Avaliação dos riscos assistenciais relacionados ao uso de equipamentos hospitalares na unidade de terapia intensiva de adultos de um hospital público da cidade de São Paulo, Brasil

Pós-graduação em Bases Gerais da Cirurgia - FMB

Experimental comparison of FBARs and SMRs responsitivities to mass loadings

The utilisation of thin film technology to develop film bulk acoustic resonators (FBARs) and solidly mounted resonators (SMRs), offers great potential to outperform the sensitivity and minimum detection limit of gravimetric sensors. Up to now, the choice between FBARs and SMRs depends primarily on the users' ability to design and fabricate Bragg reflectors and/or membranes, because neither of these two types of resonators has been demonstrated to be superior to the other. In the work reported here, it is shown that identically designed FBARs and SMRs resonating at the same frequency exhibit different responsitivities, Rm, to mass loadings, being the FBARs more responsive than the SMRs. For the specific device design and resonant frequency (~2 GHz) of the resonators presented, FBARs' mass responsitivity is ~20% greater than that of SMRs, and although this value should not be taken as universal for all possible device designs, it clearly indicates that FBAR devices should be favoured over SMRs in gravimetric sensing applications.

Properties and applications of high electron density structures based on InN and related compounds

El objetivo principal del presente trabajo es estudiar y explotar estructuras que presentan un gas bidimensional de electrones (2DEG) basadas en compuestos nitruros con alto contenido de indio. Existen muchas preguntas abiertas, relacionadas con el nitruro de indio y sus aleaciones, algunas de las cuales se han abordado en este estudio. En particular, se han investigado temas relacionados con el análisis y la tecnología del material, tanto para el InN y heteroestructuras de InAl(Ga)N/GaN como para sus aplicaciones a dispositivos avanzados. Después de un análisis de la dependencia de las propiedades del InN con respecto a tratamientos de procesado de dispositivos (plasma y térmicos), el problema relacionado con la formación de un contacto rectificador es considerado. Concretamente, su dificultad es debida a la presencia de acumulación de electrones superficiales en la forma de un gas bidimensional de electrones, debido al pinning del nivel de Fermi. El uso de métodos electroquímicos, comparados con técnicas propias de la microelectrónica, ha ayudado para la realización de esta tarea. En particular, se ha conseguido lamodulación de la acumulación de electrones con éxito. En heteroestructuras como InAl(Ga)N/GaN, el gas bidimensional está presente en la intercara entre GaN y InAl(Ga)N, aunque no haya polarización externa (estructuras modo on). La tecnología relacionada con la fabricación de transistores de alta movilidad en modo off (E-mode) es investigada. Se utiliza un método de ataque húmedo mediante una solución de contenido alcalino, estudiando las modificaciones estructurales que sufre la barrera. En este sentido, la necesidad de un control preciso sobre el material atacado es fundamental para obtener una estructura recessed para aplicaciones a transistores, con densidad de defectos e inhomogeneidad mínimos. La dependencia de la velocidad de ataque de las propiedades de las muestras antes del tratamiento es observada y comentada. Se presentan también investigaciones relacionadas con las propiedades básicas del InN. Gracias al uso de una puerta a través de un electrolito, el desplazamiento de los picos obtenidos por espectroscopia Raman es correlacionado con una variación de la densidad de electrones superficiales. En lo que concierne la aplicación a dispositivos, debido al estado de la tecnología actual y a la calidad del material InN, todavía no apto para dispositivos, la tesis se enfoca a la aplicación de heteroestructuras de InAl(Ga)N/GaN. Gracias a las ventajas de una barrera muy fina, comparada con la tecnología de AlGaN/GaN, el uso de esta estructura es adecuado para aplicaciones que requieren una elevada sensibilidad, estando el canal 2DEG más cerca de la superficie. De hecho, la sensibilidad obtenida en sensores de pH es comparable al estado del arte en términos de variaciones de potencial superficial, y, debido al poco espesor de la barrera, la variación de la corriente con el pH puede ser medida sin necesidad de un electrodo de referencia externo. Además, estructuras fotoconductivas basadas en un gas bidimensional presentan alta ganancia debida al elevado campo eléctrico en la intercara, que induce una elevada fuerza de separación entre hueco y electrón generados por absorción de luz. El uso de metalizaciones de tipo Schottky (fotodiodos Schottky y metal-semiconductormetal) reduce la corriente de oscuridad, en comparación con los fotoconductores. Además, la barrera delgada aumenta la eficiencia de extracción de los portadores. En consecuencia, se obtiene ganancia en todos los dispositivos analizados basados en heteroestructuras de InAl(Ga)N/GaN. Aunque presentando fotoconductividad persistente (PPC), los dispositivos resultan más rápidos con respeto a los valores que se dan en la literatura acerca de PPC en sistemas fotoconductivos. ABSTRACT The main objective of the present work is to study and exploit the two-dimensionalelectron- gas (2DEG) structures based on In-related nitride compounds. Many open questions are analyzed. In particular, technology and material-related topics are the focus of interest regarding both InNmaterial and InAl(Ga)N/GaNheterostructures (HSs) as well as their application to advanced devices. After the analysis of the dependence of InN properties on processing treatments (plasma-based and thermal), the problemof electrical blocking behaviour is taken into consideration. In particular its difficulty is due to the presence of a surface electron accumulation (SEA) in the form of a 2DEG, due to Fermi level pinning. The use of electrochemical methods, compared to standard microelectronic techniques, helped in the successful realization of this task. In particular, reversible modulation of SEA is accomplished. In heterostructures such as InAl(Ga)N/GaN, the 2DEGis present at the interface between GaN and InAl(Ga)N even without an external bias (normally-on structures). The technology related to the fabrication of normally off (E-mode) high-electron-mobility transistors (HEMTs) is investigated in heterostructures. An alkali-based wet-etching method is analysed, standing out the structural modifications the barrier underwent. The need of a precise control of the etched material is crucial, in this sense, to obtain a recessed structure for HEMT application with the lowest defect density and inhomogeneity. The dependence of the etch rate on the as-grown properties is observed and commented. Fundamental investigation related to InNis presented, related to the physics of this degeneratematerial. With the help of electrolyte gating (EG), the shift in Raman peaks is correlated to a variation in surface eletron density. As far as the application to device is concerned, due to the actual state of the technology and material quality of InN, not suitable for working devices yet, the focus is directed to the applications of InAl(Ga)N/GaN HSs. Due to the advantages of a very thin barrier layer, compared to standard AlGaN/GaN technology, the use of this structure is suitable for high sensitivity applications being the 2DEG channel closer to the surface. In fact, pH sensitivity obtained is comparable to the state-of-the-art in terms of surface potential variations, and, due to the ultrathin barrier, the current variation with pH can be recorded with no need of the external reference electrode. Moreover, 2DEG photoconductive structures present a high photoconductive gain duemostly to the high electric field at the interface,and hence a high separation strength of photogenerated electron and hole. The use of Schottky metallizations (Schottky photodiode and metal-semiconductor-metal) reduce the dark current, compared to photoconduction, and the thin barrier helps to increase the extraction efficiency. Gain is obtained in all the device structures investigated. The devices, even if they present persistent photoconductivity (PPC), resulted faster than the standard PPC related decay values.

Controlled growth of carbon nanotubes for high performance nanoelectronics

Unique electrical and mechanical properties of single-walled carbon nanotubes (SWNTs) have made them one of the most promising candidates for next-generation nanoelectronics. Efficient utilization of the exceptional properties of SWNTs requires controlling their growth direction (e.g., vertical, horizontal) and morphologies (e.g., straight, junction, coiled). ^ In this dissertation, the catalytic effect on the branching of SWNTs, Y-shaped SWNTs (Y-SWNTs), was investigated. The formation of Y-shaped branches was found to be dependent on the composition of the catalysts. Easier carbide formers have a strong tendency to attach to the sidewall of SWNTs and thus enhance the degree of branching. Y-SWNTs based field-effect transistors (FETs) were fabricated and modulated by the metallic branch of the Y-SWNTs, exhibiting ambipolar characteristics at room temperature. A subthreshold swing of 700 mV/decade and an on/off ratio of 105 with a low off-state current of 10-13 A were obtained. The transport phenomena associated with Y- and cross-junction configurations reveals that the conduction mechanism in the SWNT junctions is governed by thermionic emission at T > 100 K and by tunneling at T < 100 K. ^ Furthermore, horizontally aligned SWNTs were synthesized by the controlled modification of external fields and forces. High performance carbon nanotube FETs and logic circuit were demonstrated utilizing the aligned SWNTs. It is found that the hysteresis in CNTFETs can be eliminated by removing absorbed water molecules on the CNT/SiO2 interface by vacuum annealing, hydrophobic surface treatment, and surface passivation. SWNT “serpentines” were synthesized by utilization of the interaction between drag force from gas flow and Van der Waals force with substrates. The curvature of bent SWNTs could be tailored by adjusting the gas flow rate, and changing the gas flow direction with respect to the step-edges on a single-crystal quartz substrate. Resistivity of bent SWNTs was observed to increase with curvature, which can be attributed to local deformations and possible chirality shift at curved part. ^ Our results show the successful synthesis of SWNTs having controllable morphologies and directionality. The capability of tailoring the electrical properties of SWNTs makes it possible to build an all-nanotube device by integrating SWNTs, having different functionalities, into complex circuits. ^

Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure.

OBJECTIVE To use a unique multicomponent administrative data set assembled at a large academic teaching hospital to examine the risk of percutaneous blood and body fluid (BBF) exposures occurring in operating rooms. DESIGN A 10-year retrospective cohort design. SETTING A single large academic teaching hospital. PARTICIPANTS All surgical procedures (n=333,073) performed in 2001-2010 as well as 2,113 reported BBF exposures were analyzed. METHODS Crude exposure rates were calculated; Poisson regression was used to analyze risk factors and account for procedure duration. BBF exposures involving suture needles were examined separately from those involving other device types to examine possible differences in risk factors. RESULTS The overall rate of reported BBF exposures was 6.3 per 1,000 surgical procedures (2.9 per 1,000 surgical hours). BBF exposure rates increased with estimated patient blood loss (17.7 exposures per 1,000 procedures with 501-1,000 cc blood loss and 26.4 exposures per 1,000 procedures with >1,000 cc blood loss), number of personnel working in the surgical field during the procedure (34.4 exposures per 1,000 procedures having ≥15 personnel ever in the field), and procedure duration (14.3 exposures per 1,000 procedures lasting 4 to <6 hours, 27.1 exposures per 1,000 procedures lasting ≥6 hours). Regression results showed associations were generally stronger for suture needle-related exposures. CONCLUSIONS Results largely support other studies found in the literature. However, additional research should investigate differences in risk factors for BBF exposures associated with suture needles and those associated with all other device types. Infect. Control Hosp. Epidemiol. 2015;37(1):80-87.

Novel biosensing device for point-of-care applications with plastic antibodies grown on Au-Screen Printed Electrodes

A gold screen printed electrode (Au-SPE) was modified by merging Molecular Imprinting and Self-Assembly Monolayer techniques for fast screening cardiac biomarkers in point-of-care (POC). For this purpose, Myoglobin (Myo) was selected as target analyte and its plastic antibody imprinted over a glutaraldehyde (Glu)/cysteamine (Cys) layer on the gold-surface. The imprinting effect was produced by growing a reticulated polymer of acrylamide (AAM) and N,N′-methylenebisacrylamide (NNMBA) around the Myo template, covalently attached to the biosensing surface. Electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV) studies were carried out in all chemical modification steps to confirm the surface changes in the Au-SPE. The analytical features of the resulting biosensor were studied by different electrochemical techniques, including EIS, square wave voltammetry (SWV) and potentiometry. The limits of detection ranged from 0.13 to 8 μg/mL. Only potentiometry assays showed limits of detection including the cut-off Myo levels. Quantitative information was also produced for Myo concentrations ≥0.2 μg/mL. The linear response of the biosensing device showed an anionic slope of ~70 mV per decade molar concentration up to 0.3 μg/mL. The interference of coexisting species was tested and good selectivity was observed. The biosensor was successfully applied to biological fluids.

A simple device for multiplex ELISA made from melt-extruded plastic microcapillary film

We present a simple device for multiplex quantitative enzyme-linked immunosorbant assays (ELISA) made from a novel melt-extruded microcapillary film (MCF) containing a parallel array of 200µm capillaries along its length. To make ELISA devices different protein antigens or antibodies were immobilised inside individual microcapillaries within long reels of MCF extruded from fluorinated ethylene propylene (FEP). Short pieces of coated film were cut and interfaced with a pipette, allowing sequential uptake of samples and detection solutions into all capillaries from a reagent well. As well as being simple to produce, these FEP MCF devices have excellent light transmittance allowing direct optical interrogation of the capillaries for simple signal quantification. Proof of concept experiments demonstrate both quantitative and multiplex assays in FEP MCF devices using a standard direct ELISA procedure and read using a flatbed scanner. This new multiplex immunoassay platform should find applications ranging from lab detection to point-of-care and field diagnostics.