Charakterizace tenkovrstvých elektroluminiscenčních součástek

Jádrem této disertační práce bylo studovat optické a elektrické charakteristiky tenkovrstvých elektroluminiscenčních součástek řízených střídavým proudem (ACTFEL) a zejména vliv procesu stárnutí luminiforů na jejich optické a elektrické vlastnosti. Cílem této studie měl být příspěvek ke zvýšení celkové účinnosti luminoforů, vyjádřené pomocí jasu, účinnosti a stability. Vzhledem k tomu, že současnou dominantní technologií plochých obrazovek je LCD, musí se další alternativní technologie plošných displejů porovnávat s LCD. Výhodou ACTFEL displejů proti LCD je lepší rozlišení, větší teplotní rozsah činnosti, větší čtecí úhel, či možnost čtení při mnohem vyšší intenzitě pozadí. Na druhou stranu je jejich nevýhodou vyšší energetická náročnost, problém s odpovídající barevností tří základních barev a podstatně vyšší napětí nutné pro činnost displeje. K dosažení tohoto cíle jsme provedli optická, elektrická a optoelektrická měření ACTFEL struktur a ZnS:Mn luminoforů. Navíc jsme studovali vliv dotování vrstvy pomocí KCl na chování mikrostruktury a na elektroluminiscenční vlastnosti (zejména na jas a světelnou účinnost) ZnS:Mn luminoforů. Provedli jsme i některá, ne zcela obvyklá, měření ACTFEL součástek. Vypočítali jsme i rozptylový poměr nabitých barevných center a simulovali transportní charakteristiky v ACTFEL součástkách. Studovali jsme vliv stárnutí dvou typů ZnS:Mn luminoforů (s vrstvou napařenou či získanou pomocí epitaxe atomových vrstev) monitorováním závislostí svítivost-napětí (L-V), velikost vnitřního náboje - elektrické pole luminoforu (Q-Fp) a kapacitance-napětí (C-V) ve zvolených časových intervalech v průběhu stárnutí. Provedli jsme krátkodobá i dlouhodobá měření a pokusili jsme se i o vizualizaci struktury luminoforu se subvlnovým rozlišením pomocí optického rastrovacího mikroskopu pracujícího v blízkém poli (SNOM). Na praktickém případu zeleného Zn2GeO4:Mn (2% Mn) ACTFEL displeje, pracujícího při 50 Hz, jsme také studovali stabilitu svítivosti pomocí měření závislosti svítivosti na napětí (L-V) a světelné účinnosti na napětí (eta-V). Přitom byl zhodnocen význam těchto charakteristik. Nezanedbatelnou a neoddělitelnou součástí této práce je i její pedagogický aspekt. Předložený text by mohl být využit i jako učebnice pro studenty na mé univerzitě v Lybii.The objective of this thesis is to study the optical and electrical characterization of Alternating-Current Thin-Film ElectroLuminescent (ACTFEL) devices, and specifically the aging process of phosphor materials that comprise the ACTFEL display in an effort to improve the overall performance of the primary phosphor colors in terms of brightness, efficiency and stability. Since the dominant flat-panel display technology is the LCD, an alternative flat-panel display technology must gauge itself in terms of the LCD. The advantages of ACTFEL displays in comparison with LCDs are the ability to pattern much smaller pixel, performance over a wider temperature range, full-viewing angle, and readability with much greater intensity background light. The disadvantages of ACTFEL displays against LCD ones are larger power consumption, lack of adequate chromaticity of the three primary colors, and much larger driving voltages. To achieve these objectives, the optical, electrical, and opto-electric measurements of the ACTFEL structures and ZnS:Mn phosphor hosts were carried out. Moreover, the effect of KCl co-doping on the microstructure and the electroluminescent properties (mainly brightness and luminous efficiency) of ZnS:Mn phosphors has been investigated, too. A non-common electrical characterization of ACTFEL devices has also been provided. We also calculated charged center scattering rates, and simulated the electron transport process in an ACTFEL device The study of the aging characteristics of evaporated and atomic layer epitaxy ZnS:Mn phosphors has been undertaken by monitoring the luminance-voltage (L-V) internal charge-phosphor field (Q-Fp) and capacitance-voltage (C-V) electrical characteristics at in selected time intervals during aging. Short-term and long-term ACTFEL aging studies has been provided and an attempt to visualize locally the structure of phosphor with a subwavelenght resolution using Scanning near-field optical microscope (SNOM) has also been presented. The practical case of a green Zn2GeO4:Mn (2% Mn) ACTFEL device operated at 50 Hz was studied and a luminance stability by a measurement of luminance-voltage (L-V) and luminous efficiency-voltage (eta-V) characteristics has been evaluated. A non-negligible and indiscreptible task of this thesis was also its pedagogical aspect. Therefore, the presented text can be considered as a textbook suitable for our students in Libya.

New Gene Combinations Conferring Resistance to the Bacterial Blight Disease of Cotton

F2 plants comprising different gene combinations were evaluated for cotton bacterial blight resistance in the field of the Gezira Research Station and the greenhouse of the Plant Pathology Centre of the University of Gezira, Neshashiba, Wad Medani, during the autumn of 2002. Results generally showed significant differences between different gene combinations in resistance to the new race of the bacterium Xanthomonas campestris pv. malvacearum. Leaf disease grades ranged from 4 to 6. Most of the plants fell into grade 5. Genotype 12, with expected gene combination of (B2B3B6B7B9B12), expressed the highest level of resistance with a mean disease grade of 4, while genotypes 7, 11 and 15 showed the lowest level of resistance with a mean disease grade of 6. The results indicated the importance of the genetic background B2B3B7 in improving resistance to both the old and the new races when one of the following major genes B4, B6, B9, and B12 is incorporated. In such background, resistance level improves as the number of genes increases. Therefore, the commercial resistant cultivars having B2B6 genetic background to the old race of the bacterium can be replaced by the genetic background involving B2B3B7 in addition to one of the four major genes mentioned above in order to protect the cotton crop. Genotypes 5, 6, 12, and 19 were recommended for further improvement as they expressed relatively high level of resistance to the pathogen. &nbsp

Enhancing Teaching Skills Through Short Courses: A Quantitative Review of Public Health Education in Sudan

This evaluation draws evidence on the effectiveness and outcome of learning and teaching courses that were offered to a number of teaching staff of the Academies of Health Sciences, Midwifery Schools and Centres for Continuous Professional Development in Sudan. It is based on a cross-sectional study consisting of self-administered questionnaires conducted from October 2017 to January 2018. The questionnaires were used to measure the extent to which the participants of the training courses acquired knowledge and skills and applied these skills in their jobs. Data was analysed using Excel sheets and SPSS version 21 and significant tests performed. The response rate for the self-administered questionnaire was 80%. Most of participants were females, early middle-aged, bachelor’s degree holders with more than 9 years of experience in the area of teaching health care professionals. The results are presented following the Kirkpatrick framework for evaluation of training, which was used to measure participants' reactions, learning and change of behaviour. Most of the participants were satisfied with the design and content of the course but expressed concerns regarding its duration and lack of residential facilities for course participants. Pre and post tests were used to measure learning. Comparison of the two results showed that participants gained knowledge in writing learning outcomes, although presentation skills showed no improvement following the training and the use of technology remained a challenge even after the course. In terms of application of the newly gained knowledge and skills, the findings illustrated that over 90% of the participants were satisfied with what they had learned after 3 months or more following the training course, and over 65% of the participants stated that the knowledge gained from the training remained useful. In conclusion, short courses on teaching and learning can be a valuable investment to both instructors and students. The evaluation has shown that course participants were satisfied with the training courses, gained new knowledge, and were able to apply the acquired knowledge and skills without any difficulties. It is therefore suggested to cascade these training courses to all remaining States in Sudan in order to improve the skills and capabilities of teaching staff

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

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

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

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

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research