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Optical design of a high power fiber optic coupler
Fiber optic beam delivery systems are replacing conventional mirror delivery systems for many reasons (e.g., system flexibility and redundancy, stability, and ease of alignment). Commercial products are available that use of fiber optic delivery for laser surgery and materials processing. Also, pump light of dye lasers can be delivered by optical fibers. Many laser wavelengths have been transported via optical fibers; high power delivery has been reported for argon, Nd:YAG, and excimer. We have been developing fiber optic beam delivery systems for copper vapor laser light; many of the fundamental properties of these systems are applicable to other high power delivery applications. A key element of fiber optic beam delivery systems is the coupling of laser light into the optical fiber. For our application this optical coupler must be robust to a range of operating parameters and laser characteristics. We have access to a high power copper vapor laser beam that is generated by a master oscillator/power amplifier (MOPA) chain comprised of three amplifiers. The light has a pulse width of 40--50 nsec with a repetition rate of about 4 kHz. The average power (nominal) to be injected into a fiber is 200 W. (We will refer to average power in this paper.) In practice, the laser beam's direction and collimation change with time. These characteristics plus other mechanical and operational constraints make it difficult for our coupler to be opto-mechanically referenced to the laser beam. We describe specifications, design, and operation of an optical system that couples a high-power copper vapor laser beam into a large core, multimode fiber. The approach used and observations reported are applicable to fiber optic delivery applications. 6 refs., 6 figs
Why do banks promise to pay par on demand?
We survey the theories of why banks promise to pay par on demand and examine evidence about
the conditions under which banks have promised to pay the par value of deposits and banknotes on
demand when holding only fractional reserves. The theoretical literature can be broadly divided into four
strands: liquidity provision, asymmetric information, legal restrictions, and a medium of exchange. We
assume that it is not zero cost to make a promise to redeem a liability at par value on demand. If so, then
the conditions in the theories that result in par redemption are possible explanations of why banks
promise to pay par on demand. If the explanation based on customers’ demand for liquidity is correct,
payment of deposits at par will be promised when banks hold assets that are illiquid in the short run. If
the asymmetric-information explanation based on the difficulty of valuing assets is correct, the
marketability of banks’ assets determines whether banks promise to pay par. If the legal restrictions
explanation of par redemption is correct, banks will not promise to pay par if they are not required to do
so. If the transaction explanation is correct, banks will promise to pay par value only if the deposits are
used in transactions. After the survey of the theoretical literature, we examine the history of banking in
several countries in different eras: fourth-century Athens, medieval Italy, Japan, and free banking and
money market mutual funds in the United States. We find that all of the theories can explain some of the
observed banking arrangements, and none explain all of them
Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19
IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.
Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.
DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022).
INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days.
MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes.
RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively).
CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
A Psychodynamic View of Counseling Psychology
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69032/2/10.1177_001100008000900114.pd