Resonant tunnelling diodes for THz communications

Resonant tunnelling diodes realised in the InGaAs/AlAs compound semiconductor system lattice-matched to InP substrates represent one of the fastest electronic solid-state devices, with demonstrated oscillation capability in excess of 2 THz. Current state-of-the-art offers a poor DC-to-RF conversion efficiency. This thesis discusses the structural issues limiting the device performance and offers structural design optimums based on quantum transport modelling. These structures are viewed in the context of epitaxial growth limitations and their extrinsic oscillator performance. An advanced non-destructive characterisation scheme based on low-temperature photoluminescence spectroscopy and high-resolution TEM is proposed to verify the epitaxial perfection of the proposed structure, followed by recommendations to improve the statistical process control, and eventually yield of these very high-current density mesoscopic devices. This work concludes with an outward look towards other compound semiconductor systems, advanced layer structures, and antenna designs

Characterisation of High Current Density Resonant Tunneling Diodes for THz Emission Using Photoluminescence Spectroscopy

We discuss the numerical simulation of high current density InGaAs/AlAs/InP resonant tunneling diodes with a view to their optimization for application as THz emitters. We introduce a figure of merit based upon the ratio of maximum extractable THz power and the electrical power developed in the chip. The aim being to develop high efficiency emitters as output power is presently limited by catastrophic failure. A description of the interplay of key parameters follows, with constraints on strained layer epitaxy introduced. We propose an optimized structure utilizing thin barriers paired with a comparatively wide quantum well that satisfies strained layer epitaxy constraints

Fabrication, Characterisation, and Epitaxial Optimisation of MOVPE-Grown Resonant Tunnelling Diode THz Emitters

Resonant tunnelling diodes (RTDs) are a strong candidate for future wireless communications in the THz region, offering compact, room-temperature operation with Gb/s transfer rates. We employ the InGaAs/AlAs/InP material system, offering advantages due to high electron mobility, suitable band-offsets, and low resistance contacts. We describe an RTD emitter operating at 353GHz, radiating in this atmospheric transmittance window through a slot antenna. The fabrication scheme uses a dual-pass technique to achieve reproducible, very low resistivity, ohmic contacts, followed by accurate control of the etched device area. The top contact connects the device via the means of an air bridge. We then proceed to model ways to increase the resonator efficiency, in turn improving the radiative efficiency, by changing the epitaxial design. The optimization takes into account the accumulated stress limitations and realities of reactor growth. Due to the absence of useful in-situ monitoring in commercially-scalable metal-organic vapour phase epitaxy (MOVPE), we have developed a robust non-destructive epitaxial characterisation scheme to verify the quality of these mechanically shallow and atomically thin devices. A dummy copy of the active region element is grown to assist with low temperature photoluminescence spectroscopy (LTPL) characterisation. The resulting linewidths limits the number of possible solutions of quantum well (QW) width and depth pairs. In addition, the doping levels can be estimated with a sufficient degree of accuracy by measuring the Moss-Burstein shift of the bulk material. This analysis can then be combined with high resolution X-ray diffractometry (HRXRD) to increase its accuracy

Micro-Photoluminescence Characterisation of Structural Disorder in Resonant Tunneling Diodes for THz Applications

We investigated the difference between a macro scale PL and μPL (excitation and detection area ≤ 5μm2). Low-temperature micro-photoluminescence (μPL) is used to evaluate structural perfection of high current density InGaAs/AlAs/InP resonant tunnelling diodes (RTD) structure on different length scales. The thin and highly strained quantum wells (QWs) is subject to monolayer fluctuations in well and barrier thickness that can lead to random fluctuations in their band profile. μPL is performed reducing the laser spot size using a common photolithography mask to reach typical RTD mesa size (a few square microns). We observed that for spot size around 1μm2 the PL line shape present strong differences on multiple points on the wafer. These variations in the PL is investigated by line-shape fitting and discussed in terms of variations in long-range disorder brought about by strain relaxation processes. We also highlight this μPL as a powerful and cost-effective non-destructive characterization method for RTD structures

Micro-PL analysis of high current density resonant tunneling diodes for THz applications

Low-temperature micro-photoluminescence (μPL) is used to evaluate wafer structural uniformity of current densities >5mA/μm2 InGaAs/AlAs/InP resonant tunneling diode (RTD) structures on different length scales. Thin, highly strained quantum wells (QWs) are subject to monolayer fluctuations, leading to a large statistical distribution in their electrical properties. This has an important impact on the RTD device performance and manufacturability. The PL spot size is reduced using a common photolithography mask to reach a typical high Jpeak for a given RTD mesa size (1 ∼ 100 μm2). We observe that for lower strain-budget samples, the PL line shape is essentially identical for all excitation/collection areas. For higher strain-budget samples, there is a variation in the PL line shape that is discussed in terms of a variation in long-range disorder brought about by strain relaxation processes. The RTD operating characteristics are discussed in light of these findings, and we conclude that strain model limits overestimate the strain budget that can be incorporated in these devices. We also highlight μPL as a powerful nondestructive characterization method for RTD structures

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe