3D sensors for the HL-LHC

In order to increase its discovery potential, the Large Hadron Collider (LHC) accelerator will be upgraded in the next decade. The high luminosity LHC (HL-LHC) period demands new sensor technologies to cope with increasing radiation fluences and particle rates. The ATLAS experiment will replace the entire inner tracking detector with a completely new silicon-only system. 3D pixel sensors are promising candidates for the innermost layers of the Pixel detector due to their excellent radiation hardness at low operation voltages and low power dissipation at moderate temperatures. Recent developments of 3D sensors for the HL-LHC are presented.Comment: 8 pages, 5 figures, International Workshops on Radiation Imaging Detectors 201

Inverse Low Gain Avalanche Detectors (iLGADs) for precise tracking and timing applications

Low Gain Avalanche Detector (LGAD) is the baseline sensing technology of the recently proposed Minimum Ionizing Particle (MIP) end-cap timing detectors (MTD) at the Atlas and CMS experiments. The current MTD sensor is designed as a multi-pad matrix detector delivering a poor position resolution, due to the relatively large pad area, around 1 $mm^2$; and a good timing resolution, around 20-30 ps. Besides, in his current technological incarnation, the timing resolution of the MTD LGAD sensors is severely degraded once the MIP particle hits the inter-pad region since the signal amplification is missing for this region. This limitation is named as the LGAD fill-factor problem. To overcome the fill factor problem and the poor position resolution of the MTD LGAD sensors, a p-in-p LGAD (iLGAD) was introduced. Contrary to the conventional LGAD, the iLGAD has a non-segmented deep p-well (the multiplication layer). Therefore, iLGADs should ideally present a constant gain value over all the sensitive region of the device without gain drops between the signal collecting electrodes; in other words, iLGADs should have a 100${\%}$ fill-factor by design. In this paper, tracking and timing performance of the first iLGAD prototypes is presented.Comment: Conference Proceedings of VCI2019, 15th Vienna Conference of Instrumentation, February 18-22, 2019, Vienna, Austri

Gain and time resolution of 45 μ\mum thin Low Gain Avalanche Detectors before and after irradiation up to a fluence of 101510^{15} neq_{eq}/cm2^2

Low Gain Avalanche Detectors (LGADs) are silicon sensors with a built-in charge multiplication layer providing a gain of typically 10 to 50. Due to the combination of high signal-to-noise ratio and short rise time, thin LGADs provide good time resolutions. LGADs with an active thickness of about 45 $\mu$m were produced at CNM Barcelona. Their gains and time resolutions were studied in beam tests for two different multiplication layer implantation doses, as well as before and after irradiation with neutrons up to $10^{15}$ n$_{eq}$/cm$^2$. The gain showed the expected decrease at a fixed voltage for a lower initial implantation dose, as well as for a higher fluence due to effective acceptor removal in the multiplication layer. Time resolutions below 30 ps were obtained at the highest applied voltages for both implantation doses before irradiation. Also after an intermediate fluence of $3\times10^{14}$ n$_{eq}$/cm$^2$, similar values were measured since a higher applicable reverse bias voltage could recover most of the pre-irradiation gain. At $10^{15}$ n$_{eq}$/cm$^2$, the time resolution at the maximum applicable voltage of 620 V during the beam test was measured to be 57 ps since the voltage stability was not good enough to compensate for the gain layer loss. The time resolutions were found to follow approximately a universal function of gain for all implantation doses and fluences.Comment: 17 page

Methodology for the development of a taxonomy and toolkit to evaluate health-related habits and lifestyle (eVITAL)

<p>Abstract</p> <p>Background</p> <p>Chronic diseases cause an ever-increasing percentage of morbidity and mortality, but many have modifiable risk factors. Many behaviors that predispose or protect an individual to chronic disease are interrelated, and therefore are best approached using an integrated model of health and the longevity paradigm, using years lived without disability as the endpoint.</p> <p>Findings</p> <p>This study used a 4-phase mixed qualitative design to create a taxonomy and related online toolkit for the evaluation of health-related habits. Core members of a working group conducted a literature review and created a framing document that defined relevant constructs. This document was revised, first by a working group and then by a series of multidisciplinary expert groups. The working group and expert panels also designed a systematic evaluation of health behaviors and risks, which was computerized and evaluated for feasibility. A demonstration study of the toolkit was performed in 11 healthy volunteers.</p> <p>Discussion</p> <p>In this protocol, we used forms of the community intelligence approach, including frame analysis, feasibility, and demonstration, to develop a clinical taxonomy and an online toolkit with standardized procedures for screening and evaluation of multiple domains of health, with a focus on longevity and the goal of integrating the toolkit into routine clinical practice.</p> <p>Trial Registration</p> <p>IMSERSO registry 200700012672</p

Radiation Hardness of Thin Low Gain Avalanche Detectors

Low Gain Avalanche Detectors (LGAD) are based on a n++-p+-p-p++ structure where an appropriate doping of the multiplication layer (p+) leads to high enough electric fields for impact ionization. Gain factors of few tens in charge significantly improve the resolution of timing measurements, particularly for thin detectors, where the timing performance was shown to be limited by Landau fluctuations. The main obstacle for their operation is the decrease of gain with irradiation, attributed to effective acceptor removal in the gain layer. Sets of thin sensors were produced by two different producers on different substrates, with different gain layer doping profiles and thicknesses (45, 50 and 80 um). Their performance in terms of gain/collected charge and leakage current was compared before and after irradiation with neutrons and pions up to the equivalent fluences of 5e15 cm-2. Transient Current Technique and charge collection measurements with LHC speed electronics were employed to characterize the detectors. The thin LGAD sensors were shown to perform much better than sensors of standard thickness (~300 um) and offer larger charge collection with respect to detectors without gain layer for fluences <2e15 cm-2. Larger initial gain prolongs the beneficial performance of LGADs. Pions were found to be more damaging than neutrons at the same equivalent fluence, while no significant difference was found between different producers. At very high fluences and bias voltages the gain appears due to deep acceptors in the bulk, hence also in thin standard detectors

Depression in internal medicine inpatients at the time of hospital discharge and referral to primary care

Background and objectives: This is the first multi-center study intended to document the prevalence, characteristics, and associations of depression in Medicine patients at the time of hospital discharge and their referral to Primary Care (PC). Methods: Adult patients randomly selected among consecutive admissions to Medicine wards in 8 hospitals in Spain, covering health districts, were examined in a two-phase ''case-finding'' procedure. Standardized, Spanish versions of instruments were used, including the Standardized Polyvalent Psychiatric Interview (SPPI) and Cumulative Illness Rating Scale (CIRS). Cases of depression were diagnosed according to ICD-10 general hospital research criteria. Results: Three hundred and twelve patients with treatable depression and 777 non-depressed controls were identified. In a conservative estimate, the global prevalence of major depression was 7.1%, dysthymia 4.2% and adjustment depression 7.1%, and 51.9% of cases were of moderate/ severe intensity. Depression was more frequent in women, the differences being significant in all categories of depression. The prevalence of depression was lower in individuals aged 85 or more years, the differences being significant in cases of both dysthymia and adjustment depression. A clear pattern of decreasing prevalence with age was observed in women. The depressed had as an average five medical systems affected, and higher CIRS scores compared with the controls, the differences being significant in cases of both major depression and dysthymia. Conclusions: This is the first report showing a considerable prevalence of treatable cases of depression in Medicine patients at the time of hospital discharge and referral to PC. Depression is associated with the severity of the medical condition, and differences observed by age and sex have clinical implications. Paper read at the 3rd Annual Meeting of the European Association of Psychosomatic Medicine, Nuremberg 2015. © 2022 Asociación Universitaria de Zaragoza para el Progreso de la Psiquiatría y la Salud Menta

Association of Borderline Intellectual Functioning and Adverse Childhood Experience with adult psychiatric morbidity:Findings from a British birth cohort

Background To examine whether Borderline Intellectual Functioning (BIF) and Adverse Childhood Experiences independently predict adult psychiatric morbidity. Methods We performed a secondary analysis of longitudinal data derived from the 1970 British Birth Cohort Study to examine whether BIF and Adverse Childhood Experiences independently predict adult mental distress as measured by the Malaise Inventory. Factor analysis was used to derive a proxy measure of IQ from cognitive testing at age 10 or 5. Variables that could be indicators of exposure to Adverse Childhood Experiences were identified and grouped into health related and socio-economic related adversity. Results Children with BIF were significantly more likely than their peers to have been exposed to Adverse Childhood Experiences (BIF mean 5.90, non-BIF mean 3.19; Mann-Whitney z = 31.74, p < 0.001). As adults, participants with BIF were significantly more likely to score above the cut-off on the Malaise Inventory. We found statistically significant relationships between the number of socio-economic Adverse Childhood Experiences and poorer adult psychiatric morbidity (r range 0.104–0.141, all p < 001). At all ages the indirect mediating effects of Adverse Childhood Experiences were significantly related to adult psychiatric morbidity. Conclusions The relationship between BIF and adult psychiatric morbidity appears to be partially mediated by exposure to Adverse Childhood Experiences. Where possible, targeting Adverse Childhood Experiences through early detection, prevention and interventions may improve psychiatric morbidity in this population group

Cancer Survival in Adults in Spain: A Population-Based Study of the Spanish Network of Cancer Registries (REDECAN)

© 2022.This document is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by /4.0/ This document is the published version of a published work that appeared in final form in CancersThe assessment of cancer survival at the population level is essential for monitoring progress in cancer control. We aimed to assess cancer survival and its trends in adults in Spain. Individual records of 601,250 adults with primary cancer diagnosed during 2002-2013 and followed up to 2015 were included from 13 population-based cancer registries. We estimated net survival up to five years after diagnosis and analyzed absolute changes between 2002-2007 and 2008-2013. Estimates were age-standardized. Analyses were performed for 29 cancer groups, by age and sex. Overall, age-standardized five-year net survival was higher in women (61.7%, 95% CI 61.4-62.1%) than in men (55.3%, 95% CI 55.0-55.6%), and ranged by cancer from 7.2% (pancreas) to 89.6% (prostate) in men, and from 10.0% (pancreas) to 93.1% (thyroid) in women in the last period. Survival declined with age, showing different patterns by cancer. Between both periods, age-standardized five-year net survival increased overall by 3.3% (95% CI 3.0-3.7%) in men and 2.5% (95% CI 2.0-3.0%) in women, and for most cancer groups. Improvements were greater in patients younger than 75 years than in older patients. Chronic myeloid leukemia and myeloma showed the largest increases. Among the most common malignancies, the greatest absolute increases in survival were observed for colon (5.0%, 95% CI 4.0-6.0%) and rectal cancers (4.5%, 95% CI 3.2-5.9%). Survival improved even for some cancers with poor prognosis (pancreas, esophagus, lung, liver, and brain cancer). Further investigation of possible sociodemographic inequalities is warranted. This study contributes to the evaluation of cancer control and health services' effectiveness

Treatment challenges in and outside a network setting: Head and neck cancers

Head and neck cancer (HNC) is a rare disease that can affect different sites and is characterized by variable incidence and 5-year survival rates across Europe. Multiple factors need to be considered when choosing the most appropriate treatment for HNC patients, such as age, comorbidities, social issues, and especially whether to prefer surgery or radiation-based protocols. Given the complexity of this scenario, the creation of a highly specialized multidisciplinary team is recommended to guarantee the best oncological outcome and prevent or adequately treat any adverse effect. Data from literature suggest that the multidisciplinary team-based approach is beneficial for HNC patients and lead to improved survival rates. This result is likely due to improved diagnostic and staging accuracy, a more efficacious therapeutic approach and enhanced communication across disciplines. Despite the benefit of MTD, it must be noted that this approach requires considerable time, effort and financial resources and is usually more frequent in highly organized and high-volume centers. Literature data on clinical research suggest that patients treated in high-accrual centers report better treatment outcomes compared to patients treated in low-volume centers, where a lower radiotherapy-compliance and worst overall survival have been reported. There is general agreement that treatment of rare cancers such as HNC should be concentrated in high volume, specialized and multidisciplinary centers. In order to achieve this goal, the creation of international collaboration network is fundamental. The European Reference Networks for example aim to create an international virtual advisory board, whose objectives are the exchange of expertise, training, clinical collaboration and the reduction of disparities and enhancement of rationalize migration across Europe. The purpose of our work is to review all aspects and challenges in and outside this network setting planned for the management of HNC patients