112 Gbit/s single-polarization silicon coherent receiver with hybrid-integrated BiCMOS linear TIA

We report the design, fabrication and verification of a single-polarization silicon coherent receiver with a low-power linear TIA array. Error-free operation assuming FEC is shown at bitrates of 112 Gbit/s (28 Gbaud 16-QAM) and 56 Gbit/s (28 Gbaud QPSK)

What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care

<p>Abstract</p> <p>Background</p> <p>Out-of-hours care in the primary care setting is rapidly changing and evolving towards general practitioner 'cooperatives' (GPC). GPCs already exist in the Netherlands, the United Kingdom and Scandinavia, all countries with strong general practice, including gatekeepers' role. This intervention study reports the use and caseload of out-of-hours care before and after implementation of a GPC in a well subscribed region in a country with an open access health care system and no gatekeepers' role for general practice.</p> <p>Methods</p> <p>We used a prospective before/after interventional study design. The intervention was the implementation of a GPC.</p> <p>Results</p> <p>One year after the implementation of a GPC, the number of patient contacts in the intervention region significantly increased at the GPC (OR: 1.645; 95% CI: 1.439-1.880), while there were no significant changes in patient contacts at the Emergency Department (ED) or in other regions where a simultaneous registration was performed. Although home visits decreased in all general practitioner registrations, the difference was more pronounced in the intervention region (intervention region: OR: 0.515; 95% CI: 0.411-0.646, other regions: OR: 0.743; 95% CI: 0.608-0.908). At the ED we observed a decrease in the number of trauma cases (OR: 0.789; 95% CI: 0.648-0.960) and of patients who came to hospital by ambulance (OR: 0.687; 95% CI: 0.565-0.836).</p> <p>Conclusions</p> <p>One year after its implementation more people seek help at the GPC, while the number of contacts at the ED remains the same. The most prominent changes in caseload are found in the trauma cases. Establishing a GPC in an open health care system, might redirect some patients with particular medical problems to primary care. This could lead to a lowering of costs or a more cost-effective out of hours care, but further research should focus on effective usage to divert patient flows and on quality and outcome of care.</p

Mode-division-multiplexed 3x112-Gb/s DP-QPSK transmission over 80 km few-mode fiber with inline MM-EDFA and blind DSP

We show transmission of a 3x112-Gb/s DP-QPSK mode-division-multiplexed signal up to 80km, with and without multi-mode EDFA, using blind 6x6 MIMO digital signal processing. We show that the OSNR-penalty induced by mode-mixing in the multi-mode EDFA is negligible

Out of hours care: a profile analysis of patients attending the emergency department and the general practitioner on call

<p>Abstract</p> <p>Background</p> <p>Overuse of emergency departments (ED) is of concern in Western society and it is often referred to as 'inappropriate' use. This phenomenon may compromise efficient use of health care personnel, infrastructure and financial resources of the ED. To redirect patients, an extensive knowledge of the experiences and attitudes of patients and their choice behaviour is necessary. The aim of this study is to quantify the patients and socio-economical determinants for choosing the general practitioner (GP) on call or the ED.</p> <p>Methods</p> <p>Data collection was conducted simultaneously in 4 large cities in Belgium. All patients who visited EDs or used the services of the GP on call during two weekends in January 2005 were enrolled in the study in a prospective manner. We used semi-structured questionnaires to interview patients from both services.</p> <p>Results</p> <p>1611 patient contacts were suitable for further analysis. 640 patients visited the GP and 971 went to the ED. Determinants that associated with the choice of the ED are: being male, having visited the ED during the past 12 months at least once, speaking another language than Dutch or French, being of African (sub-Saharan as well as North African) nationality and no medical insurance. We also found that young men are more likely to seek help at the ED for minor trauma, compared to women.</p> <p>Conclusions</p> <p>Patients tend to seek help at the service they are acquainted with. Two populations that distinctively seek help at the ED for minor medical problems are people of foreign origin and men suffering minor trauma. Aiming at a redirection of patients, special attention should go to these patients. Informing them about the health services' specific tasks and the needlessness of technical examinations for minor trauma, might be a useful intervention.</p

Diagnostic scope in out-of-hours primary care services in eight European countries: an observational study

Background: In previous years, out- of-hours primary care has been organised in large-scale organisations in many countries. This may have lowered the threshold for many patients to present health problems at nights and during the weekend. Comparisons of out-of-hours care between countries require internationally comparable figures on symptoms and diagnoses, which were not available. This study aimed to describe the symptoms and diagnoses in out-of-hours primary care services in regions in eight European countries. Methods: We conducted a retrospective observational study based on medical records from out-of-hours primary care services in Belgium, Denmark, Germany, the Netherlands, Norway, Slovenia, Spain, and Switzerland. We aimed to include data on 1000 initial contacts from up to three organisations per country. Excluded were contacts with an administrative reason. The International Classification for Primary Care (ICPC) was used to categorise symptoms and diagnoses. In two countries (Slovenia and Spain) ICD10 codes were translated into ICPC codes. Results: The age distribution of patients showed a high consistency across countries, while the percentage of males varied from 33.7% to 48.3%. The ICPC categories that were used most frequently concerned: chapter A 'general and unspecified symptoms' (mean 13.2%), chapter R 'respiratory' (mean 20.4%), chapter L 'musculoskeletal' (mean 15.0%), chapter S 'skin' (mean 12.5%), and chapter D 'digestive' (mean 11.6%). So, relatively high numbers of patients presenting with infectious diseases or acute pain related syndromes. This was largely consistent across age groups, but in some age groups chapter H ('ear problems'), chapter L ('musculoskeletal') and chapter K ('cardiovascular') were frequently used. Acute life-threatening problems had a low incidence. Conclusions: This international study suggested a highly similar diagnostic scope in out-of-hours primary care services. The incidence rates of acute life-threatening health problems were low in all countries

The impact of bit-width reduced MIMO equalization for few mode fiber transmission systems

\u3cp\u3eExperimental multiple-input multiple-output (MIMO) transmission systems employ offline processing with 64bit floating point (FP) precision, which require extensive logic for real-time implementation. We demonstrate 12bit FP precision with \u3c/p\u3

10 Spatial Mode Transmission Using Low Differential Mode Delay 6-Lp Fiber Using All-Fiber Photonic Lanterns

To unlock the cost benefits of space division multiplexing transmission systems, higher spatial multiplicity is required. Here, we investigate a potential route to increasing the number of spatial mode channels within a single core few-mode fiber. Key for longer transmission distances and low computational complexity is the fabrication of fibers with low differential mode group delays. As such in this work, we combine wavelength and mode-division multiplexed transmission over a 4.45 km low-DMGD 6-LP-mode fiber by employing low-loss all-fiber 10-port photonic lanterns to couple light in and out of the fiber. Hence, a minimum DMGD of 0.2 ns (maximum 0.357 ns) is measured after 4.45 km. Instrumental to the multi-mode transmission system is the employed time-domain- SDM receiver, allowing 10 spatial mode channels (over both polarizations) to be captured using only 3 coherent receivers and real-time oscilloscopes in comparison with 10 for conventional methods. The spatial channels were unraveled using 20 × 20 multiple-input multiple-output digital signal processing. By employing a novel round-robin encoding technique, stable performance over a long measurement period demonstrates the feasibility of 10x increase in single-core multi-mode transmission