Flexible CMOS electronics based on p-type Ge₂Sb₂Te₅ and n-type InGaZnO₄ semiconductors

Ultra-thin p-type chalcogenide glass Ge2Sb2Te5 (GST) semiconductor layers are employed to form flexible thin-film transistors (TFTs). For the first time, TFTs based on GST show saturating output characteristics and an ON/OFF ratio up to 388, exceeding present reports by a factor of ~20. The channel current modulation is greatly enhanced by using ultra-thin 5 nm thick amorphous GST layers and 20 nm thick high-k Al2O3 gate dielectrics. Flexible CMOS circuits are realized in combination with the n-type oxide semiconductor InGaZnO4 (IGZO). The CMOS inverters show voltage gain of up to 69. Furthermore, flexible NAND gates are presented. The bending stability is shown for a tensile radius of 6 mm

Charge trapping mechanism leading to sub-60-mV/decade-Swing FETs

In this work, we present a novel method to reduce the subthreshold swing of field-effect transistors below 60 mV/dec. Through modeling, we directly relate trap charge movement between the gate electrode and the gate dielectric to subthreshold swing reduction. We experimentally investigate the impact of charge exchange between a Cu gate electrode and a 5 nm thick amorphous Al2O3 gate dielectric in an InGaZnO4 thin-film transistor. Positive trap charges are generated inside the gate dielectric while the semiconductor is in accumulation. During the subsequent de-trapping, the subthreshold swing diminishes to a minimum value of 46 mV/dec at room temperature. Furthermore, we relate the charge trapping/de-trapping effects to a negative capacitance behavior of the Cu/Al2O3 metal-insulator structure

Flexible In-Ga-Zn-O based circuits with two and three metal layers: simulation and fabrication study

The quest for high-performance flexible circuits call for scaling of the minimum feature size in Thin-Film Transistors (TFTs). Although reduced channel lengths can guarantee an improvement in the electrical properties of the devices, proper design rules also play a crucial role to minimize parasitics when designing fast circuits. In this letter, systematic Computer-Aided Design (CAD) simulations have guided the fabrication of highperformance flexible operational amplifiers (opamps) and logic circuits based on Indium-Gallium-Zinc-Oxide (IGZO) TFTs. In particular, the performance improvements due to the use of an additional third metal layer for the interconnections has been estimated for the first time. Encouraged by the simulated enhancements resulting by the decreased parasitic resistances and capacitances, both TFTs and circuits have been realized on a free-standing 50μm thick polymide foil using three metal layers. Despite the thicker layer stack, the TFTs have shown mechanical stability down to 5mm bending radii. Moreover, the opamps and the logic circuits have yielded improved electrical performance with respect to the architecture with two metal layers: gainbandwidth- product (GBWP) increased by 16:9%, for the first one, and propagation delay (tpd) decreased by 43%, for the latter one

CFHTLenS and RCSLenS cross-correlation with Planck lensing detected in fourier and configuration space

We measure the cross-correlation signature between the Planck cosmic microwave background (CMB) lensing map and the weak lensing observations from both the Red-sequence Cluster Lensing Survey and the Canada–France–Hawaii Telescope Lensing Survey. In addition to a Fourier analysis, we include the first configuration-space detection, based on the estimators 〈κCMBκgal〉 and 〈κCMBγt〉. Combining 747.2 deg2 from both surveys, we find a detection significance that exceeds 4.2σ in both Fourier- and configuration-space analyses. Scaling the predictions by a free parameter A, we obtain APlanck CFHT = 0.68 ± 0.31 and APlanck RCS = 1.31 ± 0.33. In preparation for the next generation of measurements similar to these, we quantify the impact of different analysis choices on these results. First, since none of these estimators probes the exact same dynamical range, we improve our detection by combining them. Secondly, we carry out a detailed investigation on the effect of apodization, zero-padding and mask multiplication, validated on a suite of high-resolution simulations, and find that the latter produces the largest systematic bias in the cosmological interpretation. Finally, we show that residual contamination from intrinsic alignment and the effect of photometric redshift error are both largely degenerate with the characteristic signal from massive neutrinos, however the signature of baryon feedback might be easier to distinguish. The three lensing data sets are publicly available

How is Mechanical Ventilation Employed in a Pediatric Intensive Care Unit in Brazil?

OBJECTIVE: to investigate the relationship between mechanical ventilation and mortality and the practice of mechanical ventilation applied in children admitted to a high-complexity pediatric intensive care unit in the city of São Paulo, Brazil. DESIGN: Prospective cohort study of all consecutive patients admitted to a Brazilian high-complexity PICU who were placed on mechanical ventilation for 24 hours or more, between October 1st, 2005 and March 31st, 2006. RESULTS: Of the 241 patients admitted, 86 (35.7%) received mechanical ventilation for 24 hours or more. Of these, 49 met inclusion criteria and were thus eligible to participate in the study. Of the 49 patients studied, 45 had chronic functional status. The median age of participants was 32 months and the median length of mechanical ventilation use was 6.5 days. The major indication for mechanical ventilation was acute respiratory failure, usually associated with severe sepsis / septic shock. Pressure ventilation modes were the standard ones. An overall 10.37% incidence of Acute Respiratory Distress Syndrome was found, in addition to tidal volumes > 8 ml/kg, as well as normo- or hypocapnia. A total of 17 children died. Risk factors for mortality within 28 days of admission were initial inspiratory pressure, pH, PaO2/FiO2 ratio, oxygenation index and also oxygenation index at 48 hours of mechanical ventilation. Initial inspiratory pressure was also a predictor of mechanical ventilation for periods longer than 7 days. CONCLUSION: Of the admitted children, 35.7% received mechanical ventilation for 24 h or more. Pressure ventilation modes were standard. Of the children studied, 91% had chronic functional status. There was a high incidence of Acute Respiratory Distress Syndrome, but a lung-protective strategy was not fully implemented. Inspiratory pressure at the beginning of mechanical ventilation was a predictor of mortality within 28 days and of a longer course of mechanical ventilation

Provision of Mental Health Services by Critical Access Hospital-Based Rural Health Clinics

Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural MH needs as 60 percent manage at least one Rural Health Clinic (RHC). RHCs receive Medicare cost-based reimbursement for a defined package of services including those provided by doctoral-level clinical psychologists (CPs) and licensed clinical social workers (LCSWs). This briefing paper explores the extent to which CAH-based RHCs are employing CPs and/or LCSWs to provide MH services, describes models of MH services implemented by CAH-based RHCs, examines their successes and challenges in doing so, and provides a resource to assist CAH and RHC leaders in developing MH services. It also provides a resource for State Flex Programs to work with CAH-based RHCs in the development of MH services. FMI: John Gale, [email protected]

Addressing Opioid Use in Rural Communities: Examples from Critical Access Hospitals

The opioid epidemic continues to have a devastating impact in rural areas disproportionately affected by a lack of infrastructure to provide treatment for opioid use disorders (OUDs). Critical Access Hospitals (CAHs), often the hubs of local systems of care, can play an important role in addressing OUDs. Using a substance use framework developed for the Flex Monitoring Team’s earlier study of CAH substance use strategies, this brief highlights strategies adopted by CAHs to combat opioid use in their communities. It also identifies resources that State Flex Programs can use to support CAHs with this challenging population health issue

Engaging Critical Access Hospitals in Addressing Rural Substance Use

Substance use is a significant public health issue in rural communities. Despite this fact, substance use treatment services are limited in rural areas and residents suffer from significant barriers to care. Critical Access Hospitals (CAHs), frequently the hubs of local systems of care, can play an important role in addressing substance use disorders. To develop a coordinated response to community substance use issues, CAHs must identify and prioritize local needs, mobilize local resources and partnerships, build local capacity, and screen for substance use among their patients. These activities provide a foundation upon which CAHs and their community partners can address identified local needs by selecting and implementing initiatives to minimize the onset of substance use and related harms (prevention), treat substance use disorders, and help individuals reclaim their lives (recovery). This brief makes the case for why CAHs should address substance use, provides a framework to support CAHs in doing so, describes examples of substance use activities undertaken by CAHs to substantiate the framework, and identifies resources that can be used by State Flex Programs to support CAHs in addressing this important public and population health problem