Testbeam results of the Picosecond Avalanche Detector proof-of-concept prototype

The proof-of-concept prototype of the Picosecond Avalanche Detector, a multi-PN junction monolithic silicon detector with continuous gain layer deep in the sensor depleted region, was tested with a beam of 180 GeV pions at the CERN SPS. The prototype features low noise and fast SiGe BiCMOS frontend electronics and hexagonal pixels with 100 μm pitch. At a sensor bias voltage of 125 V, the detector provides full efficiency and average time resolution of 30, 25 and 17 ps in the overall pixel area for a power consumption of 0.4, 0.9 and 2.7 W/cm2, respectively. In this first prototype the time resolution depends significantly on the distance from the center of the pixel, varying at the highest power consumption measured between 13 ps at the center of the pixel and 25 ps in the inter-pixel region

Picosecond Avalanche Detector — working principle and gain measurement with a proof-of-concept prototype

The Picosecond Avalanche Detector is a multi-junction silicon pixel detector based on a (NP)drift(NP)gain structure, devised to enable charged-particle tracking with high spatial resolution and picosecond time-stamp capability. It uses a continuous junction deep inside the sensor volume to amplify the primary charge produced by ionizing radiation in a thin absorption layer. The signal is then induced by the secondary charges moving inside a thicker drift region. A proof-of-concept monolithic prototype, consisting of a matrix of hexagonal pixels with 100 μm pitch, has been produced using the 130 nm SiGe BiCMOS process by IHP microelectronics. Measurements on probe station and with a 55Fe X-ray source show that the prototype is functional and displays avalanche gain up to a maximum electron gain of 23. A study of the avalanche characteristics, corroborated by TCAD simulations, indicates that space-charge effects due to the large primary charge produced by the conversion of X-rays from the ^55Fe source limits the effective gain

20 ps Time Resolution with a Fully-Efficient Monolithic Silicon Pixel Detector without Internal Gain Layer

A second monolithic silicon pixel prototype was produced for the MONOLITH project. The ASIC contains a matrix of hexagonal pixels with 100 {\mu}m pitch, readout by a low-noise and very fast SiGe HBT frontend electronics. Wafers with 50 {\mu}m thick epilayer of 350 {\Omega}cm resistivity were used to produce a fully depleted sensor. Laboratory and testbeam measurements of the analog channels present in the pixel matrix show that the sensor has a 130 V wide bias-voltage operation plateau at which the efficiency is 99.8%. Although this prototype does not include an internal gain layer, the design optimised for timing of the sensor and the front-end electronics provides a time resolutions of 20 ps.Comment: 11 pages, 11 figure

Testbeam Results of the Picosecond Avalanche Detector Proof-Of-Concept Prototype

The proof-of-concept prototype of the Picosecond Avalanche Detector, a multi-PN junction monolithic silicon detector with continuous gain layer deep in the sensor depleted region, was tested with a beam of 180 GeV pions at the CERN SPS. The prototype features low noise and fast SiGe BiCMOS frontend electronics and hexagonal pixels with 100 {\mu}m pitch. At a sensor bias voltage of 125 V, the detector provides full efficiency and average time resolution of 30, 25 and 17 ps in the overall pixel area for a power consumption of 0.4, 0.9 and 2.7 W/cm^2, respectively. In this first prototype the time resolution depends significantly on the distance from the center of the pixel, varying at the highest power consumption measured between 13 ps at the center of the pixel and 25 ps in the inter-pixel region

Radiation Tolerance of SiGe BiCMOS Monolithic Silicon Pixel Detectors without Internal Gain Layer

A monolithic silicon pixel prototype produced for the MONOLITH ERC Advanced project was irradiated with 70 MeV protons up to a fluence of 1 x 10^16 1 MeV n_eq/cm^2. The ASIC contains a matrix of hexagonal pixels with 100 {\mu}m pitch, readout by low-noise and very fast SiGe HBT frontend electronics. Wafers with 50 {\mu}m thick epilayer with a resistivity of 350 {\Omega}cm were used to produce a fully depleted sensor. Laboratory tests conducted with a 90Sr source show that the detector works satisfactorily after irradiation. The signal-to-noise ratio is not seen to change up to fluence of 6 x 10^14 n_eq /cm^2 . The signal time jitter was estimated as the ratio between the voltage noise and the signal slope at threshold. At -35 {^\circ}C, sensor bias voltage of 200 V and frontend power consumption of 0.9 W/cm^2, the time jitter of the most-probable signal amplitude was estimated to be 21 ps for proton fluence up to 6 x 10 n_eq/cm^2 and 57 ps at 1 x 10^16 n_eq/cm^2 . Increasing the sensor bias to 250 V and the analog voltage of the preamplifier from 1.8 to 2.0 V provides a time jitter of 40 ps at 1 x 10^16 n_eq/cm^2.Comment: Submitted to JINS

Uso del láser en urgencias por periodontitis apical post tratamiento endodóntico

Introduction: Laser therapy and stimulation of the acupuncture points are anti-inflammatory and analgesic alternative treatments in dentistry.Objective: to describe the use of low power laser therapy in the emergency treatment of apical periodontitis after endodontic treatment during 2018.Methods: observational, descriptive, longitudinal, and prospective study of patients who attended emergency department at Guama Dentistry Clinic during 2018, Pinar del Río, presenting apical periodontitis after endodontic treatment; 86 patients participated in the study. Descriptive statistics was applied, respecting the bioethical principles.Results: female gender predominated (53,49 %), apical periodontitis after endodontic treatment was more prevalent in the age group 20-24 (30,23 %); 65,5 % of the patients presented remission and relief after the third treatment session. Only 2,33 % needed more than six treatment sessions.Conclusions: apical periodontitis after endodontic treatment is more common in women during the first half of the second decade of life. The treatment showed effectiveness from the first treatment sessions.Introducción: la terapia y estimulación con láser en puntos acupunturales constituyen alternativas de tratamiento antiinflamatorio y analgésico en estomatología.Objetivo: describir el uso de la terapia láser de baja potencia en el tratamiento de urgencias por periodontitis apical post tratamiento endodóntico durante el 2018.Método: estudio observacional, descriptivo, longitudinal y prospectivo en pacientes que acudieron a la consulta de urgencias de la Clínica Estomatológica “Guamá’’, municipio Pinar del Río, en el período durante el año 2018, por presentar periodontitis apical post tratamiento endodóntico. El universo estuvo constituido por 86 pacientes trabajándose con la totalidad. Se empleó estadística descriptiva y se siguieron los principios bioéticos.Resultados: predominó el sexo femenino (53,49 %), donde la periodontitis apical post tratamiento endodóntico se presentó en mayor cuantía en el grupo etario de 20 a 24 años de edad (30,23 %). El 65,5 % de los pacientes presentaron remisión y alivio tras la tercera sesión de tratamiento. Solo el 2,33 % necesitó más de seis sesiones de tratamiento.Conclusiones: la periodontitis apical post tratamiento endodóntico se presentan en mayor cuantía en las féminas, durante la primera mitad de la segunda década de vida. El tratamiento con terapia laser de baja frecuencia mostró efectividad desde las primeras sesiones de tratamiento

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

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world