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Prior studies suggest that the influenza vaccine is protective against some outcomes in hospitalized patients infected with influenza despite vaccination. We utilized surveillance data from Columbus, Ohio to investigate this association over multiple influenza seasons and age groups. Data on laboratory-confirmed influenza-associated hospitalizations were collected as a part of the Influenza Hospitalization Surveillance Project for the 2012–2013, 2013–2014, and 2014–2015 influenza seasons. The association between influenza vaccination status was examined in relation to the outcomes of severe influenza and diagnosis of pneumonia among patients receiving antiviral treatment. Data were analyzed using multivariable logistic regression. We observed no overall association between influenza vaccination status and severe influenza among hospitalized patients. During the 2013–2014 season, those who were vaccinated were 41% less likely to be diagnosed with pneumonia compared with those who were unvaccinated (OR = 0·59 95% CI 0·41–0·86). The influenza vaccine may provide a secondary preventive function against pneumonia among influenza cases requiring hospitalization. However, a protective effect was only observed in 2013–2014, an influenza H1N1 dominant year. Differences in circulating influenza virus strains and vaccine matching to the circulating strains during influenza seasons may impact this association.
A detailed understanding of the response of mineral phases to the radiation fields experienced in a geological disposal facility (GDF) is currently poorly constrained. Prolongued ion irradiation has the potential to affect both the physical integrity and oxidation state of materials and therefore may alter a structure's ability to react with radionuclides. Radiohalos (spheres of radiation damage in minerals surrounding radioactive (α-emitting) inclusions) provide useful analogues for studying long term α-particle damage accumulation. In this study, silicate minerals adjacent to Th- and U-rich monazite and zircon were probed for redox changes and long/short range disorder using microfocus X-ray absorption spectroscopy (XAS) and high resolution X-ray diffraction (XRD) at Beamline I18, Diamond Light Source. Fe3+ → Fe2+ reduction has been demonstrated in an amphibole sample containing structural OH– groups – a trend not observed in anhydrous phases such as garnet. Coincident with the findings of Pattrick et al. (2013), the radiolytic breakdown of OH– groups is postulated to liberate Fe3+ reducing electrons. Across all samples, high point defect densities and minor lattice aberrations are apparent adjacent to the radioactive inclusion, demonstrated by micro-XRD.
Human anthrax cases reported in the country of Georgia increased 75% from 2011 (n = 81) to 2012 (n = 142). This increase prompted a case-control investigation using 67 culture- or PCR-confirmed cases and 134 controls matched by residence and gender to investigate risk factor(s) for infection during the month before case onset. Independent predictors most strongly associated with disease in the multivariable modelling were slaughtering animals [odds ratio (OR) 7·3, 95% confidence interval (CI) 2·9–18·1, P < 0·001] and disposing of dead animals (OR 13·6, 95% CI 1·5–119·8, P = 0·02). Participants owning or working with livestock (n = 131) were additionally interviewed about livestock management practices during the previous 6 months: 53 (44%) of 121 respondents vaccinated livestock against anthrax; 19 (16%) of 116 moved livestock >1 km; 15 (12%) of 125 had sick livestock; and 11 (9%) of 128 respondents reported finding dead livestock. We recommend joint public health and veterinary anthrax case investigations to identify areas of increased risk for livestock anthrax outbreaks, annual anthrax vaccination of livestock in those areas, and public awareness education.
The Australian Square Kilometre Array Pathfinder (ASKAP) will give us an unprecedented opportunity to investigate the transient sky at radio wavelengths. In this paper we present VAST, an ASKAP survey for Variables and Slow Transients. VAST will exploit the wide-field survey capabilities of ASKAP to enable the discovery and investigation of variable and transient phenomena from the local to the cosmological, including flare stars, intermittent pulsars, X-ray binaries, magnetars, extreme scattering events, interstellar scintillation, radio supernovae, and orphan afterglows of gamma-ray bursts. In addition, it will allow us to probe unexplored regions of parameter space where new classes of transient sources may be detected. In this paper we review the known radio transient and variable populations and the current results from blind radio surveys. We outline a comprehensive program based on a multi-tiered survey strategy to characterise the radio transient sky through detection and monitoring of transient and variable sources on the ASKAP imaging timescales of 5 s and greater. We also present an analysis of the expected source populations that we will be able to detect with VAST.
We are developing a purely commensal survey experiment for fast (<5 s) transient radio sources. Short-timescale transients are associated with the most energetic and brightest single events in the Universe. Our objective is to cover the enormous volume of transients parameter space made available by ASKAP, with an unprecedented combination of sensitivity and field of view. Fast timescale transients open new vistas on the physics of high brightness temperature emission, extreme states of matter and the physics of strong gravitational fields. In addition, the detection of extragalactic objects affords us an entirely new and extremely sensitive probe on the huge reservoir of baryons present in the IGM. We outline here our approach to the considerable challenge involved in detecting fast transients, particularly the development of hardware fast enough to dedisperse and search the ASKAP data stream at or near real-time rates. Through CRAFT, ASKAP will provide the testbed of many of the key technologies and survey modes proposed for high time resolution science with the SKA.
It is well known that the cadmium chloride annealing treatment is an essential step in the manufacture of efficient thin film cadmium telluride solar cells. It has been recognized that the combination of annealing at ∼4000C together with the addition of cadmium chloride at the surface induces re-crystallisation of the cadmium telluride layer and also affects the n-type cadmium sulfide. We have applied advanced micro-structural characterization techniques to distinguish the effect of the annealing and the cadmium chloride treatments on the properties of the cadmium telluride deposited via close space sublimation (CSS) and relate these observations to device performance. Transmission electron microscopy (TEM) has shown a variation in stacking fault density with annealing temperature and annealing time. Stacking faults observed within the cadmium telluride grains in TEM were partially removed post annealing; these findings show that temperature alone has a role in the reduction of stacking faults. However, since we have previously observed almost complete removal of stacking faults with annealing in combination with cadmium chloride, the cadmium chloride is essential to defect removal and high efficiency cells.
Experiments demonstrate the ~77× amplification of 0.5 to 3.5-ps pulses of seed light by interaction with Langmuir waves in a low density (1.2 × 1019 cm−3) plasma produced by a 1-ns, 230-J, 1054-nm pump beam with 1.2 × 1014 W/cm2 intensity. The waves are strongly damped (kλD = 0.38, Te = 244 eV) and grow over a ~ 1 mm length, similar to what is experienced by scattered light when it interacts with crossing beams as it exits an ignition target. The amplification reduces when the seed intensity increases above ~1 × 1011 W/cm2, indicating that saturation of the plasma waves on the electron kinetic time scale (<0.5 ps) limits the scatter to ~1% of the available pump energy. The observations are in agreement with 2D PIC simulations in this case.
As the rate of terrorism increases, it is important for health care providers to become familiar with the management of injuries inflicted by blasts and explosions. This article reviews the ocular injuries associated with explosive blasts, providing basic concepts with which to approach the blast-injured patient with eye trauma. We conducted a literature review of relevant articles indexed in PubMed between 1948 and 2007. Two hundred forty-four articles were reviewed. We concluded that ocular injury is a frequent cause of morbidity in blast victims, occurring in up to 28% of blast survivors. Secondary blast injuries, resulting from flying fragments and debris, cause the majority of eye injuries among blast victims. The most common blast eye injuries include corneal abrasions and foreign bodies, eyelid lacerations, open globe injuries, and intraocular foreign bodies. Injuries to the periorbital area can be a source of significant morbidity, and ocular blast injuries have the potential to result in severe vision loss.
(Disaster Med Public Health Preparedness. 2010;4:154-160)
The potential for the phylogeographical analysis of cereal landraces to determine the initial patterns of agricultural spread through Europe is discussed in relation to two of the first cereals to be domesticated, emmer wheat (Triticum turgidum subsp. dicoccum) and barley (Hordeum vulgare). Extant landraces available from germplasm collections have a patchy distribution, largely being confined to regions of rugged upland topography, and the phylogeographical patterns observed may be due to ‘overstamping’ by more recent crop movements. Phylogeographical studies of non-viable historical landrace material held in herbarium and old seed collections and found in historical buildings have the potential to fill in the gaps in time and space. We explore the importance of precise geographical provenance and the limitations of this in extant and historical material. Additionally, we consider the effect of various chemicals and the preservation of DNA in the historical material.
Collaborative care is an effective intervention for depression which includes both organizational and patient-level intervention components. The effect in the UK is unknown, as is whether cluster- or patient-randomization would be the most appropriate design for a Phase III clinical trial.
We undertook a Phase II patient-level randomized controlled trial in primary care, nested within a cluster-randomized trial. Depressed participants were randomized to ‘collaborative care’ – case manager-coordinated medication support and brief psychological treatment, enhanced specialist and GP communication – or a usual care control. The primary outcome was symptoms of depression (PHQ-9).
We recruited 114 participants, 41 to the intervention group, 38 to the patient randomized control group and 35 to the cluster-randomized control group. For the intervention compared to the cluster control the PHQ-9 effect size was 0.63 (95% CI 0.18–1.07). There was evidence of substantial contamination between intervention and patient-randomized control participants with less difference between the intervention group and patient-randomized control group (−2.99, 95% CI −7.56 to 1.58, p=0.186) than between the intervention and cluster-randomized control group (−4.64, 95% CI −7.93 to −1.35, p=0.008). The intra-class correlation coefficient for our primary outcome was 0.06 (95% CI 0.00–0.32).
Collaborative care is a potentially powerful organizational intervention for improving depression treatment in UK primary care, the effect of which is probably partly mediated through the organizational aspects of the intervention. A large Phase III cluster-randomized trial is required to provide the most methodologically accurate test of these initial encouraging findings.
As the limits of traditional CMOS scaling are approached, process integration has become increasingly difficult and resulting in a diminished rate of performance improvement over time. Consequently, the search for new two- and three- dimensional sub-system solutions has been pursued. One such solution is a silicon carrier-based System-on-Package (SOP) that enables high-density interconnection of heterogeneous die beyond current first level packaging densities. Silicon carrier packaging contains through silicon vias (TSV), fine pitch Cu wiring and high-density solder pads/joins, all of which are compatible with traditional semiconductor methods and tools. These same technology elements, especially the through silicon via process, also enable three dimensional stacking and integration. An approach to fabricating electrical through-vias in silicon is described, featuring annular-shaped vias instead of the more conventional cylindrical via. This difference enables large-area, uniform arrays to be produced with high yield as it is simpler to integrate into a conventional CMOS back-end-of-line (BEOL) process flow. Furthermore, the CTE-matched silicon core provides improved mechanical stability and the dimensions of the annular via allows for metallization by various means including copper electroplating or CVD tungsten deposition. An annular metal conductor process flow will be described. Through-via resistance measurements of 50, 90, and 150μm deep tungsten-filled annular vias will be compared. Two silicon carrier test vehicle designs, containing more than 2,200 and 9,600 electrical through-vias, respectively, were built to determine process yield and uniformity of via resistance. Through silicon via resistances range from 15-40 mΩ, and yields in excess of 99.99% have been demonstrated.
A monolithic, wafer-level three-dimensional (3D) technology platform is described that is compatible with next-generation wafer level packaging (WLP) processes. The platform combines the advantages of both (1) high bonding strength and adaptability to IC wafer topography variations with spin-on dielectric adhesive bonding and (2) process integration and via-area advantages of metal-metal bonding. A copper-benzocyclobutene (Cu-BCB) process is described that incorporates single-level damascene-patterned Cu vias with partially-cured BCB as the bonding adhesive layer. A demonstration vehicle consisting of a two-wafer stack of 2-4 μm diameter vias has shown the bondability of both Cu-to-Cu and BCB-to-BCB. Planarization conditions to achieve BCB-BCB bonding with low-resistance Cu-Cu contacts have been examined, with wafer-scale planarization requirements compared to other 3D platforms. Concerns about stress induced at the tantalum (Ta) liner-to-BCB interface resulting in partial delamination are discussed. While across-wafer uniformity has not been demonstrated, the viability of this WLP-compatible 3D platform has been shown.
The formation of vertical interconnects to create three-dimensional (3D) interconnects enables integration of dissimilar electronic material technologies. These vertical interconnects are metal filled blind vias etched in silicon and are formed by a series of processing steps that include: silicon etch; insulation/barrier/seed layer deposition; electroplating of Cu to fill the via; wafer grinding and thinning; and back side processing to form contacts. Deep reactive ion etching (DRIE) is used to etch silicon vias with attention given to process parameters that affect sidewall angle, sidewall roughness, and lateral etch growth at the top of the via. After etching, vias are insulated by depositing 0.5 μm of silicon dioxide by plasma enhanced chemical vapor deposition (PECVD) at 325°C. A barrier film of TaN is reactively sputtered after insulation deposition followed by a Cu sputtered seed film allowing electroplated Cu to fill the blind via. Reverse pulse plating is used to achieve bottom-up filling of the via. Once void-free electroplated vias are prepared, the process wafer is attached to a carrier wafer for silicon back grinding. Vias on the process wafer are “exposed” from the back side of the wafer with a combination of processes that include mechanical grinding, polishing, and reactive ion etching (RIE). Contact pads are then formed by conventional IC processes. Cu posts are used to connect the electronic devices and to address thermal management issues as well. This paper presents materials aspects to consider when fabricating through silicon vias (TSVs). Modeling of the Cu-filled vias to investigate thermal management schemes and Cu posts to investigate mechanical reliability is also presented.
Wafer bonding is an emerging technology for fabrication of complex three-dimensional (3D) structures; particularly it enables monolithic wafer-level 3D integration of high performance, multi-function microelectronic systems. For such a 3D integrated circuits, low-temperature wafer bonding is required to be compatible with the back-end-of-the-line processing conditions. Recently our investigation on surface melting characteristics of copper nanorod arrays showed that the threshold of the morphological changes of the nano-rod arrays occurs at a temperature significantly below the copper bulk melting point. With this unique property of the copper nanorod arrays, wafer bonding using copper nanorod arrays as a bonding intermediate layer was investigated at low temperatures (400 °C and lower). 200 mm Wafers, each with a copper nanorod array layer, were bonded at 200 – 400 °C and with a bonding down-force of 10 kN in a vacuum chamber. Bonding results were evaluated by razor blade test, mechanical grinding and polishing, and cross-section imaging using a focus ion beam/scanning electron microscope (FIB/SEM). The FIB/SEM images show that the copper nanorod arrays fused together accompanying by a grain growth at a bonding temperature of as low as 200 °C. A dense copper bonding layer was achieved at 400 °C where copper grains grew throughout the copper structure and the original bonding interface was eliminated. The sintering of such nanostructures depends not only on their feature size, but also significantly influenced by the bonding pressure. These two factors both contribute to the mass transport in the nanostructure, leading to the formation of a dense bonding layer.
Semiconductor technology has reached a point in its evolution where the package now plays an important role in the overall performance of the device. In MEMs devices, the package is often more than 75% of the cost and has a significant impact in the overall size. Through wafer interconnects allow for advanced 3-D packaging schemes. Additional miniaturization, increased interconnection density, and higher performance is possible by stacking die with through wafer interconnects. Key technologies for creating TWIs are the ability to create a via through the silicon wafer, dielectric isolation of the via metal from the substrate, and filling or coating the via with a conducting material. Through wafer interconnects have been demonstrated in silicon wafers. The process to create TWIs has been optimized. The TWI has been tested electrically and proven reliable. TWIs were incorporated into an active device wafer and a two die stack connected through solder bump technology. In current work, specific applications which take advantage of the benefits of TWI's are being explored including 3-D inductors, unique sensor packages and MEMs applications.