bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Voltage Stacked Diode Package
Authors: Boteler Lauren , Rodriguez Alexandra , Hinojosa Miguel , Urciuoli Damian
Published: November 2015

The Army is moving to a more electric force with a number of high-voltage applications. To support this transition, there have been efforts to develop high voltage (15–30 kV) single-die 4H-silicon carbide (SiC) bipolar switches and diodes. However, packaging these high-voltage devices has proven to be challenging since standard packaging methods cannot withstand the high voltages in a compact form. Therefore, this work aims to develop a compact prototype package with improved size, weight, and power density by stacking diodes. The stacked diode approach allows elimination of almost half of the wirebonds, reduces the board size by 45%, and reduces the package inductance. A module has been designed, fabricated, and tested which is the first 30 kV module reported in the literature to stack two high-voltage diodes in a series configuration. The package has a number of features specific to high-voltage packaging including (1) two fins that extend the perimeter of the package to mitigate shorting, and (2) all the leads were designed with rounded corners to minimize voltage crowding. Hi-pot tests were performed on the unpopulated package and showed the package can withstand 30 kV without breaking down. The completed package with the stacked diodes showed avalanche breakdown occurring at 29 kV. The complete package was then compared to an equivalent discrete diode module and showed a 10X reduction in size. During a clamped-inductive load test the stacked diodes showed lower parasitic capacitance, faster reverse recovery time, and lower turn on energy as compared to the discrete diode packages.
FOWLP Technology eWLB – Enabler for Packaging of IoT/IoE Modules
Authors: Kroehnert Steffen , Campos José , Cardoso André , O'Toole Eoin , Janeiro Abel , Vieira Nuno
Published: November 2015

The next big wave, the Internet of Things or Internet of Everything (IoT/IoE) is on the way. What does that mean for semiconductor packaging, assembly and test? What are the requirements? What solutions can be provided? The market will be wide and fragmented. Many different solutions will be needed. Flexibility and the capability to customize system solutions will be crucial. The fact is, it will be all about smart system integration, integration of sensors, MEMS, connectivity and memory: more functionality on less space in small and thin System-in-Package (SiP) and Package-on-Package (PoP). There will not be one specific packaging technology for IoT/IoE, and no new “IoT/IoE Packaging Technology”. The toolbox is here already, and further features required to meet the needs of future IoT/IoE modules are under development. That is actually good news, as the cost pressure will be high, and materialization of existing manufacturing environment, of mature and yielding packaging technologies will be a key for success.
Ceramic decals – predesigned thick-film sensors for variable surfaces
Authors: Seuthe Thomas , Eberstein Markus , Petersen Rolf , Amann Hans-Jürgen
Published: November 2015

Manufacturing of ceramic multilayer applications by deposition techniques like screen printing, dispensing, or aerosol jet printing is state of the art today. However, in an industrial environment it is a complex challenge to integrate all equipment for precise paste handling and screen print of the microstructures in an existing production line. Moreover, big sized devices or items with a curved surface cannot be handled with standard screen print equipment. To overcome these limitations, a decal technology was investigated. The functional layers are stacked on non-adhesive paper by screen print, fulfilling all demands on precision in line/space ratio and layer thickness. Afterwards, a polymer varnish is printed on top of the stack, which allows to transfer the high precision thick film assembly to nearly any application surface including non-planar surfaces. Since the layers are co-fired, the sintering behavior of the materials has to be regulated. The top layer needs to remain porous until the organic burn-out and the sintering of the bottom layer is complete. Ways to obtain thick film metallization and isolation pastes which have satisfying firing behavior are examined, and the excellent functional properties are discussed. The performance of the developed thick film decals is demonstrated on the example of an alarm sensor on tempered safety glass for windows.
Shrinkage controlled pastes for bulky silver and copper thick films in power electronics
Authors: Schmidt Richard , Reinhardt Kathrin , Seuthe Thomas , Schwab Olga , Feller Claudia , Eberstein Markus
Published: November 2015

Harvesting green energy and sustainable, effective use of it is based on efficient, cost-effective power electronics. To build robust, multi-functional and highly integrated electronic modules, metallizations with low resistances and the capability to carry high current loads for inner and top layer thick-films are needed. Additionally, these layers have to be interconnectable by metallized vias, soldering and bonding.

A major challenge in realization of bulky silver and copper thick-films is to allow sufficient evaporation of the gaseous products during the interface reaction. Various ways to attain evaporation possibilities via controlled shrinkage retardation of the thick metal film are examined.

The influence of composition of the used solids, their grain size distributions and the use of miscellenaous organic vehicles were examined in several research projects by variation of glass amount, particle size, shrinkage measurements as well as microstructure and film properties.

Through partial retardation, a thick printing copper paste for 300 μm and a pure silver paste for 100 μm metallizations could be realized. By use of suited additives, the film shrinkage could be almost completely constrained which allowed the development of non-shrinking via-fill pastes.
Corrosion reliability of copper wirebond (CuWB) packages-Impact of voltage and corrosive ions from packaging materials
Authors: Mathew Varughese , Chopin Sheila
Published: November 2015

Reliability of electronic devices used in extreme and harsh conditions such as in automotive applications is often associated with prevention of corrosion at the interfaces of dissimilar interconnect metals and of metal (Al or Cu) bonding pads. Packaging materials, especially molding compounds, contain several ionic components and can uptake certain level of moisture to provide electrolytic conditions to initiate corrosion processes. Probability of occurrence of corrosion in devices with high voltage applications is of special interest as many analog devices operates at higher voltages and with new CuWB packages there is a higher susceptibility of corrosive failures. This paper examines the impact of voltage on the mold compound compatibility with CuWB packages up to 65 V. Bias HAST reliability evaluation of various mold compounds at different voltages will be described. Corrosion of bonding pad (Al) and at the Al-Cu intermetallic compound interface was observed in the presence of certain ions present in mold compounds. Even though current mold compounds are “green”, the allowable amounts of halide ions can far exceed the ppm limit to prevent CuWB corrosive failures. Bromide ions are known to be very corrosive to metals. Br ions are still present in some mold compounds. The impact of the Br ion on CuWB reliability will be described. Additive impact of Br ions in presence of Cl will be examined. Another corrosive component present in many mold compounds, sulfur compounds, also can be corrosive under certain reliability stress conditions. Difference in corrosion behavior of Cu and Pd –Cu wirebonded packages due to sulfur compounds will be presented. Corrosive impact of high levels of Cl on the Al pad corrosion leading thick aluminum oxide growth and reliability failures will be discussed.
A Gallium Nitride-Based Power Module for Totem-Pole Bridgeless Power Factor Correction Rectifier
Authors: Zhang Wenli , Liu Zhengyang , Lee Fred , She Shuojie , Huang Xiucheng , Li Qiang
Published: November 2015

The totem-pole bridgeless power factor correction (PFC) rectifier has recently gained popularity for ac-dc power conversion. The emerging gallium nitride (GaN) high-electron-mobility transistor (HEMT), having a small body diode reverse recovery effect and low switching loss, is a promising device for use in the totem-pole approach. The design, fabrication, and thermal analysis of a GaN-based full-bridge multi-chip module (MCM) for totem-pole bridgeless PFC rectifier are introduced in this work. Four cascode GaN devices using the same pair of high-voltage GaN HEMT and low-voltage silicon (Si) power metal-oxide-semiconductor field-effect transistor (MOSFET) chips, as used in the discrete TO-220 package, were integrated onto one aluminum nitride direct-bonded-copper (AlN-DBC) substrate in a newly designed MCM. This integrated power module achieves the same function as four discrete devices mounted on the circuit board. In this module design, the Si and GaN bare die were arranged in a stack-die format for each cascode device to eliminate the critical common source inductance, and thus to reduce parasitic ringing at turn-off transients. In addition, an extra capacitor was added in parallel with the drain-source terminals of the Si MOSFET in each cascode GaN device to compensate for the mismatched junction capacitance between the Si MOSFET and GaN HEMT, which could accomplish the internal zero-voltage switching of the GaN device and reduce its turn-on loss. The AlN-DBC substrate and the flip-chip format were also applied in the module design. This GaN-based MCM shows an improved heat dissipation capability based on the thermal analysis and comparison with the discrete GaN device. The totem-pole bridgeless PFC rectifier built using this integrated power module is expected to have a peak efficiency of higher than 99% with a projected power density greater than 400 W/in3.
Print Copper on Ceramic for High Reliability Electronics
Authors: Persons Ryan , Gundel Paul
Published: November 2015

In the power electronics world, Direct Bonded Copper (DBC) is the primary substrate technology. In this paper, we will discuss an alternative technology utilizing screen printable copper pastes (Thick Printed Copper - TPC) on a variety of substrate technologies including Alumina (Al2O3) and Aluminum Nitride (AlN). These materials when processed, look and perform similar to DBC, but exhibit superior reliability and excellent design flexibility. DBC has drawbacks when it comes to thermal mechanical reliability and lacks the flexibility to have multiple copper thicknesses for power and signal circuits within the same design, which is easily achieved via screen printing. The benefits of this TPC system will be demonstrated through data generated on passive thermal shock tests in comparison to high end DBC. Furthermore, this Thick Print Copper technology has the excellent potential for replacing high end Metal Core Printed Circuit Board (MCPCB) technology due to utilization of higher thermal conductive dielectric materials like Al2O3 and AlN. This will allow for designers to drive their LED's harder and effectively producing LED modules with higher power densities.
A Robust, Composite Packaging Approach for a High Voltage 6.5kV IGBT and Series Diode
Authors: Morgan Adam , De Ankan , Ke Haotao , Zhao Xin , Vechalapu Kasunaidu , Hopkins Douglas C. , Bhattacharya Subhashish
Published: November 2015

The main motivation of this work is to design, fabricate, test, and compare an alternative, robust packaging approach for a power semiconductor current switch. Packaging a high voltage power semiconductor current switch into a single power module, compared to using separate power modules, offers cost, performance, and reliability advantages. With the advent of Wide-Bandgap (WBG) semiconductors, such as Silicon-Carbide, singular power electronic devices, where a device is denoted as a single transistor or rectifier unit on a chip, can now operate beyond 10kV–15kV levels and switch at frequencies within the kHz range. The improved voltage blocking capability reduces the number of series connected devices within the circuit, but challenges power module designers to create packages capable of managing the electrical, mechanical, and thermal stresses produced during operation. The non-sinusoidal nature of this stress punctuated with extremely fast changes in voltage and current, with respect to time, leads to non-ideal electrical and thermal performance. An optimized power semiconductor series current switch is fabricated using an IGBT (6500V/25A die) and SiC JBS Diode (6000V/10A), packaged into a 3D printed housing, to create a composite series current switch package (CSCSP). The final chosen device configuration was simulated and verified in an ANSYS software package. Also, the thermal behavior of such a composite package was simulated and verified using COMSOL. The simulated results were then compared with empirically obtained data, in order to ensure that the thermal ratings of the power devices were not exceeded; directly affecting the maximum attainable frequency of operation for the CSCSP. Both power semiconductor series current switch designs are tested and characterized under hard switching conditions. Special attention is given to ensure the voltage stress across the devices is significantly reduced.
Wedge Bond Process Optimization Method for 1.5 mil Al Wire on Al Bond Pad
Authors: Qi Wenjuan , Evans Daniel D.
Published: November 2015

Modern wedge bonders have evolved since their early inception in 1957. This paper will review the common challenges process engineers face when selecting a wedge bond machine configuration and developing robust processes. Wedge bond cases presented will show the tradeoff between process inputs and the resulting bond shapes, bond appearance of black ring, burrs, pull results, etc.

The purpose of this work was to optimize the process outputs: bond shape, black ring, burrs, and pulls on a die with aluminum bond pads. Process inputs included Force, Time, and Ultrasonic Level. An aluminum wafer was used to understand the basic relationship between process parameter inputs and outputs. The learning was then applied to a die with aluminum bond pads. Examples of non-compliance and compliance will be shown to help process engineers evaluate wedge bonds and make refinements.

The case studied was for an aluminum bond pad/Al wafer and 1.5 mil aluminum wire interaction that creates burrs around the bond (wire to pad interface), black ring on the bond periphery (wedge tool to wire interface) and the resulting pulls. Both the graphical and numerical results of the case study have clearly demonstrated the relationship between the typical process inputs and outputs, particularly bond shape, burrs, black ring and pulls. The findings in this study will provide a general guideline and a troubleshooting reference for wedge bonding process development.
High Reliability No-Clean Solder Paste for Designs where Flux Cannot be Dried
Authors: Chen Fen , Lee Ning-Cheng
Published: November 2015

The miniaturization trend is driving industry to adopting low standoff components or components in cavity. The cost reduction pressure is pushing telecommunication industry to combine assembly of components and electromagnetic shield in one single reflow process. As a result, the flux outgassing/drying is getting very difficult for devices due to poor venting channel. This resulted in insufficiently dried/burnt-off flux residue. For a properly formulated flux, the remaining flux activity posed no issue in a dried flux residue for no-clean process. However, when venting channel is blocked, not only solvents remain, but also activators could not be burnt off. The presence of solvents allows mobility of active ingredients and the associated corrosion, thus poses a major threat to the reliability. In this work, a new halogen-free no-clean SnAgCu solder paste, 33-76-1, has been developed. This solder paste exhibited SIR value above the IPC spec 100 MΩ without any dendrite formation, even with a wet flux residue on the comb pattern. The wet flux residue was caused by covering the comb pattern with 10 mm × 10 mm glass slide during reflow and SIR testing in order to mimic the poorly vented low standoff components. Paste 33-76-1 also showed very good SMT assembly performance, including voiding of QFN and HIP resistance. The wetting ability of paste 33-76-1 was very good under nitrogen. For air reflow, 33-76-1 still matched paste C which is widely accepted by industry for air reflow process. The above good performance on both non-corrosion with wet flux residue and robust SMT process can only be accomplished through a breakthrough in flux technology.
Improvement of High Power Cycling Reliability having Sn-Cu Based Solder
Authors: Takaaki Miyazaki , Osamu Ikeda
Published: November 2015

Demands of the raising operation temperature of power modules have been increasing in recent years. However, the power cycle capability is insufficient when used in a high temperature environment to apply the conventional Sn-based solder. In this study, we have developed a highly reliable bonding technology that improves the characteristics of the Sn phase by adding additional elements Bi, In, Sb to the Sn-7Cu solder. Power cycling test(Tjmax175°C) was carried out to evaluate the reliability. Power cycling reliability of Sn7Cu3Bi, Sn7Cu10Sb is approximately 3 times, 6 times higher than Sn7Cu.
Microstructure of Transient Liquid Phase Sintering Joint by Sn-Coated Cu Particles for High Temperature Packaging
Authors: Liu Xiangdong , Nishikawa Hiroshi
Published: November 2015

We develop a transient liquid phase sinter (TLPS) bonding using Sn-coated Cu micro-sized particles. With this bonding process, a thermally stable joint comprising Cu3Sn phase and a dispersion of ductile Cu particles can be obtained. The particle paste, which contained Cu particles with a thin Sn coating and terpineol, was used to join Cu substrates. The setup was bonded at 300 °C for 30s under an applied pressure of 10 MPa using a thermo-compression bonding system under a formic acid gas atmosphere for reducing the oxide layer on the Sn coating and the Cu substrate. After bonding, the TLPS joint showed a thermally stable microstructure with a good shear strength, which was fully consisted of Cu3Sn intermetallic compounds matrix and embedded ductile Cu particles. The kinetics of the microstructure transformation and high temperature reliability of the TLPS joint were investigated. After 300 °C isothermal aging for 200h, the shear strength and microstructure of the TLPS joints showed almost unchanged. The results demonstrate that joint with high-melting-point obtained by the TLPS bonding using Sn-coated Cu particle paste has the potential to fulfill the requirement of high temperature electronic packaging.
RF and Microwave Power Amplifiers assembly – Interaction between materials, design and process on reliability
Authors: Nguty Tennyson , Plata Tyrone , Thoonen Henk
Published: November 2015

The demand for data anywhere and at anytime (mobile internet) is putting increasing pressure on network operators in their deployment of wireless communication infrastructure. This has pushed upwards across the supply chain, from suppliers to customers. At the core of the infrastucture are RF power amplifiers (PA) with very costly design, hence important to get it right first time. Thermo-mechanical compliance are key attributes to consistent product performance and reliability amidst stringent mission profiles.

Most transistor component manufacturers focus on their core competence – component design. Network operators on the other hand focus on the PA design. In most cases, the assembly of the PA module is an after-thought and a key enabler. These transistors are usually high power devices (> 100 watts), hence demanding excellent thermal management. The packages used have a metal flange in addition to RF/DC leads which are soldered in the PA module. These act as a heat spreader and electrical interconnect which affects the product performance. Since these interconnects are in different planes, assembly requires heatsinks with cavities (flange soldering).

The main challenge being tackled in this study is the response of the materials being soldered in a different plane – leads to board and flange to heatsink interface. This is why proper soldering of the transitors (flange & leads) is an essential part in PA assembly due to the impact on module performance & reliability. To achieve the desired thermal and reliability requirements, a variety of factors are critical including the cavity design, solder and reflow soldering process. In this paper, these factors are evaluated via both thermo-mechanical simulations and experimental work. Since there are lots of materials with different properties involved in the assembly, it is vital to evaluate its behavior prior to the actual process evaluation as it has impact on cost and timing effectiveness of the study. These simulations are used as initial indication for trends which are later validated by experimental evaluations. The thermal impedance (Rth) in combination to acoustic microscopy / x-rays is used to assess the soldered flange during assembly & reliability.
Thermal Management Solutions for enhanced Digital Flight Data Acquisition Unit in Avionics Applications
Authors: Grosu Vicentiu , Lindgren Chris , Vejsz Tamas
Published: November 2015

According to the Federal Aviation Administration, the commercial airline industry should expect to see the number of passengers traveling per year to grow from its current level of 750 million to nearly 1 billion by 2030. To meet this demand, airlines are placing orders for thousands of new aircraft over the next decade and beyond. With this increase in airline traffic, newer aircraft systems will generate an ever increasing amount of data per flight, data that allows airlines to further enhance their flight operations, flight safety, and reliability. For commercial avionics, the migration of the data acquisition and reporting functions from the traditional interface environments to newer, faster, and more network-centric architectures is creating a new generation of “smart” aircraft. Teledyne Controls' enhanced Digital Flight Data Acquisition Unit is an integral part of a new generation of aircraft and combines the functions of Mandatory Data Acquisition and Recording with a sophisticated Aircraft Conditioning Monitoring System that the aircraft operator uses to monitor the performance and reliability of each aircraft in its fleet. Some of the critical goals in the development of the Digital Flight Data Acquisition Unit are reducing the size and weight over previous generations, while maximizing performance and reducing cost. All of these opposing requirements make the design and fabrication very challenging. One such challenge includes dissipating high power in a confined space, and this makes thermal management a critical component of the overall LRU (line-replaceable unit) design. In addition, to increase the reliability over the lifespan of the unit, passive cooling systems are often required in place of internal fans. This presents another set of challenges, such as optimizing the airflow provided by the aircraft in the electronics bay compartment. This paper will present some of the critical elements in thermal management such as heat sinks, components placement, thermal interface materials, thermal vias, thermal links, packaging approaches and cooling strategy. The design and optimization of the system are based on analytical solutions, conjugated heat transfer and experimental results. The LRU should safely operate under various environmental conditions: ground operation, flight operation, high operating temperature and loss of cooling air where each environmental condition has different parameters for coolant airflow rate, effect of the surroundings, and ambient and coolant air temperature. Draw-Through and Blow-Through cooling analysis were performed using CFD (Computational Fluid Dynamics). The thermal analysis problems solved are conjugated heat transfer for laminar flow with radiation in steady-state or transient regimes. Multiple approaches were identified to remove heat from the critical components through optimization of the components and subsystems. These same approaches can also be used to increase the system's performance and reliability.
Evaluating short term efficacy of educative support in a cardiovascular rehabilitation using the MICRO-Q test: a single centre experience
Authors: Rinero Katia , Testa Marzia , Vallauri Paola , Garnero Sonia , Feola Mauro
Published: November 2015

Object of this study was to evaluate the efficacy of multiprofessional meetings in order to improve patients’ knowledge about cardiovascular diseases, risk factors and correct lifestyle in a Cardiovascular Rehabilitation Department. Methods: from November 2011 to June 2012 two MICRO-Q questionnaires were given to the Fossano Cardiovascular Rehabilitation’s patients before and after the educational meetings to test their improvement after having followed educational meetings. Results: 73 patients have answered the questionnaires (57 males, mean age 68,5 ±11.73ys). From these data emerged a significant improvement of knowledge about cardiovascular risk factors (75,34% vs 91,78%; p=0,01), smoke (79,45% vs 93,15%; p=0,03), stress (76,71% vs 91,78; p=0,023), diet (84,93% vs 97,26%; p=0,02), physical activity (63,01% vs 84,93%; p=0,005) and right things to do in case of chest pain (34,25% vs 52,05%; p=0,04). Conclusions: educational meetings had an important role in improve patients’ knowledge about cardiovascular risk factors, correct lifestyle and diet. Moreover MICRO-Q questionnaires demonstrated to be useful tools in order to improve the educational meetings according to the real needs of our patients.
Ten year cardio-cerebro-vascular mortality and morbidity in a Southern Italy cohort: the VIP Project data
Authors: Capuano Vincenzo , Lamaida Norman , Torre Sergio , Capuano Ernesto , Borrelli Maria Immacolata , Capuano Eduardo , Clarizia Maria Maddalena , Capuano Rocco , De Rosa Carmela
Published: November 2015

Rationale: In Italy the mortality data were obtained almost exclusively from the data RENCAM (Name Causes of Death Register), while there are few prospective surveys. In order to assess whether there are particular epidemiological conditions in the geographical area of Mercato S. Severino, in Southern Italy, we have studied, and reassessed at ten years (1998/99 - 2008/09), a cohort of adult general population in a project of cardiovascular epidemiology and prevention. Materials and Methods: We calculated the rates of mortality and morbidity from cardiovascular events covering the period 1998/99 - 2008/09, in a cohort of 1200 persons (600 men and 600 women) aged 25 to 74 years. Data were standardized using the European standard population. Results: Mortality from cardiovascular causes was 46,5% in men and 48,7% in women; it was mainly concentrated in the age group 65-74 years where it occurred on 62,9% of deaths in men and 66,7% in women. Regarding morbidity, the incidence of events to ten years of non-fatal myocardial infarction was 2,2% in men and of 1,8% in women. PTCA interventions to ten year have been 3,3% in men and 3,4% in women, the interventions of aorto-coronary bypass have been 2,4% and 0,5% for men and women respectively. While all major cardiovascular events have been more frequent in men, in women there was a higher incidence of stroke (1,6% vs 0,9%). Conclusions: Although by comparison with other European countries Italy is among the countries considered at low-risk of coronary heart disease, in Campania cardiovascular diseases reach higher rates than the rest of the country. Our results are in line with the literature data and confirm that cardiovascular diseases are a major public health problem. Local analysis to propose means to provide useful information for planning prevention interventions targeted to their own territory.
Tamoxifen treatment and pulmunary embolism: a case report and literature review
Authors: Zanini Gregoriana , Fontanella Benedetta , Racheli Marco , Bortolotti Monica , Pasini Gianfranco
Published: November 2015

Breast carcinoma is becoming a spread disease that needs a specif teraphy. Tamoxifen is the first line treatment in patients with positivity of expression of estrogen receptors. The risk of thromboembolism is high in patients treated with tamoxifene indipendent from the neoplastic disease. This work focuses the attention on tamoxifen mechanism of thrombosis.
A pilot study on the application of the current European guidelines for the management of acute coronary syndrome without elevation of ST segment (NSTEMI) in the Emergency Department setting in the Italian region Lazio
Authors: Valli Gabriele , De Marco Francesca , Spina Maria Teresa , Valeriano Valentina , Rosa Antonello , Minerva Valentina , Mirante Enrico , Ruggieri Maria Pia , Pugliese Francesco Rocco
Published: November 2015

Background: In 2011 the European Society of Cardiology published the new guidelines for the treatment and management of acute coronary syndrome without elevation of the ST segment (NSTEMI). For the treatment of the syndrome, the use of P2Y12 inhibitors in addition to aspirin was strongly recommended (evidence IA). We studied the application of this recommendation in the setting of the emergency department in the vast and uneven area of the Italian region Lazio, three years after the release of these drugs in Italy. Methods: 121 consecutive patients (65% older than 65 years) affected by NSTEMI were recruited between May and July 2013. During the transition in the emergency department data was collected on patient’s symptoms, syndrome severity and type & timing of treatments chosen. Adherence to the guidelines was evaluated considering the number of “good treated” patients: these being the patients that received at least 80% of the main five recommendations on percutaneous coronary intervention (PCI) timing, antiplatelet and anti-coagulant therapy suggested by the European Cardiology Task Force (ESC guidelines, 2011) for the very acute phase of NSTEMI. Results: Patients were treated with: 1) 35% of cases with double antiplatelet therapy and anticoagulation (DAPT+AC), 2) 22% of cases with single antiplatelet and anticoagulation (SAPT+AC), 3) 6% of cases with a single antiplatelet therapy (SAPT), 4) 6% of cases with a double antiplatelet therapy (DAPT) and 5) 24% of cases did not receive any therapy. Data on PCI was available for 95 patients and, of these, only 82% of the patients underwent the procedure. The percentage of “good treated” patients were among of 20-40%, depending on PCI timing – as guidelines suggested – was considered as mandatory (20,5%) or as the extreme time limit (40%). Significant differences were found between patients treated in a central hospital with a hemodynamic laboratory active 24/24hr (HUB) and patients treated in the other hospital (SPOKE). HUBs showed a higher percent of “good treated” patients, a higher percentage of early invasive treated and a better adherence to recommended pharmacological therapy. Conclusions: A significant number of patients did not receive adequate treatment during the emergency department stay. The absence of hemodynamic services increases the risk of inadequate treatment.
The practice of everyday death: Thanatology and self-fashioning in John Chrysostom’s thirteenth homily on Romans
Authors: De Wet Chris L.
Published: November 2015

The purpose of this article is to investigate the relationship between the discourse of death, or thanatology, and self-fashioning, in John Chrysostom’s thirteenth homily In epistulam ad Romanos. The study argues that thanatology became a very important feature in the care of the self in Chrysostom’s thought. The central aim here is to demonstrate the multi-directional flow of death, as a corporeal discourse, between the realms of theology, ethics, and physiology. Firstly, the article investigates the link between the theological concepts of sin and death. Secondly, the study argues that death also becomes a highly paradoxical discourse when it enters the realm of Chrysostomic virtue-ethics, where the mortification of excessive passion leads to life, while ‘living’ in passion only results in death on every level of existence – death as a discourse therefore becomes interiorised, a process functioning as a subset of a more extensive biologisation of the spiritual life-cycle. Finally, Chrysostom also utilises death in a very physiological way, especially in his comments on the relationship between sin and the passions, and one’s physical health and appearance (which is also related to the soul).
Philo of Alexandria: A model for early Christian ‘spiritual readings’ of the Scriptures
Authors: Decock Paul B.
Published: November 2015

Philo of Alexandria represents a Hellenistic tradition of reading the Scriptures in which reading is seen as a spiritual exercise together with other spiritual exercises, like attention, thorough investigation of the issues, self-mastery, detachment, etcetera (see Her. 253; Leg. 3:18), which has as aim the transformation and growth of the person towards the good and happy life. Interaction with the spiritual wealth of the Greek philosophical traditions was seen as a fruitful asset and challenge. This article highlights some of the key themes of Philo’s philosophical or spiritual reading of the Scriptures: the priority of God and of the health of the soul, the importance of human progress, the recognition of one’s nothingness in order to know God, the necessity to choose, human effort and divine achievement, as well as harmony with God, nature and the self as the aims of the good life. Christian spiritual writers, like Origen, found in Philo’s approach to the Scriptures and in his reflections on the spiritual journey a very inspiring model.
Galectin-3 as a Potential Target to Prevent Cancer Metastasis
Authors: Ahmed Hafiz , Alsadek Dina M. M.
Published: November 2015

Interactions between two cells or between cell and extracellular matrix mediated by protein–carbohydrate interactions play pivotal roles in modulating various biological processes such as growth regulation, immune function, cancer metastasis, and apoptosis. Galectin-3, a member of the β-galactoside-binding lectin family, is involved in fibrosis as well as cancer progression and metastasis, but the detailed mechanisms of its functions remain elusive. This review discusses its structure, carbohydrate-binding properties, and involvement in various aspects of tumorigenesis and some potential carbohydrate ligands that are currently investigated to block galectin-3 activity.
The impact of monthly variation of the Pacific-North America (PNA) teleconnection pattern on wintertime surface-layer aerosol concentrations in the United States
Authors: Feng J. , Liao H. , Li J.
Published: November 2015

Abstract. The Pacific-North America teleconnection (PNA) is the leading general circulation pattern in the troposphere over the region of North Pacific to North America during wintertime. This study examined the impacts of monthly variation of the PNA phase (positive or negative phase) on wintertime surface-layer aerosol concentrations in the US by analyzing observations during 1999–2013 from the Air Quality System of Environmental Protection Agency (EPA-AQS) and the model results for 1986–2006 from the global three-dimensional Goddard Earth Observing System (GEOS) chemical transport model (GEOS-Chem). The composite analyses on the EPA-AQS observations over 1999–2003 showed that the average concentrations of PM2.5, sulfate, nitrate, ammonium, organic carbon, and black carbon aerosols over the US were higher in the PNA positive phases than in the PNA negative phases by 1.4 μg m−3 (12.7 %), 0.1 μg m−3 (6.4 %), 0.3 μg m−3 (39.1 %), 0.2 μg m−3 (22.8 %), 0.8 μg m−3 (21.3 %), and 0.2 μg m−3 (34.1 %), respectively. The simulated geographical patterns of the differences in concentrations of all aerosol species between the PNA positive and negative phases were similar to observations. Based on the GEOS-Chem simulation driven by the assimilated meteorological fields, the PNA-induced variation in planetary boundary layer height was found to be the most dominant meteorological factor that influenced the concentrations of PM2.5, sulfate, ammonium, organic carbon, and black carbon, and the PNA-induced variation in temperature was the most important parameter that influenced nitrate aerosol. Results from this work have important implications for understanding and prediction of air quality in the United States.
Transitivity of the climate–vegetation system in a warm climate
Authors: Port U. , Claussen M.
Published: November 2015

Abstract. To date, the transitivity of the global system has been analysed for late Quaternary (glacial, interglacial, and present-day) climate. Here, we extend this analysis to a warm, almost ice-free climate with a different configuration of continents. We use the Earth system model of the Max Planck Institute for Meteorology to analyse the stability of the climate system under early Eocene and pre-industrial conditions. We initialize the simulations by prescribing either dense forests or bare deserts on all continents. Starting with desert continents, an extended desert remains in central Asia in the early Eocene climate. Starting with dense forest coverage, the Asian desert is much smaller, while coastal deserts develop in the Americas which appear to be larger than in the simulations with initially bare continents. These differences can be attributed to differences in the large-scale tropical circulation. With initially forested continents, a stronger dipole in the 200 hPa velocity potential develops than in the simulation with initially bare continents. This difference prevails when vegetation is allowed to adjust to and interact with climate. Further simulations with initial surface conditions that differ in the region of the Asian desert only indicate that local feedback processes are less important in the development of multiple states. In the interglacial, pre-industrial climate, multiple states develop only in the Sahel region. There, local climate–vegetation interaction seems to dominate.
Living with climate change: avoiding conflict through adaptation in Malawi
Authors: Jørstad H. , Webersik C.
Published: November 2015

Abstract. In recent years, research on climate change and human security has received much attention among policy makers and academia alike. Communities in the Global South that rely on an intact resource base will especially be affected by predicted changes in temperature and precipitation. The objective of this article is to better understand under what conditions local communities can adapt to anticipated impacts of climate change and avoid conflict over the loss of resources. The empirical part of the paper answers the question to what extent local communities in the Chilwa Basin in Malawi have experienced climate change and how they are affected by it. Further, it assesses one of Malawi's adaptation projects designed to build resilience to a warmer and more variable climate, and points to some of its limitations. This research shows that not all adaptation strategies are suited to cope with a warmer and more variable climate.
Can Smartphones Pave the Path towards EFL Competence for Saudi College Students?
Authors: Ahmed Mahgoub Dafalla
Published: November 2015

The study reported here focuses on how modern technology, specifically smartphones can pave the path towards English as a foreign language (EFL) competence. It emphasizes on how smartphones can enhance EFL learning where the focus is mainly on the acquired linguistic knowledge and language skills. It sheds light on language competence in more general terms and learners' vocabulary acquisition, listening, speaking, reading and writing, in particular. The sample for the study was drawn from Saudi college students at the faculty of Science and Arts, Khulais Branch at King Abdulaziz University, Saudi Arabia. After conducting an Entry Level English language Test, 50 students from the preparatory year were selected. Then, they were split into two homogenous groups. The first group (control group) was instructed in the conventional way, while the second group (experimental group) was offered instruction and encouraged to learn through smartphones. Results showed that the participants who received treatment (experimental group) significantly outperformed than the other group. It revealed that employing smartphones yielded a positive result. Additionally, results showed that students in the experimental group who used smartphones were more enthusiastic and driven than their counterparts in the control group who were still stuck in paper-text materials.
Medical stewardship: Pathology evidence based ordering to reduce inappropriate test ordering in a teaching hospital
Authors: Gardiner Fergus William
Published: November 2015

Objective: This study was designed as an educational program aimed at promoting evidence-based pathology ordering with the aim of reducing inappropriate test ordering.Methods: Researchers benchmarked the hospital’s pathology tests ordered in 2013-2014 before conducting a multifaceted education program in 2014-2015. The intervention consisted of main priorities including pathology test auditing, in-services and lectures, development and implementation of investigation pathways, and policy and procedure compliance. The main outcome measures was a reduction in commonly inappropriate ordered pathology testing leading to a reduction in the average test per hospital admission, and a reduction in specimen collection errors.Results: Through this educational method the researchers achieved a reduction in the average test per admission in 2014-2015 (M = 12.98) from 2013-2014 (M = 13.83). A two sample t-test indicated that this difference was significant, t(3.3006) = 0.0071, p = .01. The intervention included a focus on specimen collection errors and achieved a reduction in specimen error rates (M = 2,695) from the previous year (M = 3,000). A one sample t-test indicated that this difference was significant, t(3.0804) = 0.0105, p = .05. This intervention decreased commonly inappropriate pathology requests of Full Blood Count (FBC, -4.21%), Liver Function Tests (LFTs, -8.36%), Vitamin B12 (B12, -6.45%) and Coagulation profile (-21.22%). Commonly inappropriate pathology tests decreased (M = 7,120.33) from (M = 7,609.67). A two sample t-test indicated that this difference was significant, t(3.7730) = 0.0031, p = .005.Conclusions: Results confirmed that a multi-faceted education program can reduce inappropriate pathology test ordering, commonly over-ordered pathology test ordering, and pathology specimen error rates while maintaining positive patientoutcomes.
Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps
Authors: Yim Ji Hong , Yun Jiyoung , Lee Taik Jong , Kim Eun Key , Cho Jonghan , Eom Jin Sup
Published: November 2015

Background Microvascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period.

Methods A retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed.

Results During the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation.

Conclusions The salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring.
A Socio-Legal Exploration of the Linkages between Informal Employment, Social Protection and Labour Law in Latin America
Authors: Thoene Ulf
Published: November 2015

For decades Latin American societies and policy-makers have attempted to confront the social, political and economic challenges brought about by high levels of informal employment and entrepreneurial activity. Social exclusion, low rates of political participation, dysfunctional social protection schemes and mistrust of the law are some of the social phenomena that are inextricably linked to informality. This research article takes a socio-legal approach to explore linkages between informal employment, social protection and labour law proposing that purely economic or legal approaches overlook crucial contextual issues that hinder the formulation of sound regulatory policies. Thus this paper develops an analytical perspective based on the social rights and citizenship discourse questioning current social policies and the role of labour law.
La problemática transición boliviana hacia la época postneoliberal: el caso de la economía comunitaria
Authors: Mun Nam Kwon
Published: November 2015

The government of Evo Morales has defined the contemporary era in Bolivia as the time of post-neoliberalism, a period of transition toward communitarian socialism through economic pluralism and integral economic development. The multiple paths to development among the diverse forms of production, each based on its own logic, mark the way in which it differs from other existing models. However, the evolution of the communitarian economy, which is the pillar of the new model, demonstrates through the results of the agrarian reform and the agricultural revolution that the continuance of neoliberal paradigms has perpetuated the hegemonic capitalist pattern of development. Contemporary Bolivia is thus immersed in a radical anti-neoliberal rhetoric tempered by neoliberal pragmatism.
El impacto de la crisis entre los jóvenes en España
Authors: Valls Fonayet Francesc
Published: November 2015

This article studies the impact of poverty during the process of transition to adult life in Spain within the context of the current crisis. It conceptualises young people by means of social criteria, through a multidimensional analysis of vulnerability and a methodological triangulation that combines quantitative analysis (European Union Statistics on Income and Living Conditions, EU-SILC, 2011) with qualitative analysis, through biographical interviews. It localizes the existence of socially differentiated juvenile social groups within the contemporary social structure of Spain. It also shows how each social position is affected by specific forms of vulnerability. Finally, it evaluates the process of integration of this social position in the subjectivity and practices of Spanish youths in terms of reaction strategies in the face of poverty, degradation of identity, and social isolation: everything from the alternative search (often alegal, illegal and/or stigmatized) for material resources, to subjective mechanisms for relief from or relativization of their living conditions.