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This study explores the views of healthcare professionals regarding care and treatment goals in irreversible terminal delirium and their effect on patients and caregivers.
We conducted a qualitative interview study of healthcare professionals (palliative care physician, oncologist, psycho-oncologist, and clinical psychologist) engaged in the treatment of terminally ill cancer patients. We assessed the views of healthcare workers regarding treatment goals in terminal delirium and their effect on patients and their families.
Of the 21 eligible healthcare professionals, 20 agreed to participate in this study. Three of the professionals had experience with treating terminal delirium as family caregivers. We identified five important aspects of treatment goals in terminal delirium based on the views of healthcare professionals: (1) adequate management of symptoms/distress, (2) ability to communicate, (3) continuity of self, (4) provision of care and support to families, and (5) considering a balance (between symptom alleviation and maintaining communication; between symptom alleviation and family preparations for the death of patients; balance between specific treatment goals for delirium and general treatment goals).
Significance of results
According to the views of healthcare workers questioned in this study, goals of care and treatment in terminal delirium are multidimensional and extend beyond simply controlling patient symptoms.
In the trend of scaling down metal-oxide-semiconductor field effect transistors (MOSFETs), reduction of contact resistance at the silicide/silicon (Si) interface will be essential for higher performance. Nickel silicide (NiSi) is considered as a substi-tute for a present electrode material in MOSFETs, cobalt silicide (CoSi2), because silicidation temperature can be reduced as compared with the case of the conventional CoSi2. Hence, we have focused on the NiSi/Si Schottky interface. An ordinary method to increase the dopant concentration at the interface is ion implantation before silicidation process. The dopant atoms are consequently condensed around the interface by snowplow effect, leading to the effective lowering of the Schottky bar-rier height (SBH) because of the band bending enhancement of the Si layer. However, this band bending technique does not reduce the SBH in further scaled MOSFETs. In this context, we studied another possibility of SBH modulation technique, based on the first-principles calculations. Throughout our calculations, we found that a large atomic-scale dipole between impurity and silicide atoms is generated across the interface. Impurity atoms are expected to be condensed because of a large energy gain at the interfaces, leading to the dramatic reduction of the SBH. Based on these results, we proposed a novel di-pole comforting Schottky (DCS) junction. We have also found that the thickness of the Si layer interfacing with the NiSi layer can be 1nm or less. In the present work, we applied this idea to the actual process through experimental techniques. The calculated results suggest that B implantation after silicidation leads to larger B concentration at the interface than that before silicidation, and thereby larger SBH modulation due to interface dipoles can be produced. Then, the NiSi/Si Schottky diodes were formed by ion implantation after silicidation process for dopants (As, B). We evaluated the interface dipoles contribution to the measured SBH reduction. As a result, the dopant atoms were found to be condensed beyond solubility limits on the interface Si side and we confirmed the generated interface dipoles actually reduces the SBT. Furthermore, we explored the other possibility of another type of impurity atoms applicable to the DCS junction. Among some other impurity atoms (Al, In, Mg), the calculated SBH modulation due to dipoles generated around these impurity atoms were found to be further enhanced in some cases. Based on these understandings, we propose a principle for choosing dopants towards ulti-mate lowering of the contact resistance in ultimately scaled MOSFETs.
Polycrystalline diamond films, single crystal bulk diamonds, and diamond powder were treated in microwave plasma of hydrogen at 1.6 torr under a negative direct-current bias of −150 to −300 V without metal catalyst. It was found that fibrous structures, uniformly elongated along the direction normal to the specimen surface, were formed on the diamond surfaces. Similar experiments for glasslike carbon resulted in conical structures with frizzy fibers at the tops. Transmission electron microscopy measurements indicated that the fibers formed on diamond consisted of randomly oriented diamond nanocrystals with diameters of less than 10 nm, while the conical structures formed on glasslike carbon consisted of graphite nanocrystals. Field emission measurements of the fibrous specimens exhibited better emission efficiency than untreated ones. The field emission electron microscopy of the fibrous glasslike carbon showed a presence of discrete electron emission sites at a density of approximately 10,000 sites/cm2.
Double-wall carbon nanotubes (DWCNTs) and single-wall carbon nanotubes (SWCNTs) have been synthesized by the DC abnormal glow discharge plasma CVD method using methane and hydrogen gas on a Si substrate coated with catalyst. Fe(NO3)2 and Mo(CH3COCHCOCH3)2O2 with Al2O3 support were used as catalysts. The growth temperatures were 1000 − 1400°C and the gas pressures were 9kPa - 13kPa. DC plasma was generated between an array of four W cathodes and a Cu disk anode, and the applied power was 4000–10000W (2.5–4.0A per cathode, 400–800V). Samples were characterized by high-resolution transmission electron microscopy (HRTEM) and micro-Raman spectroscopy using 514.5 nm Ar ion laser excitation. The HRTEM images showed that many carbon nanotubes had a concentric cylindrical graphene layer structure (DWCNTs). We measured the diameters of the carbon nanotubes (CNTs) from HRTEM images. The outer diameter of the DWNT was 1.52–1.64nm and the inner diameter of the DWNT was 0.73–0.81nm.
Aligned carbon nanofibers and hollow carbon nanofibers were grown by MW ECR-CVD method using methane and argon mixture gas at the temperature of 550••. Carbon nanofibers and hollow carbon nanofibers were deposited perpendicularly on Si substrate and on Si substrate coated with Ni catalyst, respectively. Raman spectra of aligned carbon nanofibers and hollow carbon nanofibers showed new bands of 1340 and 1612 cm-1 of the first-order Raman scattering and 2660, 2940 and 3220 cm-1 of the second-order Raman scattering. The second-order Raman scattering bands were assigned to two overtone and one combination bands on the basis of a similar assignment of micro crystal graphite. Combination bands are intense unusually. Field emitter characteristics of the well-aligned carbon nanofibers and hollow carbon nanofiberswere investigated and the current densities were 7.25 mA/cm2 and 0.69 mA/cm2at 12.5 V/μm, respectively.
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