High-brightness broad-area diode lasers with enhanced self-aligned lateral structure

Broad-area diode lasers with increased brightness and efficiency are presented, which are fabricated using an enhanced self-aligned lateral structure by means of a two-step epitaxial growth process with an intermediate etching step. In this structure, current-blocking layers in the device edges ensure current confinement under the central stripe, which can limit the detrimental effects of current spreading and lateral carrier accumulation on beam quality. It also minimizes losses at stripe edges, thus lowering the lasing threshold and increasing conversion efficiency, while maintaining high polarization purity. In the first realization of this structure, the current block is integrated within an extreme-triple-asymmetric epitaxial design with a thin p-doped side, meaning that the distance between the current block and the active zone can be minimized without added process complexity. Using this configuration, enhanced self-aligned structure devices with 90 µm stripe width and 4 mm resonator length show up to 20% lower threshold current, 21% narrower beam waist, and slightly higher (1.03 ) peak efficiency in comparison to reference devices with the same dimensions, while slope, divergence angle and polarization purity remain almost unchanged. These results correspond to an increase in brightness by up to 25%, and measurement results of devices with varying stripe widths follow the same trend. © 2020 The Author(s). Published by IOP Publishing Ltd

High-power diode lasers with in-situ-structured lateral current blocking for improved threshold, efficiency and brightness

We present high-power GaAs-based broad-area diode lasers with a novel variant of the enhanced self-aligned lateral structure ‘eSAS’, having a strongly reduced lasing threshold and improved peak conversion efficiency and beam quality in comparison to their standard gain-guided counterparts. To realize this new variant (eSAS-V2), a two-step epitaxial growth process involving in situ etching is used to integrate current-blocking layers, optimized for tunnel current suppression, within the p-Al0.8GaAs cladding layer of an extreme-triple-asymmetric epitaxial structure with a thin p-side waveguide. The blocking layers are thus in close proximity to the active zone, resulting in strong suppression of current spreading and lateral carrier accumulation. eSAS-V2 devices with 4 mm resonator length and varying stripe widths are characterized and compared to previous eSAS variant (eSAS-V1) as well as gain-guided reference devices, all having the same dimensions and epitaxial structure. Measurement results show that the new eSAS-V2 variant eliminates an estimated 89% of lateral current spreading, resulting in a strong threshold current reduction of 29% at 90 μm stripe width, while slope and series resistance are broadly unchanged. The novel eSAS-V2 devices also maintain high conversion efficiency up to high continuous-wave optical power, with an exemplary 90 μm device having 51.5% at 20 W. Near-field width is significantly narrowed in both eSAS variants, but eSAS-V2 exhibits a wider far-field angle, consistent with the presence of index guiding. Nonetheless, eSAS-V2 achieves higher beam quality and lateral brightness than gain-guided reference devices, but the index guiding in this realization prevents it from surpassing eSAS-V1. Overall, the different performance benefits of the eSAS approach are clearly demonstrated

Alternative proof for the localization of Sinai's walk

We give an alternative proof of the localization of Sinai's random walk in random environment under weaker hypothesis than the ones used by Sinai. Moreover we give estimates that are stronger than the one of Sinai on the localization neighborhood and on the probability for the random walk to stay inside this neighborhood

Efficacy of labral repair, biceps tenodesis, and diagnostic arthroscopy for SLAP Lesions of the shoulder: a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Surgery for type II SLAP (superior labral anterior posterior) lesions of the shoulder is a promising but unproven treatment. The procedures include labral repair or biceps tenodesis. Retrospective cohort studies have suggested that the benefits of tenodesis include pain relief and improved function, and higher patient satisfaction, which was reported in a prospective non-randomised study. There have been no completed randomised controlled trials of surgery for type II SLAP lesions. The aims of this participant and observer blinded randomised placebo-controlled trial are to compare the short-term (6 months) and long-term (2 years) efficacy of labral repair, biceps tenodesis, and placebo (diagnostic arthroscopy) for alleviating pain and improving function for type II SLAP lesions.</p> <p>Methods/Design</p> <p>A double-blind randomised controlled trial are performed using 120 patients, aged 18 to 60 years, with a history for type II SLAP lesions and clinical signs suggesting type II SLAP lesion, which were documented by MR arthrography and arthroscopy. Exclusion criteria include patients who have previously undergone operations for SLAP lesions or recurrent shoulder dislocations, and ruptures of the rotator cuff or biceps tendon. Outcomes will be assessed at baseline, three, six, 12, and 24 months. Primary outcome measures will be the clinical Rowe Score (1988-version) and the Western Ontario Instability Index (WOSI) at six and 24 months. Secondary outcome measures will include the Shoulder Instability Questionnaire (SIQ), the generic EuroQol (EQ-5 D and EQ-VAS), return to work and previous sports activity, complications, and the number of reoperations.</p> <p>Discussion</p> <p>The results of this trial will be of international importance and the results will be translatable into clinical practice.</p> <p>Trial Registration</p> <p><b>[ClinicalTrials.gov NCT00586742]</b></p

The maximum of the local time of a diffusion process in a drifted Brownian potential

We consider a one-dimensional diffusion process $X$ in a $(-\kappa/2)$-drifted Brownian potential for $\kappa\neq 0$. We are interested in the maximum of its local time, and study its almost sure asymptotic behaviour, which is proved to be different from the behaviour of the maximum local time of the transient random walk in random environment. We also obtain the convergence in law of the maximum local time of $X$ under the annealed law after suitable renormalization when $\kappa \geq 1$. Moreover, we characterize all the upper and lower classes for the hitting times of $X$, in the sense of Paul L\'evy, and provide laws of the iterated logarithm for the diffusion $X$ itself. To this aim, we use annealed technics.Comment: 38 pages, new version, merged with hal-00013040 (arXiv:math/0511053), with some additional result

PDEs for tensor image processing

Methods based on partial differential equations (PDEs) belong to those image processing techniques that can be extended in a particularly elegant way to tensor fields. In this survey paper the most important PDEs for discontinuity-preserving denoising of tensor fields are reviewed such that the underlying design principles becomes evident. We consider isotropic and anisotropic diffusion filters and their corresponding variational methods, mean curvature motion, and selfsnakes. These filters preserve positive semidefiniteness of any positive semidefinite initial tensor field. Finally we discuss geodesic active contours for segmenting tensor fields. Experiments are presented that illustrate the behaviour of all these methods

Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden

<p>Abstract</p> <p>Background</p> <p>Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden.</p> <p>Methods</p> <p>The study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model.</p> <p>Results</p> <p>204 (103 women) patients, mean age 48 (SD 11) years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16%) remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389) during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third.</p> <p>Conclusions</p> <p>The model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted.</p

The contribution of RCTs to quality management and their feasibility in practice

The randomized controlled trial (RCT) is generally accepted as the most reliable method of conducting clinical research. To obtain an unbiased evaluation of the effectiveness of spine surgery, patients should be randomly assigned to either new or standard treatment. The aim of the present article is to provide a short overview of the advantages and challenges of RCTs and to present a summary of the conclusions of the Cochrane Reviews in spine surgery and later published trials in order to evaluate their contribution to quality management and feasibility in practice. From the searches, 130 RCTs were included, 95 from Cochrane Reviews and systematic reviews, and 35 from additional search. No study comparing surgery with sham surgery was identified. The first RCT in spine surgery was published in 1974 and compared debridement and ambulatory treatment in tuberculosis of the spine. The contribution of RCTs in spinal surgery has markedly increased over the last 10 years, which indicates that RCTs are feasible in this field. The results demonstrate missing quality specifications. Despite the number of published trials there is conflicting or limited evidence to support various techniques of instrumentation. The only intervention that receives strong evidence is discectomy for faster relief in carefully selected patients due to lumbar disc prolapse with sciatica. For future trials, authors, referees, and editors are recommended to follow the CONSORT statement. RCTs provide evidence to support clinical opinions before implementation of new techniques, but the individual clinical experience is still important for the doctor who has to face the patient