Silicon-loaded surface plasmon polariton waveguides for nanosecond thermo-optical switching.

A MHz-bandwidth thermo-optical (TO) plasmonic switch operating at telecommunication wavelengths and based on a hybrid solid-state silicon-loaded surface plasmon polariton waveguide design is demonstrated numerically. The nanosecond (ns) TO response of the switch is due to the high thermal conductivities of the employed materials and we demonstrate specifically a 10 dB extinction ratio in the time-dependent switch transmission which features a pulsed 1 ns rise time followed by a 25 ns fall time when the switch is photo-thermally activated by a ns pulse at 532 nm wavelength.

Development of a specialty intensity score to estimate a patient's need for care coordination across physician specialties.

BACKGROUNDS AND AIMS: This article develops a Specialty Intensity Score, which uses patient diagnosis codes to estimate the number of specialist physicians a patient will need to access. Conceptually, the score can serve as a proxy for a patient's need for care coordination across doctors. Such a measure may be valuable to researchers studying care coordination practices for complex patients. In contrast with previous comorbidity scores, which focus primarily on mortality and utilization, this comorbidity score approximates the complexity of a patient's the interaction with the health care system. METHODS: We use 2015 inpatient claims data from the Centers for Medicare and Medicaid Services to model the relationship between a patient's diagnoses and physician specialty usage. We estimate usage of specialist doctors by using a least absolute shrinkage and selection operator Poisson model. The Specialty Intensity Score is then constructed using this predicted specialty usage. To validate our score, we test its power to predict the occurrence of patient safety incidents and compare that with the predictive power of the Charlson comorbidity index. RESULTS: Our model uses 127 of the 279 International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis subchapters to predict specialty usage, thus creating the Specialty Intensity Score. This score has significantly greater power in predicting patient safety complications than the widely used Charlson comorbidity index. CONCLUSION: The Specialty Intensity Score developed in this article can be used by health services researchers and administrators to approximate a patient's need for care coordination across multiple specialist doctors. It, therefore, can help with evaluation of care coordination practices by allowing researchers to restrict their analysis of outcomes to the patients most impacted by those practices.

Ultradense and planarized antireflective vertical silicon nanowire array using a bottom-up technique.

The production and characterization of ultradense, planarized, and organized silicon nanowire arrays with good crystalline and optical properties are reported. First, alumina templates are used to grow silicon nanowires whose height, diameter, and density are easily controlled by adjusting the structural parameters of the template. Then, post-processing using standard microelectronic techniques enables the production of high-density silicon nanowire matrices featuring a remarkably flat overall surface. Different geometries are then possible for various applications. Structural analysis using synchrotron X-ray diffraction reveals the good crystallinity of the nanowires and their long-range periodicity resulting from their high-density organization. Transmission electron microscopy also shows that the nanowires can grow on nonpreferential substrate, enabling the use of this technique with universal substrates. The good geometry control of the array also results in a strong optical absorption which is interesting for their use in nanowire-based optical sensors or similar devices.