Summary
Despite the availability of efficient drugs to prevent osteoporotic fractures, only a minority of women receives osteoporosis therapy after a fracture. The high treatment gap in our cohort ...consisted of unselected volunteer patients highlights the urgent need of additional education, especially for the medical profession, regarding the risk-benefit balance of treatment.
Introduction
Despite the availability of efficient drugs to prevent osteoporotic fractures, only a minority of women receives osteoporosis therapy after a fracture, with a treatment gap around 80%. This can have dramatic consequences for patients and the healthcare systems.
Methods
In this study based on longitudinal data from the FRISBEE (Fracture RIsk Brussels Epidemiological Enquiry) cohort of 3560 volunteer women aged 60 to 85 years, we evaluated the 1-year treatment gap after a first major incident fragility fracture.
Results
There were 386 first validated fragility fractures, 285 major osteoporotic fractures (MOF) and 101 “other major” fractures. The rate of untreated patients was 85.0% (82.8% for MOF versus 91.0 % for “other major” fracture sites) (
p
= 0.04), with a lower rate for spine (70.5%) and hip (72.5%) versus shoulder (91.6%) and wrist (94.1%) (
p
< 0.0001). More specifically, the treatment gap for patients with osteoporosis, defined by a
T
-score < − 2.5 SD was 74.6% versus 76.5% for patients with osteoporosis defined by the presence of hip, shoulder, or spine fractures, independently of DXA results. When considering age groups, the rate of untreated women was 87.9% for women 60–70 years old, 88.2% between 70 and 80 years and 77.8% above 80 years (
p
= 0.03), with a greater difference between women who were younger or older than 80 years at inclusion: 88.1% versus 77.8% (
p
= 0.009). A diagnosis of osteoporosis (
p
= 0.01) and age (
p
= 0.03) were the only clinical risk factors (CRFs) significantly associated with treatment initiation.
Conclusions
This study highlights the urgent need of additional education, especially for the medical profession, regarding the risk-benefit balance of treatment.
This paper reports on the effects of oxidation-induced stress on the generation current in pn-junction and gated diodes. It is observed that even in the regime where no extended defects are present, ...the generation current is a strong function of the compressive stress in the substrate. Experimental results are presented revealing an order of magnitude increase in generation current for stress changes of a few 100 MPa's. A stress-induced bandgap narrowing model that describes the relationship between the oxidation-induced stress and the generation current in MOS devices is proposed and experimentally verified. Using this model, we have calculated the stress-induced generation current in scaled shallow trench isolated (STI) devices due to reoxidation after STI formation. As the device pitch is reduced a large increase in stress and leakage current is observed, consistent with the experimental data.
This paper investigates the effect of the so-called twin-MOST structure on the kink-related low-frequency (LF) noise overshoot, which is observed in partially depleted (PD) SOI nMOST's. It is ...demonstrated that a significant reduction of the noise overshoot amplitude may be achieved in such a configuration, compared with a single transistor having the same effective gate length. The observed reduction is stronger than the one predicted on purely geometrical grounds, indicating that the floating body effects are indeed successfully reduced by this structure.< >
The influence of the cooling rate after field oxidation on n/sup +/-p junction diodes and residual process-induced stress is characterized. Depending on the cooling rate after field oxidation, the ...room temperature stress can be significantly higher than the stress induced during oxidation. In regions that are already highly strained, this additional stress may lead to an increase in reverse diode leakage current. Stress relaxation simulations are used to explain the cooling rate dependence of the observed leakage current.
A quasi-three-dimensional simulation of local oxidation is presented. The approach employs the solution of three-dimensional oxidant diffusion, a set of analytical solutions which can predict ...two-dimensional local oxidation of silicon (LOCOS) shape and parameterization to consider the three-dimensional oxidation enhancement effects. A synthesis step is used to combine the three-dimensional oxidant profile and two-dimensional analytical solutions for the creation of full three-dimensional LOCOS shapes. Oxidation characteristics are investigated based on atomic force microscopy (AFM) measurements that produce three-dimensional structural effects such as the bird's eye phenomena. The narrow window and narrow mask effects on the bird's beak length are simulated and compared with SEM photographs obtained using AFM measurements. Differences between two- and three-dimensional oxidation effects are shown by the comparison of simulation and experiments.< >
With the continuing reduction of device dimensions, the impact of the isolation process on device performance becomes increasingly important. A major concern when scaling LOCOS and shallow trench ...isolation structures (STI) is the build-up of localized stress near the isolation edge, often leading to dislocation formation and altering device characteristics. In this paper, we show for the first time that even when no dislocations are formed, a reduction in isolation pitch can severely degrade the device characteristics, due to the presence of high localized stresses. A stress-induced bandgap narrowing model is proposed and succesfully applied to explain the observed behavior.
The hardening of a standard 1-/spl mu/m double layer metal CMOS SOI technology to a space environment is discussed. It is shown that a 50 krad(Si) hardened technology with VLSI performance can be ...obtained by changing a few steps in the basic process flow. Optimal results are obtained for a 850/spl deg/C gate oxidation, combined with MESA-LOCOS isolation. Results of the radiation tests, using a /sup 60/Co source, indicate changes in the threshold voltage of about 100 mV for a total dose of 100 krad(Si) and hole trapping factors in the range of 0.10-0.15. The increase in the low-frequency noise observed after irradiation is mainly related to the edge region of the MOS transistors.< >
This paper describes a second generation 1.2 V high performance 0.13 /spl mu/m SOI technology. Aggressive ground rules and a tungsten damascene local interconnect render the densest 6T 0.13 /spl mu/m ...SRAM reported to date with a cell area of 1.80 /spl mu/m/sup 2/. 248 nm lithography is used for all critical levels. Interconnect performance requirements are achieved by using up to 8 levels of Cu wiring and an advanced BEOL process with low-k interlevel dielectrics and SiC barrier layers.
This paper describes a 1.2V high performance 0.13 /spl mu/m generation SOI technology. Aggressive ground-rules and a tungsten damascene local interconnect render the densest 6T SRAM reported to date ...with a cell area of 2.16 /spl mu/m/sup 2/. This is accomplished with 248nm lithography, using optical proximity correction and resolution enhancement techniques on all critical levels. Interconnect performance requirements are achieved by using up to 8 levels of Cu wiring and an advanced low-k interlevel dielectric.
