High Power GaN/AlGaN/GaN HEMTs Grown by Plasma-Assisted MBE Operating at 2 to 25 GHz

Heterostructures of the materials system GaN/AlGaN/GaN were grown by molecular beam epitaxy on 6H-SiC substrates and high electron mobility transistors (HEMTs) were fabricated. For devices with large gate periphery an air bridge technology was developed for the drain contacts of the finger structure. The devices showed DC drain currents of more than 1 A/mm and values of the transconductance between 120 and 140 mS/mm. A power added efficiency of 41 % was measured on devices with a gate length of 1 µm at 2 GHz and 45 V drain bias. Power values of 8 W/mm were obtained. Devices with submicron gates exhibited power values of 6.1 W/mm (7 GHz) and 3.16 W/mm (25 GHz) respectively. The rf dispersion of the drain current is very low, although the devices were not passivated.Heterostrukturen im Materialsystem GaN/AlGaN/GaN wurden mittels Molekularstrahlepitaxie auf 6H-SiC-Substraten gewachsen und High-Electron-Mobility-Transistoren (HEMTs) daraus hergestellt. Für Bauelemente mit großer Gateperipherie wurde eine Air-Bridge-Technik entwickelt, um die Drainkontakte der Fingerstruktur zu verbinden. Die Bauelemente zeigten Drainströme von mehr als 1 A/mm und Steilheiten zwischen 120 und 140 mS/mm. An Transistoren mit Gatelängen von 1 µm konnten Leistungswirkungsgrade (Power Added Efficiency) von 41 % (bei 2 GHz und 45 V Drain-Source-Spannung) sowie eine Leistung von 8 W/mm erzielt werden. Bauelemente mit Gatelängen im Submikrometerbereich zeigten Leistungswerte von 6,1 W/mm (7 GHz) bzw. 3,16 W/mm (25 GHz). Die Drainstromdispersion ist sehr gering, obwohl die Bauelemente nicht passiviert wurden

High Power GaN/AlGaN/GaN HEMTs Grown by Plasma-Assisted MBE Operating at 2 to 25 GHz

Heterostructures of the materials system GaN/AlGaN/GaN were grown by molecular beam epitaxy on 6H-SiC substrates and high electron mobility transistors (HEMTs) were fabricated. For devices with large gate periphery an air bridge technology was developed for the drain contacts of the finger structure. The devices showed DC drain currents of more than 1 A/mm and values of the transconductance between 120 and 140 mS/mm. A power added efficiency of 41 % was measured on devices with a gate length of 1 µm at 2 GHz and 45 V drain bias. Power values of 8 W/mm were obtained. Devices with submicron gates exhibited power values of 6.1 W/mm (7 GHz) and 3.16 W/mm (25 GHz) respectively. The rf dispersion of the drain current is very low, although the devices were not passivated.Heterostrukturen im Materialsystem GaN/AlGaN/GaN wurden mittels Molekularstrahlepitaxie auf 6H-SiC-Substraten gewachsen und High-Electron-Mobility-Transistoren (HEMTs) daraus hergestellt. Für Bauelemente mit großer Gateperipherie wurde eine Air-Bridge-Technik entwickelt, um die Drainkontakte der Fingerstruktur zu verbinden. Die Bauelemente zeigten Drainströme von mehr als 1 A/mm und Steilheiten zwischen 120 und 140 mS/mm. An Transistoren mit Gatelängen von 1 µm konnten Leistungswirkungsgrade (Power Added Efficiency) von 41 % (bei 2 GHz und 45 V Drain-Source-Spannung) sowie eine Leistung von 8 W/mm erzielt werden. Bauelemente mit Gatelängen im Submikrometerbereich zeigten Leistungswerte von 6,1 W/mm (7 GHz) bzw. 3,16 W/mm (25 GHz). Die Drainstromdispersion ist sehr gering, obwohl die Bauelemente nicht passiviert wurden

Outcomes After Transcatheter Mitral Valve Replacement According to Regurgitation Etiology.

BACKGROUND Whether transcatheter mitral valve replacement (TMVR) devices perform similarly with respect to the underlying mitral regurgitation (MR) etiology remains unelucidated yet. The aim of the present analysis was to assess outcomes of TMVR according to the MR underlying etiology among the CHoice of OptImal transCatheter trEatment for Mitral Insufficiency Registry (CHOICE-MI) registry. METHODS Out of 746 patients, 229 (30.7%) patients underwent TMVR. The study population was subdivided according to primary, secondary or mixed MR. Patients with mitral annular calcification were excluded. The primary study endpoint was a composite endpoint of all-cause mortality or hospitalisation for heart failure at 1 year. Secondary study endpoints included all-cause and cardiovascular mortality at 1 year, New York Heart Association functional class and residual MR, both at discharge and 1 year. RESULTS The predominant MR etiology was secondary MR (58.4%), followed by primary MR (28.7%), and mixed MR (12.9%). Technical success was similar according to MR etiology as was procedural mortality. Discharge echocardiography revealed residual MR 2+ in 11.3%, 3.7%, and 5.3% of patients with primary, secondary, and mixed MR, respectively (P=0.1). MR elimination was similar in all groups up to the 1-year follow-up. There was no difference in terms of primary combined outcome occurrence according to MR etiology. One-year all-cause mortality was reported in 28.8%, 24.2% and 32.1% of the patients with primary, secondary and mixed MR (P=0.07), respectively. CONCLUSIONS In our study, we did not find differences in short- and 1-year outcomes after TMVR according to MR etiology

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London