23 results on '"H.K. Dong"'
Search Results
2. Growth study of chemical beam epitaxy of GaNxP1 − x using NH3 and tertiarybutylphosphine
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J.S. Solomon, John T. Grant, N. Y. Li, H.K. Dong, William S. Wong, D.H. Tomich, and Charles W. Tu
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Reflection high-energy electron diffraction ,Inorganic chemistry ,Analytical chemistry ,Condensed Matter Physics ,Rocking curve ,Chemical beam epitaxy ,Inorganic Chemistry ,Ammonia ,chemistry.chemical_compound ,Reflection (mathematics) ,N incorporation ,chemistry ,Electron diffraction ,Materials Chemistry ,Triethylgallium - Abstract
A study in the growth of GaN x P 1 − x epilayers by chemical beam epitaxy using tertiarybutylphosphine (TBP), ammonia (NH 3 ), and elemental Ga or triethylgallium is reported. Monitoring reflection high-energy electron diffraction (RHEED) intensity oscillations, we observe that both group-III- and group-V-induced incorporation rates are increased when NH 3 is introduced into a single cracker with TBP. From the difference in the periods of group-V-induced RHEED intensity oscillations, a 16% N incorporation is expected, but X-ray rocking curve measurement shows only 0.08% N. Using separate TBP and NH 3 crackers results in no enhancement in incorporation rates. We conclude that the cracking efficiency of TBP is increased with NH 3 co-injection.
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- 1996
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3. An evaluation of alternative precursors in chemical beam epitaxy: tris-dimethylaminoarsenic, tris-dimethylaminophosphorus, and tertiarybutylphosphine
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Charles W. Tu, William S. Wong, H.K. Dong, and N. Y. Li
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Tris ,Inorganic chemistry ,Substrate (electronics) ,Condensed Matter Physics ,Isotropic etching ,Chemical beam epitaxy ,Inorganic Chemistry ,chemistry.chemical_compound ,Arsine ,chemistry ,Etching (microfabrication) ,Desorption ,Materials Chemistry ,Trimethylindium - Abstract
In this paper we evaluate the use of tris-dimethylaminoarsenic (TDMAAs), tris-dimethylaminophosphorus (TDMAP), and tertiarybutylphosphine (TBP) as safer alternative sources in CBE. TDMAAs is a viable alternative to arsine for growing GaAs. When In-containing compounds were grown using uncracked TDMAAs or TDMAP with trimethylindium, indiumenhanced TDMAP or TDMAAs desorption was observed, resulting in In droplets on the surface. InP can be grown only if TDMAP is cracked, but many surface defects are observed and the growth rate is very sensitive to the growth temperature. When TBP is used, however, a specular surface can be achieved, and the InP growth rate is independent of substrate temperature from 440 to 480°C. TDMAAs and TDMAP are found to etch GaAs, InP, and GaP, which shows potential applications in in-situ etching and regrowth.
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- 1996
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4. Growth, etching, doping and effects of Ar+ laser irradiation in chemical beam epitaxy of GaAs with novel precursors
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N. Y. Li, H.K. Dong, and Charles W. Tu
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Stereochemistry ,Photothermal effect ,Condensed Matter Physics ,Ion laser ,Photochemistry ,Chemical beam epitaxy ,law.invention ,Inorganic Chemistry ,chemistry.chemical_compound ,Arsine ,chemistry ,law ,Etching (microfabrication) ,Materials Chemistry ,Diiodomethane ,Irradiation ,Thin film - Abstract
Tris-dimethylaminoarsenic (TDMAAs) is shown to be a viable alternative to arsine. With Ar ion laser irradiation, the growth enhancement at low substrate temperatures, compared to using arsine or arsenic, has a wider temperature range by ∼100°C, indicating a photochemical effect in addition to the photothermal effect. Furthermore, TDMAAs can be used to etch GaAs at a higher temperature by amine radicals as cracked TDMAAs has no etching effect. The etch rate can be enhanced by Ar ion laser irradiation through local heating. Smooth surface morphology in selective-area growth can be obtained with cracked TDMAAs. Diiodomethane is also shown to be a viable carbon-doping source, and laser-enhanced doping has a photochemical component as well. With cracked TDMAAs, a high 10 19 cm -3 hole concentration can be obtained.
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- 1996
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5. Chemical beam epitaxy and laser-modified chemical beam epitaxy of InGaAs using tris-dimethylaminoarsenic
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H.K. Dong, N. Y. Li, and Charles W. Tu
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Photoluminescence ,Chemistry ,Analytical chemistry ,Substrate (electronics) ,Condensed Matter Physics ,Epitaxy ,Laser ,Chemical beam epitaxy ,Electronic, Optical and Magnetic Materials ,law.invention ,chemistry.chemical_compound ,law ,Materials Chemistry ,Electrical and Electronic Engineering ,Trimethylindium ,Triethylgallium ,Quantum well - Abstract
The growth of InxGaj1−xAs (x = 0.13–0.25) on GaAs by chemical beam epitaxy (CBE) and laser-modified CBE using trimethylindium (TMIn), triethylgallium (TEGa), and tris-dimethylaminoarsenic (TDMAAs) has been studied. Reflection high-energy electron diffraction measurements were used to investigate the growth behavior of InGaAs at different conditions. X-ray rocking curve and lowtemperature photoluminescence (PL) measurements were used to characterize the InGaAs/GaAs pseudomorphic strained quantum well structures. Good InGaAs/GaAs interface and optical property were obtained by optimizing the growth condition. As determined by the x-ray simulation, laser irradiation during the InGaAs quantum well growth was found to enhance the InGaAs growth rate and reduce the indium composition in the substrate temperature range studied, 440–500°C, where good interfaces can be achieved. These changes, which are believed to be caused by laser-enhanced decomposition of TEGa and laser-enhanced desorption of TDMAAs, were found to depend on the laser power density as well. With laser irradiation, lateral variation of PL exciton peaks was observed, and the PL peaks became narrower.
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- 1995
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6. p-Type GaAs doped by diiodomethane (CI2H2) in molecular beam epitaxy, metalorganic molecular beam epitaxy, and chemical beam epitaxy
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H.K. Dong, M. Geva, N. Y. Li, and Charles W. Tu
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Stereochemistry ,Annealing (metallurgy) ,Doping ,Analytical chemistry ,Condensed Matter Physics ,Epitaxy ,Chemical beam epitaxy ,Inorganic Chemistry ,chemistry.chemical_compound ,chemistry ,Materials Chemistry ,Diiodomethane ,Metalorganic vapour phase epitaxy ,Triethylgallium ,Molecular beam epitaxy - Abstract
Highly p-type carbon-doped GaAs epitaxial layers were obtained using diiodomethane (CI2H2) as a carbon source. In the low 1019 cm−3 range, almost all carbon atoms are electrically activated and at 9 × 1019 cm−3, 91% are activated. The carbon incorporation efficiency in GaAs layers grown by metalorganic molecular beam epitaxy (MBE) and chemical beam epitaxy (CBE) is lower than that by MBE due to the site-blocking effect of the triethylgallium molecules. In addition, in CBE of GaAs using tris-dimethylaminoarsenic (TDMAAs), the carbon incorporation is further reduced, but it can be increased by cracking TDMAAs. Annealing studies indicate no hydrogenation effect.
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- 1995
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7. Metal-organic molecular beam epitaxy (MOMBE) and laser-modified MOMBE of III-V semiconductors
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Charles W. Tu, H.K. Dong, and N. Y. Li
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Photoluminescence ,Condensed Matter::Other ,business.industry ,Inorganic chemistry ,Condensed Matter::Mesoscopic Systems and Quantum Hall Effect ,Condensed Matter Physics ,Laser ,Epitaxy ,law.invention ,Condensed Matter::Materials Science ,chemistry.chemical_compound ,Arsine ,Semiconductor ,chemistry ,law ,Optoelectronics ,General Materials Science ,Thin film ,business ,Quantum well ,Molecular beam epitaxy - Abstract
We shall first describe some unique features of metal-organic molecular beam epitaxy (MOMBE), then focus on the use of safer alternative precursors to arsine, and finally report on the effect of argon ion laser irradiation on the MOMBE of GaAs and GaAs InGaAs quantum well structures.
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- 1995
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8. Selectively regrown carbon-doped (Al)GaAs by chemical beam epitaxy with novel gas sources
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Y.M. Hsin, Charles W. Tu, N. Y. Li, H.K. Dong, T. Nakamura, and Peter M. Asbeck
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business.industry ,Stereochemistry ,Heterojunction bipolar transistor ,Bipolar junction transistor ,Heterojunction ,Condensed Matter Physics ,Epitaxy ,Chemical beam epitaxy ,Inorganic Chemistry ,chemistry.chemical_compound ,chemistry ,Materials Chemistry ,Optoelectronics ,Diiodomethane ,Triethylgallium ,business ,Sheet resistance - Abstract
Selective-area epitaxy of carbon-doped (Al)GaAs by chemical beam epitaxy (CBE) on (100) GaAs substrates patterned with SiO 2 has been studied. Triethylgallium, trimethylaluminum, tris-dimethylaminoarsenic (TDMAAs) and diiodomethane were used as precursors. True selectivity of GaAs and AlGaAs with a growth rate of 0.5 μm/h is achieved at a growth temperature as low as 470 o C. A flat GaAs regrown surface can be obtained, however, only by thermally cracking the TDMAAs source at 350 o C. The growth rate of GaAs:C layers is independent of the stripe openings down to about 5 μm. A growth rate enhancement is observed when the feature size is less than 5 μm. The «rabbit ear» thickness can be significantly reduced if the stripe opening is less than 5 μm or if the V/III incorporation ratio is low. A heterojunction bipolar transistor (HBT) with selectively regrown GaAs/AlGaAs:C eternal base layers has been successfully fabricated. It exhibits at least a 60% improvement in the base sheet resistance compared to the original HBT structure, demonstrating the potential of selective-area growth by CBE
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- 1995
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9. A study of chemical beam epitaxy of GaAs using tris-dimethylaminoarsenic
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H.K. Dong, M. Geva, W. C. Mitchel, Charles W. Tu, and N. Y. Li
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Electron mobility ,Reflection high-energy electron diffraction ,Analytical chemistry ,Substrate (chemistry) ,Condensed Matter Physics ,Epitaxy ,Chemical beam epitaxy ,Electronic, Optical and Magnetic Materials ,chemistry.chemical_compound ,chemistry ,Electron diffraction ,Materials Chemistry ,Electrical and Electronic Engineering ,Triethylgallium ,Thin film - Abstract
The growth of GaAs by chemical beam epitaxy using triethylgallium and trisdimethylaminoarsenic has been studied. Reflection high-energy electron diffraction (RHEED) measurements were used to investigate the growth behavior of GaAs over a wide temperature range of 300–550°C. Both group III- and group Vinduced RHEED intensity oscillations were observed, and actual V/III incorporation ratios on the substrate surface were established. Thick GaAs epitaxial layers (2–3 μm) were grown at different substrate temperatures and V/III ratios, and were characterized by the standard van der Pauw-Hall effect measurement and secondary ion mass spectroscopy analysis. The samples grown at substrate temperatures above 490°C showed n-type conduction, while those grown at substrate temperatures below 480°C showed p-type conduction. At a substrate temperature between 490 and 510°C and a V/III ratio of about 1.6, the unintentional doping concentration is n ∼2 × 1015 cm−3 with an electron mobility of 5700 cm2/V·s at 300K and 40000 cm2/V·s at 77K.
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- 1995
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10. A study of Ar ion laser-assisted metalorganic molecular beam epitaxy of GaAs by reflection high-energy electron diffraction
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Charles W. Tu, B.W. Liang, S. C. H. Hung, M.C. Ho, and H.K. Dong
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Reflection high-energy electron diffraction ,Ion beam ,Analytical chemistry ,Condensed Matter Physics ,Ion laser ,Laser ,law.invention ,Inorganic Chemistry ,chemistry.chemical_compound ,chemistry ,law ,Materials Chemistry ,Laser power scaling ,Triethylgallium ,Thin film ,Molecular beam epitaxy - Abstract
The growth behavior of Ar-ion-laser-assisted metalorganic molecular beam epitaxy (MOMBE) of (001) GaAs, in the temperature range 330–450°C with triethylgallium (TEGa) and As 4 , was studied by monitoring the specular-beam intensity oscillations of reflection high-energy electron diffraction (RHEED), with the laser turned on and off. The decomposition rate of TEGa is enhanced under Ar + laser irradiation. The Ar + laser also enhances the surface migration of adsorbates and arsenic desorption. In the arsenic-controlled growth regime, the growth rate increases monotonically at low laser power and tends to saturate at high laser power due to a balance between enhanced decomposition of TEGa and desorption of arsenic.
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- 1992
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11. RHEED Study of Ar Ion Laser-Assisted Metalorganic MBE of GaAs
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B.W. Liang, S. Hung, H.K. Dong, M.C. Ho, and C.W. Tu
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Blue laser ,Materials science ,Reflection high-energy electron diffraction ,business.industry ,Analytical chemistry ,Laser pumping ,Ion laser ,Gallium arsenide ,Vertical-cavity surface-emitting laser ,law.invention ,chemistry.chemical_compound ,chemistry ,law ,Diode-pumped solid-state laser ,Optoelectronics ,business ,Tunable laser - Published
- 2005
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12. Measuring customer's perceptions of service quality in the 90's
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H.K. Dong, S.J. Devlin, and C. Ebede
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Customer retention ,Voice of the customer ,Service quality ,Process management ,Service assurance ,Service delivery framework ,Computer science ,business.industry ,Service design ,Service level objective ,Telecommunications service ,Service level requirement ,Service provider ,Customer advocacy ,Customer Service Assurance ,Service guarantee ,Basic service ,business - Abstract
A model of service quality is presented which is based on the customer's perspective and a systematic approach to measuring that perspective. Experiences from the telecommunications industry show that this research approach allows for verification of the model and assessment of the validity of the measures. In addition, the results yield actionable data that pinpoint problems and uncover opportunities for improving service. >
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- 2002
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13. Measuring customers' perceptions of service quality
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C. Ebede, S.J. Devlin, and H.K. Dong
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Customer retention ,Service quality ,Voice of the customer ,Process management ,Service delivery framework ,Computer science ,business.industry ,Service design ,Telecommunications service ,Service level objective ,Service level requirement ,Loyalty business model ,Customer advocacy ,Customer Service Assurance ,Customer reference program ,Service guarantee ,Customer intelligence ,Customer to customer ,business - Abstract
A model of telephone service quality from the customer's perspective and a systematic approach to its measurement are discussed. Because the proposed model is designed from the customer perspective and uses a scientific process to assess the quality of the model, it provides an effective way to integrate the voice of the customer into every phase of a business. Examples from the telecommunications industry are used to show the effectiveness of this model in pinpointing service problems and uncovering opportunities for improving service. >
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- 2002
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14. Effects of Laser Irradiation on Growth and Doping Characteristics of GaAs in Chemical Beam Epitaxy
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Charles W. Tu, N. Y. Li, and H.K. Dong
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Materials science ,Ion beam ,Analytical chemistry ,Ion current ,Ion source ,Chemical beam epitaxy ,Ion ,chemistry.chemical_compound ,symbols.namesake ,chemistry ,symbols ,Fourier transform infrared spectroscopy ,Raman spectroscopy ,Carbon nitride - Abstract
Carbon Nitride (CNX) films have been grown by ion-assisted pulsed-laser deposition (IAPLD). Graphite targets were laser ablated while bombarding the substrate with ions from a broad-beam Kaufman-type ion source. the ion voltage, current density, substrate temperature, and feed gas composition (N2 in ar) have been varied. the resultant films were characterized by Raman, Fourier transform infrared (FTIR), and Rutherford back scattering (RBS) spectroscopy. Samples with -30% N/C ratio have been fabricated. the corresponding Raman and FTIR spectra indicate that nitrogen is incorporated into the samples by insertion into sp2-bonded structures. a low level of C=N triple bonds is also found. as the ion current and voltage are increased with a pure ar ion beam, Raman peaks associated with nanocrystalline graphite appear in the spectr A. adding low levels of nitrogen to the ion beam first reduces the Raman intensity in the vicinity of the graphite disorder peak without adding detectable amounts of nitrogen to the films (as measured by RBS). at higher nitrogen levels in the ion beam, significant amounts of nitrogen are incorporated into the samples, and the magnitude of the “disorder” peak increases. by increasing the temperature of the substrate during deposition, the broad peak due mainly to sp2-bonded C-N in the FTIR spectra is shifted to lower wavenumber. This could be interpreted as evidence of single-bonded C-N; however, it is more likely that the character of the sp2 bonding is changing.
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- 1995
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15. Chemical Beam Epitaxy (CBE) and Laser-Enhanced CBE of GaAs Using Tris-Dimethylaminoarsenic
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M. Geva, H.K. Dong, W. C. Mitchel, Charles W. Tu, and N. Y. Li
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Electron mobility ,Materials science ,Analytical chemistry ,Substrate (electronics) ,Atmospheric temperature range ,Laser ,Decomposition ,Chemical beam epitaxy ,law.invention ,chemistry.chemical_compound ,Arsine ,chemistry ,law ,Triethylgallium - Abstract
In this paper, we report chemical beam epitaxy (CBE) of GaAs, and for the first time, Arion laser-assisted CBE using triethylgallium (TEGa) and tris-dimethylaminoarsenic (TDMAAs), a safer alternative to arsine. Samples grown at substrate temperatures above 490° C show n-type conduction, while those grown at lower temperatures show p-type conduction. An unintentional doping concentration of n∼lx1016 cm-3 with an electron mobility of 5200 cm2/V.s at 300 K and 16000 cm2/V.s at 77 K have been achieved. These are the best results reported for GaAs grown with TDMAAs. Laser-assisted CBE of GaAs is studied in the substrate temperature range of 240-550°C. There are two different substrate-temperature regions for laser-enhanced growth, 265 to 340°C and 340 to 440°C, which are believed to be caused by different TEGa decomposition mechanisms. The laser-assisted growth with TDMAAs, compared to AS4 or AsH3, shows a wider range of growth enhancement at low substrate temperatures.
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- 1994
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16. Laser-Modified Chemical Beam Epitaxy of InGaAs/GaAs Multiple Quantum Wells Using Tris-Dimethylaminoarsenic
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H.K. Dong, Charles W. Tu, and N. Y. Li
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Materials science ,Photoluminescence ,business.industry ,Analytical chemistry ,Heterojunction ,Substrate (electronics) ,Chemical beam epitaxy ,chemistry.chemical_compound ,chemistry ,Optoelectronics ,Triethylgallium ,Trimethylindium ,business ,Quantum well ,Molecular beam epitaxy - Abstract
We report for the first time laser-modified chemical beam epitaxy (CBE) of InGaAs/GaAs multiple quantum well (MQW) structures using trimethylindium (TMIn), triethylgallium (TEGa), and tris-dimethylaminoarsenic (TDMAAs), a safer alternative to arsine. X-ray rocking curve (XRC) and low-temperature photoluminescence (PL) measurements were used to characterize the pseudomorphic strained quantum well structures. As determined by the X-ray simulation, laser irradiation during the InGaAs well growth was found to enhance the InGaAs growth rate and reduce the indium concentration in the substrate temperature range studied, 440-S00°C, where good interfaces can be achieved. We attribute these changes to laser-enhanced decomposition of TEGa and laser-enhanced desorption of TDMAAs. With laser irradiation, lateral variation of PL exciton peaks was observed, and the PL peaks became narrower.
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- 1994
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17. Reflection High-Energy Electron Diffraction Study of Arsenic Incorporation in Metalorganic Molecular Beam Epitaxy of GaAs
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Charles W. Tu, H.K. Dong, and Steven Hung
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chemistry.chemical_compound ,Reflection high-energy electron diffraction ,Materials science ,chemistry ,Electron diffraction ,Analytical chemistry ,chemistry.chemical_element ,Metalorganic vapour phase epitaxy ,Growth rate ,Triethylgallium ,Gallium ,Molecular beam epitaxy ,Volumetric flow rate - Abstract
Metalorganic molecular beam epitaxy (MOMBE) of GaAs using triethylgallium (TEGa) and As4 has been studied by reflection high-energy electron diffraction (RHEED). The effect of varying the group-Ill flow rates and group-V beam flux on the growth rate has been investigated over a wide range of substrate temperatures. For a given arsenic flux, the GaAs growth rate first increases linearly as the TEGa flow rate increases. This linear relation extends up to a certain TEGa flow rate, where the growth rate reaches its maximum value. When the TEGa flow rate is increased above this critical value, the growth rate decreases and reaches a stabilized value. From a study of both group-Ill and group-V induced RHEED intensity oscillations, we find that the V/Ill incorporation ratio is unity at the transition point. Compared to conventional molecular beam epitaxy (MBE), MOMBE behaves differently when the V/Ill incorporation ratio is less than unity. The transition region between V/III>I and V/III
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- 1994
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18. Growth of GaN by gas-source molecular beam epitaxy by ammonia and by plasma generated nitrogen radicals
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S.S. Lau, H.K. Dong, F. Deng, S. Bidnyk, Charles W. Tu, William S. Wong, N.Y. Li, Jin-Joo Song, and J. Hays
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Electron mobility ,Photoluminescence ,Chemistry ,Analytical chemistry ,chemistry.chemical_element ,Substrate (electronics) ,Condensed Matter Physics ,Nitrogen ,Inorganic Chemistry ,Crystal ,Materials Chemistry ,Sapphire ,Layer (electronics) ,Molecular beam epitaxy - Abstract
We will present a comparison between GaN grown on c - and r -plane sapphire by gas-source molecular beam epitaxy (GSMBE) using solid source elemental Ga with uncracked ammonia (NH 3 ). Improved GaN film quality was found for samples grown at substrate temperatures above 700°C with optimized temperatures at 780°C. GaN deposited on a low-temperature (∼ 350°C) GaN buffer layer grown using an rf-plasma radical beam source exhibited poor photoluminescence (PL) intensity and carrier mobility while SEM analysis showed smooth GaN surface morphologies. GaN deposited on an ammonia-grown low-temperature (∼ 550°C) GaN or AlN buffer were found to have improved PL intensity and line widths, GaN surface morphology and carrier mobility. X-ray rocking curve (XRC) data showed that the GaN crystal quality improved as a function of increasing substrate growth temperature independent of buffer layer implementation.
19. Automated Segmentation of MRI White Matter Hyperintensities in 8421 Patients with Acute Ischemic Stroke.
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Kim H, Ryu WS, Schellingerhout D, Park J, Chung J, Jeong SW, Gwak DS, Kim BJ, Kim JT, Hong KS, Lee KB, Park TH, Park JM, Kang K, Cho YJ, Lee BC, Yu KH, Oh MS, Lee SJ, Cha JK, Kim DH, Lee J, Park MS, Bae HJ, and Kim DE
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- Humans, Male, Female, Aged, Middle Aged, Algorithms, Republic of Korea, Image Interpretation, Computer-Assisted methods, Reproducibility of Results, Ischemic Stroke diagnostic imaging, Magnetic Resonance Imaging methods, White Matter diagnostic imaging, White Matter pathology, Deep Learning
- Abstract
Background and Purpose: To date, only a few small studies have attempted deep learning-based automatic segmentation of white matter hyperintensity (WMH) lesions in patients with cerebral infarction; this issue is complicated because stroke-related lesions can obscure WMH borders. We developed and validated deep learning algorithms to segment WMH lesions accurately in patients with cerebral infarction using multisite data sets involving 8421 patients with acute ischemic stroke., Materials and Methods: We included 8421 patients with stroke from 9 centers in Korea. 2D UNet and squeeze-and-excitation (SE)-UNet models were trained using 2408 FLAIR MRIs from 3 hospitals and validated using 6013 FLAIR MRIs from 6 hospitals. WMH segmentation performance was assessed by calculating the Dice similarity coefficient (DSC), the correlation coefficient, and the concordance correlation coefficient compared with a human-segmented criterion standard. In addition, we obtained an uncertainty index that represents overall ambiguity in the voxel classification for WMH segmentation in each patient based on the Kullback-Leibler divergence., Results: In the training data set, the mean age was 67.4 (SD, 13.0) years, and 60.4% were men. The mean (95% CI) DSCs for UNet in internal testing and external validation were, respectively, 0.659 (0.649-0.669) and 0.710 (0.707-0.714), which were slightly lower than the reliability between humans (DSC = 0.744; 95% CI, 0.738-0.751; P = .031). Compared with the UNet, the SE-UNet demonstrated better performance, achieving a mean DSC of 0.675 (95% CI, 0.666-0.685; P < .001) in the internal testing and 0.722 (95% CI, 0.719-0.726; P < .001) in the external validation; moreover, it achieved high DSC values (ranging from 0.672 to 0.744) across multiple validation data sets. We observed a significant correlation between WMH volumes that were segmented automatically and manually for the UNet ( r = 0.917, P < .001), and it was even stronger for the SE-UNet ( r = 0.933, P < .001). The SE-UNet also attained a high concordance correlation coefficient (ranging from 0.841 to 0.956) in the external test data sets. In addition, the uncertainty indices in most patients (86%) in the external data sets were <0.35, with an average DSC of 0.744 in these patients., Conclusions: We developed and validated deep learning algorithms to segment WMH in patients with acute cerebral infarction using the largest-ever MRI data sets. In addition, we showed that the uncertainty index can be used to identify cases in which automatic WMH segmentation is less accurate and requires human review., (© 2024 by American Journal of Neuroradiology.)
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- 2024
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20. Biological Mechanism of Sex Difference in Stroke Manifestation and Outcomes.
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Ryu WS, Chung J, Schellingerhout D, Jeong SW, Kim HR, Park JE, Kim BJ, Kim JT, Hong KS, Lee K, Park TH, Park SS, Park JM, Kang K, Cho YJ, Park HK, Lee BC, Yu KH, Oh MS, Lee SJ, Kim JG, Cha JK, Kim DH, Lee J, Han MK, Park MS, Choi KH, Lee J, Bae HJ, and Kim DE
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- Humans, Female, Male, Aged, Sex Characteristics, Treatment Outcome, Cerebral Infarction, Retrospective Studies, Ischemic Stroke, Stroke, Brain Ischemia
- Abstract
Background and Objectives: Female patients tend to have greater disability and worse long-term outcomes after stroke than male patients. To date, the biological basis of sex difference in ischemic stroke remains unclear. We aimed to (1) assess sex differences in clinical manifestation and outcomes of acute ischemic stroke and (2) investigate whether the sex disparity is due to different infarct locations or different impacts of infarct in the same location., Methods: This MRI-based multicenter study included 6,464 consecutive patients with acute ischemic stroke (<7 days) from 11 centers in South Korea (May 2011-January 2013). Multivariable statistical and brain mapping methods were used to analyze clinical and imaging data collected prospectively: admission NIH Stroke Scale (NIHSS) score, early neurologic deterioration (END) within 3 weeks, modified Rankin Scale (mRS) score at 3 months, and culprit cerebrovascular lesion (symptomatic large artery steno-occlusion and cerebral infarction) locations., Results: The mean (SD) age was 67.5 (12.6) years, and 2,641 (40.9%) were female patients. Percentage infarct volumes on diffusion-weighted MRI did not differ between female patients and male patients (median 0.14% vs 0.14%, p = 0.35). However, female patients showed higher stroke severity (NIHSS score, median 4 vs 3, p < 0.001) and had more frequent END (adjusted difference 3.5%; p = 0.002) than male patients. Female patients had more frequent striatocapsular lesions (43.6% vs 39.8%, p = 0.001) and less frequent cerebrocortical (48.2% vs. 50.7% in patients older than 52 years, p = 0.06) and cerebellar (9.1% vs. 11.1%, p = 0.009) lesions than male patients, which aligned with angiographic findings: female patients had more prevalent symptomatic steno-occlusion of the middle cerebral artery (MCA) (31.1% vs 25.3%; p < 0.001) compared with male patients, who had more frequent symptomatic steno-occlusion of the extracranial internal carotid artery (14.2% vs 9.3%; p < 0.001) and vertebral artery (6.5% vs 4.7%; p = 0.001). Cortical infarcts in female patients, specifically left-sided parieto-occipital regions, were associated with higher NIHSS scores than expected for similar infarct volumes in male patients. Consequently, female patients had a higher likelihood of unfavorable functional outcome (mRS score >2) than male patients (adjusted absolute difference 4.5%; 95% CI 2.0-7.0; p < 0.001)., Discussion: Female patients have more frequent MCA disease and striatocapsular motor pathway involvement with acute ischemic stroke, along with left parieto-occipital cortical infarcts showing greater severity for equivalent infarct volumes than in male patients. This leads to more severe initial neurologic symptoms, higher susceptibility to neurologic worsening, and less 3-month functional independence, when compared with male patients., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)
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- 2023
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21. Association of Prestroke Glycemic Control With Vascular Events During 1-Year Follow-up.
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Chang JY, Kim WJ, Kwon JH, Lee JS, Kim BJ, Kim JT, Lee J, Cha JK, Kim DH, Cho YJ, Hong KS, Lee SJ, Park JM, Lee BC, Oh MS, Lee SH, Kim C, Kim DE, Lee KB, Park TH, Choi JC, Shin DI, Sohn SI, Hong JH, Bae HJ, and Han MK
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- Adult, Aged, Aged, 80 and over, Cohort Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction blood, Myocardial Infarction epidemiology, Recurrence, Retrospective Studies, Risk Factors, Diabetes Mellitus, Glycated Hemoglobin metabolism, Glycemic Control, Stroke blood, Stroke epidemiology
- Abstract
Background and Objectives: We evaluated the association between admission glycated hemoglobin (HbA1c) and subsequent risk of composite vascular events, including stroke, myocardial infarction (MI), and vascular death, in patients with acute ischemic stroke and diabetes., Methods: Patients who had a TIA or an acute ischemic stroke within 7 days of symptom onset and diabetes were included in a retrospective cohort design using the stroke registry of the Clinical Research Center for Stroke in Korea. The association between admission HbA1c and composite vascular events, including stroke, MI, and vascular death, during 1-year follow-up was estimated using the Fine-Gray model. The risk of composite vascular events according to the ischemic stroke subtype was explored using fractional polynomial and linear-quadratic models., Results: Of the 18,567 patients, 1,437 developed composite vascular events during follow-up. In multivariable analysis using HbA1c as a categorical variable, the risk significantly increased at a threshold of 6.8%-7.0%. The influence of admission HbA1c level on the risk of composite vascular events was pronounced particularly among those in whom fasting glucose at admission was ≤130 mg/dL. The optimal ranges of HbA1c associated with minimal risks for composite vascular events were lowest for the small vessel occlusion subtype (6.6 [95% confidence internal [CI], 6.3-6.9]) compared to the large artery atherosclerosis (7.3 [95% CI, 6.8-7.9]) or the cardioembolic subtype (7.4 [95% CI, 6.3-8.5])., Dicussion: In patients with ischemic stroke and diabetes, the risks of composite vascular events were significantly associated with admission HbA1c. The optimal range of admission HbA1c was below 6.8%-7.0% and differed according to the ischemic stroke subtype., (© 2021 American Academy of Neurology.)
- Published
- 2021
- Full Text
- View/download PDF
22. Neurologic deterioration in patients with acute ischemic stroke or transient ischemic attack.
- Author
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Park TH, Lee JK, Park MS, Park SS, Hong KS, Ryu WS, Kim DE, Park MS, Choi KH, Kim JT, Kang J, Kim BJ, Han MK, Lee J, Cha JK, Kim DH, Kim JG, Lee SJ, Cho YJ, Kwon JH, Shin DI, Yeo MJ, Sohn SI, Hong JH, Lee JS, Choi JC, Kim WJ, Lee BC, Yu KH, Oh MS, Park JM, Kang K, Lee KB, Lee J, Gorelick PB, and Bae HJ
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Time Factors, Brain Ischemia epidemiology, Ischemic Attack, Transient epidemiology, Nervous System Diseases epidemiology, Stroke epidemiology
- Abstract
Objective: To improve epidemiologic knowledge of neurologic deterioration (ND) in patients with acute ischemic stroke (AIS)., Methods: In this prospective observational study, we captured ND prospectively in 29,446 patients with AIS admitted to 15 hospitals in Korea within 7 days of stroke onset. ND was defined as an increase in NIH Stroke Scale (NIHSS) score ≥2 (total), or ≥1 (motor or consciousness), or any new neurologic symptoms. Change in incidence rate after stroke onset, causes, factors associated with ND, modified Rankin Scale (mRS) score at 3 months and 1 year, and a composite of stroke, myocardial infarction, and all-cause death at 1 year were assessed., Results: ND occurred in 4,299 (14.6%) patients. The highest rate, 6.95 per 1,000 person-hours incidence, was within the first 6 hours, which decreased to 2.09 within 24-48 hours, and 0.66 within 72-96 hours after stroke onset. Old age, female sex, diabetes, early arrival, large artery atherosclerosis as a stroke subtype, high NIHSS scores, glucose level, systolic blood pressure, leukocytosis at admission, recanalization therapy, TIA without a relevant lesion, and steno-occlusion of relevant arteries were associated with ND. The causes were stroke progression (71.8%) followed by recurrence (8.5%). Adjusted relative risks (95% CI) for poor outcome (mRS 3-6) at 3 months and 1 year were 1.75 (1.70-1.80) and 1.70 (1.65-1.75), respectively. The adjusted hazard ratio (95% CI) for the composite event was 1.59 (1.45-1.74)., Conclusions: ND should be taken into consideration as a factor that may influence the outcome in acute ischemic stroke., (© 2020 American Academy of Neurology.)
- Published
- 2020
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23. Moderate alcohol intake reduces risk of ischemic stroke in Korea.
- Author
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Lee SJ, Cho YJ, Kim JG, Ko Y, Hong KS, Park JM, Kang K, Park TH, Park SS, Lee KB, Cha JK, Kim DH, Lee J, Kim JT, Lee J, Lee JS, Jang MS, Han MK, Gorelick PB, and Bae HJ
- Subjects
- Adult, Aged, Aged, 80 and over, Case-Control Studies, Female, Health Surveys, Humans, Male, Middle Aged, Republic of Korea, Risk, Young Adult, Alcohol Drinking epidemiology, Brain Ischemia epidemiology, Stroke epidemiology
- Abstract
Objective: We undertook a population-based, case-control study to examine a dose-response relationship between alcohol intake and risk of ischemic stroke in Koreans who had different alcoholic beverage type preferences than Western populations and to examine the effect modifications by sex and ischemic stroke subtypes., Methods: Cases (n = 1,848) were recruited from patients aged 20 years or older with first-ever ischemic stroke. Stroke-free controls (n = 3,589) were from the fourth and fifth Korean National Health and Nutrition Examination Survey and were matched to the cases by age (±3 years), sex, and education level. All participants completed an interview using a structured questionnaire about alcohol intake., Results: Light to moderate alcohol intake, 3 or 4 drinks (1 drink = 10 g ethanol) per day, was significantly associated with a lower odds of ischemic stroke after adjusting for potential confounders (no drinks: reference; <1 drink: odds ratio 0.38, 95% confidence interval 0.32-0.45; 1-2 drinks: 0.45, 0.36-0.57; and 3-4 drinks: 0.54, 0.39-0.74). The threshold of alcohol effect in women was slightly lower than that in men (up to 1-2 drinks in women vs up to 3-4 drinks in men), but this difference was not statistically significant. There was no statistical interaction between alcohol intake and the subtypes of ischemic stroke (p = 0.50). The most frequently used alcoholic beverage was one native to Korea, soju (78% of the cases), a distilled beverage with 20% ethanol by volume., Conclusions: Our findings suggest that light to moderate distilled alcohol consumption may reduce the risk of ischemic stroke in Koreans., (© 2015 American Academy of Neurology.)
- Published
- 2015
- Full Text
- View/download PDF
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