Surface morphological evolutions on single crystal films by strong anisotropic drift-diffusion under the capillary and electromigration forces

The morphological evolution of voids at the unpassivated surfaces and the sidewalls of the single crystal metallic films are investigated via computer simulations by using the novel mathematical model developed by Ogurtani relying on the fundamental postulates of irreversible thermodynamics. The effects of the drift-diffusion anisotropy on the development of the surface morphological scenarios are fully explored under the action of the electromigration (EM) and capillary forces (CF), utilizing numerous combination of the surface textures and the directions of the applied electric field. The interconnect failure time due to the EM induced wedge shape internal voids and the incubation time of the oscillatory surface waves, under the severe instability regimes, are deduced by the novel renormalization procedures applied on the outputs of the computer simulation experiments.Comment: 41 pages, 18 figures. related simulation movies utilizing numerous combination of the surface texture, see http://www.csl.mete.metu.edu.tr/aytac/thesis/movies/index.ht

Generic role of the anisotropic surface free energy on the morphological evolution in a strained-heteroepitaxial solid droplet on a rigid substrate

A systematic study based on the self-consistent dynamical simulations is presented for the spontaneous evolution of an isolated thin solid droplet on a rigid substrate, which is driven by the surface drift diffusion induced by the anisotropic capillary forces (surface stiffness) and mismatch stresses. In this work, we studied the affect of surface free energy anisotropies on the development kinetics of the 'Stranski-Krastanow' island type morphology. The anisotropic surface free energy and the surface stiffness were treated with well accepted trigonometric functions. Although, various tilt angles and anisotropy constants were considered during simulations, the main emphasis was given on the effect of rotational symmetries associated with the surface Helmholtz free energy topography in 2D space. Our computer simulations revealed the formation of an extremely thin wetting layer during the development of the bell-shaped Stranski-Krastanow island through the mass accumulation at the central region of the droplet via surface drift-diffusion. In the strong (anomalous) anisotropy constant domain, we demonstrated the existence of two distinct morphological modes: i) the complete stability of the initial Cosine-shaped droplet just above a certain anisotropy constant threshold level by spontaneous slight readjustments of the base and the height of the cluster; ii) the Frank-van der Merwe mode of thin film formation for very large values of the anisotropy constant by the spreading and coalescence of the droplets over the substrate surface. During the course of the simulations, we have continuously tracked both the morphology (i.e., the peak height, the extension of the wetting layer beyond the domain boundaries, and the triple junction contact angle) and energetic (the global Helmholtz free energy changes associated with the total strain and surface energy variations) of the system.Comment: anisotropic surface free energy, Quantum Dots, elastostatic load, morphological evolution, strained-heteroepitaxial soli

Helical tomotherapy experience in breast cancer adjuvant radiotherapy and acute toxicity results

Background: This study aimed to evaluate acute toxicity and oncological outcomes of breast cancer patients who underwent adjuvant radiotherapy (RT) with tomotherapy. Materials and methods: The results of 114 patients who underwent adjuvant RT with tomotherapy device between 17.08.10–12.06.2021 in XXX Hospital were evaluated retrospectively. The primary endpoint of the study was acute adverse events, and the secondary endpoints were overall survival (OS) and disease-free survival (DFS). Results: The results of 103 patients who met the inclusion criteria were analyzed.  The median follow-up was 21 (range 1–125.8) months. Grade +3 esophagitis was not observed in any patient; no esophagitis was observed in 60 (58.3%) patients. Grade 3 dermatitis was observed in 3 (2.9%) patients. In addition, dermatitis was not observed in 47 (45.6%) patients. The relationship between chest wall volume and esophagitis development was statistically significant (p = 0.006; Z score: –2769). The median OS was 24.1 (range 1–128.5) and median disease-free survival was 21.1 (range 1–125.8) months. Five patients (4.9%) died and 9 patients (8.7%) relapsed. Local recurrence was observed in only 1 (1%) patient. There was a statistically significant correlation between OS and contralateral lung V20 dose [p < 0.001; Spearman Correlation Coefficient (SCC) –406) and heart mean dose (p < 0.001; SCC –370)]. There was a statically significant correlation between DFS and cN (p < 0.001); pN (p < 0.001); heart mean dose (p < 0.001; SCC –351); contralateral lung V5 dose (p = 0.041; SCC –213); contralateral lung V20 dose (p < 0.001; SCC –434). Conclusion: Acute toxicity results show improvement in breast cancer adjuvant radiotherapy with helical tomotherapy

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effects of anisotropic surface drift diffusion on the strained heteroepitaxial nanoislands subjected to electromigration stressing

A systematic study based on self-consistent dynamical simulations is presented for the morphological evolutionary behavior of an isolated thin Ge/Si nanoisland (quantum dot) on a rigid substrate exposed to electromigration forces. This morphological evolution is basically induced by the anisotropic surface drift diffusion, driven by the capillary forces, the lattice mismatch stresses, and the wetting potential. In this study, we have mainly focused on the size and shape development kinetics of quantum dots, known as the "Stranski-Krastanov " (SK) morphology, influenced by applied electromigration stresses. Emphasis is given to the effects of rotational symmetry associated with the anisotropic diffusivity in 2D space (i.e., quantum wires in 3D). The pointed bullet-shaped "Stranski-Krastanov " islands with high aspect ratios, xi = 0.77, are formed at the cathode edge, while the whole nanoisland slightly creeps out of the initial computational domain. The favorable configuration of the Ge-20/Si-80 alloy test module, which resulted in zeta = 0.37 enhancement in the contour surface area, has a dome shape attached to the [010] top surface of the Si substrate with a zone axis of {010}/ & lang; 001 & rang;. The anisotropic surface diffusion dyadic has a fourfold rotational symmetry axis [001] lying on the (001) plane of the Si substrate, and its major axis is tilted at about phi = 45 & DEG; from the applied electrostatic field extended along the longitudinal axis [100] of the substrate. This particular experiment resulted in a SK singlet peak with a small satellite with a very small aspect ratio of approximately equal to 0.2 that may be appropriate for the conception of quantum optoelectronic devices or inter-band structures to generate photoelectrons having large energy spectra, thereby increasing the efficiency of photovoltaics exposed to solar radiations

Stranski-Krastanow islanding initiated on the stochastic rough surfaces of the epitaxially strained thin films

Quantum dots (QD) have discrete energy spectrum, which can be adjusted over a wide range by tuning composition, density, size, lattice strain, and morphology. These features make quantum dots attractive for the design and fabrication of novel electronic, magnetic and photonic devices and other functional materials used in cutting-edge applications. The formation of QD on epitaxially strained thin film surfaces, known as Stranski-Krastanow (SK) islands, has attracted great attention due to their unique electronic properties. Here, we present a systematic dynamical simulation study for the spontaneous evolution of the SK islands on the stochastically rough surfaces (nucleationless growth). During the development of SK islands through the mass accumulation at randomly selected regions of the film via surface drift-diffusion (induced by the capillary and mismatch stresses) with and/or without growth, one also observes the formation of an extremely thin wetting layer having a thickness of a few Angstroms. Above a certain threshold level of the mismatch strain and/or the size of the patch, the formation of multiple islands separated by shallow wetting layers is also observed as metastable states such as doublets even multiplets. These islands are converted into a distinct SK islands after long annealing times by coalescence through the long range surface diffusion. Extensive computer simulation studies demonstrated that after an initial transient regime, there is a strong quadratic relationship between the height of the SK singlet and the intensity of the lattice mismatch strain (in a wide range of stresses up to 8.5GPa for germanium thin crystalline films), with the exception at those critical points where the morphological (shape change with necking) transition takes place. (C) 2014 AIP Publishing LLC

Morphological evolution of edge-hillocks on single-crystal films having anisotropic drift-diffusion under the capillary and electromigration forces

The morphological evolution of hillocks at the unpassivated sidewalls of single-crystal metallic thin film interconnects is investigated via computer simulations using the free-moving boundary value problem. The effect of drift-diffusion anisotropy on the development of surface topographical scenarios is fully explored under the action of electromigration and capillary forces, utilizing numerous combinations of the surface texture, the drift-diffusion anisotropy and the direction of the applied electric field. The simulation studies yield analytical relationships for the velocity of the surface solitary waves and the drift velocity of electromigration-induced internal voids as a function of the applied current densities, which contain intrinsic and structural properties of the single-crystal thin films. The threshold value of the applied current density, above which electromigration-induced internal voids can be formed and may cause the catastrophic failure of interconnects by breaching, also appears explicitly in this relationship. (c) 2006 Published by Elsevier B.V