Digital Detection of Oxide Breakdown and Life-Time Extension in Submicron CMOS Technology

An approach is introduced to extend the lifetime of high-voltage analog circuits in CMOS technologies based on redundancy, like that known for DRAMS. A large power transistor is segmented into N smaller ones in parallel. If a sub-transistor is broken, it is removed automatically from the compound transistor. The principleis demonstrated in an RF CMOS Power Amplifier (PA) in standard 1.2V 90nm CMOS

45° light turning mirrors for hybrid integration of silica optical waveguides and photo-detectors

For hybrid integration of an optical chip with an electronic chip with photo diodes and electronic processing, light must be coupled from the optical chip to the electronic chip. This paper presents a method to fabricate metal-free 45° quasi-total internal reflecting mirrors in optical chips that enable 90° out-of-plane light coupling between flip-chip bonded chips. This method is fully compatible with fabrication of conventional optical chips. The mirrors are created using anisotropic etching of 45° facets in a Si substrate followed by fabrication of optical structures. After removal of the mirror-defining Si structures by isotropic etching, the obtained air-optical structure interface directs the output of the waveguides to out-of-plane photo detectors that are mounted flip-chip on the optical chip. Simulations show a reflection efficiency of 72.3 %, while experimentally 47% was measured on a not fully optimized first batch

An audio FIR-DAC in a BCD process for high power Class-D amplifiers

A 322 coefficient semi-digital FIR-DAC using a 1-bit PWM input signal was designed and implemented in a high voltage, audio power bipolar CMOS DMOS (BCD) process. This facilitates digital input signals for an analog class-D amplifier in BCD. The FIR-DAC performance depends on the ISI-resistant nature of this PWM-signal. An impulse response with only positive coefficients was chosen, because of its resistance to deadzone and mismatch. With a DAC current of 0.5 mA, the dynamic range is 111 dB (A-weighted), with SINAD = 103 dB (A-weighted). The current consumption is 1mA for the analog part and 4.8 mA for the digital part. The power consumption is 29 mW at V/sub dd/ = 5 V and the chip area is 2 mm/sup 2/ including the reference diode that can be shared by more channels

Employer Attitudes towards Peak Hour Avoidance

Peak Hour Avoidance is a relatively new Dutch mobility management measure. To reduce congestion frequent car drivers are given a financial reward for reducing the proportion of trips that they make during peak hours on a specific motorway section. Although previous studies show that employers are not eager to support mobility management measures, employers are nevertheless an important stakeholder. They can provide their employees with alternatives such as other travel times, work locations or travel modes and encourage their use. This paper investigates the attitudes of Dutch employers towards Peak Hour Avoidance. Exploring the factors that influence these attitudes may help to fully utilise employer support. The data from 103 employers were collected through a web questionnaire. A structural equation model on the employer support for Peak Hour Avoidance was estimated. The results demonstrate that the size of the organisation and sector only have an indirect effect on the support for Peak Hour Avoidance. Results reveal that most support for Peak Hour Avoidance can be expected from organisations who feel responsible for influencing the commuting behaviour of employees, that have human resource managers with a positive attitude towards Peak Hour Avoidance, with flexible working times and that have already implemented mobility management measures. The largest contribution to PHA that can be expected from employers is providing employees with flexible working times and encouraging employees to fully utilise this option as an alternative for driving in peak hours. This would not only be beneficial for PHA but for a wide range of mobility management initiatives as well

Discrepancy between self-perceived mycophenolic acid-associated diarrhea and stool water content after kidney transplantation

BACKGROUND: Diarrhea is a well-known side effect of mycophenolic acid (MPA) use in kidney transplant recipients (KTRs). It is unknown whether self-reported diarrhea using the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD-59R) corresponds to stool water content and how both relate to MPA usage. METHODS: MTSOSD-59R questionnaires filled out by 700 KTRs from the TransplantLines Biobank and Cohort Study(NCT03272841) were analyzed and compared with stool water content. Stool samples(N=345) were freeze-dried and a water content ≥80% was considered diarrhea. RESULTS: Self-perceived diarrhea was reported by 46%, while stool water content ≥80% was present in 23% of KTRs. MPA use was not associated with self-perceived diarrhea (odds ratio(OR) 1.32; 95% confidence interval(CI), 0.87-1.99, P=0.2), while it was associated with stool water content ≥80% (OR 2.88; 95%CI, 1.41-5.89, P=0.004), independent of potential confounders. Adjustment for prior MPA discontinuation because of severe diarrhea, uncovered an association between MPA use and self-perceived diarrhea (OR 1.80; 95%CI, 1.13-2.89, P=0.01). CONCLUSIONS: These results suggest that reporting bias could add to the discrepancy between both methods for diarrhea assessment. We recommend use of objective biomarkers or more extensive questionnaires which assess information on stool frequency and stool consistency, to investigate post-transplantation diarrhea

Esophageal Endosonography for the Diagnosis of Intrapulmonary Tumors:A Systematic Review and Meta-Analysis

BACKGROUND: Biopsy-based diagnosis in patients with paraesophageal intrapulmonary tumors suspected of lung cancer is crucial for adequate treatment planning. OBJECTIVE: To evaluate the performance of transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the diagnosis of intrapulmonary tumors located near or adjacent to the esophagus. METHODS: We performed a systematic review (PROSPERO, CRD42016033737) and searched MEDLINE, Embase, BIOSIS Previews, and Web of Science on September 22, 2016, without date or language restrictions. We included studies that evaluated the yield and/or sensitivity of EUS-FNA for diagnosing intrapulmonary tumors. Yield was defined as the number of patients in whom EUS-FNA made a biopsy-proven diagnosis (malignant or nonmalignant) relative to the total number of patients on whom EUS-FNA was performed. Sensitivity was defined as the number of patients in whom EUS-FNA made a biopsy-proven diagnosis of malignancy relative to the total number of patients in whom the tumor was found to be malignant. We performed a random-effects meta-analysis. RESULTS: Of 3,320 search results, 11 studies were included. Ten had a high risk of bias. The total number of patients was 313; the proportion of patients with malignancy ranged from 87 to 100% across these studies. The average yield was 0.90 (95% CI 0.82-0.95) and the average sensitivity was 0.92 (0.83-0.96). In the subgroup of prospective studies (n = 3), the average yield was 0.80 (0.56-0.93) and the average sensitivity was 0.83 (0.58-0.95). EUS-FNA-induced complications were reported for 5/256 patients (2.0%) for whom this information was available. CONCLUSIONS: Although the number of high-quality studies is limited, these findings suggest that EUS-FNA is safe and has a high yield for diagnosing intrapulmonary tumors

Hand dexterity, daily functioning and health-related quality of life in kidney transplant recipients

Impaired interplay between sensory and motor function may be an important, often overlooked cause of the decreased daily functioning and impaired health-related quality of life (HRQoL) of kidney transplant recipients (KTR). We assessed this interplay using a hand dexterity test, and investigated its potential associations with daily functioning and HRQoL among KTR enrolled at the TransplantLines Biobank and Cohort Study. A total of 309 KTR (58% male, mean age 56 ± 13 years) at median 4 [IQR: 1–11] years after transplantation were included. Impaired hand dexterity, as defined by a test performance slower than the 95th percentile of an age- and sex-specific reference population, was observed in 71 (23%) KTR. Worse hand dexterity was independently associated with worse performance on almost all measures of physical capacity, activities of daily living and societal participation. Finally, hand dexterity was independently associated with physical HRQoL (standardized beta − 0.22, 95%CI − 0.34 to − 0.09, P &lt; 0.001). In conclusion, impaired interplay between sensory and motor function, as assessed by hand dexterity, is prevalent among KTR. In addition, poor hand dexterity was associated with impaired daily functioning and limited physical HRQoL. Impaired interplay between sensory and motor function may be therefore an important, hitherto overlooked, phenomenon in KTR.</p