Low Noise Opto-Electro-Mechanical Modulator for RF-to-Optical Transduction in Quantum Communications.

In this work, we present an Opto-Electro-Mechanical Modulator (OEMM) for RF-to-optical transduction realized via an ultra-coherent nanomembrane resonator capacitively coupled to an rf injection circuit made of a microfabricated read-out able to improve the electro-optomechanical interaction. This device configuration can be embedded in a Fabry-Perot cavity for electromagnetic cooling of the LC circuit in a dilution refrigerator exploiting the opto-electro-mechanical interaction. To this aim, an optically measured steady-state frequency shift of 380 Hz was seen with a polarization voltage of 30 V and a Q-factor of the assembled device above 106 at room temperature. The rf-sputtered titanium nitride layer can be made superconductive to develop efficient quantum transducers.

Individual and hospital-related determinants of potentially inappropriate admissions emerging from administrative records.

INTRODUCTION: The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. METHODS: Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards. Univariate analyses and logistic regression models were used to test associations with demographic, clinical and hospital ward covariates, including organizational indicators. RESULTS: Inappropriate reliance on acute care beds ranged from 6% to 28%, depending on the type of quality indicator analyzed. Some individual features, and wards' specific characteristics were associated with at least one of the phenomena of inappropriate hospital resource usage. In particular, male gender, younger age and transferals seemed to affect inappropriate admissions to surgical wards. Potentially avoidable admissions featuring inpatients amenable to day hospital care were associated with subjects with fewer comorbidities and lower case-mix wards, while inappropriately short medical stays were influenced by patients' higher functional status and local residency and by lower bed occupancy rates. In conclusion, inappropriately long hospital stays for elderly cases were associated with patients with multiple pathologies in wards with a low bed-occupancy. Education level and citizenship did not seem to influence inappropriate admissions. CONCLUSIONS: Some individual, clinical ad structural characteristics of patients and wards emerging from administrative records could be associated with inappropriate reliance on acute hospital beds. Analyzing the indicators considered in this study could generate inexpensive real-time data for identifying what determines potentially inappropriate hospital resource usage, and thus orient auditing activities and health care policy-making.

[Clinical and treatment profiles of patients affected by acute coronary syndromes derived from administrative databases in the ASSL 10 Veneto orientale]. / Profili clinici e di trattamento di pazienti con sindromi coronariche acute ricostruiti in base a database amministrativi nell'ASSL 10 Veneto orientale.

BACKGROUND: This paper presents a revision of services provided to patient over two years following a myocardial infarction (MI) based on data derived from administrative databases. The study aims to evaluate the burden and the resources consumed by these patients, as well as the adherence to clinical guidelines. METHODS: All patient hospitalised for myocardial infarction in the cardiology unit of the hospital of San Donà di Piave (Venice, Italy) were identified. The clinical record was reviewed to reconstruct clinical history. Then from the Local Health Unit n. 10 all information regarding these patient were collected and analysed after record linkage. RESULTS: The patients with MI were 236. Of these, 20 died during the first hospitalization, 2 were lost to the follow up and 40 died within the two years period. The 214 patients who were alive after the first hospitalization produced 447 ordinary and 57 day hospital hospitalization. Specialist services were 23.250, and of these 17.583 were evaluated as being related to the cardiac disease. The value of drug prescribed over the two year period was Euro 553.108. The number of prescriptions belonging to the anatomic ATC class C were 29.076, received by 210 people. The mean pro capita estimated cost was Euro 22.058 in the first year, and Euro 6.226 in the second year. CONCLUSIONS: The characteristics of the sample population of our patients with MI were similar to those described in the literature. Follow up showed a sharp decrease of care and services received by patients during the second year after the acute event. In addition, a large part of services was not related to the cardiac diseases. Only a limited number of patients followed a rehabilitation programme. The estimated pro capita overall cost was very relevant in the first year, and the difference with the cost of the second year suggests a fall over time of the relevance attributed by the patients to the cardiac problems.

[Multivariate analysis models of costs referable to general practitioners based on administrative databases]. / Modelli di analisi multivariata dei costi riferibili ai medici di medicina generale basati su database amministrativi.

OBJECTIVES: estimation of risk adjustment models based on administrative databases in order to describe the quality of care provided by General Practitioners in an ASL of the Veneto region. Particularly, it was tested whether some variables (routinely available) can describe the severity of casemix and the value of the "ticket exemption" database. METHODS: the main administrative databases of the ASL were linked through the unique personal health identifier and analyzed by means of multivariate techniques, using the tariff as the dependent variable; the explanatory ones are a number of variables describing health conditions. RESULTS: ticket exemptions, assumed as estimator of health conditions, resulted quite reliable in predicting costs, often better than the traditional sex and age. Further, for some activities, as for instance hospitalization, they almost completely explain variability among general practitioners. CONCLUSION: ticket exemptions can be considered good estimators of the prevalence of some conditions in the general population and very good predictors of the use of health resources. They could be easily improved in this respect introducing slight modifications. Data show a good level of appropriateness in the use of hospital resources by general practitioners.