Transmission Lines and Meta-Materials based on Quantum Hall Plasmonics

The characteristic impedance of a microwave transmission line is typically constrained to a value $Z_0$ = 50 $\Omega$, in-part because of the low impedance of free space and the limited range of permittivity and permeability realizable with conventional materials. Here we suggest the possibility of constructing high-impedance transmission lines by exploiting the plasmonic response of edge states associated with the quantum Hall effect in gated devices. We analyze various implementations of quantum Hall transmission lines based on distributed networks and lumped-element circuits, including a detailed account of parasitic capacitance and Coulomb drag effects, which can modify device performance. We additionally conceive of a meta-material structure comprising arrays of quantum Hall droplets and analyze its unusual properties. The realization of such structures holds promise for efficiently wiring-up quantum circuits on chip, as well as engineering strong coupling between semiconductor qubits and microwave photons

Utilizing paramedics for in-patient critical care surge capacity

INTRODUCTION: While many hospitals have developed preliminary emergency department and in-patient surge plans, the ability to surge is often limited by critical resources. The resource which is often the most limited is usually the human resource and within this category the limiting factor is almost universally nursing. As a result, nursing shortages can result in an inability of a hospital or emergency department to create surge capacity to deal with large numbers of ill or injured patients. Utilizing paramedics in acute-care hospitals or at alternate care sites could serve as expansion staff to supplement existing nursing staff allowing fewer nurses to care for a larger numbers of patients during a disaster, act of terrorism, or public health emergency. While the procedures performed for nursing do vary from hospital to hospital, there are national certifications for both emergency nursing (CEN) and critical care nursing (CCRN) that can be used to establish a standard for comparison. METHODS: A detailed review and curriculum mapping of the specific educational objectives and competencies of the U.S. Department of Transportation National Standard Curriculum for the Emergency Medical Technician-Paramedic as well as the competencies and criteria for board certification as a Certified Emergency Nurse (CEN) and Critical Care Registered Nurse (CCRN) was performed. RESULTS: Approximately 90 percent of the CEN and CCRN knowledge skills and competencies are met or exceeded by the National Standard Paramedic Curriculum. CONCLUSIONS: With appropriate training and orientation, paramedics may be used in an in-patient setting to augment emergency and critical care nursing staff during a disaster, act of terrorism, or public health emergency

Hospital Referral Patterns: How Emergency Medical Care is Accessed in a Disaster

BACKGROUND: A prevalent assumption in hospital emergency preparedness planning is that patient arrival from a disaster scene will occur through a coordinated system of patient distribution based on the number of victims, capabilities of the receiving hospitals, and the nature and severity of illness or injury. In spite of the strength of the emergency medical services system, case reports in the literature and major incident after-action reports have shown that most patients who present at a health care facility after a disaster or other major emergency do not necessarily arrive via ambulance. If these reports of arrival of patients outside an organized emergency medical services system are accurate, then hospitals should be planning differently for the impact of an unorganized influx of patients on the health care system. Hospitals need to consider alternative patterns of patient referral, including the mass convergence of self-referred patients, when performing major incident planning. METHODS: We conducted a retrospective review of published studies from the past 25 years to identify reports of patient care during disasters or major emergency incidents that described the patients' method of arrival at the hospital. Using a structured mechanism, we aggregated and analyzed the data. RESULTS: Detailed data on 8303 patients from more than 25 years of literature were collected. Many reports suggest that only a fraction of the patients who are treated in emergency departments following disasters arrive via ambulance, particularly in the early postincident stages of an event. Our 25 years of aggregate data suggest that only 36% of disaster victims are transported to hospitals via ambulance, whereas 63% use alternate means to seek emergency medical care. CONCLUSIONS: Hospitals should evaluate their emergency plans to consider the implications of alternate referral patterns of patients during a disaster. Additional consideration should be given to mass triage, site security, and the potential need for decontamination after a major inciden

On orbital allotments for geostationary satellites

The following satellite synthesis problem is addressed: communication satellites are to be allotted positions on the geostationary arc so that interference does not exceed a given acceptable level by enforcing conservative pairwise satellite separation. A desired location is specified for each satellite, and the objective is to minimize the sum of the deviations between the satellites' prescribed and desired locations. Two mixed integer programming models for the satellite synthesis problem are presented. Four solution strategies, branch-and-bound, Benders' decomposition, linear programming with restricted basis entry, and a switching heuristic, are used to find solutions to example synthesis problems. Computational results indicate the switching algorithm yields solutions of good quality in reasonable execution times when compared to the other solution methods. It is demonstrated that the switching algorithm can be applied to synthesis problems with the objective of minimizing the largest deviation between a prescribed location and the corresponding desired location. Furthermore, it is shown that the switching heuristic can use no conservative, location-dependent satellite separations in order to satisfy interference criteria