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With ultrafast laser systems reaching presently 10 PW peak power or operating at high repetition rates, research towards ensuring the long-term, trouble-free performance of all laser-exposed optical components is critical. Our work is focused on providing insight into the optical material behavior at fluences below the standardized laser-induced damage threshold (LIDT) value by implementing a simultaneous dual analysis of surface emitted particles using a Langmuir probe (LP) and the target current (TC). ${\mathrm{HfO}}_2$ and ${\mathrm{ZrO}}_2$ thin films deposited on fused silica substrates by pulsed laser deposition at various ${\mathrm{O}}_2$ pressures for defect and stoichiometry control were irradiated by Gaussian, ultrashort laser pulses (800 nm, 10 Hz, 70 fs) in a wide range of fluences. Both TC and LP collected signals were in good agreement with the existing theoretical description of laser–matter interaction at an ultrashort time scale. Our approach for an in situ LIDT monitoring system provides measurable signals for below-threshold irradiation conditions that indicate the endurance limit of the optical surfaces in the single-shot energy scanning mode. The LIDT value extracted from the LP-TC system is in line with the multipulse statistical analysis done with ISO 21254-2:2011(E). The implementation of the LP and TC as on-shot diagnostic tools for optical components will have a significant impact on the reliability of next-generation ultrafast and high-power laser systems.
Endocrine surgery is predominantly focused on the surgery of the thyroid, parathyroid and adrenal glands. The care of patients with the rare endocrine pancreatic tumours and neuroendocrine tumours (carcinoids) is divided between endocrine surgeons, pancreatic surgeons and liver surgeons, based on the local expertise available in individual centres. Pituitary and testicular tumours are outside the remit of this chapter as they are dealt with by neurosurgeons and urologists, respectively.
For all conditions discussed in this chapter, the management of the patient has to follow the sequence described in Figure 11.1. History and clinical examination remain the cornerstone of an accurate diagnosis. For example, observing the subtle signs of Cushing’s syndrome will allow the astute clinician to consider this diagnosis in patients previously labelled as obese and depressed. Listening to the description of recurrent ‘attacks’ might trigger appropriate tests for phaeochromocytoma in patients who were previously treated for anxiety or primary hypertension. The combination of fatigue, depression, insomnia, abdominal discomfort, joint pains and nocturia might be dismissed as normal ageing but should raise the suspicion of hypercalcaemia of primary hyperparathyroidism.
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