181 research outputs found
Subpicosecond carrier lifetime in GaAs grown by molecular beam epitaxy at low temperatures
Epitaxial GaAs grown by molecular beam epitaxy (MBE) at low substrate temperatures is observed to have a significantly shorter carrier lifetime than GaAs grown at normal substrate temperatures. Using femtosecond time‐resolved‐reflectance techniques, a sub‐picosecond (<0.4 ps) carrier lifetime has been measured for GaAs grown by MBE at ∼200°C and annealed at 600 °C. With the same material as a photoconductive switch we have measured electrical pulses with a full‐width at half‐maximum of 0.6 ps using the technique of electro‐optic sampling. Good responsivity for a photoconductive switch is observed, corresponding to a mobility of the photoexcited carriers of ∼120–150 cm2/V s. GaAs grown by MBE at 200 °C and annealed at 600 °C is also semi‐insulating, which results in a low dark current in the switch application. The combination of fast recombination lifetime, high carrier mobility, and high resistivity makes this material ideal for a number of subpicosecond photoconductive applications.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71318/2/APPLAB-59-25-3276-1.pd
Ultrahigh-bandwidth vector network analyzer based on external electro-optic sampling
We report the development of an ultrahigh-bandwidth vector network analyzer useful for small-signal characterization of high-speed semiconductor devices. It employs 100-fs optical pulses for making terahertz-bandwidth electro-optic measurements of electrical signals, as well as for sub-picosecond, photoconductive, electrical-stimulus-signal generation. High-bandwidth coplanar strip transmission lines are used for signal transmission. A 0.15 x 50 [mu]m gate AlGaAs/InGaAs/GaAs HFET has been characterized over a bandwidth of 100 GHz using this network analyzer. A comparison with conventional RF network analyzer measurements performed to 40 GHz demonstrated good agreement throughout this bandwidth. Such measurements of the actual device characteristics across their entire operating frequency range should improve device development and incorporation into active circuits.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30189/1/0000574.pd
External electro-optic integrated circuit probing
An external electro-optic measurement system with subpicosecond resolution has been developed. This electro-optic sampling system is designed to operate as a non-contact probe of voltages in electrical devices and circuits with modified wafer-level test equipment and no special circuit preparation. Measurements demonstrate the system's ability to probe continuous and pulsed signals on microwave integrated circuits on arbitrary substrates with single-micron spatial resolution. We also discuss the application of external electro-optic sampling to various aspects of time-domain circuit studies, including the generation of short electrical test pulses using novel photoconductive techniques and the propagation of pulses on interconnects.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28606/1/0000415.pd
Latent cluster analysis of ALS phenotypes identifies prognostically differing groups
BACKGROUND
Amyotrophic lateral sclerosis (ALS) is a degenerative disease predominantly affecting motor neurons and manifesting as several different phenotypes. Whether these phenotypes correspond to different underlying disease processes is unknown. We used latent cluster analysis to identify groupings of clinical variables in an objective and unbiased way to improve phenotyping for clinical and research purposes.
METHODS
Latent class cluster analysis was applied to a large database consisting of 1467 records of people with ALS, using discrete variables which can be readily determined at the first clinic appointment. The model was tested for clinical relevance by survival analysis of the phenotypic groupings using the Kaplan-Meier method.
RESULTS
The best model generated five distinct phenotypic classes that strongly predicted survival (p<0.0001). Eight variables were used for the latent class analysis, but a good estimate of the classification could be obtained using just two variables: site of first symptoms (bulbar or limb) and time from symptom onset to diagnosis (p<0.00001).
CONCLUSION
The five phenotypic classes identified using latent cluster analysis can predict prognosis. They could be used to stratify patients recruited into clinical trials and generating more homogeneous disease groups for genetic, proteomic and risk factor research
Ultrafast-ultrafine probing of high-speed electrical waveforms using a scanning force microscope with photoconductive gating
Picosecond photoconductivity in low-temperature-grown GaAs (LT GaAs) has been used to provide temporal resolution both in rigid probes and in scanning force microscope probes. This article reviews the fabrication and use of such probes. 2.5 ps temporal resolution and few microvolts sensitivity are obtained at arbitrary points on circuits with a spatial definition of 100 nm. Rigid probes are tested in application to analogue and digital circuits. As an alternative to electron beam testing, scanning force probes are applied to in situ imaging and waveform measurement. Finally, the use of time-resolved waveform analysis with scanning-force microscopy probes with semiconductor laser sources is demonstrated.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43337/1/11082_2004_Article_BF00820152.pd
Differential photoconductive sampling with a resolution independent of carrier lifetime
Assessing the Relative Performance of Nurses Using Data Envelopment Analysis Matrix (DEAM)
Assessing employee performance is one of the most important issue in healthcare management services. Because of their direct relationship with patients, nurses are also the most influential hospital staff who play a vital role in providing healthcare services. In this paper, a novel Data Envelopment Analysis Matrix (DEAM) approach is proposed for assessing the performance of nurses based on relative efficiency. The proposed model consists of five input variables (including type of employment, work experience, training hours, working hours and overtime hours) and eight output variables (the outputs are amount of hours each nurse spend on each of the eight activities including documentation, medical instructions, wound care and patient drainage, laboratory sampling, assessment and control care, follow-up and counseling and para-clinical measures, attendance during visiting and discharge suction) have been tested on 30 nurses from the heart department of a hospital in Iran. After determining the relative efficiency of each nurse based on the DEA model, the nurses’ performance were evaluated in a DEAM format. As results the nurses were divided into four groups; superstars, potential stars, those who are needed to be trained effectively and question marks. Finally, based on the proposed approach, we have drawn some recommendations to policy makers in order to improve and maintain the performance of each of these groups. The proposed approach provides a practical framework for hospital managers so that they can assess the relative efficiency of nurses, plan and take steps to improve the quality of healthcare delivery
A cost and performance comparison of Public Private Partnership and public hospitals in Spain
© 2016 Caballer-Tarazona and Vivas-Consuelo. Open Access This article is distributed under the terms of the Creative
Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source,
provide a link to the Creative Commons license, and indicate if changes were made.The Erratum to this article has been published in Health Economics Review 2016 6:20[EN] Public-private partnership (PPP) initiatives are extending around the world, especially in Europe, as an innovation to
traditional public health systems, with the intention of making them more efficient.
There is a varied range of PPP models with different degrees of responsibility from simple public sector contracts
with the private, up to the complete privatisation of the service. As such, we may say the involvement of the
private sector embraces the development, financing and provision of public infrastructures and delivery services.
In this paper, one of the oldest PPP initiatives developed in Spain and transferred to other European and Latin
American countries is evaluated for first time: the integrated healthcare delivery Alzira model.
Through a comparison of public and PPP hospital performance, cost and quality indicators, the efficiency of the
PPP experience in five hospitals is evaluated to identify the influence of private management in the results.
Regarding the performance and efficiency analysis, it is seen that the PPP group obtains good results, above the
average, but not always better than those directly managed. It is necessary to conduct studies with a greater
number of PPP hospitals to obtain conclusive results.Caballer Tarazona, M.; Vivas Consuelo, DJJ. (2016). A cost and performance comparison of Public Private Partnership and public hospitals in Spain. Health Economics Review. 6(17):1-7. doi:10.1186/s13561-016-0095-5S17617La Forgia GM, Harding A. Public-Private Partnerships and Public Hospital Performance in Sao Paulo, Brazil. Health Aff. 2009;28(4):1114–26.Vecchi V, Hellowell M, Longo F. Are Italian healthcare organizations paying too much for their public-private partnerships? Public Money Manage. 2010;30(2):125–32.Hellowell M, Pollock AM. The private financing of NHS hospitals: politics, policy and practice. Econ Aff. 2009;29(1):13–9.McIntosh N, Grabowski A, Jack B, Nkabane-Nkholongo EL, Vian T. A public-private partnership improves clinical performance in a hospital network in Lesotho. Health Aff. 2015;34(6):954–62.Roehrich JK, Lewis MA, George G. Are public–private partnerships a healthy option? A systematic literature review. Soc Sci Med. 2014;113:110–9.Barlow J, Roehrich J, Wright S. Europe sees mixed results from public-private partnerships for building and managing health care facilities and services. Health Aff. 2013;32(1):146–54.Hoppe EI, Kusterer DJ, Schmitz PW. Public-private partnerships versus traditional procurement: an experimental investigation. J Econ Behav Organ. 2013;89:145–66.Vivas-Consuelo D, Uso-Talamantes R, Trillo-Mata JL, Caballer-Tarazona M, Barrachina-Martinez I, Buigues-Pastor L. Predictability of pharmaceutical spending in primary health services using Clinical Risk Groups. Health Policy. 2014;116(2-3):188–95.Lopez-Casasnovas G, Costa-Font J, Planas I. Diversity and regional inequalities in the Spanish ‘system of health care services’. Health Econ. 2005;14 Suppl 1:S221–S35.Spain NHSo. National Health System of Spain. National Health System of Spain; 2010.McKee M, Edwards N, Atun R. Public-private partnerships for hospitals. Bull World Health Organ. 2006;84(11):890–6.Caballer-Tarazona M, Moya-Clemente I, Vivas-Consuelo D, Barrachina-Martínez I. A model to measure the efficiency of hospital performance. Math Comput Model. 2010;52(7-8):1095–102.Barlow J, Roehrich JK, Wright S. De facto privatization or a renewed role for the EU? Paying for Europe’s healthcare infrastructure in a recession. J R Soc Med. 2010;103(2):51–5.Herr A, Schmitz H, Augurzky B. Profit efficiency and ownership of German hospitals. Health Econ. 2011;20(6):660–74.Alonso JM, Clifton J, Díaz-Fuentes D. The impact of New Public Management on efficiency: an analysis of Madrid’s hospitals. Health Policy. 2015;119(3):333–40.IASIST. Desarrollo metodológico de los indicadores ajustados 2009 [cited 2015 July 26]. Available from: ( http://www.iasist.com/archivos/top20-2009-metodologia_161215235006.pdf ). Accessed Sept 2015.Hollingsworth B. The measurement of efficiency and productivity of health care delivery. Health Econ. 2008;17(10):1107–28.Ozgen H, Ozcan YA. A national study of efficiency for dialysis centers: an examination of market competition and facility characteristics for production of multiple dialysis outputs. Health Serv Res. 2002;37(3):711–32.Valdmanis VG, Rosko MD, Mutter RL. Hospital quality, efficiency, and input slack differentials. Health Serv Res. 2008;43(5):1830–48.Acerete B, Stafford A, Stapleton P. Spanish healthcare public private partnerships: The ‘Alzira model’. Crit Perspect Account. 2011;22(6):533–49.Allard G, Trabant A. Public-private partnerships in Spain: lessons and opportunities. Int Business Econ Res J. 2008;7(2):1–24.Shaoul J, Stafford A, Stapleton P. The cost of using private finance to build, finance and operate hospitals. Public Money Manage. 2008;28(2):101–8
Health System Resource Gaps and Associated Mortality from Pandemic Influenza across Six Asian Territories
BACKGROUND: Southeast Asia has been the focus of considerable investment in pandemic influenza preparedness. Given the wide variation in socio-economic conditions, health system capacity across the region is likely to impact to varying degrees on pandemic mitigation operations. We aimed to estimate and compare the resource gaps, and potential mortalities associated with those gaps, for responding to pandemic influenza within and between six territories in Asia. METHODS AND FINDINGS: We collected health system resource data from Cambodia, Indonesia (Jakarta and Bali), Lao PDR, Taiwan, Thailand and Vietnam. We applied a mathematical transmission model to simulate a "mild-to-moderate" pandemic influenza scenario to estimate resource needs, gaps, and attributable mortalities at province level within each territory. The results show that wide variations exist in resource capacities between and within the six territories, with substantial mortalities predicted as a result of resource gaps (referred to here as "avoidable" mortalities), particularly in poorer areas. Severe nationwide shortages of mechanical ventilators were estimated to be a major cause of avoidable mortalities in all territories except Taiwan. Other resources (oseltamivir, hospital beds and human resources) are inequitably distributed within countries. Estimates of resource gaps and avoidable mortalities were highly sensitive to model parameters defining the transmissibility and clinical severity of the pandemic scenario. However, geographic patterns observed within and across territories remained similar for the range of parameter values explored. CONCLUSIONS: The findings have important implications for where (both geographically and in terms of which resource types) investment is most needed, and the potential impact of resource mobilization for mitigating the disease burden of an influenza pandemic. Effective mobilization of resources across administrative boundaries could go some way towards minimizing avoidable deaths
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