High field chemistry with scanning probes

Fabricating Ge and Si integrated structures with nanoscale accuracy is a challenging pursuit essential for novel advances in electronics and photonics. While several scanning probe-based techniques have been proposed, no current technique offers control of nanostructure size, shape, placement, and chemical composition. To this end, atomic force microscope direct write uses a high electric field (> 109 V m-1) to create nanoscale features as fast as 1 cm s-1 by reacting a liquid precursor with a biased AFM tip. In this work, I present the first results on fabricating inorganic nanostructures via AFM direct write. Using diphenylgermane (DPG) and diphenylsilane (DPS), carbon-free germanium and silicon nanostructures (SIMS, x-ray PEEM) are fabricated. For this chemistry, I propose a model that involves electron capture and precursor fragmentation under the high electric field. To verify this model, experimental data and simulations are presented. High field chemistry for DPG and DPS has also been demonstrated for both sequential deposition and the creation of nanoscale heterostuctures, in addition to microscale deposition using a flexible stamp approach. This high field chemistry approach to the deposition of organometallic precursors could offer a low-cost, high throughput alternative for future optical, electronic, and photovoltaic applications.

Post-Operative Pain Scores and Level of Regional Anesthesia Expertise: Using Clinical Outcomes to Assess Procedural Proficiency

Background and Objectives: Peripheral nerve blockade requires regional anesthesia skills that trainees learn in several formats. Technical proficiency has shifted from a quota to comprehensive procedural evaluation. Successful nerve blockade is the clinical endpoint validating proficiency but patient, technical and procedural factors influence this result. The purpose of this study was to determine if procedural expertise for sciatic nerve blockade influenced postoperative pain scores and opioid requirements and if patient factors, technique and repetition influenced this outcome. Method: Sciatic nerve blockade by nerve stimulation and ultrasound guidance and training level of the resident performing the procedure were recorded. Patient obesity, trauma, chronic pain, opioid use and preoperative pain scores were compared to post-procedure pain scores and opioid analgesic requirements. Results: 102 patients received sciatic nerve blockade from 47 trainees over a 36 month interval. A significant relation between training level and improved pain scores was not demonstrated but transition from nerve stimulation to ultrasound guidance lowered scores in all groups. Nerve blockade failure was frequent with chronic opioid use and trauma. Conclusion: Analgesic outcomes should be an integral part of assessment of proficiency in regional anesthesia techniques. Evaluating outcomes of procedures throughout training will longitudinally assess technical expertise.

Nucleic Acid Diagnostics using Isotachophoresis and Isothermal Amplification

Thesis (Ph.D.)--University of Washington, 2016-08