Readmission Risk Based on Debility and Psychosocial Measures: The Western 9 Algorithm.

Many studies have stressed the importance of psychosocial determinants of health such as food insecurity, housing instability, and education level, as important drivers of health outcomes. Western Health developed a set of nine screening questions (the Western 9) based on psychosocial measures to profile patients enrolled in the HealthLinks Chronic Care initiative. An aggregate score was then converted into a Low, Medium and High risk profiles. The aim of the study was to see if the Western 9 questions added additional discriminative power to existing risk of readmission algorithms. Results show that the inclusion of the risk profiles significantly improved model fit and calibration compared to a baseline risk model. Suggestions for further refinement include developing weighted indices for the Western 9 to improve model fit.

Wafer-scale heterogeneous integration of thin film lithium niobate on silicon-nitride photonic integrated circuits with low loss bonding interfaces.

Silicon nitride (Si3N4) is a versatile waveguide material platform for CMOS foundry-based photonic integrated circuits (PICs) with low loss and high-power handling. The range of applications enabled by this platform is significantly expanded with the addition of a material with large electro-optic and nonlinear coefficients such as lithium niobate. This work examines the heterogeneous integration of thin-film lithium-niobate (TFLN) on silicon-nitride PICs. Bonding approaches are evaluated based on the interface used (SiO2, Al2O3 and direct) to form hybrid waveguide structures. We demonstrate low losses in chip-scale bonded ring resonators of 0.4 dB/cm (intrinsic Q = 8.19 × 105). In addition, we are able to scale the process to demonstrate bonding of full 100-mm TFLN wafers to 200-mm Si3N4 PIC wafers with high layer transfer yield. This will enable future integration with foundry processing and process design kits (PDKs) for applications such as integrated microwave photonics and quantum photonics.

Demonstration of a highly stable 10 GHz optical frequency comb with low timing jitter from a SCOWA-based harmonically mode-locked nested cavity laser.

An optical frequency comb with mode spacing of 10 GHz operating in the c-band is produced from a harmonically mode-locked laser using a slab-coupled optical waveguide amplifier device with a fiber-coupled external cavity. An intracavity Fabry-Perot etalon serves as a high finesse optical filter for supermode suppression and as the reference for cavity length stabilization using a multi-combline Pound-Drever-Hall setup. The Allan deviation of a single optical combline near 193.4 THz is measured via a heterodyne beat with a cavity stabilized cw laser and reaches a minimum fractional frequency deviation of 3×10-13 at τ=30 ms. In addition, the phase noise of the photodetected pulsed output of the laser shows a timing jitter of <23 fs integrated from 1 Hz to the Nyquist frequency.

Low-noise RF-amplifier-free slab-coupled optical waveguide coupled optoelectronic oscillators: physics and operation.

We demonstrate a 10-GHz RF-amplifier-free slab-coupled optical waveguide coupled optoelectronic oscillator (SCOW-COEO) system operating with low phase-noise (<-115 dBc/Hz at 1 kHz offset) and large sidemode suppression (>70 dB measurement-limited). The optical pulses generated by the SCOW-COEO exhibit 26.8-ps pulse width (post compression) with a corresponding spectral bandwidth of 0.25 nm (1.8X transform-limited). We also investigate the mechanisms that limit the performance of the COEO. Our measurements indicate that degradation in the quality factor (Q) of the optical cavity significantly impacts COEO phase-noise through increases in the optical amplifier relative intensity noise (RIN).

Amplifier-free slab-coupled optical waveguide optoelectronic oscillator systems.

We demonstrate a free-running 3-GHz slab-coupled optical waveguide (SCOW) optoelectronic oscillator (OEO) with low phase-noise (<-120 dBc/Hz at 1-kHz offset) and ultra-low sidemode spurs. These sidemodes are indistinguishable from noise on a spectrum analyzer measurement (>88 dB down from carrier). The SCOW-OEO uses high-power low-noise SCOW components in a single-loop cavity employing 1.5-km delay. The noise properties of our SCOW external-cavity laser (SCOWECL) and SCOW photodiode (SCOWPD) are characterized and shown to be suitable for generation of high spectral purity microwave tones. Through comparisons made with SCOW-OEO topologies employing amplification, we observe the sidemode levels to be degraded by any amplifiers (optical or RF) introduced within the OEO cavity.

Uni-traveling-carrier variable confinement waveguide photodiodes.

Uni-traveling-carrier waveguide photodiodes (PDs) with a variable optical confinement mode size transformer are demonstrated. The optical mode is large at the input for minimal front-end saturation and the mode transforms as the light propagates so that the absorption profile is optimized for both high-power and high-speed performance. Two differently designed PDs are presented. PD A demonstrates a 3-dB bandwidth of 12.6 GHz, and saturation currents of 40 mA at 1 GHz and 34 mA at 10 GHz. PD B demonstrates a 3-dB bandwidth of 2.5 GHz, a saturation current greater than 100 mA at 1 GHz, a peak RF output power of + 19 dBm, and a third-order output intercept point of 29.1 dBm at a photocurrent of 60 mA.

Low-noise, low repetition rate, semiconductor-based mode-locked laser source suitable for high bandwidth photonic analog-digital conversion.

A semiconductor-based mode-locked laser source with low repetition rate, ultralow amplitude, and phase noise is introduced. A harmonically mode-locked semiconductor-based ring laser is time demultiplexed at a frequency equal to the cavity fundamental frequency (80MHz), resulting in a low repetition rate pulse train having ultralow amplitude and phase noise, properties usually attributed to multigigahertz repetition rate lasers. The effect of time demultiplexing on the phase noise of harmonically mode-locked lasers is analyzed and experimentally verified.

Continuous-wave two-photon absorption in a Watt-class semiconductor optical amplifier.

We report the observation of photoluminescence produced by the recombination of free carriers generated via continuous-wave (CW) two-photon absorption (TPA) in a packaged, low-confinement (Gamma approximately 0.5%) InGaAsP/InP quantum-well slab-coupled optical waveguide amplifier (SCOWA) having a saturation output power of 0.8 W and 1/e-mode-field diameters of 5 x 7 microm. Photoluminescence power measured at the wavelength corresponding to the bandgap wavelength of the SCOWA's InGaAsP waveguide (lambda(G) approximately 1040 nm) exhibits a quadratic dependence on the amplifier's 1540-nm output power. Comparison between measured and simulated CW gain saturation data reveals that the combination of TPA and TPA-generated free-carrier absorption (FCA) limits the CW output intensity of high-power, low-confinement semiconductor optical amplifiers and semiconductor lasers.

250 mW, 1.5 microm monolithic passively mode-locked slab-coupled optical waveguide laser.

We report the demonstration of a 1.5 microm InGaAsP mode-locked slab-coupled optical waveguide laser (SCOWL) producing 10 ps pulses with energies of 58 pJ and average output powers of 250 mW at a repetition rate of 4.29 GHz. To the best of our knowledge, this is the first passively mode-locked slab-coupled optical waveguide laser. The large mode and low confinement factor of the SCOWL architecture allows the realization of monolithic mode-locked lasers with high output power and pulse energy. The laser output is nearly diffraction limited with M2 values less than 1.2 in both directions.