Injection électrique pour un laser en germanium contraint

Tensile strained and n-doped germanium can be used as an active material for the realization of an optical source for silicon photonics. I have investigated electroluminescence of device as a function of tensile strain and n-doping. For that, I have performed modeling of the carrier transport through double heterostructures to obtain population inversion in the germanium layer. An operating point that reduces by two orders of magnitude the population inversion current threshold has been evidenced. For a germanium layer doped at 4×〖10〗^19 cm-3 with a 0.9% biaxial strain, the current density threshold could be reduced below the 10 kA/cm2 range. The germanium interface properties are critical. To experimentally investigate electroluminescence in germanium, I had to establish different methods of carrier injection to offer an alternative to the double heterostructure p-GaAs/n-Ge/n-GaAs. We first propose to use a Schottky heterostructure to inject carriers in n-doped germanium. We show that carrier injection and electroluminescence devices can be optimized by depositing a thin interfacial oxide layer on top of n-doped germanium. We have also developed an approach to form SiGe layers on germanium by epitaxial laser induced annealing in order to obtain a double heterostructure. I have developed several clean room processes to fabricate germanium cavities which can combine electrical injection and strain transfer, including waveguides and micropilars structures. We show that a biaxial tensile strain up to 0.72% can be transferred in micropilar cavities under electrical pumping. The evaluation of strain level was confronted to finite element simulations of mechanical deformation, taking into account the electrical carrier injectionL’utilisation du germanium dopé de type n et contraint en tension ouvre la possibilité d’obtenir une source laser monolithique pour la photonique sur silicium. Mes travaux étudient l’injection électrique dans le germanium pour sonder la réalisation d’un laser contraint. J’ai dimensionné les performances des futurs dispositifs en fonction de la contrainte et du dopage. Pour cela, j’ai simulé le transport des porteurs au travers de doubles hétérostructures afin d’obtenir l’inversion de population dans la couche de germanium a été mis en évidence. Un régime de fonctionnement qui permet de réduire de deux ordres de grandeur le courant de seuil d’inversion de population. En appliquant une déformation de 0.9%, avec un dopage de 4×〖10〗^19 cm-3, on peut obtenir des densités de courant de seuil inférieures à 10 kA/cm2. La formation d’hétérostructure avec le germanium est critique. Afin d’étudier expérimentalement l’électroluminescence du germanium, j’ai dû établir des méthodes alternatives d’injection des porteurs à la double hétérostructure GaAs-p/Ge-n/GaAs-n. On utilise des contacts redresseurs (Schottky) sur des couches de germanium dopées de type n. Cette méthode a été optimisée par la passivation de la surface du germanium avec une couche d’oxyde, qui permet l’amélioration des propriétés électriques et d’émission radiative. On a aussi développé une approche permettant de former des couches de SiGe sur germanium par épitaxie induite par recuit laser pour obtenir une double hétérostructure. J’ai réalisé plusieurs types de cavités en germanium qui permettent de combiner le transfert de la contrainte avec l’injection électrique. J’ai établi le procédé de fabrication pour des structures en guide d’onde et en micropilier en utilisant un transfert de déformation par des couches de SiN contraintes. Un niveau de déformation biaxial de 0.72% pour des cavités en micropilier sous injection électrique a été atteint. L’évaluation de la déformation à partir des spectres d’électroluminescence a été confrontée à des simulations de déformation mécanique par éléments finis, tout en considérant l’injection électrique des porteurs dans la structur

Relationship between oral declaration on adherence to ivermectin treatment and parasitological indicators of onchocerciasis in an area of persistent transmission despite a decade of mass drug administration in Cameroon

BACKGROUND: Onchocerciasis control for years has been based on mass drug administration (MDA) with ivermectin (IVM). Adherence to IVM repeated treatment has recently been shown to be a confounding factor for onchocerciasis elimination precisely in rain forest areas where transmission continues and Loa loa co-exists with Onchocerca volvulus. In this study, participants’ oral declarations were used as proxy to determine the relationship between adherence to IVM treatment and parasitological indicators of onchocerciasis in the rain forest area of Cameroon with more than a decade of MDA. METHODS: Participants were recruited based on their IVM intake profile with the aid of a semi-structured questionnaire. Parasitological examinations (skin sniping and nodule palpation) were done on eligible candidates. Parasitological indicators were calculated and correlated to IVM intake profile. RESULTS: Of 2,364 people examined, 15.5 % had never taken IVM. The majority (40.4 %) had taken the drug 1–3 times while only 18 % had taken ≥ 7 times. Mf and nodule prevalence rates were still high at 47 %, 95 % CI [44.9–49.0 %] and 36.4 %, 95 % CI [34.4–38.3 %] respectively. There was a treatment-dependent reduction in microfilaria prevalence (r(s) =−0.986, P = 0.01) and intensity (r(s) =−0.96, P = 0.01). The highest mf prevalence (59.7 %) was found in the zero treatment group and the lowest (33.9 %) in the ≥ 7 times treatment group (OR = 2.8; 95 % CI [2.09–3.74]; P < 0.001). Adults with ≥ 7 times IVM intake were 2.99 times more likely to have individuals with no microfilaria compared to the zero treatment group (OR = 2.99; 95 % CI [2.19–4.08], P < 0.0001). There was no clear correlation between treatment and nodule prevalence and intensity. CONCLUSION: Adherence to ivermectin treatment is not adequate in this rain forest area where L. loa co-exists with O. volvulus. The prevalence and intensity of onchocerciasis remained high in individuals with zero IVM intake after more than a decade of MDA. Our findings show that using parasitological indicators, reduction in prevalence is IVM intake-dependent and that participants’ oral declaration of treatment adherence could be relied upon for impact studies. The findings are discussed in the context of challenges for the elimination of onchocerciasis in this rain forest area

Situation analysis of parasitological and entomological indices of onchocerciasis transmission in three drainage basins of the rain forest of South West Cameroon after a decade of ivermectin treatment

BACKGROUND: Community-Directed Treatment with Ivermectin (CDTI) is the main strategy adopted by the African Programme for Onchocerciasis control (APOC). Recent reports from onchocerciasis endemic areas of savannah zones have demonstrated the feasibility of disease elimination through CDTI. Such information is lacking in rain forest zones. In this study, we investigated the parasitological and entomological indices of onchocerciasis transmission in three drainage basins in the rain forest area of Cameroon [after over a decade of CDTI]. River basins differed in terms of river number and their flow rates; and were characterized by high pre-control prevalence rates (60-98%). METHODS: Nodule palpation and skin snipping were carried out in the study communities to determine the nodule rates, microfilarial prevalences and intensity. Simulium flies were caught at capture points and dissected to determine the biting, parous, infection and infective rates and the transmission potential. RESULTS: The highest mean microfilaria (mf) prevalence was recorded in the Meme (52.7%), followed by Mungo (41.0%) and Manyu drainage basin (33.0%). The same trend was seen with nodule prevalence between the drainage basins. Twenty-three (23/39) communities (among which 13 in the Meme) still had mf prevalence above 40%. All the communities surveyed had community microfilarial loads (CMFL) below 10 mf/skin snip (ss). The infection was more intense in the Mungo and Meme. The intensity of infection was still high in younger individuals and children less than 10 years of age. Transmission potentials as high as 1211.7 infective larvae/person/month were found in some of the study communities. Entomological indices followed the same trend as the parasitological indices in the three river basins with the Meme having the highest values. CONCLUSION: When compared with pre-control data, results of the present study show that after over a decade of CDTI, the burden of onchocerciasis has reduced. However, transmission is still going on in this study site where loiasis and onchocerciasis are co-endemic and where ecological factors strongly favour the onchocerciasis transmission. The possible reasons for this persistent and differential transmission despite over a decade of control efforts using ivermectin are discussed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13071-015-0817-2) contains supplementary material, which is available to authorized users

Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction

Introduction Patients with cancer who develop small bowel obstruction are at high risk of malnutrition and morbidity following compromise of gastrointestinal tract continuity. This study aimed to characterise current management and outcomes following malignant small bowel obstruction. Methods A prospective, multicentre cohort study of patients with small bowel obstruction who presented to UK hospitals between 16th January and 13th March 2017. Patients who presented with small bowel obstruction due to primary tumours of the intestine (excluding left-sided colonic tumours) or disseminated intra-abdominal malignancy were included. Outcomes included 30-day mortality and in-hospital complications. Cox-proportional hazards models were used to generate adjusted effects estimates, which are presented as hazard ratios (HR) alongside the corresponding 95% confidence interval (95% CI). The threshold for statistical significance was set at the level of P ≤ 0.05 a-priori. Results 205 patients with malignant small bowel obstruction presented to emergency surgery services during the study period. Of these patients, 50 had obstruction due to right sided colon cancer, 143 due to disseminated intraabdominal malignancy, 10 had primary tumours of the small bowel and 2 patients had gastrointestinal stromal tumours. In total 100 out of 205 patients underwent a surgical intervention for obstruction. 30-day in-hospital mortality rate was 11.3% for those with primary tumours and 19.6% for those with disseminated malignancy. Severe risk of malnutrition was an independent predictor for poor mortality in this cohort (adjusted HR 16.18, 95% CI 1.86 to 140.84, p = 0.012). Patients with right-sided colon cancer had high rates of morbidity. Conclusions Mortality rates were high in patients with disseminated malignancy and in those with right sided colon cancer. Further research should identify optimal management strategy to reduce morbidity for these patient groups

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Electrical injection for a strained germanium laser

L’utilisation du germanium dopé de type n et contraint en tension ouvre la possibilité d’obtenir une source laser monolithique pour la photonique sur silicium. Mes travaux étudient l’injection électrique dans le germanium pour sonder la réalisation d’un laser contraint. J’ai dimensionné les performances des futurs dispositifs en fonction de la contrainte et du dopage. Pour cela, j’ai simulé le transport des porteurs au travers de doubles hétérostructures afin d’obtenir l’inversion de population dans la couche de germanium a été mis en évidence. Un régime de fonctionnement qui permet de réduire de deux ordres de grandeur le courant de seuil d’inversion de population. En appliquant une déformation de 0.9%, avec un dopage de 4×〖10〗^19 cm-3, on peut obtenir des densités de courant de seuil inférieures à 10 kA/cm2. La formation d’hétérostructure avec le germanium est critique. Afin d’étudier expérimentalement l’électroluminescence du germanium, j’ai dû établir des méthodes alternatives d’injection des porteurs à la double hétérostructure GaAs-p/Ge-n/GaAs-n. On utilise des contacts redresseurs (Schottky) sur des couches de germanium dopées de type n. Cette méthode a été optimisée par la passivation de la surface du germanium avec une couche d’oxyde, qui permet l’amélioration des propriétés électriques et d’émission radiative. On a aussi développé une approche permettant de former des couches de SiGe sur germanium par épitaxie induite par recuit laser pour obtenir une double hétérostructure. J’ai réalisé plusieurs types de cavités en germanium qui permettent de combiner le transfert de la contrainte avec l’injection électrique. J’ai établi le procédé de fabrication pour des structures en guide d’onde et en micropilier en utilisant un transfert de déformation par des couches de SiN contraintes. Un niveau de déformation biaxial de 0.72% pour des cavités en micropilier sous injection électrique a été atteint. L’évaluation de la déformation à partir des spectres d’électroluminescence a été confrontée à des simulations de déformation mécanique par éléments finis, tout en considérant l’injection électrique des porteurs dans la structureTensile strained and n-doped germanium can be used as an active material for the realization of an optical source for silicon photonics. I have investigated electroluminescence of device as a function of tensile strain and n-doping. For that, I have performed modeling of the carrier transport through double heterostructures to obtain population inversion in the germanium layer. An operating point that reduces by two orders of magnitude the population inversion current threshold has been evidenced. For a germanium layer doped at 4×〖10〗^19 cm-3 with a 0.9% biaxial strain, the current density threshold could be reduced below the 10 kA/cm2 range. The germanium interface properties are critical. To experimentally investigate electroluminescence in germanium, I had to establish different methods of carrier injection to offer an alternative to the double heterostructure p-GaAs/n-Ge/n-GaAs. We first propose to use a Schottky heterostructure to inject carriers in n-doped germanium. We show that carrier injection and electroluminescence devices can be optimized by depositing a thin interfacial oxide layer on top of n-doped germanium. We have also developed an approach to form SiGe layers on germanium by epitaxial laser induced annealing in order to obtain a double heterostructure. I have developed several clean room processes to fabricate germanium cavities which can combine electrical injection and strain transfer, including waveguides and micropilars structures. We show that a biaxial tensile strain up to 0.72% can be transferred in micropilar cavities under electrical pumping. The evaluation of strain level was confronted to finite element simulations of mechanical deformation, taking into account the electrical carrier injectio

“There is such a thing as asking for trouble”: taking rapid HIV testing to gay venues is fraught with challenges

Objectives: To explore the feasibility and acceptability of offering rapid HIV testing to men who have sex with men in gay social venues.Methods: Qualitative study with in-depth interviews and focus group discussions. Interview transcripts were analysed for recurrent themes. 24 respondents participated in the study. Six gay venue owners, four gay service users and one service provider took part in in-depth interviews. Focus groups were conducted with eight members of a rapid HIV testing clinic staff and five positive gay men.Results: Respondents had strong concerns about confidentiality and privacy, and many felt that HIV testing was "too serious'' an event to be undertaken in social venues. Many also voiced concerns about issues relating to post-test support and behaviour, and clinical standards. Venue owners also discussed the potential negative impact of HIV testing on social venues.Conclusion: There are currently substantial barriers to offering rapid HIV tests to men who have sex with men in social venues. Further work to enhance acceptability must consider ways of increasing the confidentiality and professionalism of testing services, designing appropriate pre-discussion and post-discussion protocols, evaluating different models of service delivery, and considering their cost-effectiveness in relation to existing services

Influence of climate warming on arctic mammals? New insights from ancient DNA studies of the collared lemming Dicrostonyx torquatus.

BACKGROUND: Global temperature increased by approximately half a degree (Celsius) within the last 150 years. Even this moderate warming had major impacts on Earth's ecological and biological systems, especially in the Arctic where the magnitude of abiotic changes even exceeds those in temperate and tropical biomes. Therefore, understanding the biological consequences of climate change on high latitudes is of critical importance for future conservation of the species living in this habitat. The past 25,000 years can be used as a model for such changes, as they were marked by prominent climatic changes that influenced geographical distribution, demographic history and pattern of genetic variation of many extant species. We sequenced ancient and modern DNA of the collared lemming (Dicrostonyx torquatus), which is a key species of the arctic biota, from a single site (Pymva Shor, Northern Pre Urals, Russia) to see if climate warming events after the Last Glacial Maximum had detectable effects on the genetic variation of this arctic rodent species, which is strongly associated with a cold and dry climate. RESULTS: Using three dimensional network reconstructions we found a dramatic decline in genetic diversity following the LGM. Model-based approaches such as Approximate Bayesian Computation and Markov Chain Monte Carlo based Bayesian inference show that there is evidence for a population decline in the collared lemming following the LGM, with the population size dropping to a minimum during the Greenland Interstadial 1 (Bølling/Allerød) warming phase at 14.5 kyrs BP. CONCLUSION: Our results show that previous climate warming events had a strong influence on genetic diversity and population size of collared lemmings. Due to its already severely compromised genetic diversity a similar population reduction as a result of the predicted future climate change could completely abolish the remaining genetic diversity in this population. Local population extinctions of collared lemmings would have severe effects on the arctic ecosystem, as collared lemmings are a key species in the trophic interactions and ecosystem processes in the Arctic

Dispersive OPA at very near-infrared wavelengths

We present a serpentine-based 16-element dispersive OPA at very near-IR wavelengths that leverages SiN waveguide feeding. 2D beam steering is achieved by wavelength sweep, with tunability of 0.11°/nm on slow and 3.52°/nm on fast axis