Gain studies of 1.3-μm dilute nitride HELLISH-VCSOA for optical communications

The hot electron light emitting and lasing in semiconductor heterostructure-vertical-cavity semiconductor optical amplifier (HELLISH-VCSOA) device is based on Ga0.35In0.65 N0.02As0.08/GaAs material for operation in the 1.3-μm window of the optical communications. The device has undoped distributed Bragg reflectors (DBRs). Therefore, problems such as those associated with refractive index contrast and current injection, which are common with doped DBRs in conventional VCSOAs, are avoided. The gain versus applied electric field curves are measured at different wavelengths using a tunable laser as the source signal. The highest gain is obtained for the 1.3-μm wavelength when an electric field in excess of 2 kV/cm is applied along the layers of the device

Overfeeding, Autonomic Regulation and Metabolic Consequences

The autonomic nervous system plays an important role in the regulation of body processes in health and disease. Overfeeding and obesity (a disproportional increase of the fat mass of the body) are often accompanied by alterations in both sympathetic and parasympathetic autonomic functions. The overfeeding-induced changes in autonomic outflow occur with typical symptoms such as adiposity and hyperinsulinemia. There might be a causal relationship between autonomic disturbances and the consequences of overfeeding and obesity. Therefore studies were designed to investigate autonomic functioning in experimentally and genetically hyperphagic rats. Special emphasis was given to the processes that are involved in the regulation of peripheral energy substrate homeostasis. The data revealed that overfeeding is accompanied by increased parasympathetic outflow. Typical indices of vagal activity (such as the cephalic insulin release during food ingestion) were increased in all our rat models for hyperphagia. Overfeeding was also accompanied by increased sympathetic tone, reflected by enhanced baseline plasma norepinephrine (NE) levels in both VMH-lesioned animals and rats rendered obese by hyperalimentation. Plasma levels of NE during exercise were, however, reduced in these two groups of animals. This diminished increase in the exercise-induced NE outflow could be normalized by prior food deprivation. It was concluded from these experiments that overfeeding is associated with increased parasympathetic and sympathetic tone. In models for hyperphagia that display a continuously elevated nutrient intake such as the VMH-lesioned and the overfed rat, this increased sympathetic tone was accompanied by a diminished NE response to exercise. This attenuated outflow of NE was directly related to the size of the fat reserves, indicating that the feedback mechanism from the periphery to the central nervous system is altered in the overfed state.

A model for the current instabilities in GaAs‐AlGaAs heterojunction

A model is proposed for the description of the current instabilities in GaAs-AlGaAs heterojunctions. It consists of three parts: the injection of electrons via the contact into the AlGaAs layer, the partial capture of these electrons in deep centers, and the change with time of the band structure. This last ingredient is crucial, since due to the increase of the total number of electrons in the AlGaAs layer the band bending decreases making real-space transfer from the AlGaAs layer to the two-dimensional electron gas possible. We have performed quasistationary simulations of the time dependence of the current. The velocities, average energies, capture rates, etc. were taken from Monte Carlo simulations. It turned out, that the parameters for the modeling of the contact, which are to a high degree unknown, play an essential role

The Role of Nonequilibrium Dynamical Screening in Carrier Thermalization

We investigate the role played by nonequilibrium dynamical screening in the thermalization of carriers in a simplified two-component two-band model of a semiconductor. The main feature of our approach is the theoretically sound treatment of collisions. We abandon Fermi's Golden rule in favor of a nonequilibrium field theoretic formalism as the former is applicable only in the long-time regime. We also introduce the concept of nonequilibrium dynamical screening. The dephasing of excitonic quantum beats as a result of carrier-carrier scattering is brought out. At low densities it is found that the dephasing times due to carrier-carrier scattering is in picoseconds and not femtoseconds, in agreement with experiments. The polarization dephasing rates are computed as a function of the excited carrier density and it is found that the dephasing rate for carrier-carrier scattering is proportional to the carrier density at ultralow densities. The scaling relation is sublinear at higher densities, which enables a comparison with experiment.Comment: Revised version with additional refs. 12 pages, figs. available upon request; Submitted to Phys. Rev.

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112