Estimating cause-specfic mortality from community- and facility-based data sources in the United Republic of Tanzania: options and implications for mortality burden estimates

Objective To compare mortality burden estimates based on direct measurement of levels and causes in communities with indirect estimates based on combining health facility cause-specific mortality structures with community measurement of mortality levels. Methods. Data from sentinel vital registration (SVR) with verbal autopsy (VA) were used to determine the cause-specific mortality burden at the community level in two areas of the United Republic of Tanzania. Proportional cause-specific mortality structures from health facilities were applied to counts of deaths obtained by SVR to produce modelled estimates. The burden was expressed in years of life lost. Findings. A total of 2884 deaths were recorded from health facilities and 2167 recorded from SVR/VAs. In the perinatal and neonatal age group cause-specific mortality rates were dominated by perinatal conditions and stillbirths in both the community and the facility data. The modelled estimates for chronic causes were very similar to those from SVR/VA. Acute febrile illnesses were coded more specifically in the facility data than in the VA. Injuries were more prevalent in the SVR/VA data than in that from the facilities. Conclusion. In this setting, improved International classification of diseases and health related problems, tenth revision (ICD-10) coding practices and applying facility-based cause structures to counts of deaths from communities, derived from SVR, appears to produce reasonable estimates of the cause-specific mortality burden in those aged 5 years and older determined directly from VA. For the perinatal and neonatal age group, VA appears to be required. Use of this approach in a nationally representative sample of facilities may produce reliable national estimates of the cause-specific mortality burden for leading causes of death in adults.

Prediction of functional capacity in chronic heart failure patients using myocardial tissue Doppler

Background. Exercise therapy improves functional capacity in CHF, but selection and individualization of training would be helped by a simple non-invasive marker of peak VO2. Peak VO2 in these pts is difficult to predict without direct measurement, and LV ejection fraction is a poor predictor. Myocardial tissue velocities are less load-dependent, and may be predictive of the exercise response in CHF pts. We sought to use tissue velocity as a predictor of peak VO2 in CHF pts. Methods. Resting 2D-echocardiography and tissue Doppler imaging were performed in 182 CHF pts (159 male, age 62±10 years) before and after metabolic exercise testing. The majority of these patients (129, 71%) had an ischemic cardiomyopathy, with resting EF of 35±13% and a peak VO2 of 13.5±4.7 ml/kg/min. Results. Neither resting EF (r=0.15) nor peak EF (r=0.18, both p=NS) were correlated with peak VO2. However, peak VO2 correlated with peak systolic velocity in septal (Vss, r=0.31) and lateral walls (Vsl, r=0.26, both p=0.01). In a general linear model (r2 = 0.25), peak VO2 was calculated from the following equation: 9.6 + 0.68*Vss - 0.09*age + 0.06*maximum HR. This model proved to be a superior predictor of peak VO2 (r=0.51, p=0.01) than the standard prediction equations of Wasserman (r= -0.12, p=0.01). Conclusions. Resting tissue Doppler, age and maximum heart rate may be used to predict functional capacity in CHF patients. This may be of use in selecting and following the response to therapy, including for exercise training.

Radial growth of Rhizocarpon section Rhizocarpon lichen thalli over six years at snoqualmie pass in the Cascade Range, Washington State

This article describes a 6-yr study of the radial growth rates (RGR, mm yr-1) of Rhizocarpon section Rhizocarpon thalli on a talus slope at Snoqualmie Pass in the Cascade Range, Washington State, United States (47°27'N; 121°26'W). At the end of the growth period, 32 of a total of 39 thalli had exhibited a positive RGR, and 7 of a total of 39 thalli showed no measurable growth. Mean RGR of all thalli was 0.07 mm yr-1 (range, 0-0.19 mm, SD = 0.06). Analysis of variance suggested no significant variation in RGR in successive growth periods, but significant differences were present both within and between thalli. The slope of a boulder facet did not influence RGR, but growth was affected by aspect, the least growth being observed on north-northwest facets. A plot of RGR against thallus diameter revealed a wide scatter of data points with little evidence for a significant change in growth with thallus size. Hence, the study showed that the RGR of Rhizocarpon thalli at Snoqualmie is extremely slow and highly variable and significantly less than estimates based on lichenometry. To determine the growth curve of a yellow-green Rhizocarpon by direct measurement at such a site would require a large sample of thalli and careful standardization of the species studied, the aspect conditions under which the thalli were measured, and the initial hypothallus width of the thalli. © 2005 Regents of the University of Colorado.

Growth of crustose lichens: a review

Crustose species are the slowest growing of all lichens. Their slow growth and longevity, especially of the yellow-green Rhizocarpon group, has made them important for surface-exposure dating (‘lichenometry’). This review considers various aspects of the growth of crustose lichens revealed by direct measurement including: 1) early growth and development, 2) radial growth rates (RGR, mm yr-1), 3) the growth rate-size curve, and 4) the influence of environmental factors. Many crustose species comprise discrete areolae that contain the algal partner growing on the surface of a non-lichenised fungal hypothallus. Recent data suggest that ‘primary’ areolae may develop from free-living algal cells on the substratum while ‘secondary’ areolae develop from zoospores produced within the thallus. In more extreme environments, the RGR of crustose species may be exceptionally slow but considerably faster rates of growth have been recorded under more favourable conditions. The growth curves of crustose lichens with a marginal hypothallus may differ from the ‘asymptotic’ type of curve recorded in foliose and placodioid species and the latter are characterized by a phase of increasing RGR to a maximum and may be followed by a phase of decreasing growth. The decline in RGR in larger thalli may be attributable to a reduction in the efficiency of translocation of carbohydrate to the thallus margin or to an increased allocation of carbon to support mature ‘reproductive’ areolae. Crustose species have a low RGR accompanied by a low demand for nutrients and an increased allocation of carbon for stress resistance; therefore enabling colonization of more extreme environments.

The analysis and prediction of the quantity and composition of household refuse

This thesis describes the development of a simple and accurate method for estimating the quantity and composition of household waste arisings. The method is based on the fundamental tenet that waste arisings can be predicted from information on the demographic and socio-economic characteristics of households, thus reducing the need for the direct measurement of waste arisings to that necessary for the calibration of a prediction model. The aim of the research is twofold: firstly to investigate the generation of waste arisings at the household level, and secondly to devise a method for supplying information on waste arisings to meet the needs of waste collection and disposal authorities, policy makers at both national and European level and the manufacturers of plant and equipment for waste sorting and treatment. The research was carried out in three phases: theoretical, empirical and analytical. In the theoretical phase specific testable hypotheses were formulated concerning the process of waste generation at the household level. The empirical phase of the research involved an initial questionnaire survey of 1277 households to obtain data on their socio-economic characteristics, and the subsequent sorting of waste arisings from each of the households surveyed. The analytical phase was divided between (a) the testing of the research hypotheses by matching each household's waste against its demographic/socioeconomic characteristics (b) the development of statistical models capable of predicting the waste arisings from an individual household and (c) the development of a practical method for obtaining area-based estimates of waste arisings using readily available data from the national census. The latter method was found to represent a substantial improvement over conventional methods of waste estimation in terms of both accuracy and spatial flexibility. The research therefore represents a substantial contribution both to scientific knowledge of the process of household waste generation, and to the practical management of waste arisings.

Optical linewidth of a passively mode-locked semiconductor laser

We measured the optical linewidths of a passively mode-locked quantum dot laser and show that, in agreement with theoretical predictions, the modal linewidth exhibits a parabolic dependence with the mode optical frequency. The minimum linewidth follows a Schawlow-Townes behavior with a rebroadening at high power. In addition, the slope of the parabola is proportional to the RF linewidth of the laser and can therefore provide a direct measurement of the timing jitter. Such a measurement could be easily applied to mode-locked semiconductor lasers with a fast repetition rate where the RF linewidth cannot be directly measured.

Lichen growth and lichenometry

Lichenometry is one of the most widely used methods available for dating the surface age of various substrata including rock surfaces, boulders, walls, and archaeological remains. It depends on the assumption that if the lag time before colonisation of a substratum by a lichen is known and lichen age can be estimated, then a minimum date can be obtained by measuring the diameter (or another property related to size) of the largest lichen at the site. Lichen age can be determined by variety of methods including calibrating lichen size against surfaces of known age (‘indirect lichenometry’), by constructing a growth rate-size curve from direct measurement of lichen growth (‘direct lichenometry’), using radio-carbon (RC) dating, and from lichen ‘growth rings’. This chapter describes: (1) lichen growth rates and longevity, (2) methods of estimating lichen age, (3) the methodology of lichenometry and (4) applications of lichenometry. Despite its limitations, lichenometry is likely to continue to play an important role in dating a variety of surfaces and also in providing data that contribute to the debate regarding global warming and climate change.

The use of the lichen genus Rhizocarpon in lichenometric dating with special reference to Holocene glacial events

Lichenometry is one of the most widely used methods of dating the surface age of substrata including rock surfaces, boulders, walls, and archaeological remains and has been particularly important in dating late Holocene glacial events. Yellow-green species of the crustose genus Rhizocarpon have been the most useful lichens in lichenometry because of their low growth rates and longevity. This review describes: (1) the biology of the genus Rhizocarpon, (2) growth rates and longevity, (3) environmental growth effects, (4) methods of estimating lichen age, (5) the methodology of lichenometry, (6) applications to dating glacial events, and (7) future research. Lichenometry depends on many assumptions, most critically that if the lag time before colonisation of a substratum is known and lichen age can be estimated, then a minimum surface age date can be obtained by measuring the size of the largest Rhizocarpon thallus. Lichen age can be estimated by calibrating thallus size against surfaces of known age (‘indirect lichenometry’), by constructing a growth rate-size curve from direct measurement of growth (‘direct lichenometry’), using radio-carbon (RC) dating, or from lichen ‘growth rings’. Future research should include a more rigorous investigation of the assumptions of lichenometry, especially whether the largest thallus present at a site is a good indicator of substratum age, and further studies on the establishment, development, growth, senescence, and mortality of Rhizocarpon lichens.

Energy estimation of cosmic rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30-80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy-corrected for geometrical effects-is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.

Detecting metrologically useful entanglement in the vicinity of Dicke states

We present a method to verify the metrological usefulness of noisy Dicke states of a particle ensemble with only a few collective measurements, without the need for a direct measurement of the sensitivity. Our method determines the usefulness of the state for the usual protocol for estimating the angle of rotation with Dicke states, which is based on the measurement of the second moment of a total spin component. It can also be used to detect entangled states that are useful for quantum metrology. We apply our method to recent experimental results.

Disentangling the magnetic force noise contribution in LISA Pathfinder

Magnetically-induced forces on the inertial masses on-board LISA Path finder are expected to be one of the dominant contributions to the mission noise budget, accounting for up to 40%. The origin of this disturbance is the coupling of the residual magnetization and susceptibility of the test masses with the environmental magnetic field. In order to fully understand this important part of the noise model, a set of coils and magnetometers are integrated as a part of the diagnostics subsystem. During operations a sequence of magnetic excitations will be applied to precisely determine the coupling of the magnetic environment to the test mass displacement using the on-board magnetometers. Since no direct measurement of the magnetic field in the test mass position will be available, an extrapolation of the magnetic measurements to the test mass position will be carried out as a part of the data analysis activities. In this paper we show the first results on the magnetic experiments during an end-to-end LISA Path finder simulation, and we describe the methods under development to map the magnetic field on-board.

Holistic Design In High-Speed Optical Interconnects

Integrated circuit scaling has enabled a huge growth in processing capability, which necessitates a corresponding increase in inter-chip communication bandwidth. As bandwidth requirements for chip-to-chip interconnection scale, deficiencies of electrical channels become more apparent. Optical links present a viable alternative due to their low frequency-dependent loss and higher bandwidth density in the form of wavelength division multiplexing. As integrated photonics and bonding technologies are maturing, commercialization of hybrid-integrated optical links are becoming a reality. Increasing silicon integration leads to better performance in optical links but necessitates a corresponding co-design strategy in both electronics and photonics. In this light, holistic design of high-speed optical links with an in-depth understanding of photonics and state-of-the-art electronics brings their performance to unprecedented levels. This thesis presents developments in high-speed optical links by co-designing and co-integrating the primary elements of an optical link: receiver, transmitter, and clocking.

In the first part of this thesis a 3D-integrated CMOS/Silicon-photonic receiver will be presented. The electronic chip features a novel design that employs a low-bandwidth TIA front-end, double-sampling and equalization through dynamic offset modulation. Measured results show -14.9dBm of sensitivity and energy efficiency of 170fJ/b at 25Gb/s. The same receiver front-end is also used to implement source-synchronous 4-channel WDM-based parallel optical receiver. Quadrature ILO-based clocking is employed for synchronization and a novel frequency-tracking method that exploits the dynamics of IL in a quadrature ring oscillator to increase the effective locking range. An adaptive body-biasing circuit is designed to maintain the per-bit-energy consumption constant across wide data-rates. The prototype measurements indicate a record-low power consumption of 153fJ/b at 32Gb/s. The receiver sensitivity is measured to be -8.8dBm at 32Gb/s.

Next, on the optical transmitter side, three new techniques will be presented. First one is a differential ring modulator that breaks the optical bandwidth/quality factor trade-off known to limit the speed of high-Q ring modulators. This structure maintains a constant energy in the ring to avoid pattern-dependent power droop. As a first proof of concept, a prototype has been fabricated and measured up to 10Gb/s. The second technique is thermal stabilization of micro-ring resonator modulators through direct measurement of temperature using a monolithic PTAT temperature sensor. The measured temperature is used in a feedback loop to adjust the thermal tuner of the ring. A prototype is fabricated and a closed-loop feedback system is demonstrated to operate at 20Gb/s in the presence of temperature fluctuations. The third technique is a switched-capacitor based pre-emphasis technique designed to extend the inherently low bandwidth of carrier injection micro-ring modulators. A measured prototype of the optical transmitter achieves energy efficiency of 342fJ/bit at 10Gb/s and the wavelength stabilization circuit based on the monolithic PTAT sensor consumes 0.29mW.

Lastly, a first-order frequency synthesizer that is suitable for high-speed on-chip clock generation will be discussed. The proposed design features an architecture combining an LC quadrature VCO, two sample-and-holds, a PI, digital coarse-tuning, and rotational frequency detection for fine-tuning. In addition to an electrical reference clock, as an extra feature, the prototype chip is capable of receiving a low jitter optical reference clock generated by a high-repetition-rate mode-locked laser. The output clock at 8GHz has an integrated RMS jitter of 490fs, peak-to-peak periodic jitter of 2.06ps, and total RMS jitter of 680fs. The reference spurs are measured to be –64.3dB below the carrier frequency. At 8GHz the system consumes 2.49mW from a 1V supply.

Investigations of Cloud Microphysical Response to Mixing Using Digital Holography

Cloud edge mixing plays an important role in the life cycle and development of clouds. Entrainment of subsaturated air affects the cloud at the microscale, altering the number density and size distribution of its droplets. The resulting effect is determined by two timescales: the time required for the mixing event to complete, and the time required for the droplets to adjust to their new environment. If mixing is rapid, evaporation of droplets is uniform and said to be homogeneous in nature. In contrast, slow mixing (compared to the adjustment timescale) results in the droplets adjusting to the transient state of the mixture, producing an inhomogeneous result. Studying this process in real clouds involves the use of airborne optical instruments capable of measuring clouds at the `single particle' level. Single particle resolution allows for direct measurement of the droplet size distribution. This is in contrast to other `bulk' methods (i.e. hot-wire probes, lidar, radar) which measure a higher order moment of the distribution and require assumptions about the distribution shape to compute a size distribution. The sampling strategy of current optical instruments requires them to integrate over a path tens to hundreds of meters to form a single size distribution. This is much larger than typical mixing scales (which can extend down to the order of centimeters), resulting in difficulties resolving mixing signatures. The Holodec is an optical particle instrument that uses digital holography to record discrete, local volumes of droplets. This method allows for statistically significant size distributions to be calculated for centimeter scale volumes, allowing for full resolution at the scales important to the mixing process. The hologram also records the three dimensional position of all particles within the volume, allowing for the spatial structure of the cloud volume to be studied. Both of these features represent a new and unique view into the mixing problem. In this dissertation, holographic data recorded during two different field projects is analyzed to study the mixing structure of cumulus clouds. Using Holodec data, it is shown that mixing at cloud top can produce regions of clear but humid air that can subside down along the edge of the cloud as a narrow shell, or advect down shear as a `humid halo'. This air is then entrained into the cloud at lower levels, producing mixing that appears to be very inhomogeneous. This inhomogeneous-like mixing is shown to be well correlated with regions containing elevated concentrations of large droplets. This is used to argue in favor of the hypothesis that dilution can lead to enhanced droplet growth rates. I also make observations on the microscale spatial structure of observed cloud volumes recorded by the Holodec.

Unveiling the expansion history of the universe with cosmic chronometers and gravitational waves

This Thesis explores two novel and independent cosmological probes, Cosmic Chronometers (CCs) and Gravitational Waves (GWs), to measure the expansion history of the Universe. CCs provide direct and cosmology-independent measurements of the Hubble parameter H(z) up to z∼2. In parallel, GWs provide a direct measurement of the luminosity distance without requiring additional calibration, thus yielding a direct measurement of the Hubble constant H0=H(z=0). This Thesis extends the methodologies of both of these probes to maximize their scientific yield. This is achieved by accounting for the interplay of cosmological and astrophysical parameters to derive them jointly, study possible degeneracies, and eventually minimize potential systematic effects. As a legacy value, this work also provides interesting insights into galaxy evolution and compact binary population properties. The first part presents a detailed study of intermediate-redshift passive galaxies as CCs, with a focus on the selection process and the study of their stellar population properties using specific spectral features. From their differential aging, we derive a new measurement of the Hubble parameter H(z) and thoroughly assess potential systematics. In the second part, we develop a novel methodology and pipeline to obtain joint cosmological and astrophysical population constraints using GWs in combination with galaxy catalogs. This is applied to GW170817 to obtain a measurement of H0. We then perform realistic forecasts to predict joint cosmological and astrophysical constraints from black hole binary mergers for upcoming gravitational wave observatories and galaxy surveys. Using these two probes we provide an independent reconstruction of H(z) with direct measurements of H0 from GWs and H(z) up to z∼2 from CCs and demonstrate that they can be powerful independent probes to unveil the expansion history of the Universe.

Development of wearable electrochemical sensors for the determination of biological analytes

Wearable biosensors are attracting interest due to their potential to provide continuous, real-time physiological information via dynamic, non-invasive measurements of biochemical markers in biofluids, such as interstitial fluid (ISF). One notable example of their applications is for glycemic monitoring in diabetic patients, which is typically carried out either by direct measurement of blood glucose via finger pricking or by wearable sensors that can continuously monitor glucose in ISF by sampling it from below the skin with a microneedle. In this context, the development of a new and minimally invasive multisensing tattoo-based platform for the monitoring of glucose and other analytes in ISF extracted through reverse iontophoresis in proposed by the GLUCOMFORT project. This elaborate describes the in-vitro development of flexible electrochemical sensors based on inkjet-printed PEDOT:PSS and metal inks that are capable of determining glucose and chloride at biologically relevant concentrations, making them good candidates for application in the GLUCOMFORT platform. In order to make PEDOT:PSS sensitive to glucose at micromolar concentrations, a biocompatible functionalization based on immobilized glucose oxidase and electrodeposited platinum was developed. This functionalization was successfully applied to bulk and flexible amperometric devices, the design of which was also optimized. Using the same strategy, flexible organic electrochemical transistors (OECTs) for glucose sensing were also made and successfully tested. For the sensing of chloride ions, an organic charge-modulated field-effect transistor (OCMFET) featuring a silver/silver chloride modified floating gate electrode was developed and tested.