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Introduction: Extreme heat events due to climate change are becoming increasingly frequent and severe, and may have an impact on human health. Administrative database studies using International Classification of Diseases 10th revision codes (ICD-10) are powerful tools to measure the burden of acute heat illness (AHI) in Canada. We aimed to assess the validity of the coding algorithm for emergency department (ED) encounters for AHI in our region. Methods: Two independent reviewers retrospectively abstracted data from 507 medical records of patients presenting at two EDs in Ontario between May-September 2015-2018. The Gold Standard definition of an AHI is chart-documented heat exposure with a heat related complaint, such as syncope while working outdoors on a hot day. To determine ICD coding algorithm positive predictive value (PPV), records that were previously coded as ICD-10 heat illnesses were compared to the Gold Standard for AHI. To determine sensitivity (Sn), specificity (Sp) and negative predictive values (NPV), the Gold Standard was compared to randomly selected records. A total of 326,702 ED visits were included in study period with 208 having an ICD-10 code related to heat illness. Sample size calculation demonstrated a need to manually review 62 previously coded heat illnesses and 931 random cases, of which 50 and 474 have been reviewed, respectively. In both abstractions, 20% of cases underwent a blinded duplicate review. Results: In our review of 474 random records, 2 cases were identified as AHI but without an appropriate ICD-10 code, 445 were not AHIs, and no cases had been identified as having an AHI ICD-10 inappropriately applied. In our review of 50 previously coded heat illnesses, 34 were found to be appropriately coded and 16 inappropriately coded, as AHI ICD-10. Average patient age and gender of heat illness vs non-heat illness ED presentations were 32 and 48 years of age and 49% and 64% male, respectively. The leading complaint in AHI was heat stroke/exhaustion (39%), followed by headaches (15%), dizziness (9%), shortness of breath (9%) and syncope/presyncope (6%). 76% of all heat illness presentations presented following a period of physical exertion. Conclusion: Final calculation of Sn, Sp, PPV, NPV for the algorithm will occur upon completion of the review. Preliminary results suggest that ICD-10 coding for AHI may be applied correctly in the ED. This study will help to determine if administrative data can accurately be used to measure the burden of heat illness in Canada.
Adverse childhood experiences (ACE) exhibit long-lasting consequences on later life and are considered as a major public health problem. ACEs can be divided into household dysfunctions, which affect the child indirectly, and direct maltreatment. As a high correlation between ACEs in general is known, we assessed the risk for child maltreatment associated with the occurrence of household dysfunctions. To provide a better understanding for the mechanisms leading to the deleterious sequelae of ACEs, we furthermore assessed whether the long-term consequences of household dysfunction are mediated by child maltreatment and thereby might be targeted by effective child protection programs.
A representative sample of the German population above the age of 14 (N = 2531) was assessed in a cross-sectional observational population-based survey.
The data reveal that mental illness of a household member was associated with significantly increased risks for all child maltreatment subtypes (ORs 4.95–5.55), just as household substance abuse (ORs 5.32–6.98), violence against the mother (ORs 4.43–10.26), incarceration of a household member (ORs 6.11–14.93) and parental separation (OR 3.37–4.87). Child maltreatment partially mediated the association of household mental illness, substance abuse and parental separation with later depression, anxiety, life satisfaction and subjective general health status and completely mediated the associations of intimate partner violence (IPV) and incarceration of a household member with anxiety, depression and subjective health status in adulthood.
ACEs linked to household dysfunction are associated with an increased risk for all subtypes of child maltreatment. The assessed widespread consequences of household dysfunction are mediated by child maltreatment. This underlines the role of prevention of child maltreatment in families with household dysfunction and implies child protection as a priority in any interventions.
The effect of transportation and lairage on the faecal shedding and post-slaughter contamination of carcasses with Escherichia coli O157 and O26 in young calves (4–7-day-old) was assessed in a cohort study at a regional calf-processing plant in the North Island of New Zealand, following 60 calves as cohorts from six dairy farms to slaughter. Multiple samples from each animal at pre-slaughter (recto-anal mucosal swab) and carcass at post-slaughter (sponge swab) were collected and screened using real-time PCR and culture isolation methods for the presence of E. coli O157 and O26 (Shiga toxin-producing E. coli (STEC) and non-STEC). Genotype analysis of E. coli O157 and O26 isolates provided little evidence of faecal–oral transmission of infection between calves during transportation and lairage. Increased cross-contamination of hides and carcasses with E. coli O157 and O26 between co-transported calves was confirmed at pre-hide removal and post-evisceration stages but not at pre-boning (at the end of dressing prior to chilling), indicating that good hygiene practices and application of an approved intervention effectively controlled carcass contamination. This study was the first of its kind to assess the impact of transportation and lairage on the faecal carriage and post-harvest contamination of carcasses with E. coli O157 and O26 in very young calves.
The primate malaria Plasmodium knowlesi has a long-standing history as an experimental malaria model. Studies using this model parasite in combination with its various natural and experimental non-human primate hosts have led to important advances in vaccine development and in our understanding of malaria invasion, immunology and parasite–host interactions. The adaptation to long-term in vitro continuous blood stage culture in rhesus monkey, Macaca fascicularis and human red blood cells, as well as the development of various transfection methodologies has resulted in a highly versatile experimental malaria model, further increasing the potential of what was already a very powerful model. The growing evidence that P. knowlesi is an important human zoonosis in South-East Asia has added relevance to former and future studies of this parasite species.
The high cost of single-crystal III–V substrates limits the use of gallium arsenide (GaAs) and related sphalerite III–V materials in many applications, especially photovoltaics. However, by making devices from epitaxially grown III–V layers that are separated from a growth substrate, one can recycle the growth substrate to reduce costs. Here, we show damage-free removal of an epitaxial single-crystal GaAs film from its GaAs growth substrate using a laser that is absorbed by a smaller band gap, pseudomorphic indium gallium arsenide nitride layer grown between the substrate and the GaAs film. The liftoff process transfers the GaAs film to a flexible polymer substrate, and the transferred GaAs layer is indistinguishable in structural quality from its growth substrate.
The ternary system Fe - 25 at% Co - 9 at% Mo shows an age hardening behavior similar to aluminum alloys. After solution annealing followed by rapid quenching, the Fe-Co-matrix is hardened during subsequent aging through precipitation of the intermetallic µ-phase (Fe,Co)7Mo6. In aged condition the entire Mo content is present in coarse primary and fine µ-phase particles and, therefore, the matrix consists exclusively of 71 at% Fe and 29 at% Co. The binary system Fe-Co shows a transformation from the disordered bcc structure to the ordered B2 structure between 25 and 72 at% Co at a critical ordering temperature ranging from room temperature to 723°C. As a consequence, the remaining overaged matrix in the Fe - 25 at% Co - 9 at% Mo system should also show such a transition. However, an ordered phase is brittle and, thus, not wanted for many applications. Better mechanical properties in terms of ductility can be achieved with a partially or fully disordered phase. Such a state can be obtained by rapid quenching from temperatures above the critical ordering temperature. In this study such an approach was implemented on the ternary Fe - 25 at% Co - 9 at% Mo alloy. The effect of different cooling rates on the mechanical properties was investigated by means of hardness testing. The actual ordering transition of the Fe - 29 at% Co matrix was determined with differential scanning calorimetry and neutron diffraction.
Intermetallic titanium aluminides solidifying via the disordered β-phase are of great interest for several high-temperature applications in automotive and aircraft industries. In this paper the thermocyclic oxidation behavior of three β-solidifying γ-TiAl-based alloys at 800°C and 900°C in air, with and without fluorine treatment, is reported for the first time. The behavior of the well-known TNM alloy (Ti-43.5Al-4Nb-1Mo-0.1B, in at.%) is compared with that of two Nb-free model alloys which contain different amounts of Mo (Ti-44Al-3Mo and Ti-44Al-7Mo, in at.%). During thermocyclic high-temperature exposure in air a mixed oxide scale develops on all three untreated alloys. Small additions of fluorine in the subsurface region of the alloys change the oxidation mechanism from mixed oxide scale formation to alumina at both temperatures. The oxidation resistance of the fluorine treated samples was significantly improved compared to the untreated samples.
Grain boundaries (GBs) in polycrystalline silicon (poly-Si) thin film solar cells are frequently found to be detrimental for device performance. Biaxiallytextured silicon with grains that are well-aligned in-plane and out-of-plane can possess fewer GB defects. In this work, we use TCAD Sentaurus device simulator and known experimental work to investigate and quantify the potential performance gains of biaxially-textured silicon. Simulation shows there can be performance gain from well-aligned grains when GB defects dominate carrier recombination or when grains are small. On the other hand, when intra-grain defects dominate recombination and grains are large, well-aligned grains do not lead to much performance gain. Another important result from our simulation is when intra-grain and GB defects are few, Jsc is almost independent of grain size while Voc drops with decreasing grain size.
Thin-film absorber layers for photovoltaics have attracted much attention for their potential for low cost per unit power generation, due both to reduced material consumption and to higher tolerance for defects such as grain boundaries. Cu2ZnGeSe4 (CZGSe) comprises one such material system which has a near-optimal direct band gap of 1.6 eV for absorption of the solar spectrum, and is made primarily from earth-abundant elements.
CZGSe metallic precursor films were sputtered from Cu, Zn, and Ge onto Mo-coated soda lime glass substrates. These were then selenized in a two-zone close-space sublimation furnace using elemental Se as the source, with temperatures in the range of 400 to 500 C, and at a variety of background pressures. Films approximately 1-1.5 µm thick were obtained with the expected stannite crystal structure.
Next, Cu2ZnSnSe4 (CZTSe), which has a direct band gap of 1.0 eV, was prepared in a similar manner and combined with CZGSe as either compositionally homogeneous or layered absorbers. The compositional uniformity of selenide absorbers made by selenizing compositionally homogeneous Cu-Zn-Ge-Sn precursor layers was determined and the band gap as a function of composition was investigated in order to demonstrate that the band gap is tuneable for a range of compositions. For layered Cu-Zn-Ge/Cu-Zn-Sn precursor films, the composition profile was measured before and after selenization to assess the stability of the layered structure, and its applicability for forming a band-gap-graded device for improved current collection.
Ensuring microstructural stability under technical relevant conditions is a determining criterion for the development of innovative high-temperature materials. In this work, the influ-ence of C and Si on the microstructural stability during creep exposure was investigated for a β-solidifying γ-TiAl based alloy with a nominal composition of Ti-43.5Al-4Nb-1Mo-0.1B (in at.%), named TNM. With a two-step heat treatment a microstructure consisting of fine lamellar α2/γ-colonies, surrounded by βo-phase and areas of discontinuous precipitation, starting from the boundaries of the lamellar colonies, was adjusted. Creep tests were carried out to examine the potential of C and Si to prevent microstructural instability during creep and hence improving the creep properties. At 815 °C the discontinuous precipitation process of the TNM alloy continues during ensuing creep testing leading to a reduced creep resistance. In comparison, the minimum creep rate of the TNM-0.3C-0.3Si alloy was significantly decreased caused by the lower βo-phase content and average lamellar spacing within the α2/γ-colonies, the precipitation of p-Ti3AlC carbides and the retarded kinetics of discontinuous precipitation.
The distribution of alloying elements in the constituent phases of a C-containing γ-TiAl based alloy has been characterized locally by atom probe tomography. The major elements of the alloy under consideration – Ti, Al, Nb, and Mo – are distributed uniformly within each of the constituent phases. Furthermore, Mo is preferentially dissolved in the βo-phase, whereas Nb content is similar in all phases. The selected C concentration of the alloy is below the overall solubility limit as no precipitates have been observed. Therefore, C is enriched in the α2-phase, whereas the βo-phase is depleted of C. In addition, βo/γ-interfaces have been prepared by site specific sample preparation and characterized by atom probe tomography. Segregation of Mo and C into the interfaces and their close vicinity was observed.
Electronic devices made from single crystal thin films attached to inexpensive support substrates offer reduced material costs compared to wafer-based devices; however, scalable and inexpensive processes for producing these single crystal film structures have remained elusive. In this work, we describe a new approach for fabricating these structures. In our approach, an epitaxial film is grown on a single crystal template and is then separated from its growth surface via fracture along a weak heteroepitaxial interface between the single crystal film and its growth substrate. We show that epitaxial films of Si, Ge, and GaAs, with thicknesses ranging from 100 nm to 1 μm, grown on epitaxial CaF2 overlayers on Si <111> substrates, can be transferred to glass substrates by inducing fracture along the heteroepitaxial interface between the semiconductor film and CaF2, or between CaF2 and the Si wafer, assisted by the presence of water as in moisture-assisted cracking.
In the fall of 2012 the Stanford University materials science course Solar Cells, Fuel Cells and Batteries: Materials for the Energy Solution was offered as a flipped class and a massively open online course (MOOC). To the best of our knowledge, this was the first materials science MOOC. Here we describe how the course was implemented, and present results on performance, demographics and other observations that were made. Finally, we provide some perspectives for the future of the implementation of these engineering MOOCs.
After almost three decades of intensive fundamental research and development activities intermetallic titanium aluminides based on the -TiAl phase have found applications in automotive and aircraft engine industries. The advantages of this class of innovative high-temperature materials are their low density as well as their good strength and creep properties up to 750°C. A drawback, however, is their limited ductility at room temperature, which is reflected by a low plastic strain at fracture. This behavior can be attributed to a limited dislocation movement along with microstructural inhomogeneity. Advanced TiAl alloys, such as β-solidifying TNM™ alloys, are complex multi-phase materials which can be processed by ingot or powder metallurgy as well as precision casting methods. Each production process leads to specific microstructures which can be altered and optimized by thermo-mechanical processing and/or subsequent heat-treatments. The background of these heat-treatments is at least twofold, i.e. concurrent increase of ductility at room temperature and creep strength at elevated temperature. In order to achieve this goal the knowledge of the occurring solidification processes and phase transformation sequences is essential. Therefore, thermodynamic calculations were conducted to predict phase fraction diagrams of engineering TiAl alloys. After experimental verification, these phase diagrams provided the base for the development of heat treatments to adjust balanced mechanical properties. To determine the influence of deformation and kinetic aspects, sophisticated ex- and in-situ methods have been employed to investigate the evolution of the microstructure during thermo-mechanical processing and subsequent multi-step heat-treatments. For example, in-situ high-energy X-ray diffraction was conducted to study dynamic recovery and recrystallization processes during hot-deformation tests. Summarizing all results a consistent picture regarding microstructure formation and its impact on mechanical properties in TNM alloys can be given.