Lower Tier Research Articles

(068) VAGINAL ESTROGEN PRESCRIPTION COVERAGE IN THE MID-ATLANTIC: A CROSS-SECTIONAL STUDY

Abstract Introduction Vaginal estrogen is an essential medication for many post-menopausal women. However, cost can be prohibitive for patients and insurance coverage can be difficult to predict. Objective The objective of this study was to describe the insurance coverage of vaginal estrogen formulations in terms of overall coverage score and cost across the Mid-Atlantic for 2024 insurance plans. Methods This is a cross-sectional study examining coverage scores, tiers, and cost of vaginal estrogen formulations (generic estradiol cream and tablets, Premarin, Imvexxy, Femring, Estring, Estrace cream and tablets, Vagifem, Yuvafem) in the mid-Atlantic states (Delaware, District of Columbia, Maryland, New York, New Jersey, Pennsylvania, Virginia, and West Virginia). Census data was used to identify the most populous three districts in each state. All insurance plans for the top ten insurers in each district were then reviewed for the tier and cost of vaginal estrogen formulations. A weighted coverage score ranging from 0.2 to 1.0 was then adopted based on the proportion of tier coverage for each formulation, with lower tiers (and thus better prescription coverage) conferring a greater weight in the calculation of the score. Analyses were performed using STATA. Fisher’s exact test and chi-squared tests were used where appropriate. Medians were used as the distribution of cost was non-parametric. Multivariate regression including formulation, location, and insurer was also performed. Results Three-hundred and forty-two insurance plans were ultimately included in the analysis. The median cost of tier 1 formulations was $0 (IQR $0 to $0) while the median cost of tier 4 formulations was $100 (IQR $36 to $226). Non-formulary medications were much more expensive with a median cost of $413 (IQR $204 to $413). Estradiol tablets overall had the best coverage score of 0.75 compared to Estrace tablets and Vagifem which had coverage scores of 0.2. On initial analysis by high ($150 or greater) or low (<$150) cost formulations, prescriptions from Delaware made up a greater percentage of higher compared to lower cost (14% vs 9%, p<0.001), while formulations from Virginia made up a greater percentage of lower compared higher cost (24% vs 18%, p=0.02). Insurer impacted cost and this persisted on regression analysis when controlling for location and tier, with Aetna (aOR 1.18, p=0.048) and Kaiser (aOR 2.9, p<0.001) remaining predictive for higher cost. Conclusions High costs of vaginal estrogen may be prohibitive to patients using these medications. Living in Delaware or having Aetna or Kaiser insurance may result in higher costs. Disclosure No.

Assessing regional disparities and vulnerability in stroke care across Gyeonggi Province: A focus on hospital service areas

BackgroundThis study aims to illuminate regional disparities and identify vulnerable areas in stroke care across Gyeonggi Province's hospital service areas. MethodsUsing data from the Korea National Cardio-cerebrovascular Disease Management Commission, we included 4,427 acute stroke patients admitted in 2018 to hospitals within Gyeonggi Province. Our evaluation focused on: 1) stroke care quality indicators, including rates of defect-free care, intravenous thrombolysis (IVT), endovascular thrombectomy (EVT), and acute reperfusion therapy (either IVT or EVT); 2) intra-regional treatment rates; and 3) one-year mortality across the province and its 12 hospital service areas. These were compared both with national averages and inter-regionally. Vulnerable areas were pinpointed by evaluating the number of quality indicators falling below the national average and through visual distribution mapping, categorizing each indicator into higher (ranks 1-4), middle (ranks 5-8), and lower (ranks 9-12) tiers. ResultsDespite fewer qualified stroke centers and specialists, Gyeonggi Province exhibited higher defect-free care rates (84.6 % vs. 80.7 %), intra-regional treatment rates (57.8 % vs. 51.0 %), and marginally lower one-year mortality (16.2 % vs. 17.3 %) compared to national averages. Notable regional disparities were observed; the highest-performing areas for defect-free care and acute reperfusion therapy exceeded the lowest by 1.4 and 3.3 times, respectively. Nine out of twelve areas fell below the national average for EVT rates, seven for IVT and reperfusion therapy rates, and five for intra-regional treatment rates. Pyeongtaek, with all stroke care quality indicators below the national average coupled with the highest one-year mortality, emerges as a critical area needing improvement in acute stroke care. ConclusionThis study not only exposes the regional disparities in stroke care within Gyeonggi Province's hospital service areas but also identifies areas most vulnerable. Consequently, a customized support strategy for these areas is imperative.

K-Means clustering of dermatology journals: comparing the distribution of "free-to-publish" and "pay-to-publish" models.

This study investigates the impact of Free-to-Publish (F2P) versus Pay-to-Publish (P2P) models in dermatology journals, focusing on their differences in terms of journal metrics, Article Processing Charges (APCs), and Open Access (OA) status. Utilizing k-means clustering, the research evaluates dermatology journals based on SCImago Journal Rankings (SJR), H-Index, and Impact Factor (IF), and examines the correlation between these metrics, APCs, and OA status (Full or Hybrid). Data from the SCImago Journal Rank and Journal Citation Report databases were used, and metrics from 106 journals were normalized and grouped into three tiers.The study reveals a higher proportion of F2P journals, especially in higher-tier journals, indicating a preference for quality-driven research acceptance. Conversely, a rising proportion of P2P journals in lower tiers suggests potential bias towards the ability to pay. This disparity poses challenges for researchers from less-funded institutions or those early in their careers. The study also finds significant differences in APCs between F2P and P2P journals, with hybrid OA being more common in F2P.Conclusively, the study highlights the disparities in dermatology journals between F2P and P2P models and underscores the need for further research into authorship demographics and institutional affiliations in these journals. It also establishes the effectiveness of k-means clustering as a standardized method for assessing journal quality, which can reduce reliance on potentially biased individual metrics.

Study on Master-Slave Game Optimization Operation of Integrated Energy Microgrid Considering PV Output Uncertainty and Shared Energy Storage

Integrated energy microgrids and shared energy storage have significant benefits in improving the energy utilization of the system, which is gradually becoming the current research hotspot. And the uncertainty of new energy output also significantly affects the stable and economic operation of integrated energy microgrid. So how to establish a set of integrated energy microgrids optimization operation model considering photovoltaic (PV) output uncertainty and shared energy storage is an urgent problem to be solved nowadays. Firstly, this paper introduces the framework of an integrated energy system microgrid containing a shared energy storage operator (ESO), and analyzes the scheduling method of the upper tier operator within the system as well as the economic benefits at the lower tier user end. Secondly, to address the randomness of PV output, Monte Carlo method is used to generate the scenarios, and then the scenarios are cut down by using the fast antecedent elimination technique. Then, an optimal operation model is established for micro grid operator (MGO) and user aggregator (UA), respectively, and based on the master-slave game relationship, so that the MGO is the leader and the UA is the follower, a Stackelberg game model is proposed to consider the integrated demand response of electricity and heat between the MGO and UA in the context of the participation of ESO in the auxiliary service of the UA. Finally, the proposed model is brought into a typical residential building community for simulation verification, and the results show that the model proposed in this paper can effectively balance the interests of MGOs and UAs, and realize win-win benefits for UA and ESO.

Broken Ladders? Labour Market Inequality in Indonesia and India

This paper examines labour market inequality in Indonesia and India, using a common conceptual approach that draws on a job ladder framework. In the framework, I differentiate between self-employment and wage-informal employment and between formal, upper-tier informal and lower-tier informal employment. I find that Indonesia and India both have job ladders that are narrow at the top and broad at the bottom, with the share of workers in lower-tier informal jobs significantly exceeding the share of workers in upper informal and formal employment. However, more people are in formal wage-employment in Indonesia than in India. Unlike in Indonesia, where the share of wage-employment in total employment increased from 2001 to 2020, the corresponding share in India was relatively constant from 1988 to 2022. Sharp disparities are evident in the earnings of workers in different tiers of the labour market in Indonesia and India, and evidence of convergence in earnings is limited between lower-tier informal workers and formal workers, at least in Indonesia. I also find that females and less-educated workers occupy the lower tiers of the labour markets in the two countries.

Disaster, Societal Responses, and State Legitimacy in Crisis in Vietnam

This article examines the role of celebrity activism in post-disaster politics in the context of state authoritarianism in Vietnam. In late 2020, a chain of violent tropical storms hit Vietnam’s central highland region – host to hundreds of hydropower dams – triggering severe landslides and floods that devastated human lives and local livelihoods. Drawing on data gathered through social media, online platforms, and interviews with non-governmental organisations and private sector actors, this article shows how the rupture of these disaster events facilitated socio-political openings in state–society relations that might otherwise have remained closed. It explores these political contestations, attributions of blame, and the competing recovery efforts that emerged between government actors, celebrities, and citizens. Public debates over the natural and political catalysts of the disaster revealed major structural and governance problems for the state, which allowed voluntary charity work by a celebrity to supplement state functions during the disaster. Considered illegal under state law, the article shows how support from the public and lower tiers of government for private charity work challenged state legitimacy. Under pressure from within and from citizens, the central government had to amend its policies to accommodate voluntary disaster relief – to restore its flagging legitimacy.

The engineering legacy of the FIFA World Cup Qatar 2022TM: Al Thumama Stadium

The structures of the Al Thumama Stadium, built for the FIFA World Cup Qatar 2022, can be categorised into four main building components. The permanent bowl structure with lower and middle tiers is mainly cast-in-place reinforced concrete with precast seating units. Structural steel was used for the upper tier stands, to be dismantled for legacy conversion after the tournament. The roof and façade system use steel and cable systems with a unique membrane cladding design derived from the cultural gahfiya symbol. The roof is a self-anchored tension–compression ring system based on the principle of a horizontal spoked wheel, with one compression ring along the outer perimeter and two tension rings along the oculus. The façade consists of lightweight double-layered and prestressed cable nets spanning between curved vertical beams. A translucent polytetrafluoroethylene-coated glass fibre membrane with highly transparent mesh inserts form the cladding of the stadium, providing its unique architectural design. This article gives an overview of the stadium's design and construction methodology.

Two-level optimal scheduling of source–storage-load interactive distribution network based on particle swarm optimization algorithm

In response to the difficulties of grid integration and consumption of a high proportion of new energy generation, as well as the high pressure on traditional thermal power generation to regulate peak loads, this paper constructs a wind-solar-fire-water complementary power generation system with “dual energy storage” and proposes a two-layer scheduling optimization strategy for this system. The scheduling model’s higher layer uses the system’s complementary power generation system’s maximum benefit as its objective function. The lower tier model has the minimization of the system’s cost of regulating load peaks as the objective function, and the model is solved by the improved adaptive immune particle swarm optimization algorithm considering various constraints. Taking the improved IEEE30 node system as an example for analysis, according to the operation of the original power system and the different characteristics of pumped storage and storage power plants, pumped storage and energy storage power stations are gradually added to the system for scheduling comparative analysis, and different capacities are configured, respectively. Through the analysis of examples, it is verified that the proposed dual-storage joint scheduling optimization strategy can effectively improve the overall operation of the system, reduce the peaking pressure of thermal power units, and achieve the expected goal of maximizing economic benefits. It also improves the new energy consumption in the region and alleviates the thermal power peaking pressure.

The Association Between Social Determinants of Health, Risk Factors, Job Performance, and Health Care Costs in an Employed Population.

The aim of the study is to compare employees of a US school district based on their social determinants of health (SDoH). Methods: Employees ( N = 5006) were categorized into low-, medium-, or high-need SDoH tiers. Of them, n = 2469 also participated in a health risk appraisal in 2019. Subjects' average health care costs, health risk factors, and self-rated job performance were compared by SDoH tier and race. Results: Significant differences were observed among the SDoH comparison groups regarding age, gender, race, and marital status. SDoH was associated with health care costs, number of health risk factors, and self-rated job performance differently for Black and White employees. Conclusions: SDoH are complex and multifaceted. Black employees in the high-need SDoH group had higher average health care costs, lower self-rated job performance, and more average health risk factors than subjects in the lower need tiers.

Theorizing the governance of direct and indirect transactions in multi‐tier supply chains

AbstractAn outsourcing decision does not equate to the outsourcing of a sourcing decision. Many indirect transactions with lower tier suppliers are embedded in transactions with first‐tier suppliers. Building on the identification of a transaction as the fundamental unit of analysis, this study proposes that transactions comprise bundles of intertwined direct transactions at the firm level and indirect transactions at the supply chain level. These indirect transactions require separate but not independent sourcing decisions. Using a buyer's decision to control or delegate the governance of indirect transactions for an externally sourced product, this study demonstrates that disaggregating the transaction advances theory by extending the range of outcomes, refining the calculus of the make‐or‐buy decision, and providing a coherent theoretical framework for multi‐tier supply chain management. This study considers the theoretical, managerial, and societal implications across various contingencies involving inter‐firm relationships.

Regulatory and contextual factors influencing earnings and capital management decisions: evidence from the European banking sector

This study investigates whether some regulatory and contextual features influenced Euro Area listed banks decisions to manage earnings and regulatory capital through discretionary provisions in the period 2013–2018. The new regulation factors are the pressure to increase high-quality regulatory capital (Basel III) and more timely recognition of loan losses (IFRS 9). The contextual features are the intensified banking competition at a national level, and the significant money market pressure. Results demonstrate that the pressure to increase high-quality regulatory capital for banks with lower Common Equity Tier 1 capital (CET1) in year t − 1 is negatively associated with upward earnings and capital management in year t. The more timely recognition of loan losses in year t compared to year t + 1 is negatively associated with upward earnings and capital management in year t. The strengthening of banking competition is positively associated with upward earnings management, but not associated with upward capital management. The increasing money market pressure is negatively associated with upward earnings management, but not associated with upward capital management. This study should be helpful to standard-setters, regulators, investors and academics interested in incentives and constraints to earnings and capital management by providing evidence regarding how listed banks reacted to the regulatory, accounting, and contextual factors, observed holistically during a unique historical period (i.e., 2013–2018) and regulatory setting (i.e., European banking sector).

Investigating social sustainability practices in global supply networks: A fuzzy-set qualitative comparative analysis

Given the paucity of research that examines the impact of Social Sustainability Practices (SSP) on performance outcomes, this study investigates the adoption and influence of these practices on firms' and suppliers’ overall performance, whilst also considering the level of complexity of operational environments of global supply networks. A Fuzzy-sets Qualitative Comparative Analysis (FsQCA) approach is adopted, based on eight primary case studies within the food, chemical and textile sectors, with data collected through semi-structured interviews conducted with representatives from each company.The research identified four key categories of SSP: informative, control, collaborative, and supply network redesign practices. The findings offer empirical support for the notion that SSP adoption yields improved performance outcomes for both the firm and its suppliers. These positive effects encompass enhanced firm profitability, increased supplier efficiency, and heightened supplier innovativeness. Nevertheless, the research uncovered that the relationship between adopting SSP and their impact on performance is not always straightforward. In certain instances, a combination of these practices may be necessary to achieve the desired performance level.In addition, a prudent consideration of the operational complexity present in global supply networks is crucial for informed decision-making pertaining to the selection and adoption of the most appropriate SSP. Driving profits in complex operational environments requires integrating both informative and collaborative practices, whilst tight control is necessary to improve supplier efficiency, regardless of the extent of complexity. Collaboration also emerged as a core factor of success in enhancing supplier innovation regarding social sustainability. Decision makers should also collaborate with external entities, particularly Non-Governmental-Organisations (NGOs) and industry associations/peers, to educate suppliers, thus creating an auspicious environment where suppliers are accountable for their own sustainability performance. This research carries significant practical implications. Managers should evaluate diverse combinations of SSP to confront global sustainability challenges through the utilization of customized strategies that can yield enhanced performance results. Expanding sustainability beyond primary suppliers can often be challenging in a global supply networks, given a firm's limited oversight, transparent knowledge and control over lower tier suppliers. Consequently, managers should seek to strengthen controls and oversight within the manageable segments of the supply network, all the while facilitating self-adaptation within the extended supply network with the adoption of informative and collaborative practices that extend reach, homogeneity, and improve overall governance.

Hierarchical Slicing: A New Paradigm of Radio Resource Management for Mobile Networks

Radio access network slicing is considered to be highly challenging due to the complexity of mobile environments and the diversity of mobile services. Existing works in this area mainly decompose the radio resource management problem into slice-level resource management and user-level resource scheduling. In this paper, we propose a hierarchical three-tier slicing architecture, where an additional tier is introduced to merge the gap between the conventional two tiers in time and spatial scales. Specifically, the medium-scale tier provides intercell and inter-slice coordination to address short-term dynamics caused by local user mobility and traffic variations, which highly simplifies the upper and lower tiers by allowing them to focus on long-term traffic distribution and instant user demands, respectively. Thus, it allows each independent iter to apply more flexible and more efficient radio resource management methods with appropriate time and spatial scales. A proof of concept is provided to show that the proposed three-tier architecture can achieve a better tradeoff between slice isolation and slice capacity as compared to the state-of-the-art two-tier solution.

Impact of florfenicol dosing regimen on the phenotypic and genotypic resistance of enteric bacteria in steers

The food animal sector’s use of antimicrobials is heavily critiqued for its role in allowing resistance to develop against critically important antimicrobials in human health. The WHO recommends using lower tier antimicrobials such as florfenicol for disease treatment. The primary objective of this study was to assess the differences in resistance profiles of enteric microbes following administration of florfenicol to steers using both FDA-approved dosing regimens and two different detection methods. Our hypothesis was that we would identify an increased prevalence of resistance in the steers administered the repeated, lower dose of florfenicol; additionally, we hypothesized resistance profiles would be similar between both detection methods. Twelve steers were administered either two intramuscular (20 mg/kg q 48 h; n = 6) or a single subcutaneous dose (40 mg/kg, n = 6). Fecal samples were collected for 38 days, and E. coli and Enterococcus were isolated and tested for resistance. Fecal samples were submitted for metagenomic sequencing analysis. Metagenomics revealed genes conferring resistance to aminoglycosides as the most abundant drug class. Most multidrug resistance genes contained phenicols. The genotypic and phenotypic patterns of resistance were not similar between drug classes. Observed increases in resistant isolates and relative abundance of resistance genes peaked after drug administration and returned to baseline by the end of the sampling period. The use of a “lower tier” antimicrobial, such as florfenicol, may cause an increased amount of resistance to critically important antimicrobials for a brief period, but these changes largely resolve by the end of the drug withdrawal period.

The Bretskyan hierarchy, multiscale allopatry, and geobiomes—on the nature of evolutionary things

AbstractThe process of evolution and the structures it produces are best understood in the light of hierarchy theory. The biota traditionally is described by either the genealogical Linnaean hierarchy or economic hierarchies of communities or ecosystems. Here we describe the Bretskyan hierarchy—a hybrid eco-genealogical hierarchy that consists of nested sets of different-sized, usually polyphyletic communities of interacting individuals separated from other such communities in space and time at multiple scales. The Bretskyan hierarchy consists of elements that have both genealogical and economic properties and functions—situated between, and connecting the elements of, the economic hierarchies (Vernadskyan) and the genealogical (Linnaean) hierarchy. The described hierarchy at lower tiers is populated by holobionts, individuals composed of multiple polyphyletic lineages integrated by functional interactions or biotically fabricated structures, such as membranes. At larger spatial tiers and longer time scales, the members of the Bretskyan hierarchy are of a more diffuse nature, partially due to the small size and relatively short duration of us as observers of larger and longer-lasting structures, here described as geobiomes. Their individuality is externally forced and directly tied to the spatial and temporal physical structures of our planet. These are sub-bioprovinces and bioprovinces—large and effectively isolated spatiotemporal structures of biota integrated internally by coevolution and individuated externally by a hierarchy of barriers. Gaia is here understood as the largest eco-genealogical individual compartmentalized by the outer space of the Earth and integrated at long time scales by biotic interactions and plate tectonic mixing of biota. The existence of a hierarchy of barriers and multilevel allopatry suggests that geographic isolation takes part not only in individuating species lineages, but also in producing coherent complexes of separate lineages forming bioprovinces at multiple space and time scales. The sizes, configurations, and durations of Bretskyan units are directly tied to geodynamics, demonstrating the central role of the physical planet in the processes of individuation and merging of geobiomes and the control of coevolution, and all its ramifications, at multiple space and time scales. The Bretskyan hierarchy also allows the integration of previously unconnected themes—“egalitarian” major transitions in individuality (e.g., eukaryogenesis) and some of the megatrajectories in the history of life—into a single theoretical framework of spatial and temporal scaling of eco-genealogy. The pervasive scaling of geodynamical processes and the direct connection of geodynamics to the dynamics of Bretskyan units allows us to formulate conjectures on the scales and limits of spatial and temporal contingency and competitiveness of biotas in evolution.

Key Factors Influencing the Operationalization and Effectiveness of Telemedicine Services in Henan Province, China: Cross-Sectional Analysis.

Telemedicine has demonstrated its potential in alleviating the unbalanced distribution of medical resources across different regions. Henan, a province in China with a population of approximately 100 million, is especially affected by a health care divide. The province has taken a proactive step by establishing a regional collaborative platform for telemedicine services provided by top-tier provincial hospitals. We aim to identify the key factors that influence the current operationalization and effectiveness of telemedicine services in Henan province. The insights gained from this study will serve as valuable references for enhancing the efficient operation of telemedicine platforms in low- and middle-income regions. We analyzed service reports from the performance management system of telemedicine services in Henan province throughout 2020. Using descriptive statistics and graphical methods, we examined key influencing factors, such as management competency; device configuration; and hospital capability, capacity, and service efficacy, across hospitals at 2 different tiers. In addition, we used generalized linear models and multiple linear regression models to identify key operational factors that significantly affect the service volume and efficacy of 2 major telemedicine services, namely teleconsultation and tele-education. Among the 89 tier 3 hospitals and 97 tier 2 hospitals connected to the collaborative telemedicine platform, 65 (73%) and 55 (57%), respectively, have established standardized management procedures for telemedicine services. As the primary delivery method for telemedicine services, 90% (80/89) of the tier 3 hospitals and 94% (91/97) of the tier 2 hospitals host videoconferencing consultations through professional hardware terminals rather than generic computers. Teleconsultation is the dominant service type, with an average annual service volume per institution of 173 (IQR 37-372) and 60 (IQR 14-271) teleconsultations for tier 3 and tier 2 hospitals, respectively. Key factors influencing the service volume at each hospital include available funding, management competency, the number of connected upper tiers, and the number of professional staff. After receiving teleconsultations from tier 3 (65/89, 73%) and tier 2 (61/97, 63%) hospitals, patients reported significant improvements in their medical conditions. In addition, we observed that service efficacy is positively influenced by management competency, financial incentives, the number of connected upper or lower tiers, and the involvement of participating medical professionals. Telemedicine has become increasingly popular in Henan province, with a notable focus on teleconsultation and tele-education services. Despite its popularity, many medical institutions, especially tier 2 hospitals, face challenges related to management competency. In addition to enhancing the effectiveness of existing telemedicine services, health care decision-makers in Henan province and other low- and middle-income regions should consider expanding the service categories, such as including remote emergency care and telesurgery, which have promise in addressing crucial health care needs in these regions.

Molecular genetic analysis as a method of detecting microorganisms in industrial poultry farming

Methods of molecular genetic analysis are widely used to study the air microbiota. These methods make it possible to study all groups of microorganisms without the need for their cultivation. The purpose of the study was to analyze the microbiota of the poultry house air environment by the qPCR method and identify the presence of representatives of the normophlora, opportunistic and pathogenic microflora. The research plan included sampling of the air microbiota from a three-tier cage battery for poultry rearing for 42 days. The data obtained revealed an increase in the presence of microorganisms during the entire experiment, the largest number of them was detected on the 42nd day of cultivation on the lower tier. The results of the study emphasize the importance of timely detection and assessment of the microbiota of the air to prevent the spread of diseases and their impact on the health and productivity of birds.

The Determinants of FinTech Implementation in Microfinance Companies – A Systematic Literature Review

As financial technology continues to disrupt and reshape the financial industry, there is a growing body of work investigating how it can be harnessed to improve access to basic financial services and promote financial inclusion for individuals at the lower tier of the economic pyramid. In the context of microfinance companies, there has been limited exploration into the key determinants influencing the successful implementation of digital finance products and services. This research aims to explore the potential role of financial technology in supporting the sustainability, growth, and advancement of microfinance companies by identifying the internal and external determinants that impact the fintech decision-making process. To achieve this, a systematic review was conducted, thoroughly examining relevant publications indexed in the Web of Science database. The review process involved a „coding scheme” (content analysis) to extract essential concepts from the primary publications. The research findings highlight the significance of various determinants related to social, economic, organizational, and technological dynamics in driving the implementation of digital finance solutions. Based on these results, a comprehensive model is proposed, illustrating the interplay among the three potential domains identified in the context of this review.

(Invited) Sequential 3D Integration of Ge Transistors on Si CMOS

In order to keep the scaling progress going is to go 3D. This paper outlines some technology challenges and solutions to integrate Ge p-type MOSFETs sequentially on Si CMOS. Such a solution addresses the grand challenge to enable increased device density. However, the device itself does not have to scale but at the same time innovative solutions are suggested for low supply voltage operation enabling energy efficient integrated circuits (ICs) that will not be dominated by energy consumption in interconnects.By stacking the transistors on top of each other, and connect them with inter-tier via, the density of transistors per unit area increases. This approach demands that transistors are fabricated at a lower temperature compared to today’s Si CMOS technology. Therefore, we have focused on Ge based transistors, which has an inherently lower process temperature compared to Si transistors.In this paper several technological and design breakthroughs towards realizing Ge based sequential 3D circuits will be shown. We will present: A process to realize thin single crystalline Ge layers on planarized wafers with metal layers in lower tiers.A gate dielectric stack (Ge/Si/TmSiO/Tm2O3/HfO2/TiN) on Ge that enables adequately low defect densities at the dielectric/Ge interface allowing predictable and reliable Ge transistorsFully depleted Ge pFET devices fabricated at a low temperature compatible with sequential 3D. The devices exhibits 60% higher mobility compared to reference Si devices.3D digital circuits with pFETs on top of nFETs can enable area reduction by 30-50% depending on cell type.3D standard cells with lower parasitic capacitance (~30%) compared to 2D cells, enabling lower dynamic power consumption and more energy efficient integrated circuits.

СПОСОБИ НОМІНАЦІЇ ДИКИХ ТВАРИН У НІМЕЦЬКИХ ПАРЕМІЯХ

The present article discusses the ways of nomination of wild animals in German paremias. Wild animals are free beings living in the natural environment and representing three parts of the World Tree: upper, middle and lower. The upper part is associated with birds, the middle – with animals, the lower – with insects, fi sh, amphibians, arthropods, reptiles, and molluscs. Indeterminate creatures are also associated with the lower tier. Paremia is defi ned through the prism of a small form of folk poetic creativity – a proverb and a saying that summarizes the history, culture, experience, and wisdom of the Germanic-German ethnos about the animal world. This testifi es to the fact that paremias belong to ancient written records. A feature of Germanic paremias is their use of the so-called initial rhyme, with the help of which alliteration is created. The remains of the initial rhyme are recorded, for example, at the beginning of words with the sound b (Bär bleibt Bar <…>), f (Den Fuchs muss man mit Füchsen fangen) or with the phoneme ʃ (In der schönsten Haut steckt die gefährlichste Schlange), etc. M.D. Stepanovaʼs theory of word formation was chosen to study the ways of naming wild animals in German paremias. This theory makes it possible to diff erentiate the ways of word formation, systematize their means, reconstruct models, outline the paradigm of grammatical suffi xes and infl ections, word forms, trace the word-forming rules or laws of language that regulate the use of methods of forming the names of wild animals. The methodological base of the proposed study combines general scientifi c and special scientifi c methods. It was found that the conceptual and terminological apparatus correlates with the dominant linguistic paradigm, national scientifi c traditions and the subject of the study. It was established that the register of wild animals is more diverse than that of domestic animals, and it was found that the method of nomination of wild animals is infl uenced by non-linguistic and linguistic factors. The role of language factors in the creation of the phenomenon was assessed to a greater extent. According to the type of word-forming form, the names of wild animals in German paremias are conventionally classifi ed into four varieties: 1) root, 2) derived, 3) complex, 4) compound, 5) sentence. The root method of word formation dominates; word formation resonates with syntactic constructions, i.e. it is subject to grammatical laws that generalize from the individual and specific. Key words: wild animals, method of nomination, paremia, root words, derived words, complex words, compound words.