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1.
Opt Express ; 27(13): 18673-18682, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31252806

RESUMO

Optically active perovskite nanocrystals have shown considerable promise for a myriad of applications, such as single photon source, light-emitting diodes and nanophotonics. Coupling those nanocrystals to photonic micro- and nanostructures will offer additional degrees of freedom to manipulate their optical properties. Herein, we demonstrate the coupling of perovskite nanocrystals to a mechanically robust, poly(methyl-methacrylate) (PMMA)-encapsulated silicon nitride nanobeam photonic crystal cavity at room temperature. As determined from the time-resolved photoluminescence decay measurements, we observed enhanced spontaneous emission from the perovskite nanocrystals by a factor of 1.4, consistent with finite difference time domain simulation. In addition, by varying the concentration of the perovskite nanocrystal in the PMMA layer, the effective index of the layer can be modified, allowing us to tune the cavity mode resonance. Our results show that solution-processable perovskite nanocrystals hold a promising prospect for applications such as on-chip light sources, optoelectronic devices and photonic integrated circuits.

2.
BMC Nephrol ; 18(1): 317, 2017 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-29058639

RESUMO

BACKGROUND: Acute Kidney Injury (AKI) has evoked much interest over the past decade and is reported to be associated with high inpatient mortality. Preventable death and increased readmission rates related to AKI have been the focus of considerable interest. METHODS: We studied hospital acquired AKI in all emergency hospital admissions, except transfers from ICU to ICU or patients known to renal services, to ascertain mortality and readmission rates, and trackable modifiable factors for death, using cox regression and Kaplan Meier survival curves. Data was extracted from the electronic patient records and a series of case notes reviewed. Admissions were included between April 2006 and March 2010 (and patients followed up until September 2011). RESULTS: Overall incidence of AKI was 2.2%, (AKI stage 1, 61%, stage 2,27% and stage 3, 12%). In patients who sustain in-hospital AKI, 34% die in hospital, 42% are dead at 90 days and 48% at 1 year post discharge, compared to 12% 1 year mortality in patients without AKI. In multivariable analyses, AKI is an independent risk factor for in-hospital mortality (Hazard Ratio 1.6: 95% confidence intervals 1.43-1.75: P < 0.001), death within 90 days of discharge (Hazard Ratio 1.5: 95% confidence intervals 1.3-1.9: P < 0.001) and subsequent mortality beyond 90 days (Hazard Ratio 2.9: 95% confidence intervals 2.7-3.1: P < 0.001) after adjustment for co-morbidities and peak C-reactive protein. Thirty percent of the patients who died in the first 90 days post discharge and had AKI, also had malignancy. Readmission rates at 30 and 90 days were not increased by AKI after adjustment for co-morbidities and peak C-reactive protein. CONCLUSIONS: A significant proportion of deaths in the first 90 days post-discharge may not be avoidable, due to malignancy and other end-stage disease. Readmission rates were not higher in patients who had had AKI.


Assuntos
Injúria Renal Aguda/mortalidade , Mortalidade Hospitalar , Hospitais/estatística & dados numéricos , Neoplasias/mortalidade , Readmissão do Paciente/estatística & dados numéricos , Injúria Renal Aguda/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/metabolismo , Comorbidade , Feminino , Humanos , Doença Iatrogênica/epidemiologia , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco , Taxa de Sobrevida , Fatores de Tempo , Reino Unido/epidemiologia
3.
Int J Qual Health Care ; 25(5): 564-72, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23744995

RESUMO

OBJECTIVE: To investigate the changes in overdue doses rates over a 4-year period in an National Health Service (NHS) teaching hospital, following the implementation of interventions associated with an electronic prescribing system used within the hospital. DESIGN: Retrospective time-series analysis of weekly dose administration data. SETTING: University teaching hospital using a locally developed electronic prescribing and administration system (Prescribing, Information and Communication System or PICS) with an audit database containing details on every drug prescription and dose administration. PARTICIPANTS: Prescription data extracted from the PICS database. INTERVENTION(S): Four interventions were implemented in the Trust: (i) the ability for doctors to pause medication doses; (ii) clinical dashboards; (iii) visual indicators for overdue doses and (iv) overdue doses Root Cause ANALYSIS: (RCA) meetings and a National Patient Safety Agency (NPSA) Rapid Response Alert. Main outcome measure(s) The percentage of missed medication doses. RESULTS: Rates of both missed antibiotic and non-antibiotic doses decreased significantly upon the introduction of clinical dashboards (reductions of 0.60 and 0.41 percentage points, respectively), as well as following the instigation of executive-led overdue doses RCA meetings (reductions of 0.83 and 0.97 percentage points, respectively) and the publication of an associated NPSA Rapid Response Alert. Implementing a visual indicator for overdue doses was not associated with significant decreases in the rates of missed antibiotic or non-antibiotic doses. CONCLUSIONS: Electronic prescribing systems can facilitate data collection relating to missed medication doses. INTERVENTIONS: providing hospital staff with information about overdue doses at a ward level can help promote reductions in overdue doses rates.


Assuntos
Erros de Medicação/prevenção & controle , Melhoria de Qualidade , Antibacterianos/uso terapêutico , Hospitais de Ensino/normas , Hospitais de Ensino/estatística & dados numéricos , Humanos , Sistemas de Registro de Ordens Médicas , Erros de Medicação/estatística & dados numéricos , Sistemas de Medicação no Hospital/organização & administração , Sistemas de Medicação no Hospital/normas , Melhoria de Qualidade/organização & administração , Estudos Retrospectivos
4.
BMJ Open Qual ; 12(1)2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36649943

RESUMO

AIMS AND OBJECTIVES: This study sets out to describe benefits from the implementation of electronic observation charting in intensive care units (ICU). This was an extension to the existing hospital wide digital health system. We evaluated error reduction, time-savings and the costs associated with conversion from paper to digital records. The world health emergency of COVID-19 placed extraordinary strain on ICU and staff opinion was evaluated to test how well the electronic system performed. METHODS: A clinically led project group working directly with programmers developed an electronic patient record for intensive care. Data error rates, time to add data and to make calculations were studied before and after the introduction of electronic charts. User feedback was sought pre and post go-live (during the COVID-19 pandemic) and financial implications were calculated by the hospital finance teams. RESULTS: Error rates equating to 219 000/year were avoided by conversion to electronic charts. Time saved was the equivalent of a nursing shift each day. Recurrent cost savings per year were estimated to be £257k. Staff were overwhelmingly positive about electronic charts in ICU, even during a health pandemic and despite redeployment into intensive care where they were using the electronic charts for the first time. DISCUSSION: Electronic ICU charts have been successfully introduced into our institution with benefits in terms of patient safety through error reduction and improved care through release of nursing time. Costs have been reduced. Staff feel supported by the digital system and report it to be helpful even during redeployment and in the unfamiliar environment of intensive care.


Assuntos
COVID-19 , Pandemias , Humanos , Saúde Global , Cuidados Críticos , Unidades de Terapia Intensiva
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