Numerical modeling of Dy3+-doped aluminosilicate fiber lasers for yellow light emission.

Numerical simulations of D y 3+-doped aluminosilicate fiber lasers for yellow light emission are presented. The 4 F 9/2→6 H 13/2 laser transition emitting at approximately 580 nm has been developed experimentally with 445 nm diode pumping and shows promise for higher output power in both silicate and in particular fluoride glass hosts. In this report, we focus on accumulating the published spectroscopic data in order to quantify cross relaxation (CR) in each of these hosts and use it to estimate its role in the laser dynamics. The model involves calculation of the branching ratios, and radiative and nonradiative decay rates and compares well with reported experimental results. We show the important role of the background losses on previous laser performance and the relatively strong increase in the laser threshold as a result of CR despite the moderately low D y 3+ concentrations that have been experimentally tested.

Evaluating the Efficacy of ChatGPT as a Patient Education Tool in Prostate Cancer: Multimetric Assessment.

BACKGROUND: Artificial intelligence (AI) chatbots, such as ChatGPT, have made significant progress. These chatbots, particularly popular among health care professionals and patients, are transforming patient education and disease experience with personalized information. Accurate, timely patient education is crucial for informed decision-making, especially regarding prostate-specific antigen screening and treatment options. However, the accuracy and reliability of AI chatbots' medical information must be rigorously evaluated. Studies testing ChatGPT's knowledge of prostate cancer are emerging, but there is a need for ongoing evaluation to ensure the quality and safety of information provided to patients. OBJECTIVE: This study aims to evaluate the quality, accuracy, and readability of ChatGPT-4's responses to common prostate cancer questions posed by patients. METHODS: Overall, 8 questions were formulated with an inductive approach based on information topics in peer-reviewed literature and Google Trends data. Adapted versions of the Patient Education Materials Assessment Tool for AI (PEMAT-AI), Global Quality Score, and DISCERN-AI tools were used by 4 independent reviewers to assess the quality of the AI responses. The 8 AI outputs were judged by 7 expert urologists, using an assessment framework developed to assess accuracy, safety, appropriateness, actionability, and effectiveness. The AI responses' readability was assessed using established algorithms (Flesch Reading Ease score, Gunning Fog Index, Flesch-Kincaid Grade Level, The Coleman-Liau Index, and Simple Measure of Gobbledygook [SMOG] Index). A brief tool (Reference Assessment AI [REF-AI]) was developed to analyze the references provided by AI outputs, assessing for reference hallucination, relevance, and quality of references. RESULTS: The PEMAT-AI understandability score was very good (mean 79.44%, SD 10.44%), the DISCERN-AI rating was scored as "good" quality (mean 13.88, SD 0.93), and the Global Quality Score was high (mean 4.46/5, SD 0.50). Natural Language Assessment Tool for AI had pooled mean accuracy of 3.96 (SD 0.91), safety of 4.32 (SD 0.86), appropriateness of 4.45 (SD 0.81), actionability of 4.05 (SD 1.15), and effectiveness of 4.09 (SD 0.98). The readability algorithm consensus was "difficult to read" (Flesch Reading Ease score mean 45.97, SD 8.69; Gunning Fog Index mean 14.55, SD 4.79), averaging an 11th-grade reading level, equivalent to 15- to 17-year-olds (Flesch-Kincaid Grade Level mean 12.12, SD 4.34; The Coleman-Liau Index mean 12.75, SD 1.98; SMOG Index mean 11.06, SD 3.20). REF-AI identified 2 reference hallucinations, while the majority (28/30, 93%) of references appropriately supplemented the text. Most references (26/30, 86%) were from reputable government organizations, while a handful were direct citations from scientific literature. CONCLUSIONS: Our analysis found that ChatGPT-4 provides generally good responses to common prostate cancer queries, making it a potentially valuable tool for patient education in prostate cancer care. Objective quality assessment tools indicated that the natural language processing outputs were generally reliable and appropriate, but there is room for improvement.

High-efficiency fluoroindate glass fiber laser.

We report the high-efficiency operation of a 3.05 µm dysprosium-doped fluoroindate glass fiber laser that is in-band pumped at 2.83 µm using an erbium-doped fluorozirconate glass fiber laser. The demonstrated slope efficiency of the free-running laser of 82% represents approximately 90% of the Stokes efficiency limit; a maximum output power of 0.36 W, the highest for a fluoroindate glass fiber laser, was recorded. Narrow-linewidth wavelength stabilization at 3.2 µm was achieved by utilizing a first-reported, to the best of our knowledge, high-reflectivity fiber Bragg grating inscribed in the Dy3+-doped fluoroindate glass. These results lay the foundation for future power-scaling of mid-infrared fiber lasers using fluoroindate glass.

Laparoscopic donor nephrectomy-Technique and peri-operative outcomes in an Australian transplant center.

INTRODUCTION: Demand for donor kidneys far exceeds the availability of organs from deceased donors. Living donor kidneys are an important part of addressing this shortfall, and laparoscopic nephrectomy is an important strategy to reduce donor morbidity and increase the acceptability of living donation. AIM: To retrospectively review the intraoperative and postoperative safety, technique, and outcomes of patients undergoing donor nephrectomy at a single tertiary hospital in Sydney, Australia. METHOD: Retrospective capture and analysis of clinical, demographic, and operative data for all living donor nephrectomies performed between 2007 and 2022 at a single University Hospital in Sydney, Australia. RESULTS: Four hundred and seventy-two donor nephrectomies were performed: 471 were laparoscopic, two of which were converted from laparoscopic to open and hand-assisted nephrectomy, respectively, and one (.2%) underwent primary open nephrectomy. The mean warm ischemia time was 2.8 min (±1.3 SD, median 3 min, range 2-8 min) and the mean length of stay (LOS) was 4.1 days (±1.0 SD). The mean renal function on discharge was 103 µmol/L (±23.0 SD). Seventy-seven (16%) patients had a complication with no Clavien Dindo IV or V complications seen. Outcomes demonstrated no impact of donor age, gender, kidney side, relationship to the recipient, vascular complexity; or surgeon experience, on complication rate or LOS. CONCLUSION: Laparoscopic donor nephrectomy is a safe and effective procedure with minimal morbidity and no mortality in this series.

Scattering under the Rayleigh-Debye-Gans condition for transparent glass ceramics.

We reviewed the various theoretical relations that quantify light scattering under the Rayleigh-Debye-Gans (RDG) approximation and applied these relations to calculate scattering within transparent glass ceramics (TGCs) composed of large nanocrystals within a glass matrix. For a more realistic picture of scattering, we included material dispersion of the crystals and glasses across the transparency range of these materials by way of the Sellmeier equation. We first selected a number of crystal-glass sets that are near-index-matched in the visible and near-IR to fulfill one of the RDG criterion. We found that the various forms of scattering under the RDG approximation differ significantly across the visible and near-IR. We also found that the inclusion of material dispersion significantly changes the trends in the calculated scattering cross section across the studied wavelength range. Overall, we found that calculation of the scattering cross section is highly dependent on the chosen theoretical relation and that the inclusion of material dispersion is vital to better understand scattering loss in this new class of optical materials.

Imaging system aberrations through optical windows with nonuniform laser heating.

An optical window is a critical component of an imaging system. When operating in harsh environments with extreme heating, nonuniform temperature changes occur throughout the window and cause nonuniform refractive index changes and mechanical deformations due to thermal expansion, which can degrade the imaging system's performance. In this paper, we present results collected from an experimental setup developed to characterize these aberrations. This setup includes a C O 2 laser for sample heating, an infrared camera for measuring front and back surface temperatures, and a visible imaging system and a wavefront sensor for measuring degradations of a collimated beam from a point source transmitted through the heated window. Sapphire samples are laser heated with a Gaussian profile to temperatures in excess of 500 K with surface temperature gradients in excess of 15 K/mm. These measurements are compared with first principles models, which show quantitative agreement for window temperatures and qualitative agreement with the transmitted wavefront and imaged point source.

Picosecond pulse formation in the presence of atmospheric absorption.

Mode-locked mid-infrared (MIR) fiber laser research has been dominated by the generation of pulses in the picosecond regime using saturable absorbers (SAs) and more recently frequency shifted feedback (FSF). Despite the significant emphasis placed on the development of materials to serve as the SAs for the MIR, published pulse durations have been substantially longer than what has been reported in the near-infrared (NIR). In this report we present experimental data supporting the view that the majority of demonstrations involving SAs and FSF have been limited by the presence of molecular gas absorption in the free-space sections of their cavities. We show that the pulse duration is directly linked to the width of an absorption-free region of the gaseous absorption profile and that the resulting optical spectrum is nearly always bounded by strong absorption features.

Long wavelength operation of a dysprosium fiber laser for polymer processing.

We demonstrate operation of a mid-infrared dysprosium-doped fiber laser with emission at 3388 nm, representing the longest wavelength yet achieved from this class of laser, to the best of our knowledge. Oscillation far removed from the Dy3+ gain peak around 3 µm is achieved through the design of a high feedback optical cavity employing a directly inscribed fiber Bragg grating as the output coupler. Laser performance is characterized by a slope efficiency with respect to injected pump power of 38% and maximum output power of 134 mW, an improvement of at least three orders of magnitude over prior attempts at long wavelength Dy3+ fiber laser operation. This wavelength coincides with a maximum in the absorption coefficient of PMMA, which we exploit for preliminary demonstration of the utility of this source in polymer processing.

Ultrafast 3.5 µm fiber laser.

We report, to the best of our knowledge, the first mode-locked fiber laser to operate in the femtosecond regime well beyond 3 µm. The laser uses dual-wavelength pumping and nonlinear polarization rotation to produce 3.5 µm wavelength pulses with minimum duration of 580 fs at a repetition rate of 68 MHz. The pulse energy is 3.2 nJ, corresponding to a peak power of 5.5 kW.

Electrical neuromodulation in bladder dysfunction: Mapping the state-of-the-art with bibliometric analysis of field and top 100 cited articles.

AIMS: Electrical neuromodulation of bladder function has been extensively investigated in the literature. To date, there has been no characterization of the field, and there is a lack of bibliometric literature to guide future studies. We directed this scientometric analysis to characterize the distribution, characteristics and relationships of the field, with subanalysis of top 100 articles. METHODS: The Web of Science Core Collection of the Thompson Reuters Web of Science was searched and analyzed to determine distributions and characteristics of clinical research investigating electrical neuromodulation in bladder dysfunction. Field citation and coauthorship networks were mapped, and recent citation bursts of the past decade are described. The top 100 cited articles were categorized, with level of evidence rating system applied. RESULTS: A total of 872 articles published from 1949 until October 2020 were included in field analysis. Europe demonstrated the highest continental productivity within field (n = 539, 61.81%), and the United States the top nation (35.55% of field, 39.24% of top 100 articles). The Journal of Urology has historically published the most articles in the field (n = 150, 17.20%), and top 100 articles (n = 41, 40.20%). Top 100 articles reported studies of neuromodulation effects via sacral neuromodulation (n = 59); of non-neurological bladder dysfunction (n = 72); urinary incontinence (n = 92), frequency (n = 73) and urgency (n = 68) symptomology. CONCLUSIONS: Analysis of electrical neuromodulation of bladder dysfunction literature reveals historical development, core research clusters and relationships, and an increase in publication activity over past decades.

Fiber-based sources of coherent MIR radiation: key advances and future prospects (invited).

The mid-infrared (MIR) represents a large portion of the electromagnetic spectrum that is progressively being exploited for an enormous number of applications. Thermal imaging cameras, dental and skin resurfacing lasers, and narcotics detectors at airports are all mainstream examples involving the MIR, but potential applications of MIR technologies are much larger. Accessing the unique opportunities afforded by the MIR is critically dependent on the specific characteristics of MIR emitting sources that become available. In this review, we survey an important enabling technology to the opening up of MIR science and applications, namely that driven by fiber-based sources of coherent MIR radiation. In this review paper, we describe many of the key advances in the innovation and development of such sources over the past few decades and discuss many of the underlying science and technology issues that have resulted in specific recent source achievements, especially in light of new applications enabled by these new source capabilities. We also discuss a few specific anticipated future needs and some potentially disruptive approaches to future MIR fiber source development.

Electronically tunable picosecond pulse generation from Ho3+-doped fluoride fiber laser using frequency-shifted feedback.

In this Letter, we demonstrate electronically tunable picosecond (ps) pulse emission from the 5I6-5I7 transition of the Ho3+ ion by using an acousto-optic tunable filter. The holmium- and praseodymium-codoped ZBLAN fiber laser produced sub-50 ps pulses over a 100 nm tuning range, critically reaching a longest wavelength of 2.94 µm, which overlaps with the peak absorption of liquid water. Measured pulse energies of 8.1 nJ well exceed those expected from picosecond solitonic operation, suggesting possible application in ablative medicine. Furthermore, we present harmonically mode-locked operation of the oscillator, which indicates the possibility of expanding the capabilities of mid-infrared frequency shifted-feedback lasers through the ability to achieve higher pulse repetition rates.

Long Pulse-Width Setting Improves Holmium-YAG Laser Lithotripsy - Enhanced Fragmentation and Retropulsion Characteristics of Renal Calculi in a Novel In-Vivo Setting.

The aim of this novel in vivo study was to characterize the effect of short pulse-width versus long pulse-width Holmium-YAG laser lithotripter settings on retropulsion and fragmentation in a real-life setting. A prospective, crossover study was conducted at a tertiary teaching hospital in NSW, Australia. Patients who underwent flexible ureteroscopy with laser lithotripsy for renal calculi in 2018 were included. All patients underwent flexible ureteroscopy using a Flexor® 10.7/12 French ureteric access sheath (Cook Medical LLC, Bloomington, IN, USA) and lithotripsy with a 30W Holmium-YAG laser (Rocamed, Monaco). Thirty-two renal calculi were subjected to 1 min of laser treatment using both short and long pulse-width settings. Using 5-point, operator-assessed Likert scales, the level of retropulsion and fragmentation efficacy were assessed. There was significantly less retropulsion and improved stone fragmentation (p<0.001) using the long pulse-width compared to the short pulse-width setting. Regardless of stone size, in vivo renal calculi lithotripsy with a long pulse-width significantly improves the efficacy of lithotripter treatment.

Towards subdiffraction imaging with wire array metamaterial hyperlenses at MIR frequencies.

We describe the fabrication of metamaterial magnifying hyperlenses with subwavelength wire array structures for operation in the mid-infrared (around 3 µm). The metadevices are composed of approximately 500 tin wires embedded in soda-lime glass, where the metallic wires vary in diameter from 500 nm to 1.2 µm along the tapered structure. The modeling of the hyperlenses indicates that the expected overall losses for the high spatial frequency modes in such metadevices are between 20 dB to 45 dB, depending on the structural parameters selected, being promising candidates for far-field subdiffraction imaging in the mid-infrared. Initial far-field subdiffraction imaging attempts are described, and the problems encountered discussed.

Directly diode-pumped mid-infrared dysprosium fiber laser.

We report the demonstration of a Dy3+-doped ZBLAN fiber laser directly diode-pumped at 800 nm utilizing a codoping scheme with Tm3+ serving as the donor ion. In this initial demonstration, a modest output power of 12 mW is generated with a slope efficiency of 0.3% at an emission wavelength of 3.23 µm. Energy transfer dynamics are investigated through excited state lifetime analysis and comparison to resonant pumping of the Dy3+ upper state. The likely presence of an energy transfer upconversion process is identified, which has an undesirable effect on 3 µm class lasers but may be of significant benefit for future 4 µm systems.

Ultrafast mid-infrared fiber laser mode-locked using frequency-shifted feedback.

We demonstrate ultrashort pulse generation from a fluoride fiber laser co-doped with holmium and praseodymium. To date, the majority of work focused on short pulse generation from this class of fiber laser has employed loss modulators in the cavity, both real and artificial. In this Letter, we alternatively employ a frequency shifting element: an acousto-optic modulator (AOM) in the cavity. This results in mode-locked output of sub-5 ps pulses with 10 nJ of energy at a center wavelength of 2.86 µm and a pulse repetition frequency of 30.1 MHz, equating to a peak power of 1.9 kW. Additional experimental investigation of the relationship between frequency shift and cavity round trip offer insight into the complex underlying dynamics. As a complementary mode-locking technique to conventional loss modulation, this method of pulse-formation may greatly expand the design flexibility of pulsed mid-infrared fiber lasers.

Dysprosium-doped ZBLAN fiber laser tunable from 2.8 µm to 3.4 µm, pumped at 1.7 µm.

We demonstrate a mid-infrared dysprosium-doped fluoride fiber laser with a continuously tunable output range of 573 nm, pumped by a 1.7 µm Raman fiber laser. To the best of our knowledge, this represents the largest tuning range achieved to date from any rare-earth-doped fiber laser and, critically, spans the 2.8-3.4 µm spectral region, which contains absorption resonances of many important functional groups and is uncovered by other rare-earth ions. Output powers up to 170 mW are achieved, with 21% slope efficiency. We also discuss the relative merits of the 1.7 µm pump scheme, including possible pump excited-state absorption.

Emission beyond 4 µm and mid-infrared lasing in a dysprosium-doped indium fluoride (InF3) fiber.

Optical emission from rare-earth-doped fluoride fibers has thus far been limited to less than 4 µm. We extend emission beyond this limit by employing an indium fluoride (InF3) glass fiber as the host, which exhibits an increased infrared transparency over commonly used zirconium fluoride (ZBLAN). Near-infrared pumping of a dysprosium-doped InF3 fiber results in broad emission centered around 4.3 µm, representing the longest emission yet achieved from a fluoride fiber. The first laser emission in an InF3 fiber is also demonstrated from the 3 µm dysprosium transition. Finally, a frequency domain excited state lifetime measurement comparison between fluoride hosts suggests that multiphonon effects are significantly reduced in indium fluoride fiber, paving the way to more efficient, longer wavelength lasers compared to ZBLAN fibers.

Direct inscription of Bragg gratings into coated fluoride fibers for widely tunable and robust mid-infrared lasers.

We report the development of a widely tunable all-fiber mid-infrared laser system based on a mechanically robust fiber Bragg grating (FBG) which was inscribed through the polymer coating of a Ho3+-Pr3+ co-doped double clad ZBLAN fluoride fiber by focusing femtosecond laser pulses into the core of the fiber without the use of a phase mask. By applying mechanical tension and compression to the FBG while pumping the fiber with an 1150 nm laser diode, a continuous wave (CW) all-fiber laser with a tuning range of 37 nm, centered at 2870 nm, was demonstrated with up to 0.29 W output power. These results pave the way for the realization of compact and robust mid-infrared fiber laser systems for real-world applications in spectroscopy and medicine.

Highly efficient mid-infrared dysprosium fiber laser.

A new, highly efficient and power scalable pump scheme for 3 µm class fiber lasers is presented. Using the free-running 2.8 µm emission from an Er3+-doped fluoride fiber laser to directly excite the upper laser level of the H13/26→H15/26 transition of the Dy3+ ion, output at 3.04 µm was produced with a record slope efficiency of 51%. Using comparatively long lengths of Dy3+-doped fluoride fiber, a maximum emission wavelength of 3.26 µm was measured.