MEASURES

The primary outcome was the incidence of complete healing, defined as complete re-epithelialization at 2 consecutive visits during the treatment period assessed on the full-analysis set (FAS) of all participants with postrandomization data collected. Safety outcomes included assessment of the incidences of adverse events, clinical laboratory values, and vital signs.

RESULTS

In the FAS, 236 eligible patients (175 men [74.2%]; mean [SD] age, 57.0 [10.9] years; mean [SD] glycated hemoglobin level, 8.1% [1.6%]) with DFUs classified as Wagner grade 1 or 2 (mean [SD] ulcer area, 4.8 [4.4] cm2) were randomized to receive either the ON101 cream (n = 122) or the absorbent dressing (n = 114) for as long as 16 weeks. The incidence of complete healing in the FAS included 74 patients (60.7%) in the ON101 group and 40 (35.1%) in the comparator group during the 16-week treatment period (difference, 25.6 percentage points; odds ratio, 2.84; 95% CI, 1.66-4.84; P < .001). A total of 7 (5.7%) treatment-emergent adverse events occurred in the ON101 group vs 5 (4.4%) in the comparator group. No treatment-related serious adverse events occurred in the ON101 group vs 1 (0.9%) in the comparator group.

CONCLUSIONS AND RELEVANCE

In this multicenter randomized clinical trial, ON101 exhibited better healing efficacy than absorbent dressing alone in the treatment of DFUs and showed consistent efficacy among all patients, including those with DFU-related risk factors (glycated hemoglobin level, ≥9%; ulcer area, >5 cm2; and DFU duration, ≥6 months).

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01898923.

Characterizing the spatial entanglement from laser modes analogous to quantum wave functions

The Schmidt decomposition is exploited to study the spatial entanglement of laser transverse modes analogous to quantum Lissajous states. Based on the inverse Fourier transform, the stationary Lissajous state can be analytically derived as a coherent superposition of degenerate Hermite-Gaussian eigenmodes. With the derived stationary state, the Schmidt modes and the participation number N can be employed to evaluate the spatial localization and the quantum entanglement. The larger the participation number, the more localized is the stationary coherent state on the Lissajous figure. Moreover, the larger the participation number, the higher is the spatial entanglement.

Detection rate of breast malignancy of needle localization biopsy of breast microcalcification

OBJECTIVE

The current study aimed to retrospectively assess the cancer detection rate of needle localization biopsy of breast microcalcifications undetectable on sonography.

MATERIALS AND METHODS

Patients who underwent mammography-guided needle localization biopsy of breast microcalcifications undetectable on sonography from January 2005 to December 2017 were included in the study. Patients with incomplete medical records were excluded from the study. Patient mammograms were categorized using the Breast Imaging-Reporting and Data System (BI-RADS) assessment criteria. The percentages of benign and malignant lesions were determined by pathological examination of surgically recovered specimens. Correlation between preoperative imaging assessment and final diagnosis was investigated, and the complications associated with the procedures were recorded.

RESULTS

A total of 301 needle-localized biopsies were performed under mammographic guidance. The mean age of the patients was 58.18 ± 7.73 years. The overall ductal carcinoma in situ (DCIS) and cancer detection rate was 23.3%. The proportion of patients with BI-RADS 0 category and undergoing second mammography was higher in the DCIS and cancer group. A total of 227 patients did not undergo second mammography. Of these patients, 70 demonstrated BI-RADS 4 category, 34 were diagnosed with DCIS, and 5 were diagnosed with breast cancer during subsequent follow-up.

CONCLUSION

Needle-localized excision of microcalcifications undetectable on sonography has high detection rate for early stage of breast cancer with low risk of associated complications. Regular mammography is a satisfactory follow-up tool for female patients with microcalcifications in the breasts. Additional studies should be performed to compare between needle-localized excision and vacuum-assisted breast biopsy.

Propagation-dependent evolution of interfering multiple beams and kaleidoscopic vortex lattices

In this Letter, we experimentally explore the propagation-dependent evolution of generating the pseudo-nondiffracting quasi-crystalline (crystalline) beams based on the multibeam interference. We originally derived an analytical formula to exactly manifest the propagation evolution of interfering multiple beams. With the analytical formula, the formation of quasi-crystalline structures in the focal plane can be explicitly verified. Furthermore, the distance of the effective propagation-invariant region can be verified in terms of experimental parameters. More importantly, we employed the developed formula to confirm the formation of kaleidoscopic vortex lattices by means of numerically computing the propagation-dependent phase singularities.

High-power structured laser modes: manifestation of quantum Green's function

The distributions of resonant frequencies in an astigmatic cavity are theoretically confirmed to be analogously equivalent to the quantum energy structures of two-dimensional commensurate harmonic oscillators. In the first part [Opt. Lett.45, 4096 (2020)OPLEDP0146-959210.1364/OL.399251] of this two-part series study, the lasing modes were verified to reveal a variety of vortex array structures. Here, in the second part of this two-part series study, the lasing modes are confirmed to agree very well with the quantum Green's functions that correspond to a bundle of Lissajous figures in the high-order regime.

Exploiting a monolithic passively Q-switched Nd:YAG laser to mimic a single neuron cell under periodic stimulation

A monolithic passively Q-switched Nd:YAG laser under periodic pulse pumping is originally exploited to emulate the response of a single neuron cell stimulated by periodic pulse inputs. Experimental results reveal that the output characteristics of the monolithic passively Q-switched laser can analogously manifest not only the firing patterns but also the frequency-locked plateaus of the single neuron cell. Moreover, the sine circle map is innovatively used to generate the output pulse sequences that can exactly correspond to experimental firing patterns. The present exploration indicates that a monolithic passively Q-switched solid-state laser is highly feasible to be developed as a compact artificial neuron cell.

High-power structured laser modes: direct generation of a vortex array

The frequency degeneracy induced by the astigmatism in a nearly hemispherical cavity is originally exploited to generate vortex array laser modes with the output power up to 300 mW. The inhomogeneous Helmholtz equation is employed to derive the wave function for manifesting the characteristics of the lasing modes. The theoretical wave function explicitly reveals the role of the Gouy phase in the formation of vortex arrays. Numerical analyses are further performed to confirm that the thermal lensing effect in the laser crystal assists the lasing transverse order to increase with increasing pump power. It is believed that the high efficiency enables the present laser modes to be useful in the applications of structured vortex beams.

Timing jitter reduction of passively Q-switched solid-state lasers by coupling resonance between pumping and firing rates

The coupling resonance between pumping and firing rates is originally proposed to achieve the timing jitter reduction of a Nd:YVO₄ laser passively Q-switched with a saturable absorber. When the pumping rate is higher than the spontaneous emission rate, it is experimentally confirmed that the pulse firing rate can be fractionally locked with the pumping rate by controlling the pump power. The locking characteristics of the firing rate display a variety of complex plateaus that can be excellently manifested with the sine-circle map. From numerical analyses, the coupling strength can be verified to be effectively enhanced by reducing the duty cycle of the pumping rate.

Anti-inflammatory effects of powdered product of Bu Yang Huan Wu decoction: Possible role in protecting against Transient Focal Cerebral Ischemia

Bu Yang Huan Wu decoction (BYHW) is a traditional Chinese medicine (TCM) that consists of several herbs and has been used in patients with ischemic stroke for centuries. Although powdered formula of BYHW has widely been prescribed in clinic nowadays, evidence-based effectiveness and mechanism of action of BYHW powdered product in stroke remain to be characterized. Adult male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 90 min followed by reperfusion for 24 h (ischemia/reperfusion; I/R) or sham surgery. After I/R, the rats were then given low dose (0.5 g/kg) and high dose (2.5 g/kg) of BYHW or vehicle by oral gavage twice a day for seven consecutive days. The results showed that I/R induced obvious cerebral infarction and neurobehavioral defects, in parallel with histological aberrations and extensive signaling of proinflammatory cytokines, including tumor necrosis factor (TNF-α) and interleukin-6 (IL-6), in the stroke model. Post-I/R treatment with BYHW powdered product significantly reduced the infarct area and ameliorated neurofunctional defects in a dose-dependent manner. The dose dependence was associated with TNF-α downregulation and interleukin-10 (IL-10) induction. In summary, the present findings demonstrated that BYHW powdered product exhibited therapeutic efficacy for experimental stroke and a higher dose treatment may strengthen the effectiveness via inflammatory modulation.

Immuohistochemical score of matrix metalloproteinase-1 may indicate the severity of symptomatic cervical and lumbar disc degeneration

BACKGROUND CONTEXT

Intervertebral disc (IVD) degeneration is related to numerous risk factors, including obesity. Leptin, one of the commonly measured adipokines, is proven to play an important role in the pathogenesis of IVD degeneration. In the context of IVD degeneration, matrix metalloproteinase-1 (MMP-1), which is upregulated and activated by leptin, is the most abundant catabolic enzyme. It remains unclear which of the factors mentioned above is most strongly associated with IVD degeneration.

PURPOSE

To investigate the influence of MMP-1 in IVD degeneration, we determined the strength of different predictors, including age, sex, magnetic resonance imaging (MRI), Modic changes (MCs), body mass index (BMI), leptin, and MMP-1. This was achieved by assessing the correlation among these factors and histologic degeneration score (HDS).

STUDY DESIGN

This study included 89 patients undergoing cervical discectomy for disc herniation, 93 who underwent lumbar discectomy, and 90 control subjects. Herniated disc tissue and plasma were used after the study was approved by the Human Ethics Review Committee at the authors' institution.

METHODS

Hematoxylin and eosin (H&E), Alcian blue-PAS and immunohistochemical (IHC) staining were performed to measure the expression levels of leptin and MMP-1. Circulating plasma levels of leptin and MMP-1 were measured using an enzyme-linked immunosorbent assay. To assess the correlation with HDS, measurements of age, sex, BMI, MRI scale, MCs scale, leptin/MMP-1 plasma concentration, and leptin/MMP-1 IHC expression were analyzed.

RESULTS

Patients with cervical or lumbar discectomy had significantly higher BMI than controls. Significantly more men than women were involved in the lumbar patients as compared with the cervical patients and the control subjects. After adjustment for age and sex, plasma leptin and leptin IHC score correlated significantly with BMI in patients with cervical or lumbar discectomy. Age, sex, MRI scale, MCs scale, and leptin/MMP-1 plasma concentration were not positively correlated with HDS. HDS was significantly associated with BMI, leptin IHC score, and MMP-1 IHC score. After a stepwise-multiple linear regression analysis to evaluate the strength of the correlations between HDS and various factors, only the MMP-1 IHC score demonstrated an independent association with HDS in patients with degeneration of the cervical or lumbar disc.

CONCLUSIONS

MMP-1 IHC score is an independent predictor of the severity of cervical or lumbar IVD degeneration.

CLINICAL SIGNIFICANCE

MMP-1 IHC score may be used as an indicator of IVD degeneration.

Origin of continuous curves and dotted spots in laser transverse modes with geometric structures

The transverse structures of geometric modes in degenerate laser resonators with large astigmatism are systematically investigated by starting from the Gaussian wave packet formulation with ray-wave connections. The overlapping degree D between Gaussian wave packets is derived as an analytic expression that manifests the critical overlapping with D=1. The transverse patterns are confirmed to display a structure of continuous curves or dotted spots, depending on D>1 or D<1, respectively. A thorough comparison between experimental results and numerical calculations is performed to validate the theoretical analysis.

Generalized wave-packet formulation with ray-wave connections for geometric modes in degenerate astigmatic laser resonators

The parametric equations for periodic rays in degenerate astigmatic laser resonators are derived in a generalized way. The derived parametric equations clearly reveal the formation of Lissajous geometric modes with phase variation along the propagation. Using the representation of a quantum coherent state, a generalized wave-packet formula is derived to connect with the periodic rays of geometric modes. The derived wave-packet formula is not only validated through comparing with various experimental patterns, but also is directly exploited to manifest the spatial asymmetries of Lissajous lasing modes due to a highly transmissive output coupler.

Ultraviolet B irradiation induced Nrf2 degradation occurs via activation of TRPV1 channels in human dermal fibroblasts

Ultraviolet (UV) irradiation causes cellular oxidative stress. Under redox imbalance, Keap1-dependent Nrf2 degradation is minimal. In this study, we examined the role of Ca²⁺ in Nrf2 homeostasis after UVB irradiation using human dermal fibroblasts. UVB irradiation stimulates 12-lipoxygenase and the product 12-hydroxyeicosatetraenoic acid then activates TRPV1 increasing the cell's cytosolic Ca²⁺ concentration. UVB irradiation induced reactive oxygen species generation and apoptosis are inhibited in the absence of Ca²⁺ or in the presence of either a 12-lipoxygenase inhibitor or a TRPV1 inhibitor during and after UVB irradiation. Thus, the Ca²⁺ increase via TRPV1 is a critical factor in UVB irradiation induced oxidative stress. UVB irradiation induces a Ca²⁺ dependent Nrf2 degradation and thus activation of TRPV1 with 12-hydroxyeicosatetraenoic acid also decreasing Nrf2 levels. UVB irradiation induced Nrf2 degradation is inhibited by co-treatment of cells with W-7, cyclosporin A, SB-216763 or MG-132, which are inhibitors of calmodulin, calcineurin, GSK3β and the proteasome, respectively. Furthermore, UVB irradiation in parallel induces GSK3β dephosphorylation in a Ca²⁺ dependent manner. Co-immunoprecipitation showed that UVB irradiation induces an increase in Nrf2 phosphorylation, an increase in the binding of β-TrCP and Nrf2, and an increase in Nrf2 ubiquitination; these effects are all Ca²⁺ dependent. These findings suggest that UVB irradiation induced GSK3β activation in a Ca²⁺ dependent manner, which then stimulates the phosphorylation and ubiquitination of Nrf2 via β-TrCP. Indeed, silencing of β-TrCP was found to inhibit UVB irradiation-induced oxidative stress, Nrf2 degradation and apoptosis, while it had no effect on the Ca²⁺ increase. Taken together, our results suggest that a Ca²⁺ influx via TRPV1 is responsible for UVB irradiation-induced Nrf2 degradation and that modulation of the Ca²⁺-calmodulin-calcineurin-GSK3β-Nrf2-β-TrCP-Cullin-1 pathway may explain Ca²⁺ dependent Nrf2 degradation.

Exploring the formation of thermally detuned transverse patterns in a broad-area square VCSEL

The formation of thermally detuned transverse patterns of a broad-area square-aperture vertical-cavity surface-emitting laser (VCSEL) via cryogenic cooling is explored. It is found that the transverse wave vector gradually rotates from the horizontal or vertical direction to the diagonal direction of the square boundary as the transverse mode order increases. A model based on the quantum billiards with a finite potential well is developed to emulate the transition behavior of lasing modes. Combining the effective modal gain analysis with the response wave function of driven finite potential billiards, all experimental lasing patterns under different operation temperatures are well reconstructed.

Wave representation for asymmetric elliptic vortex beams generated from the astigmatic mode converter

An analytical wave representation is derived to express the asymmetric elliptic vortex beams generated by using an astigmatic mode converter to transform the asymmetric Hermite-Gaussian modes. The effect of the spatial asymmetry on the elliptic vortex beam can be straightforwardly considered in the analytical wave representation. A detailed comparison with experimental intensity patterns and phase structures is made. The good agreement between experimental results and theoretical analyses confirms the characterization and generation of the asymmetric elliptic vortex beams.

Manipulating exchange bias by spin-orbit torque

Exchange bias, a shift in the hysteresis loop of a ferromagnet arising from interfacial exchange coupling between adjacent ferromagnetic and antiferromagnetic layers, is an integral part of spintronic devices. Here, we show that spin-orbit torque generated from spin current, a promising approach to switch the ferromagnetic magnetization of next-generation magnetic random access memory, can also be used to manipulate the exchange bias. Applying current pulses to a Pt/Co/IrMn trilayer causes concurrent switching of ferromagnetic magnetization and exchange bias, but with different underlying mechanisms. This implies that the ferromagnetic magnetization and exchange bias can be manipulated independently. Our work demonstrates that spin-orbit torque in ferromagnet/antiferromagnet heterostructures facilitates independent manipulations of distinct magnetic properties, motivating innovative designs for future spintronics devices.

The antecedents of innovation performance: the moderating role of top management team diversity

Purpose

The purpose of this paper is to investigate why firms engaged in R&D investment and international diversification produce different results in innovation performance.

Design/methodology/approach

This study is based on a sample of 283 Taiwanese manufacturing firms in the information technology industry.

Findings

The findings showed that in the top management teams (TMTs) with greater tenure diversity there was a stronger relationship between R&D investment and innovation performance. In addition, the TMTs with greater educational diversity enhanced the relationship between international diversification and innovation performance.

Originality/value

This study stresses the vital role of TMT diversity in resource allocation and information processing during the process of innovation. The authors examined the critical role of TMT educational diversity in bringing a wider range of network resources and the role of TMT tenure diversity in the allocation of firm-specific resources. The TMT diversity causes firms to experience different innovation results during the innovation process.

Exploring elliptical vortex beams with the spatial damping effect

A general integral formula is analytically derived to represent the wave function of elliptical vortex modes. The derived formula can be straightforwardly employed to take account of spatial damping to explore vortex structure. Spatial damping is found to cause the central degenerate singularity of the circular vortex mode to be split into several singularities with different topological charges. For the non-circular vortex beam, the influence of spatial damping on the distribution of singularities is not significant. Theoretical analyses are confirmed to agree very well with the experimental measurements.

Impact of a 3-Day High-Altitude Trek on Xue Mountain (3886 m), Taiwan, on the Emotional States of Children: A Prospective Observational Study

AIMS

Changes in emotions associated with mountain treks have rarely been reported. This study examined emotional state changes in sixth-grade elementary school students before and after a 3-day high-altitude mountain trek from the trailhead (2140 m) to Xue Mountain (3886 m) in Taiwan.

METHODS

In June 2011, 201 students participated in the trek. The round-trip distance was 21.8 km. The age, gender, blood group, and family configuration of the participants were documented before the trek. A 36-item short-form survey instrument, including the Mood and Anxiety Symptom Questionnaire and the Positive and Negative Affect Scale for Children, was used to evaluate the participants' emotional states (happiness, anticipation, sadness, and anger). The participants answered the questionnaires 1 month before and 1 week after the trek. A Likert scale was used to evaluate individual items (range 1-4; from strongly disagree to strongly agree). We calculated scores for each index before and after the trek. The incidence and presentation of acute mountain sickness (AMS) among the participants was also studied and published previously.

RESULTS

In total, 187 (112 boys and 75 girls) participants (mean age 11.9 ± 0.4 years) completed the trek and the survey. The sadness and anger scores (negative emotions) were significantly lower after than before the trek (39.5 vs. 36.6; p < 0.01). The happiness and anticipation scores (positive emotions) before and after the trek did not differ significantly (49.9 vs. 48.9; p = 0.11). No participant used AMS prophylaxis, while 78 participants met the AMS criteria. Negative emotions decreased more in those with AMS than without AMS (-4.6 vs. -1.8; p = 0.04), and the use of medications or acetazolamide did not alter the emotions.

CONCLUSIONS

A 3-day high-altitude mountain trek can reduce children's negative emotions. Negative emotions decreased more in those with AMS, whereas medications or acetazolamide did not alter their emotions.

Narrowing spectral linewidth in passively mode-locked solid-state lasers

A novel scheme to realize a mode-locked laser with a narrow spectral linewidth is demonstrated by exploiting a reflected Fabry-Perot (FP) cavity to introduce an intense FP effect. Stable continuous-wave mode-locked operation is achieved with the repetition rate of 48 MHz and the maximum average output power of 2.6 W under an incident pump power of 11.9 W. The mode-locked pulse width is systematically investigated by varying the optical thickness of the reflected FP cavity. The pulse duration is experimentally found to be in a range of 0.8 to 2.6 ns. The experimental results reveal that the reflected FP cavity is the key factor leading to the pulse generation in the nanosecond regime. This Letter is believed to provide a promising method for generating optical pulses with narrow spectral linewidths.

Generating high-power asymmetrical Laguerre-Gaussian modes and exploring topological charges distribution

We employ an off-axis pumped Nd:YVO₄ laser and control the reflectance of output coupler to directly generate asymmetrical Hermite-Gaussian (HG) modes with various transverse orders. By using an astigmatic mode converter, the generated asymmetrical HG modes are straightforwardly transformed into asymmetrical Laguerre-Gaussian (LG) modes with a crescent-like shape. The average output power of all the crescent-shaped LG modes can exceed 1W at the pump power of 4W. Furthermore, experimental results are theoretically verified by resonant modes derived from the inhomogeneous Helmholtz equation with the localized source distribution. Theoretical resonant modes are also used to explore the dependence of the phase structures of LG modes on the system loss. As the loss increases, it is found that the singularities at the origin will be rearranged and new singularities are formed in the outside region with average orbital angular momentum remaining unchanged.

Characterization and generation of high-power multi-axis vortex beams by using off-axis pumped degenerate cavities with external astigmatic mode converter

The generalized geometric mode with several high-order Hermite-Gaussian (HG) beams localized on ray periodic orbits in the degenerate resonator is generated by an off-axis pumped Nd:YVO₄ laser, by performing beam transformation via an astigmatic mode converter, the generalized geometric modes are found that can be converted into the multi-axis vortex beams with the bundled-rings structures. Experimental results reveal that the generated multi-axis vortex beams can preserve quite stable beam structures even under high-power operation. Moreover, the radius of the bundled rings for the multi-axis vortex beams can be flexibly adjusted by the off-axis pumping to lead to vortex structures with easily controlled orbital angular momentum distribution. The good agreement between the experimental and theoretical results of propagation evolution for the astigmatic transformation of generalized geometric modes further verify the feasibility of using the proposed system to realize various high-powered, multi-center vortex beams with good reliability and predictability.

Enhancement of matrix metalloproteinases 2 and 9 accompanied with neurogenesis following collagen glycosaminoglycan matrix implantation after surgical brain injury

Surgical brain injury may result in irreversible neurological deficits. Our previous report showed that partial regeneration of a traumatic brain lesion is achieved by implantation of collagen glycosaminoglycan (CGM). Matrix metalloproteinases (MMPs) may play an important role in neurogenesis but there is currently a lack of studies displaying the relationship between the stimulation of MMPs and neurogenesis after collagen glycosaminoglycan implantation following surgical brain trauma. The present study was carried out to further examine the expression of MMP2 and MMP9 after implantation of collagen glycosaminoglycan (CGM) following surgical brain trauma. Using the animal model of surgically induced brain lesion, we implanted CGM into the surgical trauma. Rats were thus divided into three groups: (1) sham operation group: craniotomy only; (2) lesion (L) group: craniotomy + surgical trauma lesion; (3) lesion + CGM (L + CGM) group: CGM implanted following craniotomy and surgical trauma lesion. Cells positive for SOX2 (marker of proliferating neural progenitor cells) and matrix metalloproteinases (MMP2 and MMP9) in the lesion boundary zone were assayed and analyzed by immunofluorescence and ELISA commercial kits, respectively. Our results demonstrated that following implantation of CGM after surgical brain trauma, significant increases in MMP2+/SOX2+ cells and MMP9+/SOX2+ cells were seen within the lesion boundary zone in the L + CGM group. Tissue protein concentrations of MMP2 and MMP9 also increased after CGM scaffold implantation. These findings suggest that implantation of a CGM scaffold alone after surgical brain trauma can enhance the expression of MMP2 and MMP9 accompanied by neurogenesis.

Exploring the self-mode locking and vortex structures of nonplanar elliptical modes in selectively end-pumped Nd:YVO4 lasers: manifestation of large fractional orbital angular momentum

An end-pumped Nd:YVO₄ laser under selective pumping is used to excite lasing modes with transverse patterns performed to exhibit the characteristics of multiple spots arranged on elliptical features near degenerate cavities. The spatial distribution of elliptical lasing modes is clearly revealed to be localized on the nonplanar ray orbits, so-called nonplanar elliptical modes, which possess large fractional orbital angular momentum. Moreover, temporal dynamics for the output emission of nonplanar elliptical modes are verified to obtain self-mode-locked operation. We further numerically manifest not only the influence of radial-asymmetry distributions on the vortex structures of nonplanar elliptical modes, but also the vector field of transverse lasing modes altered with twisting phase structures in the propagation direction.

Incidence and severity of acute mountain sickness and associated symptoms in children trekking on Xue Mountain, Taiwan

BACKGROUND

Acute mountain sickness (AMS) occurs in non-acclimatized people after an acute ascent to an altitude of 2,500 m or higher. The aim of this study was to examine the incidence and severity of AMS and associated symptoms in children.

METHODS

The prospective observational study included 197 healthy, non-acclimatized 11 and 12-year-old children trekking the round-trip from the trailhead to the summit of Xue Mountain, Taiwan (2,179 m to 3,886 m) over 3 days. AMS was evaluated at Qika Hut (2,460 m) on Day 1, at Sanliujiu Hut on Day 2 (3,100 m), and at the same altitude (3,100 m) after reaching the summit on Day 3. We used the Lake Louise Score (LLS) to diagnose AMS and record daily AMS-associated symptoms. We gave acetazolamide to children with mild to moderate AMS. Dexamethasone was reserved for individuals suffering from severe AMS. Acetaminophen was administrated to children with headache, and metoclopramide for those with nausea or vomiting.

RESULTS

There were 197 subjects eligible for analysis. The overall incidence of AMS was 40.6%, which was higher in males and in subjects with a higher body mass index (BMI) (p < 0.05). The prevalence of AMS on Day 1 was 5.6%, which was significantly lower than that on Day 2 (29.4%) and Day 3 (23.4%). The mean LLS of all subjects was 1.77 ± 2.08. The overall incidence of severe AMS (LLS ≥ 5) was 12.5%. The mean LLS of the AMS group (3.02 ± 2.46) was significantly higher than that of the non-AMS group (0.92 ± 1.16, p < 0.001). Among the AMS group, the mean LLS was 1.00 ± 1.55 on Day 1, 4.09 ± 1.97 on Day 2, and 3.98 ± 2.42 on Day 3. The most common symptom was sleep disturbance followed by dizziness, and headache. The prevalence of headache was 46.2% on Day 2 at 3,100 m, and 31.3% on Day 3 at the same altitude after climbing the summit (3,886 m). Males experienced significantly more headache and fatigue than females (p < 0.05). The LLS and prevalence of all AMS symptoms were significantly higher in the AMS than the non-AMS group (p < 0.05).

CONCLUSIONS

The AMS incidence among children trekking to Xue Mountain was 40.6%. AMS is common and mostly manifests as mild symptoms. Gender (male) and a higher BMI could be considered two independent risk factors of higher AMS incidence. Sleep disturbance is the most common symptom, and the lower prevalence of headache on Day 3 may be due to the effects of medication and/or acclimatization.

Quality of life of breast and cervical cancer survivors

Background

Breast and cervical cancer are the most common cancers affecting women. The symptom distresses experienced by cancer survivors are critical factors influencing their quality of life (QOL). This study investigated the QOL of breast and cervical cancer survivors, their physical, psychological and social conditions.

Methods

The participants were older than 20 years, had been diagnosed with breast or cervical cancer for more than 2 years, and had completed their cancer treatment. The survey incorporated the QOL questionnaires developed by the European Organization of Research and Treatment for Cancer and a self-designed questionnaire.

Results

The mean age at diagnosis was 48.89 ± 8.53 years for the breast cancer survivors and 49.00 ± 10.30 years for the cervical cancer survivors. The corresponding QOL scores were 75.33 ± 20.25 and 75.56 ± 17.93. The factors influencing QOL of breast cancer survivors were household income, number of comorbidities, stage of cancer, type of cancer treatment and duration of illness, whereas the factor related to QOL of cervical cancer survivors was only household income.

Conclusions

The QOL of the two groups was similar. Healthcare providers should demonstrate greater concern toward breast and cervical cancer survivors.

Ultraviolet B irradiation increases keratin 1 and keratin 10 expressions in HaCaT keratinocytes via TRPV1 activation and ERK phosphorylation

In this study, we characterized the effect of ultraviolet B (UVB) irradiation with or without epidermal growth factor (EGF) on the regulation of keratinocyte differentiation under physiological concentration of Ca²⁺ (1.8 mM). In addition, growth factor deprivation used to measure signal transduction and kinase phosphorylation in many studies is physiologically unreal. Therefore, 1% of serum was also included in all experiment. We found that UVB irradiation Ca²⁺ dependently induced morphological differentiation and increased keratin 1 and 10 (K1/K10) expressions. Both were inhibited by treatment of cells with EGF. In quiescent cells, phosphorylation of ERK was stimulated by acute EGF treatment, while it rapidly desensitized in chronic EGF treatment or 1% serum exposure. UVB irradiation-induced keratinocyte differentiation required Ca²⁺ influx through TRPV1. Ca²⁺ -dependent phosphorylation of ERK was responsible for the expression of K1/10. Cotreatment of cells with EGF during UVB irradiation inhibits the UVB irradiation-induced differentiation by desensitizing ERK phosphorylation.

Extracting trajectory equations of classical periodic orbits from the quantum eigenmodes in two-dimensional integrable billiards

The trajectory equations for classical periodic orbits in the equilateral-triangular and circular billiards are systematically extracted from quantum stationary coherent states. The relationship between the phase factors of quantum stationary coherent states and the initial positions of classical periodic orbits is analytically derived. In addition, the stationary coherent states with noncoprime parametric numbers are shown to correspond to the multiple periodic orbits, which cannot be explicable in the one-particle picture. The stationary coherent states are further verified to be linked to the resonant modes that are generally observed in the experimental wave system excited by a localized and unidirectional source. The excellent agreement between the resonant modes and the stationary coherent states not only manifests the importance of classical features in experimental systems but also paves the way to manipulate the mesoscopic wave functions localized on the periodic orbits for applications.

Characterizing classical periodic orbits from quantum Green's functions in two-dimensional integrable systems: Harmonic oscillators and quantum billiards

A general method is developed to characterize the family of classical periodic orbits from the quantum Green's function for the two-dimensional (2D) integrable systems. A decomposing formula related to the beta function is derived to link the quantum Green's function with the individual classical periodic orbits. The practicality of the developed formula is demonstrated by numerically analyzing the 2D commensurate harmonic oscillators and integrable quantum billiards. Numerical analyses reveal that the emergence of the classical features in quantum Green's functions principally comes from the superposition of the degenerate states for 2D harmonic oscillators. On the other hand, the damping factor in quantum Green's functions plays a critical role to display the classical features in mesoscopic regime for integrable quantum billiards, where the physical function of the damping factor is to lead to the coherent superposition of the nearly degenerate eigenstates.

Initialization-Free Multilevel States Driven by Spin-Orbit Torque Switching

By engineering multidomain formation in Co/Pt multilayers, it is demonstrated how multilevel storage can be achieved by spin-orbit torque switching. It is rather remarkable that, by modulating the writing pulse conditions, the final magnetization states can be controlled, independent of the initial configurations. The initialization-free multilevel memory advances the spin-orbit-torque magnetic random access memory to higher storage density for practical applications.

Exploring vortex structures in orbital-angular-momentum beams generated from planar geometric modes with a mode converter

It is theoretically demonstrated that the planar geometric mode with a π/2 mode converter, so called the circularly geometric mode, can be solved from the inhomogeneous Helmholtz equation by considering the pump distribution on the lasing mode. Theoretical analysis clearly reveal that the vortex structures of circularly geometric modes are determined by the minimum order of transverse lasing modes, the total number of transverse lasing modes and the degenerate condition in the cavity. Moreover, we experimentally manifest that the circularly geometric mode can be generated from the selective pumped solid-state laser with an external π/2 mode converter. To explore the vortex structures of the generated geometric modes, the interference patterns are performed by an experimental apparatus consisting of a Mach-Zehnder interferometer. The good agreement between experimental observations and numerical calculations confirms the analysis of vortex structures is reliable.

Synchronized self-mode-locked 1061-nm and 1064-nm monolithic Nd:YAG laser at cryogenic temperatures with two orthogonally polarized emissions: generation of 670 GHz beating

A dual-wavelength self-mode-locked monolithic Nd:YAG laser at 1061 and 1064 nm is realized at cryogenic temperatures. At an incident pump power of 5.5 W, the total output power can reach 2.5 W and the mode-locked pulse width is 29 ps at a pulse repetition rate of 7.75 GHz. The synchronization of the dual-wavelength emissions leads to a beat frequency of 670 GHz in the individual mode-locked pulse. It is further discovered that the laser output consists of two orthogonally polarized components with a central frequency difference of 127 MHz. The central frequency difference between two orthogonal polarizations mainly arises from the external mechanical stress introduced by the copper holder for the laser crystal.

Observation of reflection feedback induced the formation of bright-dark pulse pairs in an optically pumped semiconductor laser

It is experimentally demonstrated that the tiny reflection feedback can lead the optically pumped semiconductor laser (OPSL) to be operated in a self-mod-locked state with a pulse train of bright-dark pulse pairs. A theoretical model based on the multiple reflections in a phase-locked multi-longitudinal-mode laser is developed to confirm the formation of bright-dark pulse pairs. The present finding can offer an important insight into the temporal dynamics in mode-locked OPSLs.

Elevation of troponin I in acute ischemic stroke

Background. Cardiac morbidities account for 20% of deaths after ischemic stroke and is the second commonest cause of death in acute stroke population. Elevation of cardiac troponin has been regarded as a prognostic biomarker of poor outcome in patients with acute stroke.

Methods. This retrospective study enrolled 871 patients with acute ischemic stroke from August 2010 to March 2015. Data included vital signs, laboratory parameters collected in the emergency department, and clinical features during hospitalization. National Institutes of Health Stroke Scale (NIHSS), Barthel index, and modified Rankin Scale (mRS) were used to assess stroke severity and outcome.

Results. Elevated troponin I (TnI) > 0.01 µg/L was observed in 146 (16.8%) patients. Comparing to patients with normal TnI, patients with elevated TnI were older (median age 77.6 years vs. 73.8 years), had higher median heart rates (80 bpm vs. 78 bpm), higher median white blood cells (8.40 vs. 7.50 1,000/m³) and creatinine levels (1.40 mg/dL vs. 1.10 mg/dL), lower median hemoglobin (13.0 g/dL vs. 13.7 g/dL) and hematocrit (39% vs. 40%) levels, higher median NIHSS scores on admission (11 vs. 4) and at discharge (8 vs. 3), higher median mRS scores (4 vs3) but lower Barthel index scores (20 vs. 75) at discharge (p < 0.001). Multivariate analysis revealed that age ≥ 76 years (OR 2.25, CI [1.59–3.18]), heart rate ≥ 82 bpm (OR 1.47, CI [1.05–2.05]), evidence of clinical deterioration (OR 9.45, CI [4.27–20.94]), NIHSS score ≥ 12 on admission (OR 19.52, CI [9.59–39.73]), and abnormal TnI (OR 1.98, CI [1.18–3.33]) were associated with poor outcome. Significant factors for in-hospital mortality included male gender (OR 3.69, CI [1.45–9.44]), evidence of clinical deterioration (OR 10.78, CI [4.59–25.33]), NIHSS score ≥ 12 on admission (OR 8.08, CI [3.04–21.48]), and elevated TnI level (OR 5.59, CI [2.36–13.27]). C-statistics revealed that abnormal TnI improved the predictive power of both poor outcome and in-hospital mortality. Addition of TnI > 0.01 ug/L or TnI > 0.1 ug/L to the model-fitting significantly improved c-statistics for in-hospital mortality from 0.887 to 0.926 (p = 0.019) and 0.927 (p = 0.028), respectively.

Discussion. Elevation of TnI during acute stroke is a strong independent predictor for both poor outcome and in-hospital mortality. Careful investigation of possible concomitant cardiac disorders is warranted for patients with abnormal troponin levels.

Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG-2005) Retrospective Cohort Study (A STROBE-Compliant Article)

In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n = 464; stage IV, n = 77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0-258 months) and median OS was 52 months (range 1-258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12-2.09; P = 0.007), histological grade 3 (HR 2.0, 95% CI 1.47-2.75; P < 0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13-6.72; P < 0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34-2.64; P < 0.001), and histological grade 3 (HR 2.42, 95% CI 1.75-3.35; P < 0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16-0.45; P < 0.001, and HR 0.14, 95% CI 0.08-0.26; P < 0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79-0.92; P = 0.017, and HR 0.48; 95% CI 0.31-0.75; P = 0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality.

Thermal dewetting with a chemically heterogeneous nano-template for self-assembled L1(0) FePt nanoparticle arrays

A design for the fabrication of metallic nanoparticles is presented by thermal dewetting with a chemically heterogeneous nano-template. For the template, we fabricate a nanostructured polystyrene-b-polydimethylsiloxane (PS-b-PDMS) film on a Si|SiO2 substrate, followed by a thermal annealing and reactive ion etching (RIE) process. This gives a template composed of an ordered hexagonal array of SiOC hemispheres emerging in the polystyrene matrix. After the deposition of a FePt film on this template, we utilize the rapid thermal annealing (RTA) process, which provides in-plane stress, to achieve thermal dewetting and structural ordering of FePt simultaneously. Since the template is composed of different composition surfaces with periodically varied morphologies, it offers more tuning knobs to manipulate the nanostructures. We show that both the decrease in the area of the PS matrix and the increase in the strain energy relaxation transfer the dewetted pattern from the randomly distributed nanoparticles into a hexagonal periodic array of L10 FePt nanoparticles. Transmission electron microscopy with the in situ heating stage reveals the evolution of the dewetting process, and confirms that the positions of nanoparticles are aligned with those of the SiOC hemispheres. The nanoparticles formed by this template-dewetting show an average diameter and center-to-center distance of 19.30 ± 2.09 nm and 39.85 ± 4.80 nm, respectively. The hexagonal array of FePt nanoparticles reveals a large coercivity of 1.5 T, much larger than the nanoparticles fabricated by top-down approaches. This approach offers an efficient pathway toward self-assembled nanostructures in a wide range of material systems.

Exploiting broad-area surface emitting lasers to manifest the path-length distributions of finite-potential quantum billiards

Broad-area vertical-cavity surface-emitting lasers (VCSELs) with different cavity sizes are experimentally exploited to manifest the influence of the finite confinement strength on the path-length distribution of quantum billiards. The subthreshold emission spectra of VCSELs are measured to obtain the path-length distributions by using the Fourier transform. It is verified that the number of the resonant peaks in the path-length distribution decreases with decreasing the confinement strength. Theoretical analyses for finite-potential quantum billiards are numerically performed to confirm that the mesoscopic phenomena of quantum billiards with finite confinement strength can be analogously revealed by using broad-area VCSELs.

Analysis of the optimal temperature for the cryogenic monolithic Nd:YAG laser at 946-nm

The optimal temperature for the cryogenic monolithic Nd:YAG laser at 946-nm is theoretically and experimentally analyzed. It is clear that decreasing temperature can considerably eliminate the thermal population at the lower laser level to enhance the quantum efficiency. However, the narrowing of the absorption bandwidth for the gain medium leads to a reduction of the effective absorption efficiency as the temperature is decreased. Consequently, an optimal temperature for the maximum output power is found to be in the range of approximately 120 K to 140 K. It is experimentally verified that employing a pump source with a narrower emission spectrum linewidth contributes a more efficient output for the cryogenic laser.

Incidence and risk factors associated with acute mountain sickness in children trekking on Jade Mountain, Taiwan

BACKGROUND

Acute mountain sickness (AMS) is a pathophysiological symptom complex that occurs in high-altitude areas. The incidence of AMS on Jade Mountain, the highest peak in Taiwan (3952 m), has been reported to be ∼36%. There is a lack of data in children trekking at altitude in Taiwan. The purpose of this study was to determine the incidence, risk factors and symptoms of AMS in children trekking on Jade Mountain, Taiwan.

METHODS

This prospective cohort study included a total of 96 healthy non-acclimatized children aged 11-12 years who trekked from an elevation of 2600-3952 m in 3 days. The Lake Louise AMS score was used to record symptoms associated with AMS.

RESULTS

AMS were reported in 59% of children trekking on Jade Mountain over a 3 day period. AMS incidence increased significantly with increasing altitude. The most common AMS symptom was headache, followed by fatigue or weakness, difficulty sleeping, dizziness or lightheadedness and gastrointestinal symptoms. Children who had experienced upper respiratory infection (URI) within the 7 days before their trek tended to have a greater risk for development of AMS. AMS incidence did not significantly differ according to gender, recent acute gastroenteritis, menstruation and body mass index.

CONCLUSIONS

The incidence of AMS in children trekking on Jade Mountain is greater than that observed in adults, and was associated with altitude and recent URI.

Manifesting the evolution of eigenstates from quantum billiards to singular billiards in the strongly coupled limit with a truncated basis by using RLC networks

The coupling interaction between the driving source and the RLC network is explored and characterized as the effective impedance. The mathematical form of the derived effective impedance is verified to be identical to the meromorphic function of the singular billiards with a truncated basis. By using the derived impedance function, the resonant modes of the RLC network can be divided into the open-circuit and short-circuit states to manifest the evolution of eigenvalues and eigenstates from closed quantum billiards to the singular billiards with a truncated basis in the strongly coupled limit. The substantial differences of the wave patterns between the uncoupled and strongly coupled eigenmodes in the two-dimensional wave systems can be clearly revealed with the RLC network. Finally, the short-circuit resonant states are exploited to confirm that the experimental Chladni nodal-line patterns in the vibrating plate are the resonant modes subject to the strong coupling between the oscillation system and the driving source.

High-peak-power optically-pumped AlGaInAs eye-safe laser with a silicon wafer as an output coupler: comparison between the stack cavity and the separate cavity

An intrinsic silicon wafer is exploited as an output coupler to develop a high-peak-power optically-pumped AlGaInAs laser at 1.52 μm. The gain chip is sandwiched with the diamond heat spreader and the silicon wafer to a stack cavity. It is experimentally confirmed that not only the output stability but also the conversion efficiency are considerably enhanced in comparison with the separate cavity in which the silicon wafer is separated from other components. The average output power obtained with the stack cavity was 2.02 W under 11.5 W average pump power, corresponding to an overall optical-to-optical efficiency of 17.5%; the slope efficiency was 18.6%. The laser operated at 100 kHz repetition rate and the pulse peak power was 0.4 kW.

Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea

BACKGROUND

Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases. Although CPAP is the first treatment choice for moderate-to-severe OSA, acceptance of and adherence to CPAP remain problematic. High CPAP adherence is generally defined as ≥4 h of use/night for ≥70% of the nights monitored. We investigated the long-term beneficial effects of CPAP on sleep quality and blood pressure in subjects with moderate-to-severe OSA according to high or low CPAP adherence.

METHODS

We retrospectively analyzed 121 subjects with moderate-to-severe OSA from August 2008 to July 2012. These subjects were divided into 3 groups: (1) no CPAP treatment (n = 29), (2) low CPAP adherence (n = 28), and (3) high CPAP adherence (n = 64). All subjects were followed up for at least 1 y. The 3 groups were compared regarding anthropometric and polysomnographic variables, presence of cardiovascular comorbidities, and blood pressure at baseline and at the last follow-up.

RESULTS

The no-treatment group showed significant increases in oxygen desaturation index and blood pressure. The high-adherence group showed significant improvement in daytime sleepiness, apnea-hypopnea index (AHI), oxygen desaturation index, and blood pressure. Although the AHI was also significantly decreased after CPAP treatment in the low-adherence group, blood pressure remained unchanged.

CONCLUSIONS

CPAP treatment had beneficial effects on both sleep quality and blood pressure only in subjects with OSA and high CPAP adherence who used CPAP for ≥4 h/night for ≥70% of nights monitored. Subjects with low CPAP adherence received beneficial effects on AHI, but not blood pressure.