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Lasers with hertz linewidths at time scales of seconds are critical for metrology, timekeeping, and manipulation of quantum systems. Such frequency stability relies on bulk-optic lasers and reference cavities, where increased size is leveraged to reduce noise but with the trade-off of cost, hand assembly, and limited applications. Alternatively, planar waveguide-based lasers enjoy complementary metal-oxide semiconductor scalability yet are fundamentally limited from achieving hertz linewidths by stochastic noise and thermal sensitivity. In this work, we demonstrate a laser system with a 1-s linewidth of 1.1 Hz and fractional frequency instability below 10 -14 to 1 s. This low-noise performance leverages integrated lasers together with an 8-ml vacuum-gap cavity using microfabricated mirrors. All critical components are lithographically defined on planar substrates, holding potential for high-volume manufacturing. Consequently, this work provides an important advance toward compact lasers with hertz linewidths for portable optical clocks, radio frequency photonic oscillators, and related communication and navigation systems.

Background: We aimed to determine whether heart, stroke, and vascular disease (HSVD) prevalence and emergency primary evacuation (EPE), hospitalisation, and mortality differ by patient characteristics., Methods: An Australian-wide incidence population based study, with prospective data collected form the 1 July 2019 to the 30 October 2020., Findings: Indigenous Australians reported significantly higher prevalence of HSVD at 229.0 per-1000 as compared to 152.0 per-1000 non-Indigenous Australians: risk ratio 1.5 (95% CI 1.2-1.8). 583 remote patients received an EPE for HSVD, consisting of 388 (66.6%; 95% CI: 62.6-70.4) males and 195 (33.0%; 95% CI: 29.6-37.4) females. There were 289 (49.6%; 95% CI 45.4- 53.7) patients who identified as Indigenous, and 294 (50.4%; 95% CI 46.3- 54.6) as non-Indigenous. The mean Indigenous age during EPE was 48.0 (95% CI 45.9-50.1) years old, significantly lower than the non-Indigenous mean age of 55.6 (95% CI 53.8-57.4). Indigenous patients hospitalised for HSVD were younger, the majority younger than 65 years (n=21175; 73.7% 95% CI 73.2-74.2) as compared to non-Indigenous patients (n= 357654; 33.1% 95% CI 33.0-33.15). When adjusted for HSVD prevalence, remote Indigenous patients had a higher hospitalisation rate as compared to non-remote Indigenous patients (rate ratio: 1.6; 95% CI 1.3-2.0) and remote non-Indigenous patients (rate ratio: 1.2; 95% CI 1.0-1.5). More Indigenous patients died of HSVD before the age of 65 years (n=1875; 56.5% 95% CI 54.8-58.2) as compared to non-Indigenous patients (n= 16161; 10.6% 95% CI 10.45-10.8)., Interpretation: Indigenous Australians have a higher prevalence, and younger age during EPE, and hospitalisation for HSVD than non-Indigenous Australians., Funding: This is a self/internally-funded study, with the lead organisation being the Royal Flying Doctor Service (RFDS) of Australia. For the duration of the study period, the RFDS provided in-kind support including one full-time equivalent (FTE) and resources (office space, computer, research software, and office equipment). There was no external funding source that had a role in study design or data analysis or interpretation., Competing Interests: None., (© 2021 The Author(s).)

Delivering on the revolutionary promise of a universal quantum computer will require processors with millions of quantum bits (qubits) 1-3 . In superconducting quantum processors 4 , each qubit is individually addressed with microwave signal lines that connect room-temperature electronics to the cryogenic environment of the quantum circuit. The complexity and heat load associated with the multiple coaxial lines per qubit limits the maximum possible size of a processor to a few thousand qubits 5 . Here we introduce a photonic link using an optical fibre to guide modulated laser light from room temperature to a cryogenic photodetector 6 , capable of delivering shot-noise-limited microwave signals directly at millikelvin temperatures. By demonstrating high-fidelity control and readout of a superconducting qubit, we show that this photonic link can meet the stringent requirements of superconducting quantum information processing 7 . Leveraging the low thermal conductivity and large intrinsic bandwidth of optical fibre enables the efficient and massively multiplexed delivery of coherent microwave control pulses, providing a path towards a million-qubit universal quantum computer.

Background: Little is known on the trends of aeromedical retrieval (AR) during social isolation., Aim: To compare the pre, lockdown, and post-lockdown AR patient characteristics during a period of Coronavirus 2019 (COVID-19) social isolation., Methods: An observational study with retrospective data collection, consisting of AR between 26 January and 23 June 2020., Results: There were 16 981 AR consisting of 1983 (11.7%) primary evacuations and 14 998 (88.3%) inter-hospital transfers, with a population median age of 52 years (interquartile range 29.0-69.0), with 49.0% (n = 8283) of the cohort being male and 38.0% (n = 6399) being female. There were six confirmed and 230 suspected cases of COVID-19, with the majority of cases (n = 134; 58.3%) in the social isolation period. As compared to pre-restriction, the odds of retrieval for the restriction and post-restriction period differed across time between the major diagnostic groups. This included, an increase in cardiovascular retrieval for both restriction and post-restriction periods (odds ratio (OR) 1.12, 95% confidence interval (CI) 1.02-1.24 and OR 1.18 95%, CI 1.08-1.30 respectively), increases in neoplasm in the post restriction period (OR 1.31, 95% CI 1.04-1.64) and increases for congenital conditions in the restriction period (OR 2.56, 95% CI 1.39-4.71). Cardiovascular and congenital conditions had increased rates of priority 1 patients in the restriction and post restriction periods. There was a decrease in endocrine and metabolic disease retrievals in the restriction period (OR 0.72, 95% CI 0.53-0.98). There were lower odds during the post-restriction period for retrievals of the respiratory system (OR 0.78, 95% CI 0.67-0.93), and disease of the skin (OR 0.78, 95% CI 0.6-1.0). Distribution between the 2019 and 2020 time periods differed (P < 0.05), with the lockdown period resulting in a significant reduction in activity., Conclusion: The lockdown period resulted in increased AR rates of circulatory and congenital conditions., (© 2020 Royal Australasian College of Physicians.)

Optical atomic clocks are poised to redefine the Système International (SI) second, thanks to stability and accuracy more than 100 times better than the current microwave atomic clock standard. However, the best optical clocks have not seen their performance transferred to the electronic domain, where radar, navigation, communications, and fundamental research rely on less stable microwave sources. By comparing two independent optical-to-electronic signal generators, we demonstrate a 10-gigahertz microwave signal with phase that exactly tracks that of the optical clock phase from which it is derived, yielding an absolute fractional frequency instability of 1 × 10 -18 in the electronic domain. Such faithful reproduction of the optical clock phase expands the opportunities for optical clocks both technologically and scientifically for time dissemination, navigation, and long-baseline interferometric imaging., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Introduction: Rural, remote, and Indigenous stroke patients have worse stroke outcomes than urban Australians. This may be due to lack of timely access to expert facilities., Objectives: We aimed to describe the characteristics of patients who underwent aeromedical retrieval for stroke, estimate transfer times, and investigate if flight paths corresponded with the locations of stroke units (SUs) throughout Australia., Methods: Prospective review of routinely collected Royal Flying Doctor Service (RFDS) data. Patients who underwent an RFDS aeromedical retrieval for stroke, July 2014-June 2018 (ICD-10 codes: I60-I69), were included. To define the locations of SUs throughout Australia, we accessed data from the 2017 National Stroke Audit. The main outcome measures included determining the characteristics of patients with an in-flight diagnosis of stroke, their subsequent pickup and transfer locations, and corresponding SU and imaging capacity., Results: The RFDS conducted 1,773 stroke aeromedical retrievals, consisting of 1,028 (58%) male and 1,481 (83.5%) non-Indigenous and 292 (16.5%) Indigenous patients. Indigenous patients were a decade younger, 56.0 (interquartile range [IQR] 45.0-64.0), than non-Indigenous patients, 66.0 (IQR 54.0-76.0). The most common diagnosis was "stroke not specified," reflecting retrieval locations without imaging capability. The estimated median time for aeromedical retrieval was 238 min (95% confidence interval: 231-244). Patients were more likely to be transferred to an area with SU and imaging capability (both p < 0.0001)., Conclusion: Stroke patients living in rural areas were younger than those living in major cities (75 years, Stroke Audit Data), with aeromedically retrieved Indigenous patients being a decade younger than non-Indigenous patients. The current transfer times are largely outside the time windows for reperfusion methods. Future research should aim to facilitate more timely diagnosis and treatment of stroke., (© 2020 S. Karger AG, Basel.)

Introduction: The aim of this study was to assess whether apical lesions are associated with inflammatory serum markers of cardiovascular risk, especially high-sensitivity C-reactive protein (hsCRP), in young adults., Methods: In this cross-sectional study, otherwise healthy individuals with apical lesions of endodontic origin (ALEOs) and a clinical diagnosis of asymptomatic apical periodontitis and controls aged between 18 and 40 years were included. Patients' sociodemographic characteristics, medical history, and classic cardiovascular risk factors were recorded, and the pathobiological determinants of atherosclerosis in youth score was calculated. Oral clinical and radiographic examinations were performed. Blood samples were collected to determine the lipid profile, glycated hemoglobin, hsCRP, immunoglobulin G, interleukin (IL)-6, IL-10, IL-12p70, matrix metalloproteinase 8, soluble vascular cellular adhesion molecule-1, soluble intercellular adhesion molecule-1, and soluble E-selectin. Bivariate and multivariate analyses adjusting for oral and classic cardiovascular risk factors were performed., Results: hsCRP levels were significantly higher in ALEO patients versus controls (median = 2.54 vs 0.78), whereas the pathobiological determinants of atherosclerosis in youth score was comparable among the groups. Also, the levels of IL-6, matrix metalloproteinase 8, and soluble E-selectin were significantly higher in ALEO patients. hsCRP, IL-6, and IL-12 correlated with soluble adhesion molecules. Bivariate analysis based on hsCRP serum concentrations ≥1 mg/L showed an odds ratio (OR) = 6.8, and the risk increased 3.3 times for an additional ALEO. In multivariate analysis, ALEO was significantly associated with hsCRP levels ≥1 mg/L (OR = 5.1-12.8) independently of the adjustment model. ALEO also associated with CRP levels >3 mg/L, which was significant after the adjustment for covariates (OR = 4.0)., Conclusions: ALEO is associated with the systemic inflammatory burden and cardiovascular risk determined by hsCRP, supporting a mechanistic link for cardiovascular diseases in young adults., (Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Analog photonic links require high-fidelity, high-speed optical-to-electrical conversion for applications such as radio-over-fiber, synchronization at kilometer-scale facilities, and low-noise electronic signal generation. Photodetector nonlinearity is a particularly vexing problem, causing signal distortion and excess noise, especially in systems utilizing ultrashort optical pulses. Here we show that photodetectors designed for high power handling and high linearity can perform optical-to-electrical conversion of ultrashort optical pulses with unprecedented linearity over a large photocurrent range. We also corroborate and expand upon the physical understanding of how the broadband, complex impedance of the circuit following the photodiode modifies the linearity - in some cases quite significantly. By externally manipulating the circuit impedance, we extend the detector's linear range to higher photocurrents, with over 50 dB rejection of amplitude-to-phase conversion for photocurrents up to 40 mA. This represents a 1000-fold improvement over state-of-the-art photodiodes and significantly extends the attainable microwave power by a factor of four. As such, we eliminate the long-standing requirement in ultrashort pulse detection of precise tuning of the photodiode's operating parameters to coincide with a nonlinearity minimum. These results should also apply more generally to reduce nonlinear distortion in a range of other microwave photonics applications.

Light sources that are ultrafast and ultrastable enable applications like timing with subfemtosecond precision and control of quantum and classical systems. Mode-locked lasers have often given access to this regime, by using their high pulse energies. We demonstrate an adaptable method for ultrastable control of low-energy femtosecond pulses based on common electro-optic modulation of a continuous-wave laser light source. We show that we can obtain 100-picojoule pulse trains at rates up to 30 gigahertz and demonstrate sub-optical cycle timing precision and useful output spectra spanning the near infrared. Our source enters the few-cycle ultrafast regime without mode locking, and its high speed provides access to nonlinear measurements and rapid transients., (Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

We demonstrate an easy-to-manufacture 25-mm-long ultra-stable optical reference cavity for transportable photonic microwave generation systems. Employing a rigid holding geometry that is first-order insensitive to the squeezing force and a cavity geometry that improves the thermal noise limit at room temperature, we observe a laser phase noise that is nearly thermal noise limited for three frequency decades (1 Hz to 1 kHz offset) and supports 10 GHz generation with phase noise near -100  dBc/Hz at 1 Hz offset and <-173  dBc/Hz for all offsets >600  Hz. The fractional frequency stability reaches 2×10 -15 at 0.1 s of averaging.

We frequency stabilize the output of a miniature stimulated Brillouin scattering (SBS) laser to rubidium atoms in a microfabricated cell to realize a laser system with frequency stability at the 10 -11 level over seven decades in averaging time. In addition, our system has the advantages of robustness, low cost and the potential for integration that would lead to still further miniaturization. The SBS laser operating at 1560 nm exhibits a spectral linewidth of 820 Hz, but its frequency drifts over a few MHz on the 1 hour timescale. By locking the second harmonic of the SBS laser to the Rb reference, we reduce this drift by a factor of 10 3 to the level of a few kHz over the course of an hour. For our combined SBS and Rb laser system, we measure a frequency noise of 4 × 10 4 Hz 2 /Hz at 10 Hz offset frequency which rapidly rolls off to a level of 0.2 Hz 2 /Hz at 100 kHz offset. The corresponding Allan deviation is ≤2 × 10 -11 for averaging times spanning 10 -4 to 10 3 s. By optically dividing the signal of the laser down to microwave frequencies, we generate an RF signal at 2 GHz with phase noise at the level of -76 dBc/Hz and -140 dBc/Hz at offset frequencies of 10 Hz and 10 kHz, respectively.

We investigate the low timing jitter properties of a tunable single-pass optoelectronic frequency comb generator. The scheme is flexible in that both the repetition rate and center frequency can be continuously tuned. When operated with 10 GHz comb spacing, the integrated residual pulse-to-pulse timing jitter is 11.35 fs (1 Hz to 10 MHz) with no feedback stabilization. The corresponding phase noise at 1 Hz offset from the photodetected 10 GHz carrier is -100 dBc/Hz.

Applications with optical atomic clocks and precision timing often require the transfer of optical frequency references to the electrical domain with extremely high fidelity. Here we examine the impact of photocarrier scattering and distributed absorption on the photocurrent noise of high-speed photodiodes when detecting ultralow jitter optical pulses. Despite its small contribution to the total photocurrent, this excess noise can determine the phase noise and timing jitter of microwave signals generated by detecting ultrashort optical pulses. A Monte Carlo simulation of the photodetection process is used to quantitatively estimate the excess noise. Simulated phase noise on the 10 GHz harmonic of a photodetected pulse train shows good agreement with previous experimental data, leading to the conclusion that the lowest phase noise photonically generated microwave signals are limited by photocarrier scattering well above the quantum limit of the optical pulse train.

We investigate the impact of pulse interleaving and optical amplification on the spectral purity of microwave signals generated by photodetecting the pulsed output of an Er:fiber-based optical frequency comb. It is shown that the microwave phase noise floor can be extremely sensitive to delay length errors in the interleaver, and the contribution of the quantum noise from optical amplification to the phase noise can be reduced ∼10  dB for short pulse detection. We exploit optical amplification, in conjunction with high power handling modified unitraveling carrier photodetectors, to generate a phase noise floor on a 10 GHz carrier of -175  dBc/Hz, the lowest ever demonstrated in the photodetection of a mode-locked fiber laser. At all offset frequencies, the photodetected 10 GHz phase noise performance is comparable to or better than the lowest phase noise results yet demonstrated with stabilized Ti:sapphire frequency combs.

We present the design of a novel, ultralow-phase-noise frequency synthesizer implemented with extremely-low-noise regenerative frequency dividers. This synthesizer generates eight outputs, viz. 1.6 GHz, 320 MHz, 160 MHz, 80 MHz, 40 MHz, 20 MHz, 10 MHz and 5 MHz for an 8 GHz input frequency. The residual single-sideband (SSB) phase noises of the synthesizer at 5 and 10 MHz outputs at 1 Hz offset from the carrier are -150 and -145 dBc/Hz, respectively, which are unprecedented phase noise levels. We also report the lowest values of phase noise to date for 5 and 10 MHz RF signals achieved with our synthesizer by dividing an 8 GHz signal generated from an ultra-stable optical-comb-based frequency division. The absolute SSB phase noises achieved for 5 and 10 MHz signals at 1 Hz offset are -150 and -143 dBc/Hz, respectively; at 100 kHz offset, they are -177 and -174 dBc/Hz, respectively. The phase noise of the 5 MHz signal corresponds to a frequency stability of approximately 7.6 × 10(-15) at 1 s averaging time for a measurement bandwidth (BW) of 500 Hz, and the integrated timing jitter over 100 kHz BW is 20 fs.

We utilized and characterized high-power, high-linearity modified unitraveling carrier (MUTC) photodiodes for low-phase-noise photonic microwave generation based on optical frequency division (OFD). When illuminated with picosecond pulses from a repetition-rate-multiplied gigahertz Ti:sapphire modelocked laser, the photodiodes can achieve a 10 GHz signal power of +14 dBm. Using these diodes, we generated a 10 GHz microwave tone with less than 500 attoseconds absolute integrated timing jitter (1 Hz-10 MHz) and a phase noise floor of -177 dBc/Hz.We also characterized the electrical response, amplitude-to-phase conversion, saturation, and residual noise of the MUTC photodiodes.

We describe and characterize a 25 GHz laser frequency comb based on a cavity-filtered erbium fiber mode-locked laser. The comb provides a uniform array of optical frequencies spanning 1450 nm to 1700 nm, and is stabilized by use of a global positioning system referenced atomic clock. This comb was deployed at the 9.2 m Hobby-Eberly telescope at the McDonald Observatory where it was used as a radial velocity calibration source for the fiber-fed Pathfinder near-infrared spectrograph. Stellar targets were observed in three echelle orders over four nights, and radial velocity precision of ∼10 m/s (∼6 MHz) was achieved from the comb-calibrated spectra.

We report Carrier Envelope Offset (CEO) frequency measurements of a 10 GHz harmonically mode-locked, Fabry-Perot etalon-stabilized, semiconductor optical frequency comb source. A modified multi-heterodyne mixing technique with a reference frequency comb was utilized for the measurement. Also, preliminary results from an attempt at f-2f self-referencing measurement are presented. The CEO frequency was found to be ~1.47 GHz for the particular etalon that was used.

We present an optical frequency divider based on a 200 MHz repetition rate Er:fiber mode-locked laser that, when locked to a stable optical frequency reference, generates microwave signals with absolute phase noise that is equal to or better than cryogenic microwave oscillators. At 1 Hz offset from a 10 GHz carrier, the phase noise is below -100 dBc/Hz, limited by the optical reference. For offset frequencies >10 kHz, the phase noise is shot noise limited at -145 dBc/Hz. An analysis of the contribution of the residual noise from the Er:fiber optical frequency divider is also presented., (© 2011 Optical Society of America)

A 12.5 GHz-spaced optical frequency comb locked to a global positioning system disciplined oscillator for near-infrared (IR) spectrograph calibration is presented. The comb is generated via filtering a 250 MHz-spaced comb. Subsequent nonlinear broadening of the 12.5 GHz comb extends the wavelength range to cover 1380-1820 nm, providing complete coverage over the H-band transmission window of earth's atmosphere. Finite suppression of spurious sidemodes, optical linewidth, and instability of the comb has been examined to estimate potential wavelength biases in spectrograph calibration. Sidemode suppression varies between 20 and 45 dB, and the optical linewidth is approximately 350 kHz at 1550 nm. The comb frequency uncertainty is bounded by +/-30 kHz (corresponding to a radial velocity of +/-5 cm/s), limited by the global positioning system disciplined oscillator reference. These results indicate that this comb can readily support radial velocity measurements below 1 m/s in the near IR.

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.

We experimentally verify the theory of Haus et al. [IEEE J. Quantum Electron. 40, 41 (2004)] on the effects of timing jitter using intracavity phase modulation on the pulse train of a mode-locked laser. The theory is based on the solution of the Heisenberg-Langevin equation in the presence of dispersion and intracavity phase modulation. Using active intracavity phase modulation, we have reduced the timing jitter on a 10.24 GHz mode-locked diode laser by 50% from 304 to 150 fs integrated from 1 Hz to the Nyquist frequency of 5.12 GHz.

The response of an optical frequency comb from an etalon-based coupled optoelectronic oscillator to changes in drive current, optoelectronic loop phase, modulator bias, and laser cavity length has been measured. It is found that controlling the phase of the optoelectronic loop is best suited for control of the pulse repetition rate, whereas controlling the laser cavity length is best for stabilization of the optical carrier frequency. Moreover, by measuring the instabilities of the carrier frequency at the fixed-point frequency of the optoelectronic phase, changes to the optoelectronic phase can be decoupled from changes to the laser cavity.

We propose a novel technique based on negative impulse modulation for pulse repetition rate multiplication by rational harmonic mode locking with pulse-amplitude-equalized pulses directly from the laser cavity. We have generated a pulse train of 15 GHz with more than 16 dB suppression of unwanted amplitude modulation spurs by using a 1 GHz RF signal. This is the highest suppression ratio for a repetition rate multiplication factor of 15 to our knowledge.

We report a semiconductor-based, low-noise, 10.24 GHz actively mode-locked laser with 4.65 fs of relative timing jitter and a 0.0365% amplitude fluctuation (1 Hz to 100 MHz) of the optical pulse train. The keys to obtaining this result were the laser's high optical power and the low phase noise of the rf source used to mode lock the laser. The low phase noise of the rf source not only improves the absolute and relative timing jitter of the laser, but also prevents coupling of the rf source phase noise to the pulse amplitude fluctuations by the mode-locked laser.

The phase noise of two low noise, high quality factor actively modelocked lasers is investigated. It is found that increasing the quality factor of a laser can increase the phase noise relative to the RF source used to modelock the laser, even though the absolute noise of the laser is decreased. The filtering of phase noise from the modelocking source that causes both the increase in relative noise and the decrease in absolute noise is exploited to reveal phase noise information otherwise obscured in a high quality factor laser.

An analytic expression for the phase noise spectrum is estimated when two arbitrary longitudinal modes are selected for beating from the output of an actively mode-locked laser. A separate experiment confirmed the theory qualitatively. It was found that two-mode beating possesses more phase noise than the beating involving the entire mode spectrum, especially at low offset frequency, even though two mode beating noise is decoupled from the RF oscillator noise to the first order.