High performance 3-folded symmetric decoupled MEMS gyroscopes

This thesis reports, for the first time, on a novel design and architecture for realizing inertial grade gyroscope based on Micro-Electro-Mechanical Systems (MEMS) technology. The proposed device is suitable for high-precision Inertial Navigation Systems (INS). The new design has been investigated analytically and numerically by means of Finite Element Modeling (FEM) of the shapes, resonance frequencies and decoupling of the natural drive and sense modes of the various implementations. Also, famous phenomena known as spring softening and spring hardening are studied. Their effect on the gyroscope operation is modeled numerically in Matlab/Simulink platform. This latter model is used to predict the drive/sense mode matching capability of the proposed designs. Based on the comparison with the best recently reported performance towards inertial grade operation, it is expected that the novel architecture further lowers the dominant Brownian (thermo-mechanical) noise level by more than an order of magnitude (down to 0.08º/hr). Moreover, the gyroscope\u27s figure of merit, such as output sensitivity (150 mV/º/s), is expected to be improved by more than two orders of magnitude. This necessarily results in a signal to noise ratio (SNR) which is up to three orders of magnitude higher (up to 1,900mV/ º/hr). Furthermore, the novel concept introduced in this work for building MEMS gyroscopes allows reducing the sense parasitic capacitance by up to an order of magnitude. This in turn reduces the drive mode coupling or quadrature errors in the sensor\u27s output signal. The new approach employs Silicon-on-Insulator (SOI) substrates that allows the realization of large mass (\u3e1.6mg), large sense capacitance (\u3e2.2pF), high quality factors (\u3e21,000), large drive amplitude (~2-4 µm) and low resonance frequency (~3-4 KHz) as well as the consequently suppressed noise floor and reduced support losses for high-performance vacuum operation. Several challenges were encountered during fabrication that required developing high aspect ratio (up to 1:20) etching process for deep trenches (up to 500 µm). Frequency Response measurement platform was built for devices characterization. The measurements were performed at atmospheric pressures causing huge drop of the devices performance. Therefore, various MEMS gyroscope packaging technologies are studied. Wafer Level Packaging (WLP) is selected to encapsulate the fabricated devices under vacuum by utilizing wafer bonding. Through Silicon Via (TSV) technology was developed (as connections) to transfer the electrical signals (of the fabricated devices) outside the cap wafers

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially