A 40 Gb/s InP-monolithically integrated DPSK-demolulator enhanced by cross-gain-compensation in an SOA

We fabricated and experimentally tested a novel monolithically integrated Indium Phosphide optical circuit for differential phase-shift keying demodulation, which is robust to noise degradations of the received signal. The circuit consists of a one-bit-delay interferometer that demodulates the incoming signal and a semiconductor optical amplifier where the constructive and destructive demodulated outputs synchronously counter-propagate experiencing a reshaping effect. The novel optical circuit has been fabricated for 40 Gb/s signals, and the amplitude signal restoration is demonstrated by comparing the obtained output eye diagrams with those of a commercial fiber-based demodulator. We find a net improvement in the signal to noise ratio when the circuit is fed with a noisy input signal

Design of InP membrane SOA with butt-joint active passive interface

A butt-joint SOA design for InP on Si membrane (IMOS) platform is proposed. The new design features the butt-joint interface between the SOA and passive nanophotonic waveguide, which makes the interface a factor of 2 to 6 shorter than in the current twin-guide SOAs, with possibility to reduce it further to factor of 5-10. This makes the new SOA a promising candidate for high-speed directly modulated lasers (DML) applications, where extremely short SOAs (40-100 μm long) and short distances between reflectors are usually required

Conductivity of twin walls - surface junctions in ferroelastics: interplay of deformation potential, octahedral rotations, improper ferroelectricity and flexoelectric coupling

Electronic and structural phenomena at the twin domain wall-surface junctions in the ferroelastic materials are analyzed. Carriers accumulation caused by the strain-induced band structure changes originated via the deformation potential mechanism, structural order parameter gradient, rotostriction and flexoelectric coupling is explored. Approximate analytical results show that inhomogeneous elastic strains, which exist in the vicinity of the twin walls - surface junctions due to the rotostriction coupling, decrease the local band gap via the deformation potential and flexoelectric coupling mechanisms. This is the direct mechanism of the twin walls static conductivity in ferroelastics and, by extension, in multiferroics and ferroelectrics. On the other hand, flexoelectric and rotostriction coupling leads to the appearance of the improper polarization and electric fields proportional to the structural order parameter gradient in the vicinity of the twin walls - surface junctions. The "flexo-roto" fields leading to the carrier accumulation are considered as indirect mechanism of the twin walls conductivity. Comparison of the direct and indirect mechanisms illustrates complex range of phenomena directly responsible for domain walls static conductivity in materials with multiple order parameters.Comment: 35 pages, 11 figures, 3 table, 3 appendices Improved set of rotostriction coefficients are used in calculation

III-V-on-silicon multi-frequency lasers

Compact multi-frequency lasers are realized by combining III-V based optical amplifiers with silicon waveguide optical demultiplexers using a heterogeneous integration process based on adhesive wafer bonding. Both devices using arrayed waveguide grating routers as well as devices using ring resonators as the demultiplexer showed lasing with threshold currents between 30 and 40 mA and output powers in the order of a few mW. Laser operation up to 60°C is demonstrated. The small bending radius allowable for the silicon waveguides results in a short cavity length, ensuring stable lasing in a single longitudinal mode, even with relaxed values for the intra-cavity filter bandwidths

Adaptability and learning Intraprofessional collaboration of residents during the COVID-19 pandemic

CONTEXT: The COVID-19 pandemic created a worldwide public health emergency, in which hospitals created new COVID departments and doctors from different disciplines had to work together. In the Netherlands, a large proportion of doctors in these departments were residents. With knowledge of the disease developing only gradually, the influx of COVID-19 patients called for adaptability, innovative work behavior, and intraprofessional collaboration (intraPC) between residents and between residents and medical specialists. RESEARCH GOAL: This study investigates how the delivery of COVID-19 care in hospital settings altered the way residents develop their sense of adaptability and intraPC during their training. METHODS: Sixteen semi-structured interviews were conducted with residents and medical specialists from various disciplines who worked at a COVID department or Intensive Care Unit (ICU) during the COVID pandemic in the Netherlands, focusing on adaptability and intraPC learning. Transcripts were analyzed using (thematic) template analysis. RESULTS: Four themes that influenced learning during COVID care were identified: collective uncertainty, social cohesion and a sense of safety, the need for adaptive performance and intraPC learning. During the first wave, collective uncertainty about the unknown disease and the continuation of the crisis urged residents to adapt in order to take care of patients with a disease that was as yet unknown. The combination of collective uncertainty, social cohesion and a sense of safety, and the presence of different disciplines in one department promoted residents’ intraPC learning. However, intraPC learning was not always the matter of course due to the scope of the crisis and the huge numbers of new patients. CONCLUSION: Collective uncertainty affected the residents’ adaptability. The combination of collective uncertainty, social cohesion, and the presence of different disciplines in one department promoted the residents’ intraPC learning. An important facilitating factor for both adaptability and intraPC learning is a high level of social cohesion and safety. The physical and psychological proximity of supervisors is an important factor contributing to a safe learning environment. This study provides implications for practice for learning during postgraduate training in non-crisis settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-022-03868-9

Heterogeneously integrated III-V/Si single mode lasers based on a MMI-ring configuration and triplet-ring reflectors

In this paper we show that using a DVS-BCB adhesive bonding process compact heterogeneously integrated III-V/silicon single mode lasers can be realized. Two new designs were implemented: in a first design a multimode interferometer coupler (MMI) – ring resonator combination is used to provide a comb-like reflection spectrum, while in a second design a triplet-ring reflector design is used to obtain the same. A broadband silicon Bragg grating reflector is implemented on the other side of the cavity. The III-V optical amplifier is heterogeneously integrated on the 400nm thick silicon waveguide layer, which is compatible with high-performance modulator designs and allows for efficient coupling to a standard 220nm high index contrast silicon waveguide layer. In order to make the optical coupling efficient, both the III-V waveguide and the silicon waveguide are tapered, with a tip width of the III-V waveguide of around 500nm. The III-V thin film optical amplifier is implemented as a 3µm wide mesa etched through to the n-type InP contact layer. In this particular device implementation the amplifier section was 500µm long. mW-level waveguide coupled output power at 20°C and a side mode suppression ratio of more than 40dB is obtained

Day and night surgery: is there any influence in the patient postoperative period of urgent colorectal intervention?

Background Medical activity performed outside regular work hours may increase risk for patients and professionals. There is few data with respect to urgent colorectal surgery. The aim of this work was to evaluate the impact of daytime versus nighttime surgery on postoperative period of patients with acute colorectal disease. Methods A retrospective study was conducted in a sample of patients with acute colorectal disease who underwent urgent surgery at the General Surgery Unit of Braga Hospital, between January 2005 and March 2013. Patients were stratified by operative time of day into a daytime group (surgery between 8:00 and 20:59) and the nighttime group (21:00–7:59) and compared for clinical and surgical parameters. A questionnaire was distributed to surgeons, covering aspects related to the practice of urgent colorectal surgery and fatigue. Results A total of 330 patients were included, with 214 (64.8 %) in the daytime group and 116 (35.2 %) in the nighttime group. Colorectal cancer was the most frequent pathology. Waiting time (p?<?0.001) and total length of hospital stay (p?=?0.008) were significantly longer in the daytime group. There were no significant differences with respect to early or late complications. However, 100 % of surgeons reported that they are less proficient during nighttime. Conclusions Among patients with acute colorectal disease subjected to urgent surgery, there was no significant association between nighttime surgery and the presence of postoperative medical and surgical morbidities. Patients who were subjected to daytime surgery had longer length of stay at the hospital

Towards integration of general practitioner posts and accident and emergency departments: a case study of two integrated emergency posts in the Netherlands

<p>Abstract</p> <p>Background</p> <p>Accident and emergency (A&E) departments and general practitioner (GP) posts are often used inappropriately, leading to overcrowding. In the Netherlands, increasingly more integrated emergency posts (IEPs) are being created, integrating the care provided by GP posts and A&E departments, in order to improve the provision of the emergency care.</p> <p>Methods</p> <p>This explorative study compares the efficiency and patient and employee satisfaction in IEPs with those in two GP posts and two A&E departments. To this end, information was retrieved from hospital and GP patient records for the first quarter of the year before and of the year after the creation of IEPs. Patients and employees were sent a questionnaire to measure their satisfaction. Lastly, groups of hospital doctors, GPs, GP assistants, and nurses were interviewed.</p> <p>Results</p> <p>After the creation of IEPs, there was a shift of more than fifteen percent from secondary care to primary care for emergency consultations and waiting/consultation times were shortened by more than ten percent. Compared with the control settings, patients were more satisfied about telephone contact with an IEP, but professionals working at the IEP were less satisfied with several aspects of their work.</p> <p>Conclusion</p> <p>IEPs could be a promising innovation to organize emergency care more efficiently; however, it might take time to convince professionals of the possible advantages. Studies involving more IEPs and longer follow-up times are needed to determine whether such integration should be stimulated.</p

Fine mapping of the 9q31 Hirschsprung’s disease locus

Hirschsprung’s disease (HSCR) is a congenital disorder characterised by the absence of ganglia along variable lengths of the intestine. The RET gene is the major HSCR gene. Reduced penetrance of RET mutations and phenotypic variability suggest the involvement of additional modifying genes in the disease. A RET-dependent modifier locus was mapped to 9q31 in families bearing no coding sequence (CDS) RET mutations. Yet, the 9q31 causative locus is to be identified. To fine-map the 9q31 region, we genotyped 301 tag-SNPs spanning 7 Mb on 137 HSCR Dutch trios. This revealed two HSCR-associated regions that were further investigated in 173 Chinese HSCR patients and 436 controls using the genotype data obtained from a genome-wide association study recently conducted. Within one of the two identified regions SVEP1 SNPs were found associated with Dutch HSCR patients in the absence of RET mutations. This ratifies the reported linkage to the 9q31 region in HSCR families with no RET CDS mutations. However, this finding could not be replicated. In Chinese, HSCR was found associated with IKBKAP. In contrast, this association was stronger in patients carrying RET CDS mutations with p = 5.10 × 10−6 [OR = 3.32 (1.99, 5.59)] after replication. The HSCR-association found for IKBKAP in Chinese suggests population specificity and implies that RET mutation carriers may have an additional risk. Our finding is supported by the role of IKBKAP in the development of the nervous system