Impact of perioperative low-molecular-weight heparin therapy on clinical events of elderly patients with prior coronary stents implanted > 12 months undergoing non-cardiac surgery: a randomized, placebo-controlled trial.

BACKGROUND: Little is known about the safety and efficacy of discontinuing antiplatelet therapy via LMWH bridging therapy in elderly patients with coronary stents implanted for > 12 months undergoing non-cardiac surgery. This randomized trial was designed to compare the clinical benefits and risks of antiplatelet drug discontinuation via LMWH bridging therapy. METHODS: Patients were randomized 1:1 to receive subcutaneous injections of either dalteparin sodium or placebo. The primary efficacy endpoint was cardiac or cerebrovascular events. The primary safety endpoint was major bleeding. RESULTS: Among 2476 randomized patients, the variables (sex, age, body mass index, comorbidities, medications, and procedural characteristics) and percutaneous coronary intervention information were not significantly different between the bridging and non-bridging groups. During the follow-up period, the rate of the combined endpoint in the bridging group was significantly lower than in the non-bridging group (5.79% vs. 8.42%, p = 0.012). The incidence of myocardial injury in the bridging group was significantly lower than in the non-bridging group (3.14% vs. 5.19%, p = 0.011). Deep vein thrombosis occurred more frequently in the non-bridging group (1.21% vs. 0.4%, p = 0.024), and there was a trend toward a higher rate of pulmonary embolism (0.32% vs. 0.08%, p = 0.177). There was no significant difference between the groups in the rates of acute myocardial infarction (0.81% vs. 1.38%), cardiac death (0.24% vs. 0.41%), stroke (0.16% vs. 0.24%), or major bleeding (1.22% vs. 1.45%). Multivariable analysis showed that LMWH bridging, creatinine clearance < 30 mL/min, preoperative hemoglobin < 10 g/dL, and diabetes mellitus were independent predictors of ischemic events. LMWH bridging and a preoperative platelet count of < 70 × 109/L were independent predictors of minor bleeding events. CONCLUSIONS: This study showed the safety and efficacy of perioperative LMWH bridging therapy in elderly patients with coronary stents implanted > 12 months undergoing non-cardiac surgery. An alternative approach might be the use of bridging therapy with half-dose LMWH. TRIAL REGISTRATION: ISRCTN65203415.

Second harmonic generation of visible vortex laser based on a waveguide-grating emitter in LBO.

In this work, we propose a practical solution to visible vortex laser emission at 532 nm based on second harmonic generation (SHG) in a well-designed waveguide-grating structure. Such an integrated structure is fabricated by femtosecond laser direct writing (FsLDW) in an LBO crystal. Confocal micro-Raman spectroscopy is employed for detailed analysis of FsLDW-induced localized crystalline damage. By optical excitation at 1064 nm, the guiding properties, SHG performance, as well as vortex laser generation of the waveguide-grating hybrid structure are systematically studied. Our results indicate that FsLDW waveguide-grating emitter is a reliable design holding great promise for nonlinear vortex beam generation in integrated optics.

Free-space laser emission from Nd:YAG elliptical microdisks.

The utilization of deformed microcavities, such as elliptical microdisks, has been widely acknowledged as an effective solution for achieving free-space emission in microcavity lasers. However, the deformations introduced in the microcavity structure tend to decrease the quality factor (Q factor), resulting in weakened output intensity. To address this issue, one potential approach is to employ highly efficient laser gain media that can compensate for the negative impact of the structure on the output intensity. In this study, we employed the exceptional laser crystal material Nd:YAG as the laser gain medium and successfully fabricated an elliptical microdisk laser with a major semiaxis of 15 µm and an eccentricity ratio of 0.15. By utilizing an 808 nm laser for pumping, we were able to achieve free-space laser emission with a slope efficiency of 1.7% and a remarkable maximum output power of 58 µW. This work contributes toward the advancement of the application of deformation microcavity lasers.

Heterogeneous integration of an on-chip Nd:YAG whispering gallery mode laser with a lithium-niobate-on-insulator platform.

The integration of heterogeneous optical components onto an optical platform is crucial for the advancement of photonic chips. To achieve this, efficient coupling of optical signals between components and the platform is essential. Here, we have successfully integrated a Nd:YAG microdisk laser with a lithium-niobate-on-insulator (LNOI) photonic platform by modulating the propagation modes of LNOI. Ridge waveguides are fabricated on the LNOI by carefully adjusting the cross-sectional dimensions to enable the propagation of higher-order propagation modes. This ridge waveguide ensures that the effective refractive index of the higher-order mode closely matches that of the fundamental mode of the Nd:YAG microdisk, ensuring efficient waveguide-microdisk coupling. This on-chip laser, consisting of an Nd:YAG microdisk and LNOI integration, achieves a maximum output power of 23 µW, and a mode suppression ratio of 53.6 dB. This research presents an efficient approach for constructing highly functional heterogeneous integrated optical chips.

Femtosecond laser writing of waveguides in zinc oxide crystals: fabrication and mode modulation.

We report for the first time on optical waveguides in zinc oxide (ZnO) crystals fabricated by femtosecond laser direct writing. The confocal Raman microscopy under 488 nm laser excitation is used to investigate the micro-modifications of the laser irradiation, and guiding properties are studied via the end-face coupling at 632.8 nm. The mode modulation has been achieved by the adjustment of laser writing parameters. A minimum propagation loss of ∼6 dB/cm is obtained for the double-line waveguide structures. A Y-branch waveguide beam splitter is also fabricated, reaching a splitting ratio of nearly 1:1. The original optical properties in the guiding region have been well preserved, according to the confocal Raman investigation, which suggests potential applications of the ZnO waveguides for integrated photonics and nonlinear optics.

Second harmonic generation of femtosecond laser written depressed cladding waveguides in periodically poled MgO:LiTaO3 crystal.

We report on the fabrication of depressed cladding waveguides in periodically poled MgO doped LiTaO3 by using low-repetition-rate femtosecond laser writing, and their use for guided-wave second harmonic generation (SHG). The cladding waveguides exhibit different guiding performance along the extraordinary and ordinary polarizations. The temperature-dependent quasi-phase-matching (QPM) is realized to obtain SHG in the depressed cladding waveguides. The results show that the QPM temperature was dependent on the poling period and on the features of the cladding waveguides. The highest nonlinear conversion efficiency (0.74%W-1cm-2) was found in the waveguide fabricated with large scanning velocity (0.75 mm/s) and small radius (15 µm).

High repetition rates optically active langasite electro-optically Q-switched laser at 1.34 µm.

An electro-optically Q-switched pulsed laser at 1.34 µm with a repetition rate of 100 kHz applying optically active langasite (La3Ga5SiO14) crystal has been reported. With Nd:YVO4 as laser crystal, the electro-optically Q-switched pulsed lasers were obtained with the maximum repetition rate of 100 kHz, maximum average output power of 2.42 W, and a minimum pulse width of 2.4 ns. Based on the theory of rate equations, the optimal pulse energy of the electro-optical Q-switching could be calculated. The experimental results have been found to be matched well with the theoretical calculations. To the best of our knowledge, this work presents the highest repetition rate and shortest pulse width which are achieved by an electric-optic LGS Q-switching at the wavelength of 1.34 µm, and it enriches the material categories for generating the high repetition rate pulsed laser.

Second harmonic generation of diamond-blade diced KTiOPO4 ridge waveguides.

We report on the fabrication of ridge waveguides in KTiOPO4 nonlinear optical crystals through carbon ion irradiation followed by precise diamond blade dicing. The diced side-walls have low roughness, which allows for low propagation loss of ~1dB/cm in fabricated of ridges. The waveguide property investigation has been performed at 1064 nm as well as 532 nm, showing good guidance at both TE and TM polarizations. Based on type II phase matching configuration, efficient second harmonic generation of green light at room temperature has been realized. High conversion efficiencies of ~1.12%W-1 and ~12.4% have been obtained for frequency doubling under the pump of continuous-wave (CW) and pulsed fundamental waves at 1064 nm, respectively.

Type-II second-harmonic-generation properties of YCOB and GdCOB single crystals.

As excellent nonlinear optical (NLO) crystals, YCa(4)O(BO(3))(3) (YCOB) and GdCa(4)O(BO(3))(3) (GdCOB) have been paid much attention since their first appearance in 1990's. From that time to now, almost all of related researches and applications have focused on their type-I phase-matching (PM) configurations which possess large effective NLO coefficient (d(eff)). In this paper, type-II second-harmonic-generation (SHG) properties of these two crystals are reported, including PM curve, d(eff), angular acceptance and walk-off angle. Both of the type-II SHG experiments for 1064 and 1320 nm have indicated that the optimum directions which have maximum d(eff) locate in the second octant, i.e. (90° < θ< 180°, 0° < ϕ < 90°). For a (112°, 81.3°)-cut, 24 mm long YCOB crystal, the largest type-II SHG conversion efficiency of a 1064 nm Nd:YAG pico-second laser is 55%, which reaches the same level of the optimum type-I sample. To our knowledge this is the first time that type-II SHG performance of YCOB and GdCOB crystals is investigated intensively. Our research has shown that the smaller d(eff) of type-II PM can be compensated by its larger angular acceptance and less beam walk-off. The same level SHG conversion efficiency implies for such type crystals the type-II components have the potential to replace type-I ones and obtain important NLO applications in the future.

Tunable Stokes laser generation based on the stimulated polariton scattering in KTiOPO4 crystal.

The tunable Stokes laser characteristics based on the stimulated polariton scattering in KTiOPO4 (KTP) crystal and the intracavity frequency doubling properties for the Stokes laser are investigated for the first time. When the pumping laser wavelength is 1064.2 nm, and the angle between the pumping and Stokes beams outside the KTP crystal changes from 1.875° to 6.750°, the obtained tunable Stokes laser wavelength varies discontinuously from 1076.5 nm to 1091.4 nm with four gaps. When the pumping pulse energy is 120.0 mJ, the maximum Stokes pulse energy is 46.5 mJ obtained at the wavelength of 1086.6 nm. By inserting a LiB3O5 (LBO) crystal into the cavity, the obtained frequency-doubled laser wavelength is inconsecutive tunable from 538.5 nm to 543.8 nm. The maximum frequency-doubled laser pulse energy is 15.9 mJ at the wavelength of 543.5 nm.

Energy scaling of terahertz-wave parametric sources.

Terahertz-wave parametric oscillators (TPOs) have advantages of room temperature operation, wide tunable range, narrow line-width, good coherence. They have also disadvantage of small pulse energy. In this paper, several factors preventing TPOs from generating high-energy THz pulses and the corresponding solutions are analyzed. A scheme to generate high-energy THz pulses by using the combination of a TPO and a Stokes-pulse-injected terahertz-wave parametric generator (spi-TPG) is proposed and demonstrated. A TPO is used as a source to generate a seed pulse for the surface-emitted spi-TPG. The time delay between the pump and Stokes pulses is adjusted to guarantee they have good temporal overlap. The pump pulses have a large pulse energy and a large beam size. The Stokes beam is enlarged to make its size be larger than the pump beam size to have a large effective interaction volume. The experimental results show that the generated THz pulse energy from the spi-TPG is 1.8 times as large as that obtained from the TPO for the same pumping pulse energy density of 0.90 J/cm(2) and the same pumping beam size of 3.0 mm. When the pumping beam sizes are 5.0 and 7.0 mm, the enhancement times are 3.7 and 7.5, respectively. The spi-TPG here is similar to a difference frequency generator; it can also be used as a Stokes pulse amplifier.

Four-wavelength laser based on intracavity BaWO4 Raman conversions of a dual-wavelength Q-switched Nd:YLF laser.

By using diode-end-pumped acousto-optically Q-switched intracavity Raman laser configurations, we demonstrate a four-wavelength laser emitting at 1047.0, 1053.0, 1159.4 and 1166.8 nm. Two Nd:YLiF4 crystals are employed to generate 1047.0-nm and 1053.0-nm laser radiations. These two lasers are then frequency converted by a BaWO4 Raman crystal to generate 1159.4-nm and 1166.8-nm first-Stokes waves. With pulse synchronization realized, we obtain the maximum output powers of 427, 418, 423 and 332 mW for 1047.0-nm, 1053.0-nm, 1159.4-nm and 1166.8-nm lasers, respectively. The total optical-to-optical conversion efficiency is 15.1%.

Synchronized dual tunable wavelength Q-switched Nd:Glass laser.

A flash-lamp pumped electro-optically Q-switched dual tunable wavelength Nd:Glass laser is demonstrated. An Nd:Glass rod was selected as the laser medium and a DKDP crystal was employed as the Q-switch. A cubic polarizer was placed in the cavity to divide the randomly polarized radiation into two orthogonally polarized beams. The two beams were tuned by two Littman-gratings and output independently. For Q-switched operation, the tuning range was 1050.1 - 1061.6 nm and 1050.5 - 1060.2 nm for the horizontal and vertical polarizations, respectively. When the horizontally polarized output was fixed at 1059.1 nm, the synchronized vertically polarized one can be tuned from 1051.5 to 1057.5 nm.

THz-wave generation via stimulated polariton scattering in KTiOAsO4 crystal.

A terahertz parametric oscillator based on KTiOAsO(4) crystal is demonstrated for the first time. With the near-forward scattering configuration X(ZZ)X + Δφ, the polarizations of the pump, the Stokes and the generated THz waves are parallel to the z-axis of the crystal KTA. When the incident angle θext of the pump wave is changed from 1.875° to 6.500°, the THz wave is intermittently tuned from 3.59 to 3.96 THz, from 4.21 to 4.50 THz, from 4.90 to 5.16 THz, from 5.62 to 5.66 THz and from 5.92 to 6.43 THz. The obtained maximum THz wave energy is 627 nJ at 4.30 THz with a pump energy of 100 mJ. It is believed that the terahertz wave generation is caused by the stimulated scattering of the polaritons associated with the most intensive transverse A(1) mode of 233.8 cm(-1). Four much weaker transverse A(1) modes of 132.9 cm(-1), 156.3 cm(-1),175.1 cm(-1), and 188.4 cm(-1) cause four frequency gaps, from 3.97 THz to 4.20 THz, from 4.51 to 4.89 THz, from 5.17 to 5.61 THz and from 5.67 to 5.91 THz, respectively.

Terahertz parametric oscillator based on KTiOPO4 crystal.

KTiOPO4 (KTP) crystal is used as the nonlinear medium in a surface-emitted terahertz-wave parametric oscillator for the first time. The oscillating Stokes beam propagates along the x axis of the KTP crystal, the pumping beam propagates with a small incident angle θ(ext) to the x axis, and the polarizations of the pumping beam, the Stokes beam, and the THz wave are along the z axis. When θ(ext) is changed from 1.250° to 6.000°, the THz wave is intermittently tuned from 3.17 to 3.44 THz, from 4.19 to 5.19 THz, and from 5.55 to 6.13 THz. The maximum output of the THz wave is 336 nJ, obtained at 5.72 THz with a pumping energy of 80 mJ. The two frequency gaps, from 3.44 to 4.19 THz and from 5.19 to 5.55 THz, are located in the vicinities of the A1 modes of 134 and 178.7 cm⁻¹, which are strongly infrared absorbing.

Femtosecond-laser micromachined optical waveguides in Bi4Ge3O12 crystals.

The optical waveguides in Bi(4)Ge(3)O(12) (BGO) crystals in both depressed-cladding and dual-line configurations have been produced using femtosecond-laser micromachining. The guiding properties and thermal stabilities of the BGO waveguides have been investigated for both geometries, showing different performance of the fabricated structures. Both depressed-cladding and dual-line waveguides support guidance along both TE and TM polarizations. Thermal annealing treatments up to 600°C reduce the propagation loss of dual-line waveguides to as low as 0.5 dB/cm, while the cladding waveguide is only stable under thermal treatment not higher than 260°C, reaching a propagation loss of 2.1 dB/cm.

Guided-wave second harmonics in Nd:YCOB optical waveguides for integrated green lasers.

We report on guided-wave second-harmonic generations in nonlinear Nd:YCa4O(BO3)3 (Nd:YCOB) optical waveguides that are produced by the low-fluence swift Ar8+ ion irradiation. The guided-wave second harmonics are realized through the frequency doubling and the self-frequency-doubling of the waveguides under the optical pumps at wavelengths of 1064 and 810 nm, respectively. By virtue of the self-frequency-conversion configuration, the Nd:YCOB waveguides are promising candidates as novel, compact, miniature green laser sources.

Second harmonic and raman imaging of He+ implanted KTiOPO4 waveguides.

We report on the micro second harmonic (µ-SH) and micro Raman (µ-Raman) images of ion implanted channel and planar waveguides in KTiOPO4 (KTP) crystals. The µ-SH images reveal that the nonlinear properties in the waveguides have not been deteriorated during the implantation process. This is consistent with the µ-Raman images that evidences that lattice distortions are minimal at waveguide's volume. Both the structural and nonlinear properties of the KTP lattice have been only modified at the end of ions' trajectory, which is in good agreement with the positions with maximum refractive index changes.

Second harmonic generation of swift carbon ion irradiated Nd:GdCOB waveguides.

We report on the second harmonic generation at ~532 nm of optical waveguides in Nd:GdCOB produced by swift carbon ion irradiation. The fabricated waveguide shows good guiding property. Under pump of ~1064-nm fundamental light, the optical conversion efficiency of the frequency doubling is 0.48% W(-1) and 6.8% W(-1) for continuous wave and pulsed laser beams, respectively.

Channel waveguide lasers in Nd:GGG crystals fabricated by femtosecond laser inscription.

Buried channel waveguides have been fabricated in Nd:GGG crystals by using the femtosecond laser inscription. The waveguides are confined between two filaments with propagation losses of 2.0 dB/cm. Stable continuous wave laser oscillation at ~1061 nm has been demonstrated at room temperature. Under 808 nm optical excitation, a pump threshold of 29 mW and a slope efficiency of 25% have been obtained.