Characteristics of Ni-Doped IZO Layers Grown on IZO Anode for Enhancing Hole Injection in OLEDs

The preparation and characteristics of a Ni-doped indium zinc oxide (NIZO) layer were investigated to enhance hole injection in organic light emitting diodes (OLEDs). A thin NIZO layer with a thickness of 5 nm was cosputtered onto an indium zinc oxide (IZO) anode using tilted Ni and IZO dual targets dc magnetron sputtering at room temperature in a pure Ar atmosphere. Using 3 W of Ni dc power, we can obtain a NIZO (5 nm)/IZO (135 nm) double-layer anode with a sheet resistance of 30.04 / and an optical transmittance of 83.8% at a wavelength of 550 nm. In addition, it was found that the work function of the NIZO layer was higher than that of a pure IZO anode due to the presence of a NiOx phase in the NIZO layer. An increase of Ni dc power above 7 W significantly degrades the electrical and optical properties in the NIZO layer. X-ray diffraction examination demonstrated that the NIZO layer consisted of an amorphous structure regardless of the Ni dc deposition power due to low substrate temperature. Furthermore, an OLED fabricated on the NIZO layer exhibited a higher current density, luminance, and efficiency due to improved hole injection by the high work function NIZO. These results indicate that the NIZO/IZO anode scheme is a promising anode material system for enhancing hole injection from the anode into the active layer of OLEDs.The authors acknowledge financial support from LG Displays, OLED Panel Development team

Molecular diagnosis of hereditary spherocytosis by multi-gene target sequencing in Korea: matching with osmotic fragility test and presence of spherocyte

Background Current diagnostic tests for hereditary spherocytosis (HS) focus on the detection of hemolysis or indirectly assessing defects of membrane protein, whereas direct methods to detect protein defects are complicated and difficult to implement. In the present study, we investigated the patterns of genetic variation associated with HS among patients clinically diagnosed with HS. Methods Multi-gene targeted sequencing of 43 genes (17 RBC membrane protein-encoding genes, 20 RBC enzyme-encoding genes, and six additional genes for the differential diagnosis) was performed using the Illumina HiSeq platform. Results Among 59 patients with HS, 50 (84.7%) had one or more significant variants in a RBC membrane protein-encoding genes. A total of 54 significant variants including 46 novel mutations were detected in six RBC membrane protein-encoding genes, with the highest number of variants found in SPTB (n = 28), and followed by ANK1 (n = 19), SLC4A1 (n = 3), SPTA1 (n = 2), EPB41 (n = 1), and EPB42 (n = 1). Concurrent mutations of genes encoding RBC enzymes (ALDOB, GAPDH, and GSR) were detected in three patients. UGT1A1 mutations were present in 24 patients (40.7%). Positive rate of osmotic fragility test was 86.8% among patients harboring HS-related gene mutations. Conclusions This constitutes the first large-scaled genetic study of Korean patients with HS. We demonstrated that multi-gene target sequencing is sensitive and feasible that can be used as a powerful tool for diagnosing HS. Considering the discrepancies of clinical and molecular diagnoses of HS, our findings suggest that molecular genetic analysis is required for accurate diagnosis of HS.Support was provided by: the National Research Foundation of Korea (NRF) grant funded by the Korea government(MSIT) (NRF-2017R1A2A1A17069780) http://www.nrf.re.kr/

Association of Preferences for Participation in Decision-making with Care Satisfaction among Hospitalized Patients

Importance: The association of patient desire to participate in health care decisions with care satisfaction is poorly understood. The contributions of such desire, expectations of care, and quality of care in assessing patient satisfaction are not known.Objective: To investigate the association of hospitalized patients' desire to delegate decisions to their physician with care dissatisfaction.Design, Setting, and Participants: Survey study in an academic research setting. As part of The University of Chicago Hospitalist Study, data were collected on 13902 hospitalized patients admitted to the general internal medicine service of The University of Chicago Medical Center between July 1, 2004, and September 30, 2012, who answered an inpatient survey administered soon after the time of admission and a 30-day follow-up survey. The dates of analysis were January 2014 to June 2015. Exposure: Patient-reported preference to leave medical decisions to their physician (definitely agree or somewhat agree vs somewhat disagree or definitely disagree).Main Outcomes and Measures: The main outcomes were patient-reported dissatisfaction with overall service, dissatisfaction with physician care, and lack of confidence and trust in the physicians providing treatment, which were obtained from the 30-day follow-up survey.Results: The sample population included 13 902 patients (mean [SD] age, 56.7 [19.1] years; 60.4% female [n = 8397] and 74.2% African American [n = 10 310]) who completed both surveys. Overall, 53.2% had no higher educational attainment, 22.7% were insured by Medicaid, and 51.1% reported a general self-assessed health status of fair or poor. The proportions of respondents who agreed and disagreed with delegating decisions to the responsible physician were 71.1% and 28.9%, respectively. A statistically significantly higher proportion of those who agreed rated their overall care as excellent or very good compared with those who disagreed (68.0% vs 62.5%; P Conclusions and Relevance: The findings suggest that patient preferences to participate in medical decision-making are statistically significantly associated with dissatisfaction of hospitalized patients. Clinicians should individualize their encouragement of patient participation in diagnostic and management decisions to maximize patient satisfaction.</p

The Impact of Meaningful Use and Electronic Health Records on Hospital Patient Safety

The HITECH Act aimed to leverage Electronic Health Records (EHRs) to improve efficiency, quality, and patient safety. Patient safety and EHR use have been understudied, making it difficult to determine if EHRs improve patient safety. The objective of this study was to determine the impact of EHRs and attesting to Meaningful Use (MU) on Patient Safety Indicators (PSIs). A multivariate regression analysis was performed using a generalized linear model method to examine the impact of EHR use on PSIs. Fully implemented EHRs not attesting to MU had a positive impact on three PSIs, and hospitals that attested to MU had a positive impact on two. Attesting to MU or having a fully implemented EHR were not drivers of PSI-90 composite score, suggesting that hospitals may not see significant differences in patient safety with the use of EHR systems as hospitals move towards pay-for-performance models. Policy and practice may want to focus on defining metrics and PSIs that are highly preventable to avoid penalizing hospitals through reimbursement, and work toward adopting advanced analytics to better leverage EHR data. These findings will assist hospital leaders to find strategies to better leverage EHRs, rather than relying on achieving benchmarks of MU objectives

Impact of Community Socioeconomic Characteristics on Emergency Medical Service Delays in Responding to Fatal Vehicle Crashes

Introduction: This study aimed to determine the impact of community socioeconomic status on emergency medical services’ response time for fatal vehicle crashes. Methods: Authors used the 2019 National Highway Traffic Safety Administration Fatality Analysis Reporting System and 2019–2020 Area Health Resource Files to obtain emergency medical services’ time intervals and county socioeconomic characteristics (e.g., median household income, availability of trauma centers, and rurality), generating a study sample of 18,540 individuals involved in fatal vehicle crashes between January and December 2019. Generalized linear models with log-link and Gamma-family were used to obtain estimates, and other variables were adjusted in the model. Results: Both the mean time of the emergency medical service arrival to the site of the crash and the mean transport time from the crash site to hospital varied by county SES. Counties with a higher mean household income had 12% shorter emergency medical services’ arrival times and up to 7% shorter emergency medical services’ hospital transport times than counties with lower SES. The emergency medical services’ hospital transport times by emergency medical services also varied by proximity to trauma centers and were 15% shorter in counties that had ≥2 trauma centers than in counties without trauma centers. Conclusions: This study shows socioeconomic disparities in emergency medical service rescue time for fatal vehicle crashes. Community characteristics play a major role in emergency medical services’ arrival time intervals. Prior research demonstrated a strong link between the timeliness of emergency medical service response and the likelihood of survival in fatal motor vehicle accidents. These findings showing that socioeconomically disadvantaged areas and those lacking trauma facilities had slower emergency medical service rescue times, suggest that socioeconomic status may be a predictor of mortality in fatal motor vehicle accidents. Effective emergency medical services are essential to reduce the morbidity and mortality among motor vehicle crash victims; however, disparities exist in the timeliness of these services by geographic and socioeconomic county characteristics. Further research is urgently needed to inform policy interventions

IMPURITY DIFFUSION ENHANCEMENT OF INTERDIFFUSION IN GAINASP HETEROSTRUCTURES LATTICE MATCHED TO GAAS AND INP

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