Ag films grown by remote plasma enhanced atomic layer deposition on different substrates

Plasma-assisted atomic layer deposition (PALD) was carried for growing thin boron oxide films onto silicon aiming at the formation of dopant sources for shallow boron doping of silicon by rapid thermal annealing (RTA). A remote capacitively coupled plasma source powered by GaN microwave oscillators was used for generating oxygen plasma in the PALD process with tris(dimethylamido)borane as boron containing precursor. ALD type growth was obtained; growth per cycle was highest with 0.13 nm at room temperature and decreased with higher temperature. The as-deposited films were highly unstable in ambient air and could be protected by capping with in-situ PALD grown antimony oxide films. After 16 weeks of storage in air, degradation of the film stack was observed in an electron microscope. The instability of the boron oxide, caused by moisture uptake, suggests the application of this film for testing moisture barrier properties of capping materials particularly for those grown by ALD. Boron doping of silicon was demonstrated using the uncapped PALD B2O3 films for RTA processes without exposing them to air. The boron concentration in the silicon could be varied depending on the source layer thickness for very thin films, which favors the application of ALD for semiconductor doping processesInvestment Bank Berlin and EFR

Use of B2O3 films grown by plasma-assisted atomic layer deposition for shallow boron doping in silicon

Plasma-assisted atomic layer deposition (PALD) was carried for growing thin boron oxide films onto silicon aiming at the formation of dopant sources for shallow boron doping of silicon by rapid thermal annealing (RTA). A remote capacitively coupled plasma source powered by GaN microwave oscillators was used for generating oxygen plasma in the PALD process with tris(dimethylamido)borane as boron containing precursor. ALD type growth was obtained; growth per cycle was highest with 0.13 nm at room temperature and decreased with higher temperature. The as-deposited films were highly unstable in ambient air and could be protected by capping with in-situ PALD grown antimony oxide films. After 16 weeks of storage in air, degradation of the film stack was observed in an electron microscope. The instability of the boron oxide, caused by moisture uptake, suggests the application of this film for testing moisture barrier properties of capping materials particularly for those grown by ALD. Boron doping of silicon was demonstrated using the uncapped PALD B2O3 films for RTA processes without exposing them to air. The boron concentration in the silicon could be varied depending on the source layer thickness for very thin films, which favors the application of ALD for semiconductor doping processes.Investment Bank Berlin and EFR

Understanding patient non-transport decision theories in the pre-hospital setting: a narrative review

© 2023 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Background In pre-hospital emergency care, decisions regarding patient non-conveyance emerged as significant determinants of healthcare outcomes and resource utilization. These complex decisions became integral to the progress of emergency medical services, thus warranting an evolving exploration within the medical discourse. Objectives and methods This narrative review aimed to synthesize and critically evaluate various theoretical stances on patient non-conveyance in the pre-hospital emergency. The focus on studies published between January 2012 and August 2022 was intentional to capture contemporary practices and insights. PubMed and Google Scholar served as the primary databases for the investigation, while the AL-Rayyan® software facilitated a thorough screening process. Results and discussion Twenty-nine studies—encompassing articles, books, and theses—were discovered through our search, each presenting unique perspectives on patient non-transport, thus highlighting its criticality as a healthcare concern. Predominant factors influencing non-transport decisions were classified into patient-initiated refusals (PIR), clinician-initiated decisions (CID), and dispatcher-initiated decisions (DID). Conclusions The issue of patient non-conveyance to hospitals continues to pose a crucial challenge to the seamless operation of emergency healthcare systems, warranting increased attention from various healthcare entities. To comprehend and pinpoint potential areas of improvement, a comprehensive analysis of pre-hospital non-transport events is imperative. A well-informed, strategic approach could prevent resource waste while ensuring patients receive the required and definitive care.Peer reviewe

An integrated evanescent field sensor for the simultaneous measurement of layer refractive index and thickness

A novel integrated sensor for the simultaneous measurement of layer refractive index and thickness based on evanescent fields is proposed. The theoretical limits for the accuracy of the sensor were examined for the example of a TiO2 layer. The influence of production tolerance on the accuracy was evaluated. In the experimental part of this work, a sensor chip containing nanowire and nanorib waveguides realized in silicon on insulator technology was used to demonstrate the detection of refractive index and thickness of a TiO2 atomic layer deposition (ALD) layer.DFG, 414044773, Open Access Publizieren 2021 - 2022 / Technische Universität Berli

Epidemiological Determinants of Patient Non-Conveyance to the Hospital in an Emergency Medical Service Environment

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Background: The increasing prevalence of comorbidities worldwide has spurred the need for time-effective pre-hospital emergency medical services (EMS). Some pre-hospital emergency calls requesting EMS result in patient non-conveyance. Decisions for non-conveyance are sometimes driven by the patient or the clinician, which may jeopardize the patients’ healthcare outcomes. This study aimed to explore the distribution and determinants of patient non-conveyance to hospitals in a Middle Eastern national Ambulance Service that promotes the transportation of all emergency call patients and does not adopt clinician-based non-conveyance decision. Methods: Using R Language, descriptive, bivariate, and binary logistic regression analyses were conducted for 334,392 multi-national patient non-conveyance emergency calls from June 2018 to July 2022, from a total of 1,030,228 calls to which a response unit was dispatched. Results: After data pre-processing, 237,862 cases of patient non-conveyance to hospital were retained, with a monthly average of 41.96% (n = 8799) of the emergency service demands and a standard deviation of 5.49% (n = 2040.63). They predominantly involved South Asians (29.36%, n = 69,849); 64.50% (n = 153,427) were of the age category from 14 to 44 years; 61.22% (n = 145,610) were male; 74.59% (n = 177,424) from the urban setting; and 71.28% (n = 169,552) had received on-scene treatment. Binary logistic regression with full variables and backward methods identified the final models of the determinants of patient non-conveyance decisions with an Akaike information criterion prediction estimator, respectively, of (250,200) and (250,169), indicating no significant difference between both models (Chi-square test; p-value = 0.63). Conclusions: Despite exercising a cautious protocol by encouraging patient transportation to hospital, patient non-conveyance seems to be a problem in the healthcare system that strains the pre-hospital medical response teams’ resources. Policies and regulations should be adopted to encourage individuals to access other primary care centers when required rather than draining emergency services for non-emergency situations.Peer reviewe

Epidemiology of prehospital emergency calls according to patient transport decision in a middle eastern emergency care environment: Retrospective cohort‐based

© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Background and Aim: Though emergency medical services (EMS) respond to all types of emergency calls, they do not always result in the patient being transported to the hospital. This study aimed to explore the determinants influencing emergency call‐response‐based conveyance decisions in a Middle Eastern ambulance service. Methods: This retrospective quantitative analysis of 93,712 emergency calls to the Hamad Medical Corporation Ambulance Service (HMCAS) between January 1 and May 31, 2023, obtained from the HMCAS electronic system, was analyzed to determine pertinent variables. Sociodemographic, emergency dispatch‐related, clinical, and miscellaneous predictors were analyzed. Descriptive, bivariate, ridge logistic regression, and combination analyses were evaluated. Results: 23.95% (N = 21,194) and 76.05% (N = 67,285) resulted in patient nontransport and transportation, respectively. Sociodemographic analysis revealed that males predominantly activated EMS resources, and 60% of males (n = 12,687) were not transported, whilst 65% of females (n = 44,053) were transported. South Asians represented a significant proportion of the transported patients (36%, n = 24,007). “Home” emerged as the primary emergency location (56%, n = 37,725). Bivariate analysis revealed significant associations across several variables, though multicollinearity was identified as a challenge. Ridge regression analysis underscored the role of certain predictors, such as missing provisional diagnoses, in transportation decisions. The upset plot shows that hypertension and diabetes mellitus were the most common combinations in both groups. Conclusions: This study highlights the nuanced complexities governing conveyance decisions. By unveiling patterns such as male predominance, which reflects Qatar's expatriate population, and specific temporal EMS activity peaks, this study accentuates the importance of holistic patient assessment that transcends medical histories.Peer reviewe

Exploring factors influencing time from dispatch to unit availability according to the transport decision in the pre-hospital setting: an exploratory study

© 2024 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Background: Efficient resource distribution is important. Despite extensive research on response timings within ambulance services, nuances of time from unit dispatch to becoming available still need to be explored. This study aimed to identify the determinants of the duration between ambulance dispatch and readiness to respond to the next case according to the patients’ transport decisions. Methods: Time from ambulance dispatch to availability (TDA) analysis according to the patients’ transport decision (Transport versus Non-Transport) was conducted using R-Studio™ for a data set of 93,712 emergency calls managed by a Middle Eastern ambulance service from January to May 2023. Log-transformed Hazard Ratios (HR) were examined across diverse parameters. A Cox regression model was utilised to determine the influence of variables on TDA. Kaplan–Meier curves discerned potential variances in the time elapsed for both cohorts based on demographics and clinical indicators. A competing risk analysis assessed the probabilities of distinct outcomes occurring. Results: The median duration of elapsed TDA was 173 min for the transported patients and 73 min for those not transported. The HR unveiled Significant associations in various demographic variables. The Kaplan–Meier curves revealed variances in TDA across different nationalities and age categories. In the competing risk analysis, the ‘Not Transported’ group demonstrated a higher incidence of prolonged TDA than the ‘Transported’ group at specified time points. Conclusions: Exploring TDA offers a novel perspective on ambulance services’ efficiency. Though promising, the findings necessitate further exploration across diverse settings, ensuring broader applicability. Future research should consider a comprehensive range of variables to fully harness the utility of this period as a metric for healthcare excellence.Peer reviewe

Hazardous material and chemical, biological, radiological, and nuclear incident readiness among prehospital care professionals in the State of Qatar

This study aimed to determine whether the Hamad Medical Corporation Ambulance Service (HMCAS) personnel fulfil the pre-hospital readiness requirements for hazardous material and chemical, biological, radiological, and nuclear (HazMat-CBRN) incidents. This cross-sectional study performed an online assessment of non-specialist paramedics’ behaviour and knowledge about HazMat-CBRN incident management, followed by a ‘HazMat-CBRN incident management’ course with pre-and post-activity assessments. The validity and reliability of the knowledge assessment questions were also tested. The pre-and-post course assessement responses revealed certain deficiencies in staff knowledge. The multiple linear regression and paired groups t-test demonstrated that this was rectified after the training intervention. The results indicate that the implemented course helped HMCAS staff acquire a satisfactory level of knowledge to ensure their readiness for safe and effective responses to potential HazMat-CBRN incidents in Qatar

Exploring pre‐hospital healthcare workers' readiness for chemical, biological, radiological, and nuclear threats in the State of Qatar: A cross‐sectional study

Background Hazardous Material—Chemical, Biological, Radiological, and Nuclear (HazMat-CBRN) incidents, though infrequent, are environmentally precarious and perilous to living beings. They can be deliberate or accidental or follow the re-emergence of highly contagious diseases. Successful management of such incidents in pre-hospital settings requires having well-trained and prepared healthcare workers. Aims This study aimed to explore the reliability and validity of a satisfaction survey, answered by Specialized Emergency Management (SEM) personnel from a national Middle Eastern ambulance service, with a “Hazardous Material Incident Management” course offered to them as a continuing professional development activity and seek their opinion regarding Hamad Medical Corporation Ambulance Service personnel needs for other HazMat-CBRN related training topics. Method In the cross-sectional study, we conducted an online satisfaction survey for this group of course participants to obtain their feedback as subject matter experts. Aiken's content validity coefficient (CVC) was calculated to assess the content validity. Cronbach's α coefficient was determined to explore the survey's reliability. IBM®-SPSS® version 26 was utilized to explore the data. Results The SEM satisfaction survey demonstrated important satisfaction with the implemented training with its robust reliability and content validity (Cronbach's α = 0.922 and CVC = 0.952). The participants also recommended additional related topics. Conclusion Sustaining and reinforcing the HazMat-CBRN Incident Management course was strongly recommended, considering the increase of HazMat-CBRN threats worldwide

Hazardous materials and CBRN incidents: Fundamentals of pre-hospital readiness in the State of Qatar

Background: Hazardous Materials and Chemical/Biological/Radiological/Nuclear (HazMat-CBRN) incidents represent a serious threat to the population and the environment. They require a pre-hospital medical response system well equipped and supported with logistics and clinicians with appropriate knowledge and skills to prevent exposure and mitigate risks. Our aim is to determine if the Hamad Medical Corporation Ambulance Service (HMCAS) fulfils the pre-hospital readiness requirements for such incidents. Methods: This cross-sectional study was performed in HMCAS. An online survey assessed staff behaviour and knowledge in relation to HazMat-CBRN incidents. Responses were obtained on health risks and pre-hospital medical management of related threats in Qatar. Based on the results, a training module “HazMat Incident Management” was prepared with pre-/post-activity assessments. The results were explored using a multivariate linear regression and non-parametric Wilcoxon test for paired samples. Specialized Emergency Management (SEM) staff opinion about this training was assessed through an online survey. Both surveys’ validity and reliability tests were conducted. Ishikawa cause and effects diagram was built for the identification of the factors leading to a pre-hospital successful response to HazMat-CBRN incidents. Results: HMCAS has the proper logistics and plans to manage potential HazMat-CBRN incidents. The knowledge survey demonstrated that the pre-hospital medical staff information about this topic needs reinforcement. The multivariate linear regression and non-parametric Wilcoxon test demonstrated that this was obtained thanks to the implemented training module. The course satisfaction survey showed not only a big interest in this activity but also staff recommended more related topics. Earlier-RSDAT (Recognition, Safety, Decontamination, Antidot, Transport) is a tool proposed as a response acronym to build a successful risk-based response for HazMat CBRN incidents in pre-hospital setting. Conclusion: HMCAS fulfills the readiness requirements for safe and effective response to potential HazMat-CBRN incidents in Qatar. The RSDAT response matrix might help in mitigating pre-hospital response risks