Millimeter-wave FET modeling based on a frequency extrapolation approach

An empirical distributed model, based on electromagnetic analysis and standard S-parameter measurements up to microwave frequencies, is shown to be capable of accurate small-signal predictions up to the millimeter-wave range. The frequency-extrapolation approach takes advantage from a physically-expected, smooth behavior of suitably defined elementary active devices connected to a passive distributed network. On this basis, small-signal millimeter-wave FET modeling becomes an affordable task in any laboratory equipped with a standard microwave vector network analyzer and electromagnetic simulation capabilities. In the paper, wide experimental validation of the proposed model up to 110GHz is presented for PHEMT devices with different sizes and bias conditions

Global modeling approach to the design of an MMIC amplifier using Ohmic Electrode-Sharing Technology

An innovative technique for high--density, high-frequency integrated circuit design is proposed.The procedure exploits the potentialities of a global modeling approach,previously applied only at device level,enabling the circuit designer to explore flexible layout solutions imed at important reduction in chip size and cost.The new circuit design technique is presented by means of an example consisting of a wide-band amplifier,implemented with the recently proposed Ohmic Electrode-Sharing Technology (OEST).The good agreement between experimental and simulated results confirms the validity of the proposed MMIC design approach

Fringe integral equation method for a truncated grounded dielectric slab

The problem of scattering by a semi-infinite grounded dielectric slab illuminated by an arbitrary incident TM z polarized electric field is studied by solving a new set of "fringe" integral equations (F-IEs), whose functional unknowns are physically associated to the wave diffraction processes occuring at the truncation. The F-IEs are obtained by subtracting from the surface/surface integral equations pertinent to the truncated slab, an auxiliary set of equations obtained for the canonical problem of an infinite grounded slab illuminated by the same source. The F-IEs are solved by the method of moments by using a set of subdomain basis functions close to the truncation and semi-infinite domain basis functions far from it. These latter functions are properly shaped to reproduce the asymptotic behaviour of the diffracted waves, which is obtained by physical inspection. The present solution is applied to the case of an electric line source located at the air-dielectric interface of the slab. Numerical results are compared with those calculated by a physical optics approach and by an alternative solution, in which the integral equation is constructed from the field continuity through an aperture orthogonal to the slab. The applications of the solution to an array of line currents are also presented and discussed

The collaborative communication model for patient handover at the interface between high-acuity and low-acuity care

Background: Cross-unit handovers transfer responsibility for the patient among healthcare teams in different clinical units, with missed information, potentially placing patients at risk for adverse events. Objectives: We analysed the communications between high-acuity and low-acuity units, their content and social context, and we explored whether common conceptual ground reduced potential threats to patient safety posed by current handover practices. Methods: We monitored the communication of five content items using handover probes for 22 patient transitions of care between high-acuity ' sender units' and low-acuity 'recipient units'. Data were analysed and discussed in focus groups with healthcare professionals to acquire insights into the characteristics of the common conceptual ground. Results: High-acuity and low-acuity units agreed about the presence of alert signs in the discharge form in 40% of the cases. The focus groups identified prehandover practices, particularly for anticipatory guidance that relied extensively on verbal phone interactions that commonly did not involve all members of the healthcare team, particularly nursing. Accessibility of information in the medical records reported by the recipient units was significantly lower than reported by sender units. Common ground to enable interpretation of the complete handover content items existed only among selected members of the healthcare team. Conclusions: The limited common ground reduced the likelihood of correct interpretation of important handover information, which may contribute to adverse events. Collaborative design and use of a shared set of handover content items may assist in creating common ground to enable clinical teams to communicate effectively to help increase the reliability and safety of cross-unit handovers

Advance care planning in patients with advanced cancer: A 6-country, cluster-randomised clinical trial

Background Advance care planning (ACP) supports individuals to define, discuss, and record goals and preferences for future medical treatment and care. Despite being internationally recommended, randomised clinical trials of ACP in patients with advanced cancer are scarce. Methods and findings To test the implementation of ACP in patients with advanced cancer, we conducted a cluster-randomised trial in 23 hospitals across Belgium, Denmark, Italy, Netherlands, Slovenia, and United Kingdom in 2015–2018. Patients with advanced lung (stage III/IV) or colorectal (stage IV) cancer, WHO performance status 0–3, and at least 3 months life expectancy were eligible. The ACTION Respecting Choices ACP intervention as offered to patients in the intervention arm included scripted ACP conversations between patients, family members, and certified facilitators; standardised leaflets; and standardised advance directives. Control patients received care as usual. Main outcome measures were quality of life (operationalised as European Organisation for Research and Treatment of Cancer [EORTC] emotional functioning) and symptoms. Secondary outcomes were coping, patient satisfaction, shared decision-making, patient involvement in decision-making, inclusion of advance directives (ADs) in hospital files, and use of hospital care. In all, 1,117 patients were included (442 intervention; 675 control), and 809 (72%) completed the 12-week questionnaire. Patients’ age ranged from 18 to 91 years, with a mean of 66; 39% were female. The mean number of ACP conversations per patient was 1.3. Fidelity was 86%. Sixteen percent of patients found ACP conversations distressing. Mean change in patients’ quality of life did not differ between intervention and control groups (T-score −1.8 versus −0.8, p = 0.59), nor did changes in symptoms, coping, patient satisfaction, and shared decision-making. Specialist palliative care (37% versus 27%, p = 0.002) and AD inclusion in hospital files (10% versus 3%, p < 0.001) were more likely in the intervention group. A key limitation of the study is that recruitment rates were lower in intervention than in control hospitals. Conclusions Our results show that quality of life effects were not different between patients who had ACP conversations and those who received usual care. The increased use of specialist palliative care and AD inclusion in hospital files of intervention patients is meaningful and requires further study. Our findings suggest that alternative approaches to support patient-centred end-of-life care in this population are needed

Patient Safety in Orthopedics and Traumatology

Surgical specialties have a higher risk of errors and adverse events as represented in literature Orthopedics is one such specialty in which the clinical risk is more conspicuous and, consequently, it has a high exposure to medical-legal disputes . The aim of this work is to analyze the clinical risk and alleged malpractice in medical practice, in order to map professional risk and identify recurrent pitfalls