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Superlattices have attracted great interest because their use may make it possible to modify the spectra of two-dimensional electron systems and, ultimately, create materials with tailored electronic properties. In previous studies (see, for example, refs 1-8), it proved difficult to realize superlattices with short periodicities and weak disorder, and most of their observed features could be explained in terms of cyclotron orbits commensurate with the superlattice. Evidence for the formation of superlattice minibands (forming a fractal spectrum known as Hofstadter's butterfly) has been limited to the observation of new low-field oscillations and an internal structure within Landau levels. Here we report transport properties of graphene placed on a boron nitride substrate and accurately aligned along its crystallographic directions. The substrate's moiré potential acts as a superlattice and leads to profound changes in the graphene's electronic spectrum. Second-generation Dirac points appear as pronounced peaks in resistivity, accompanied by reversal of the Hall effect. The latter indicates that the effective sign of the charge carriers changes within graphene's conduction and valence bands. Strong magnetic fields lead to Zak-type cloning of the third generation of Dirac points, which are observed as numerous neutrality points in fields where a unit fraction of the flux quantum pierces the superlattice unit cell. Graphene superlattices such as this one provide a way of studying the rich physics expected in incommensurable quantum systems and illustrate the possibility of controllably modifying the electronic spectra of two-dimensional atomic crystals by varying their crystallographic alignment within van der Waals heterostuctures.
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Few-layer black phosphorus was recently rediscovered as a narrow-bandgap atomically thin semiconductor, attracting unprecedented attention due to its interesting properties. One feature of this material that sets it apart from other atomically thin crystals is its structural in-plane anisotropy which manifests in strongly anisotropic transport characteristics. However, traditional angle-resolved conductance measurements present a challenge for nanoscale systems, calling for new approaches in precision studies of transport anisotropy. Here, we show that the nonlocal response, being exponentially sensitive to the anisotropy value, provides a powerful tool for determining the anisotropy in black phosphorus. This is established by combining measurements of the orientation-dependent nonlocal resistance response with the analysis based on the anamorphosis relations. We demonstrate that the nonlocal response can differ by orders of magnitude for different crystallographic directions even when the anisotropy is at most order-one, allowing us to extract accurate anisotropy values.
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Monolayers of molybdenum and tungsten dichalcogenides are direct bandgap semiconductors, which makes them promising for optoelectronic applications. In particular, van der Waals heterostructures consisting of monolayers of MoS2 sandwiched between atomically thin hexagonal boron nitride (hBN) and graphene electrodes allows one to obtain light emitting quantum wells (LEQWs) with low-temperature external quantum efficiency (EQE) of 1%. However, the EQE of MoS2- and MoSe2-based LEQWs shows behavior common for many other materials: it decreases fast from cryogenic conditions to room temperature, undermining their practical applications. Here we compare MoSe2 and WSe2 LEQWs. We show that the EQE of WSe2 devices grows with temperature, with room temperature EQE reaching 5%, which is 250× more than the previous best performance of MoS2 and MoSe2 quantum wells in ambient conditions. We attribute such different temperature dependences to the inverted sign of spin-orbit splitting of conduction band states in tungsten and molybdenum dichalcogenides, which makes the lowest-energy exciton in WSe2 dark.
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OBJECTIVE: To determine if prenatal diagnosis improves the chance that a newborn with critical congenital heart disease will survive to undergo planned cardiac surgery. METHODS: A systematic review of the medical literature identified eight studies which met the following criteria: compared outcomes between newborns with prenatal and those with postnatal diagnosis of critical congenital heart disease; compared groups of patients with the same anatomical diagnosis; provided detailed information on cardiac anatomy; included detailed information on preoperative cause of death. A meta-analysis was performed to assess differences in preoperative mortality rates between newborns with prenatal diagnosis and those with postnatal diagnosis. Patients with established risk factors for increased mortality (high risk) and those whose families chose comfort care rather than cardiac surgery were excluded. RESULTS: In patients with comparable anatomy, standard risk, a parental desire to treat and optimal care, newborns with a prenatal diagnosis of critical congenital heart disease were significantly less likely to die prior to planned cardiac surgery than were those with a comparable postnatal diagnosis (pooled odds ratio, 0.26; 95% CI, 0.08-0.84). CONCLUSIONS: For newborns most likely to benefit from treatment for their critical congenital heart disease, because they did not have additional risk factors and their families pursued treatment, prenatal diagnosis reduced the risk of death prior to planned cardiac surgery relative to patients with a comparable postnatal diagnosis. Further study and efforts to improve prenatal diagnosis of congenital heart disease should therefore be considered.
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Cardiopatías Congénitas/diagnóstico por imagen , Ultrasonografía Prenatal , Femenino , Cardiopatías Congénitas/mortalidad , Cardiopatías Congénitas/cirugía , Humanos , Recién Nacido , Embarazo , Resultado del Embarazo , Factores de RiesgoRESUMEN
The new paradigm of heterostructures based on two-dimensional (2D) atomic crystals has already led to the observation of exciting physical phenomena and creation of novel devices. The possibility of combining layers of different 2D materials in one stack allows unprecedented control over the electronic and optical properties of the resulting material. Still, the current method of mechanical transfer of individual 2D crystals, though allowing exceptional control over the quality of such structures and interfaces, is not scalable. Here we show that such heterostructures can be assembled from chemically exfoliated 2D crystals, allowing for low-cost and scalable methods to be used in device fabrication.
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Grafito/química , Tinta , Nanopartículas/química , Nanoestructuras/química , Electrónica/instrumentación , Diseño de Equipo , Nanopartículas/ultraestructura , Nanoestructuras/ultraestructura , Nanotecnología/instrumentación , Impresión/instrumentaciónRESUMEN
Hexagonal boron nitride is the only substrate that has so far allowed graphene devices exhibiting micrometer-scale ballistic transport. Can other atomically flat crystals be used as substrates for making quality graphene heterostructures? Here we report on our search for alternative substrates. The devices fabricated by encapsulating graphene with molybdenum or tungsten disulfides and hBN are found to exhibit consistently high carrier mobilities of about 60 000 cm(2) V(-1) s(-1). In contrast, encapsulation with atomically flat layered oxides such as mica, bismuth strontium calcium copper oxide, and vanadium pentoxide results in exceptionally low quality of graphene devices with mobilities of â¼1000 cm(2) V(-1) s(-1). We attribute the difference mainly to self-cleansing that takes place at interfaces between graphene, hBN, and transition metal dichalcogenides. Surface contamination assembles into large pockets allowing the rest of the interface to become atomically clean. The cleansing process does not occur for graphene on atomically flat oxide substrates.
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When two-dimensional crystals are brought into close proximity, their interaction results in reconstruction of electronic spectrum and crystal structure. Such reconstruction strongly depends on the twist angle between the crystals, which has received growing attention due to interesting electronic and optical properties that arise in graphene and transitional metal dichalcogenides. Here we study two insulating crystals of hexagonal boron nitride stacked at small twist angle. Using electrostatic force microscopy, we observe ferroelectric-like domains arranged in triangular superlattices with a large surface potential. The observation is attributed to interfacial elastic deformations that result in out-of-plane dipoles formed by pairs of boron and nitrogen atoms belonging to opposite interfacial surfaces. This creates a bilayer-thick ferroelectric with oppositely polarized (BN and NB) dipoles in neighbouring domains, in agreement with our modeling. These findings open up possibilities for designing van der Waals heterostructures and offer an alternative probe to study moiré-superlattice electrostatic potentials.
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Commensurability effects play a crucial role in the formation of electronic properties of novel layered heterostructures. The interest in these moiré superstructures has increased tremendously since the recent observation of a superconducting state (Nature 2018, 556, 43-50) and metal-insulator transition (Nature 2018, 556, 80-84) in twisted bilayer graphene. In this regard, a straightforward and efficient experimental technique for detection of the alignment of layered materials is desired. In this work, we use optical second harmonic generation, which is sensitive to the inversion symmetry breaking, to investigate the alignment of graphene/hexagonal boron nitride heterostructures. To achieve that, we activate a commensurate-incommensurate phase transition by a thermal annealing of the sample. We find that this structural change in the system can be directly observed via a strong modification of a nonlinear optical signal. Unambiguous interpretation of obtained results reveals the potential of a second harmonic generation technique for probing of structural changes in layered systems.
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BACKGROUND: falls are the leading causes of accidental death and fragility fractures in older adults. Interventions that assess and reduce falls risk are underutilised. OBJECTIVE: to evaluate the impact of a multifaceted community-based programme aimed at optimising evidence-based management of patients at risk for fall-related fractures. DESIGN: this was a randomised trial performed from 2003 to 2006. SETTING: community-based intervention in Ontario, Canada. PARTICIPANTS: eligible patients were community-dwelling, aged > or =55 years and identified to be at risk for fall-related fractures. A total of 201 patients were allocated to the intervention group or to usual care. INTERVENTION: components of the intervention included assessment of falls risk, functional status and home environment, and patient education. MEASUREMENTS: primary outcome was the implementation of appropriate falls risk assessment at 6 months. Secondary outcomes included falls and fractures at 6 and 12 months. RESULTS: the mean age of participants was 72 years, and 41% had fallen with injury in the previous year. Compared to usual care, the intervention increased the number of referrals made to physiotherapy [21% (21/101) vs 6.0% (6/100); relative risk (RR) 3.47, 95% confidence interval (CI) 1.46-8.22] and occupational therapy [15% (15/101) vs 0%; RR 30.7, 95% CI 1.86 to >500]. At 12 months, the number of falls in the intervention group was greater than in the usual care group [23% (23/101) vs 11% (11/100); RR 2.07, 95% CI 1.07-4.02]. CONCLUSIONS: compared to usual care, a multi-faceted intervention increased referrals to physiotherapy and occupational therapy but did not reduce risk of falls. Similar falls reduction interventions cannot be recommended based on the results of this study.
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Accidentes por Caídas/prevención & control , Actividades Cotidianas , Gestión de Riesgos/organización & administración , Anciano , Anciano de 80 o más Años , Medicina Basada en la Evidencia , Femenino , Evaluación Geriátrica , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Ontario , Evaluación de Resultado en la Atención de Salud , Educación del Paciente como Asunto , Factores de RiesgoRESUMEN
The knowledge of the mechanism of stress transfer from a polymer matrix to a 2-dimensional nano-inclusion such as a graphene flake is of paramount importance for the design and the production of effective nanocomposites. For efficient reinforcement the shape of the inclusion must be accurately controlled since the axial stress transfer from matrix to the inclusion is affected by the axial-shear coupling observed upon loading of a flake of irregular geometry. Herein, we study true axial phenomena on regular- exfoliated-graphene micro-ribbons which are perfectly aligned to the loading direction. We exploit the strain sensitivity of vibrational wave numbers in order to map point-by-point the strain built up along the length of graphene. By considering the balance of shear-to-axial forces, we identify the shear stress at the interface and develop a universal inverse-length parameter that governs the stress transfer process at the nanoscale. An important parameter that has come out of this approach is the prediction and measurement of the transfer length that is required for efficient stress in these systems.
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When two-dimensional (2D) atomic crystals are brought into close proximity to form a van der Waals heterostructure, neighbouring crystals may influence each other's properties. Of particular interest is when the two crystals closely match and a moiré pattern forms, resulting in modified electronic and excitonic spectra, crystal reconstruction, and more. Thus, moiré patterns are a viable tool for controlling the properties of 2D materials. However, the difference in periodicity of the two crystals limits the reconstruction and, thus, is a barrier to the low-energy regime. Here, we present a route to spectrum reconstruction at all energies. By using graphene which is aligned to two hexagonal boron nitride layers, one can make electrons scatter in the differential moiré pattern which results in spectral changes at arbitrarily low energies. Further, we demonstrate that the strength of this potential relies crucially on the atomic reconstruction of graphene within the differential moiré super cell.
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Microelectromechanical systems, which can be moved or rotated with nanometre precision, already find applications in such fields as radio-frequency electronics, micro-attenuators, sensors and many others. Especially interesting are those which allow fine control over the motion on the atomic scale because of self-alignment mechanisms and forces acting on the atomic level. Such machines can produce well-controlled movements as a reaction to small changes of the external parameters. Here we demonstrate that, for the system of graphene on hexagonal boron nitride, the interplay between the van der Waals and elastic energies results in graphene mechanically self-rotating towards the hexagonal boron nitride crystallographic directions. Such rotation is macroscopic (for graphene flakes of tens of micrometres the tangential movement can be on hundreds of nanometres) and can be used for reproducible manufacturing of aligned van der Waals heterostructures.
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Compuestos de Boro/química , Grafito/química , Nanoestructuras/química , Cristalización , Elasticidad , Microscopía de Fuerza Atómica , Nanoestructuras/ultraestructura , Rotación , TermodinámicaRESUMEN
Computerized medical databases are increasingly used for research. The influence of different definitions of the accuracy of matching on the estimated accuracy of diagnosis data was assessed in a database of visits to a public pediatric clinic. Differences between definitions involved 1) unit of analysis, 2) number of diagnoses required to match per visit, and/or 3) whether database contents are required to match the medical record or medical record contents are required to be matched in the database. Overall, 90% of diagnoses in the database (391/435) were accurately coded relative to the medical record. Alternatively, 77% of diagnoses listed in the medical record (391/506) were accurately coded in the database. When individual visits were used as the unit of analysis, estimates of accuracy using six definitions ranged from 65% to 92%. The most appropriate definition to use for estimating accuracy of diagnosis data likely depends on the purpose of the study. Use of two or more such definitions may enhance portrayal of the accuracy of diagnosis data.
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Interpretación Estadística de Datos , Bases de Datos Factuales , Sistemas de Registros Médicos Computarizados , Otitis Media/diagnóstico , Garantía de la Calidad de Atención de Salud , Algoritmos , Humanos , Lactante , Reproducibilidad de los ResultadosRESUMEN
OBJECTIVE: To confirm the vertical transmission of Citrobacter diversus from a mother to her infant and to evaluate the epidemiologic usefulness of a new automated procedure for analysis of polymerase chain reaction (PCR)-generated DNA fingerprints. DESIGN: Repetitive element-based PCR (rep-PCR) analysis of C diversus isolates from the blood and amniotic fluid of a mother and the blood of her infant was performed. Unrelated C diversus isolates also were characterized and compared with the isolates from mother and infant. DNA fingerprints were generated by gel electrophoresis of PCR products derived from either unlabeled standard repetitive sequence-based oligonucleotide primers or fluorescent primers. The standard rep-PCR fingerprints were analyzed by visual inspection. The fluorescent primers were used in fluorophore-enhanced rep-PCR (FERP), and the FERP DNA fingerprints were analyzed by an Applied BioSystems (ABI) Model 373A laser scanning unit equipped with Genescan 672 software (Applied Biosystems, Inc, Foster City, CA). SETTING AND PATIENTS: A mother and her newborn infant, both with invasive disease due to C diversus, in an urban tertiary-care hospital. RESULTS: The DNA fingerprints of the maternal blood, amniotic fluid, and infant blood isolates of C diversus were identical by both visual inspection of ethidium bromide-stained agarose gels and computer-aided analysis of FERP patterns. These strains appeared to differ from all but one control isolate, which had been collected 7 years earlier in the same city in which the infant was born. CONCLUSIONS: Vertical transmission of C diversus from mother to infant can occur in utero. Automated analysis of rep-PCR-generated DNA fingerprints derived using fluorescent primers is an objective means for comparing isolates of C diversus and in all likelihood would be useful for other species of bacteria that possess repetitive elements.
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Citrobacter/aislamiento & purificación , Dermatoglifia del ADN , Infecciones por Enterobacteriaceae/transmisión , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo/microbiología , Adulto , Líquido Amniótico/microbiología , Antibacterianos/uso terapéutico , Citrobacter/clasificación , Diabetes Gestacional/complicaciones , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones por Enterobacteriaceae/microbiología , Femenino , Herpes Genital/complicaciones , Hospitales Urbanos , Humanos , Recién Nacido , Masculino , Reacción en Cadena de la Polimerasa/métodos , EmbarazoRESUMEN
[structure: see text]. Palladium-based carbon-carbon coupling reactions in sequence with halogen-exchange chemistry on a series of heterocycles lead to an efficient synthetic strategy for oligopyridines that bind metal ions such as ruthenium to form coordination racks. The particular structures are designed to form terpyridine subunits for octahedral binding. Reaction of 4,6-diiodopyrimidine produces a "double-bay" terpyridine from which binuclear coordination complexes have been formed.
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OBJECTIVE: To examine dieting, eating and exercise behaviors, use of diet pills, and vomiting or use of laxatives to lose weight among younger adolescents. DESIGN: Analysis of data from a modified version of the Youth Risk Behavior Survey administered to middle school students in North Carolina in 1995. SETTING: Fifty-three randomly selected middle schools in North Carolina. SUBJECTS: Two thousand three hundred thirty-one students in the sixth, seventh, and eighth grades. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Responses to questions regarding weight control practices, including vomiting or laxative use, dieting, exercise, or diet pill use. RESULTS: Of the students surveyed, 110 (9.7%) of the girls and 46 (4.0%) of the boys reported vomiting or using laxatives to lose weight. Among the girls, vomiting or laxative use was associated with feeling overweight, other weight loss practices, older age, being a poor student, smoking, eating more salads or vegetables, and eating more candy or other sweets (P< or =.01). A logistic regression model consisting of diet pill use, dieting to lose weight, lower academic achievement, and currently trying to lose weight correctly classified 92% of female students who had or had not vomited or used laxatives. Among boys, vomiting or laxative use was associated with feeling overweight, other weight loss practices, minority racial status, smoking, frequency of eating hamburgers or other high-fat meats, and frequency of eating french fries or potato chips (P< or =.01). A model consisting of diet pill use, minority race, dieting to lose weight, smoking, feeling overweight, and number of servings of hamburgers, hot dogs, or barbecue correctly classified 97% of the boys who had or had not vomited or used laxatives. CONCLUSION: Younger adolescents trying to lose weight engage in a variety of problem dieting and weight loss behaviors that can compromise health and may be associated with eating disorders.
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Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Adolescente , Depresores del Apetito/administración & dosificación , Catárticos , Niño , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Femenino , Humanos , Masculino , Psicología del Adolescente , Autoimagen , Vómitos , Pérdida de PesoRESUMEN
OBJECTIVE: To examine the association between carrying a weapon at school and the age of onset of substance use, other indicators of violence, and other health risk behaviors among middle school students. DESIGN: In 1995, a modified version of the Centers for Disease Control and Prevention Youth Risk Behavior Survey was administered to 2227 students (49% were female) attending 53 (of 463) randomly selected middle schools in North Carolina. Weapon carrying on school property during school hours was measured with 2 questions assessing carrying a gun and carrying other weapons such as knives or clubs. The Youth Risk Behavior Survey also assessed other indicators of violence, drug use, suicide plans and attempts, and being threatened with a weapon at school. Variables significantly (P< or =.001) associated with gun and other weapon carrying by chi2 tests were analyzed with stepwise logistic regression using the likelihood ratio approach. Odds ratios (ORs) were adjusted for all other variables in the model and 95% confidence intervals (CIs) were computed. RESULTS: Our study showed that 3% of students had carried a gun and 14.1% had carried a knife or club to school. Gun carrying was associated with increased age (OR, 1.57 [95% CI, 1.15-2.14]); male sex (OR, 5.62 [95% CI, 2.42-13.03]); minority ethnicity (OR, 3.30 [95% CI, 1.55-5.05]); and earlier age of onset of cigarette (OR, 0.85 [95% CI, 0.74-0.97]), alcohol (OR, 0.81 [95% CI, 0.71-0.94]), marijuana (OR, 0.81 [95% CI, 0.71-0.92]), and cocaine use (OR, 0.73 [95% CI, 0.62-0.86]). Knife or club carrying was associated with age (OR, 1.32 [95% CI, 1.14-1.53]); male sex (OR, 2.39 [95% CI, 1.77-2.32]); and ear-lier age of onset of cigarette (OR, 0.88 [95% CI, 0.84-0.94]), alcohol (OR, 0.81 [95% CI, 0.76-0.86]), and marijuana use (OR, 0.77 [95% CI, 0.72-0.83]). Gun carrying was also associated with frequency of cigarette (OR, 1.34 [95% CI, 1.14-1.57]), alcohol (OR, 4.59 [95% CI, 1.27-16.58]), cocaine (OR, 2.96 [95% CI, 1.29-6.82]), and marijuana use (OR, 3.66 [95% CI, 1.67-8.06]) after adjusting for male sex and minority ethnicity. Carrying a knife or club was associated with carrying a gun (OR, 1.83 [95% CI, 1.31-2.55]); being threatened with a weapon at school (OR, 1.65 [95% CI, 1.10-2.49]); fighting (OR, 4.62 [95% CI, 2.56-8.37]); frequency of alcohol (OR, 2.91 [95% CI, 1.88-4.50]) and cigarette use (OR, 1.20 [95% CI, 1.10-1.31]); and a suicide plan (OR, 1.54 [95% CI, 1.07-2.20]). CONCLUSIONS: Middle school students are more likely to carry a knife or club (14.1%) than a gun (3%) to school. Young adolescents who initiate substance use early and engage in it frequently are more likely to carry guns and other weapons to school, after adjusting for age, sex, and ethnicity. Being threatened with a weapon at school and fighting were only associated with knife or club carrying at school. These findings suggest that school-based prevention programs targeting both violence prevention and substance use should be introduced in elementary school.
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Conducta del Adolescente , Armas de Fuego , Instituciones Académicas , Violencia , Adolescente , Consumo de Bebidas Alcohólicas/epidemiología , Niño , Femenino , Humanos , Modelos Logísticos , Masculino , Grupos Minoritarios/estadística & datos numéricos , North Carolina/epidemiología , Asunción de Riesgos , Fumar/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/prevención & control , Violencia/prevención & controlRESUMEN
Genotypic, or DNA-based, methods have become increasingly applicable for infectious disease diagnosis and epidemiologic analysis. The ability to assess the pathogen's genotype directly bypasses requirements for cultivation and may diminish diagnostic delays with fastidious organisms. Genotypic typing methods have enhanced epidemiologic studies by providing techniques with greater discriminatory ability and smaller proportions of nontypeable samples. Hence, these methods enable rigorous studies to be performed regarding the nature of disease outbreaks. Phenotypic, or conventional, methods will remain important in diagnostic microbiology, especially with organisms that are relatively easy to culture. However, genotypic methods may become increasingly prominent in clinical microbiology laboratories, particularly with respect to diagnosis of fastidious pathogens, because of their relative speed, versatility, and lack of cultivation requirements.
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Bacterias/genética , Técnicas de Tipificación Bacteriana , ADN Bacteriano/análisis , Infecciones Bacterianas/diagnóstico , Humanos , Epidemiología Molecular/métodosRESUMEN
Recent developments in the technology of van der Waals heterostructures made from two-dimensional atomic crystals have already led to the observation of new physical phenomena, such as the metal-insulator transition and Coulomb drag, and to the realization of functional devices, such as tunnel diodes, tunnel transistors and photovoltaic sensors. An unprecedented degree of control of the electronic properties is available not only by means of the selection of materials in the stack, but also through the additional fine-tuning achievable by adjusting the built-in strain and relative orientation of the component layers. Here we demonstrate how careful alignment of the crystallographic orientation of two graphene electrodes separated by a layer of hexagonal boron nitride in a transistor device can achieve resonant tunnelling with conservation of electron energy, momentum and, potentially, chirality. We show how the resonance peak and negative differential conductance in the device characteristics induce a tunable radiofrequency oscillatory current that has potential for future high-frequency technology.