ABSTRACT
A high-entropy oxide nanocomposite with Ag(CuZn)(AlCr)2O4 and CuO phases is fabricated to form an abundantly hierarchical wrinkled surface. Application of a mechanical force to the nanocomposite resulted in a nonhomogeneous strain gradient at the interface between the Ag(CuZn)(AlCr)2O4 and CuO phases, changing the local charge distribution and creating flexoelectric polarization that delayed electron/hole recombination. Transmission electron microscopy energy-dispersive X-ray spectroscopy mapping revealed that the Ag, Cu, Zn, Al, Cr, and O elements were highly distributed throughout the nanocomposite. The nanocomposite produced 2116 µmol·g-1 h-1 of H2 without external light irradiation, which is 980% higher than the H2 produced by the same nanocomposite under the photocatalytic process. A strong electrical field is observed at the interface between the Ag(CuZn)(AlCr)2O4 and CuO phases, demonstrating that a flexoelectric potential (flexopotential) is established at the structural boundaries because the strain gradient is localized at these interfaces. The nanocomposite is a promising approach for environmentally friendly energy production.
ABSTRACT
BACKGROUND: The Ho-Chi-Minh-city Heart Institute in Vietnam took part in the Optimize Heart Failure (OHF) Care Program, designed to improve outcomes following heart failure (HF) hospitalization by increasing patient awareness and optimizing HF treatment. METHODS: HF patients hospitalized with left ventricular ejection-fraction (LVEF) <50% were included. Patients received guideline-recommended HF treatment and education. Clinical signs, treatments and outcomes were assessed at admission, discharge, 2 and 6â¯months (M2, M6). Patients' knowledge and practice were assessed at M6 by telephone survey. RESULTS: 257 patients were included. Between admission and M2 and M6, heart rate decreased significantly, and clinical symptoms improved significantly. LVEF increased significantly from admission to M6. 85% to 99% of patients received education. At M6, 45% to 78% of patients acquired knowledge and adhered to practice regarding diet, exercise, weight control, and detection of worsening symptoms. High use of renin-angiotensin-aldosterone-system inhibitors (91%), mineralocorticoid-receptor-antagonists (77%) and diuretics (85%) was noted at discharge. Beta-blocker and ivabradine use was less frequent at discharge but increased significantly at M6 (from 33% to 51% and from 9% to 20%, respectively, pâ¯<â¯0.001). There were no in-hospital deaths. Readmission rates at 30 and 60â¯days after discharge were 8.3% and 12.5%, respectively. Mortality rates at 30â¯days, 60â¯days and 6â¯months were 1.2%, 2.5% and 6.4%, respectively. CONCLUSIONS: The OHF Care Program could be implemented in Vietnam without difficulty and was associated with high usage of guideline-recommended drug therapy. Although education was delivered, patient knowledge and practice could be further improved at M6 after discharge.
