Vertical cavity surface emitting laser action of an all monolithic ZnO-based microcavity

We report on room temperature laser action of an all monolithic ZnO-based vertical cavity surface emitting laser (VCSEL) under optical pumping. The VCSEL structure consists of a 2{\lambda} microcavity containing 8 ZnO/Zn(0.92)Mg(0.08)O quantum wells embedded in epitaxially grown Zn(0.92)Mg(0.08)O/Zn(0.65)Mg(0.35)O distributed Bragg reflectors (DBRs). As a prerequisite, design and growth of high reflectivity DBRs based on ZnO and (Zn,Mg)O for optical devices operating in the ultraviolet and blue-green spectral range are discussed.Comment: Copyright (2011) American Institute of Physics. This article may be downloaded for personal use only. Any other use requires prior permission of the author and the American Institute of Physics. The following article appeared in Appl. Phys. Lett. 98, 011101 (2011) and may be found at http://apl.aip.org/resource/1/applab/v98/i1/p011101_s

Erityisyyden merkitys minäkuvalle:erilaisuuden kokemuksia

Tiivistelmä. Erityisyys pohjaa yhteiskunnan arvojen ja sosiaalisten normien pohjalta määritettyyn ajatukseen normaalista ja poikkeavasta. Poikkeavuus on ilmiönä universaali, mutta ei ole olemassa universaalia tapaa olla poikkeava. Lääketieteen näkökulmasta erilaisuutta voidaan määritellä diagnoosien perusteella. Tässä tutkimuksessa erityisyys ja erilaisuus nousevat ulkoapäin määriteltyjen diagnoosien pohjalta. Minäkuva kuvaa yksilön käsitystä itsestään, vastaten kysymyksen ”millainen olen”. Miten ulkoapäin erilaiseksi määrittely kohtaa yksilön omissa kuvailuissa itsestään ja mikä merkitys saadulla diagnoosilla on tässä yhteydessä. Tämän tutkimuksen tarkoituksena on selvittää, mikä merkitys ulkoapäin määritellyllä erityisyydellä on yksilön minäkuvan kehitykselle. Merkityksiä pyritään löytämään haastateltavien henkilökohtaisten erilaisuuden kokemusten kautta. Teoreettinen viitekehys tässä tutkimuksessa muodostuu erilaisuuden ja minäkuvan käsitteiden tarkastelusta. Tutkimus on toteutettu kvalitatiivisia eli laadullisia tutkimusmenetelmiä käyttäen. Aineistoa on lähestytty narratiivisen tutkimusotteen näkökulmasta painottaen henkilökohtaisia kokemuksia. Tämän laadullisen tutkimuksen aineisto on kerätty teemahaastattelun avulla viideltä eri tavoin diagnosoidulta aikuiselta tammikuun 2019 aikana. Haastateltavien diagnoosit ovat moninaisia ja he ovat iältään 22–45-vuotiaita. Tutkimuksen aineisto on analysoitu sisällönanalyysin keinoin. Tutkimustuloksissa oman erityisyyden merkitys itselle koettiin positiivisten, neutraalien ja negatiivisten kokemusten kautta. Erilaisuuden kokemuksia synnyttäviksi tekijöiksi määriteltiin koettu minä ja muut -asetelma, ulkoapäin saatu palaute sekä samaistumattomuus. Erilaisuuden kokemuksia ehkäiseviksi tekijöiksi nimettiin omien ja ympäristön ajatusmallien muutoksia sekä koulun toimintaympäristöön liittyviä kehitysehdotuksia. Tutkimuksessa omaa erityisyyttä ei nähty vahvuutena tai heikkoutena. Oman erilaisuuden koettiin olevan vaikuttavana tekijänä masennuksen puhkeamiseen sekä kykenemättömyyteen opiskella. Tulosten perusteella ei voida yleistää erityisyyden merkityksiä minäkuvalle. Tuloksista voidaan nostaa koulun merkittävyys erilaisuuden kokemusta mahdollistavaksi. Minä ja muut -asetelma kuvaa erilaisuuden sisäänrakennettua olemusta.How difference influences one self’s self-concept : experiences of being different. Abstract. Difference is a universal phenomenon but there is no universal way of being different. From medical point of view difference can be defined by diagnosis. In this study difference and special needs are defined from the outside by diagnosis. Individual forms an opinion about him-/herself through self-concept. Self-concept responds to the question “What am I like?”. How does the act of being defined different from the outside meets the individual’s way of describing him-/herself and what kind of a role does the given diagnosis have in this process? The main focus in this study is to find out what kind of relevance does difference defined form outside have for the development of self-concept. In this study relevancies are searched through individual’s personal experiences about being different. The theoretical framework of this study consists of observing the concepts of being different and self-concept. This study is a qualitative study. The data has been approached by their narrative aspect emphasizing personal experiences. The data of this study consists of five (5) interview. Interviewees are young adults aged form 22 to 45 years with different kind of diagnosis. The data has been collected during January 2019. The data has been analyzed with content analysis. The results of this study shows that individual’s own difference was seen through positive, neutral and negative experiences. Otherness, feedback from the others and un-identifying were experienced as factors that produce difference. Changes in the ways of thinking and in the school concept were named to be preventing factors for experiences of difference. In this study individual’s own difference was not seen as weaknesses or strengths. However individual’s own difference was found to be an active factor for depression and inability to study. Based on these results it can’t be generalized how difference influences one self’s self-concept. The results highlights the importance of school concept for producing and preventing the experiences of difference. The otherness that rose from being different from others describes the universal nature of difference

Traditional Cardiovascular Risk Factors as Predictors of Cardiovascular Events in the U.S. Astronaut Corps

Risk prediction equations from the Framingham Heart Study are commonly used to predict the absolute risk of myocardial infarction (MI) and coronary heart disease (CHD) related death. Predicting CHD-related events in the U.S. astronaut corps presents a monumental challenge, both because astronauts tend to live healthier lifestyles and because of the unique cardiovascular stressors associated with being trained for and participating in space flight. Traditional risk factors may not hold enough predictive power to provide a useful indicator of CHD risk in this unique population. It is important to be able to identify individuals who are at higher risk for CHD-related events so that appropriate preventive care can be provided. This is of special importance when planning long duration missions since the ability to provide advanced cardiac care and perform medical evacuation is limited. The medical regimen of the astronauts follows a strict set of clinical practice guidelines in an effort to ensure the best care. The purpose of this study was to evaluate the utility of the Framingham risk score (FRS), low-density lipoprotein (LDL) and high-density lipoprotein levels, blood pressure, and resting pulse as predictors of CHD-related death and MI in the astronaut corps, using Cox regression. Of these factors, only two, LDL and pulse at selection, were predictive of CHD events (HR(95% CI)=1.12 (1.00-1.25) and HR(95% CI)=1.70 (1.05-2.75) for every 5-unit increase in LDL and pulse, respectively). Since traditional CHD risk factors may lack the specificity to predict such outcomes in astronauts, the development of a new predictive model, using additional measures such as electron-beam computed tomography and carotid intima-media thickness ultrasound, is planned for the future

Disease-modifying antirheumatic drugs are associated with a reduced risk for cardiovascular disease in patients with rheumatoid arthritis: a case control study

Rheumatoid arthritis (RA) is characterized by inflammation and an increased risk for cardiovascular disease (CVD). This study investigates possible associations between CVD and the use of conventional disease-modifying antirheumatic drugs (DMARDs) in RA. Using a case control design, 613 RA patients (5,649 patient-years) were studied, 72 with CVD and 541 without CVD. Data on RA, CVD and drug treatment were evaluated from time of RA diagnosis up to the first cardiovascular event or the end of the follow-up period. The dataset was categorized according to DMARD use: sulfasalazine (SSZ), hydroxychloroquine (HCQ) or methotrexate (MTX). Odds ratios (ORs) for CVD, corrected for age, gender, smoking and RA duration, were calculated per DMARD group. Patients who never used SSZ, HCQ or MTX were used as a reference group. MTX treatment was associated with a significant CVD risk reduction, with ORs (95% CI): 'MTX only', 0.16 (0.04 to 0.66); 'MTX and SSZ ever', 0.20 (0.08 to 0.51); and 'MTX, SSZ and HCQ ever', 0.20 (0.08 to 0.54). The risk reductions remained significant after additional correction for the presence of rheumatoid factor and erosions. After correction for hypertension, diabetes and hypercholesterolemia, 'MTX or SSZ ever' and 'MTX, SSZ and HCQ ever' showed significant CVD risk reduction. Rheumatoid factor positivity and erosions both increased CVD risk, with ORs of 2.04 (1.02 to 4.07) and 2.36 (0.92 to 6.08), respectively. MTX and, to a lesser extent, SSZ were associated with significantly lower CVD risk compared to RA patients who never used SSZ, HCQ or MTX. We hypothesize that DMARD use, in particular MTX use, results in powerful suppression of inflammation, thereby reducing the development of atherosclerosis and subsequently clinically overt CVD

Predicting out of intensive care unit cardiopulmonary arrest or death using electronic medical record data

BACKGROUND: Accurate, timely and automated identification of patients at high risk for severe clinical deterioration using readily available clinical information in the electronic medical record (EMR) could inform health systems to target scarce resources and save lives. METHODS: We identified 7,466 patients admitted to a large, public, urban academic hospital between May 2009 and March 2010. An automated clinical prediction model for out of intensive care unit (ICU) cardiopulmonary arrest and unexpected death was created in the derivation sample (50% randomly selected from total cohort) using multivariable logistic regression. The automated model was then validated in the remaining 50% from the total cohort (validation sample). The primary outcome was a composite of resuscitation events, and death (RED). RED included cardiopulmonary arrest, acute respiratory compromise and unexpected death. Predictors were measured using data from the previous 24 hours. Candidate variables included vital signs, laboratory data, physician orders, medications, floor assignment, and the Modified Early Warning Score (MEWS), among other treatment variables. RESULTS: RED rates were 1.2% of patient-days for the total cohort. Fourteen variables were independent predictors of RED and included age, oxygenation, diastolic blood pressure, arterial blood gas and laboratory values, emergent orders, and assignment to a high risk floor. The automated model had excellent discrimination (c-statistic=0.85) and calibration and was more sensitive (51.6% and 42.2%) and specific (94.3% and 91.3%) than the MEWS alone. The automated model predicted RED 15.9 hours before they occurred and earlier than Rapid Response Team (RRT) activation (5.7 hours prior to an event, p=0.003) CONCLUSION: An automated model harnessing EMR data offers great potential for identifying RED and was superior to both a prior risk model and the human judgment-driven RRT

ELECTRON AVALANCHE IN LIQUID XENON

We present detailed measurements of the electron avalanche process in liquid Xenon. The measurements were made by using liquid-Xe-filled proportional chambers with anode diameters of 2.9, 3.5, and 5.0 {approx} to detect 279-keV y rays and measure the photopeak pulse height as a function of applied voltage. The use of uniform pulses of electrons enabled us to discriminate against secondary Townsend processes. We present a table of the first Townsend coefficient a as a function of electric field E; a typical value is {alpha} = (4.5 {+-} 0.3) x 10{sup 4} cm{sup -1} at E = 2 x 10{sup 6} V/cm. The electron avalanche occurs in liquid Xe at electric fields 26 times smaller than would be predicted using measurements made in gaseous Xe and E/{rho} density scaling