Stabilizing ultrathin Silver (Ag) films on different substrates

This paper reports an effective method of stabilizing ultrathin Silver (Ag) films on substrates using a filler metal (Zn). Ag films with a thickness < 15 nm were deposited by DC magnetron sputtering above a Zn filler metal on glass, quartz, silicon and PET (polyethylene terephthalate) substrates. Zinc is expected to partially or fully fill the roughness associated with the substrates. The Zn filler material and ultrathin Ag film form a 3-D augmented atomically chemically graded interface. 3-D interfaces have smoothly varying chemistry. The ability of Zn to partially or fully fill the substrate roughness improves the adhesion of Zn along with the Ag to the substrate. Also, Zn acts as a barrier layer against the diffusion of Ag into the substrate. This technique leads to ultrathin Ag films with low sheet resistance (~ 3 {\Omega}/Sq.), low mean absolute surface roughness (~1 nm), good optical transparency (~ 65 %), better stability and compatibility with the environment. The results indicate significant potential for applying stable ultrathin Ag film/electrode as a practical and economically feasible design solution for optoelectronic (transparent and conductive electrodes for solar cells and LEDs) and plasmonic devices. This film shows good conductivity, transparency, stability, and flexibility.Comment: 16 pages,8 figures, 3 table

Is the new orleans criteria for head ct useful for inpatient falls?

Background: Inpatient falls are a patient safety concern in all healthcare facilities. There is currently limited data on the utility of head computed tomography (CT) for inpatient falls. The New Orleans Criteria (NOC) is a validated tool used to determine the appropriateness of neuroimaging in the emergency department after sustaining a fall with minor head injury. The NOC include minor head injury with one of the following; headache, vomiting, age above 60, drug or alcohol intoxication, anterograde amnesia, trauma above the clavicles, and seizure activity. The aim of this study was to evaluate the significance of inpatient falls and determine if the NOC could be applied to triage these patients. Methods: This study is a retrospective review of inpatient falls from a multi-center health system, which includes an urban tertiary teaching hospital, 3 suburban community hospitals, 1 inpatient psychiatric facility and 1 inpatient rehab. Patient safety data was queried for all inpatient falls, classified as with injury, from May 1, 2015 through April 30, 2016. Encounters were manually reviewed for demographic data, circumstances of fall, laboratory results, components of NOC, CT head orders and results. Outcomes of interest include a head CT with any abnormal findings or an acute intracranial process. Results: Inpatient falls over the 1-year period totaled 332. Of the cases reviewed, 57% received a head CT after sustaining a fall. There were 12 (3.6%) CTs that showed a significant finding, and of those 7 (2.1%) had an acute intracranial process. No patients required surgical intervention or had a fatality related to the fall. Details of each fall case with an acute intracranial process are listed in Table 1. 250 (75.3%) patients met at least 1 component of the NOC, with 161 (64.6% of NOC positive) receiving a head CT. The NOC was positive in 6 of the 7 cases, with the missing case having a significant coagulopathy. Test characteristics of the NOC with and without the addition of coagulopathy for acute intracranial process are listed in Table 2. Conclusions: The NOC has been demonstrated as an effective tool in the emergency room; however, based on our findings its utility to evaluate potential intracranial injury in patients with in-hospital falls is limited. Adding additional criteria to the NOC can improve its test characteristics, but was unable to achieve both high specificity and sensitivity. Further investigation is required to develop a method to appropriately triage patients with in-hospital falls for significant neurological injury

Association of Metformin Treatment with Reduced Severity of Diabetic Retinopathy in Type 2 Diabetic Patients

Purpose. To evaluate effects of long-term metformin on the severity of diabetic retinopathy (DR) in high-risk type 2 diabetic (T2D) patients. Methods. A retrospective chart review study was conducted involving 335 DR patients with T2D ≥ 15 years from 1990 to 2013. The severity of DR was determined by Early Treatment Diabetic Retinopathy Study scale. The associations between metformin and DR severity were evaluated. Comparison with stratification for the use of sulfonylurea and insulin was performed to identify possible confounding effects. Results. Severe nonproliferative diabetic retinopathy or proliferative diabetic retinopathy (SNPDR/PDR) was more often diagnosed in nonmetformin users (67/142, 47%) versus metformin users (48/193, 25%) (p<0.001), regardless of gender and race of the patients. The odds ratio of metformin associated with SNPDR/PDR was 0.37 in all cases (p<0.001), 0.35 in sulfonylurea use cohort (p<0.05), 0.45 in nonsulfonylurea use cohorts (p<0.01), and 0.42 in insulin use cohort (p<0.01). Insulin users had a higher rate of SNPDR/PDR. Metformin had no influence on the occurrence of clinical significant diabetic macular edema. Conclusions. Long-term use of metformin is independently associated with a significant lower rate of SNPDR/PDR in patients with type 2 diabetes ≥ 15 years

Association of Metformin Treatment with Reduced Severity of Diabetic Retinopathy in Type 2 Diabetic Patients

Purpose: To evaluate effects of long-term metformin on the severity of diabetic retinopathy (DR) in high-risk type 2 diabetic (T2D) patients. Methods: A retrospective chart review study was conducted involving 335 DR patients with T2D ≥ 15 years from 1990 to 2013. The severity of DR was determined by Early Treatment Diabetic Retinopathy Study scale. The associations between metformin and DR severity were evaluated. Comparison with stratification for the use of sulfonylurea and insulin was performed to identify possible confounding effects. Results: Severe nonproliferative diabetic retinopathy or proliferative diabetic retinopathy (SNPDR/PDR) was more often diagnosed in nonmetformin users (67/142, 47%) versus metformin users (48/193, 25%) (p \u3c 0.001), regardless of gender and race of the patients. The odds ratio of metformin associated with SNPDR/PDR was 0.37 in all cases (p \u3c 0.001), 0.35 in sulfonylurea use cohort (p \u3c 0.05), 0.45 in nonsulfonylurea use cohorts (p \u3c 0.01), and 0.42 in insulin use cohort (p \u3c 0.01). Insulin users had a higher rate of SNPDR/PDR. Metformin had no influence on the occurrence of clinical significant diabetic macular edema. Conclusions: Long-term use of metformin is independently associated with a significant lower rate of SNPDR/PDR in patients with type 2 diabetes ≥ 15 years