Impact of COVID-19 on posttraumatic stress disorder in ICU survivors: a prospective observational comparative cohort study.

BACKGROUND: Posttraumatic stress disorder (PTSD) after a stay in the intensive care unit (ICU) can affect one in five ICU survivors. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, admission to the ICU for COVID-19 was stressful due to the severity of this disease. This study assessed whether admission to the ICU for COVID-19 was associated with a higher prevalence of PTSD compared with other causes of ICU admission after adjustment for pre-ICU psychological factors. METHODS: This prospective observational comparative cohort study included 31 ICUs. Eligible patients were adult ICU survivors hospitalized during the first wave of COVID-19 pandemic in France, regardless of the reason for admission. The prevalence of presumptive diagnosis of PTSD at 6 months was assessed using the PTSD Checklist for DSM-5 (PCL-5). Sociodemographics, clinical data, history of childhood trauma (Childhood Trauma Questionnaire [CTQ]), and exposure to potentially traumatic events (Life Events Checklist for DSM-5 [LEC-5]) were assessed. RESULTS: Of the 778 ICU survivors included during the first wave of COVID-19 pandemic in France, 417 and 361 were assigned to the COVID-19 and non-COVID-19 cohorts, respectively. Fourteen (4.9%) and 11 (4.9%), respectively, presented with presumptive diagnosis of PTSD at 6 months (p = 0.976). After adjusting for age, sex, severity score at admission, use of invasive mechanical ventilation, ICU duration, CTQ and LEC-5, COVID-19 status was not associated with presumptive diagnosis of PTSD using the PCL-5. Only female sex was associated with presumptive diagnosis of PTSD. However, COVID-19 patients reported significantly more intrusion and avoidance symptoms than non-COVID patients (39% vs. 29%, p = 0.015 and 27% vs. 19%, p = 0.030), respectively. The median PCL-5 score was higher in the COVID-19 than non-COVID-19 cohort (9 [3, 20] vs. 4 [2, 16], p = 0.034). CONCLUSION: Admission to the ICU for COVID-19 was not associated with a higher prevalence of PTSD compared with admission for another cause during the first wave of the COVID-19 pandemic in France. However, intrusion and avoidance symptoms were more frequent in COVID-19 patients than in non-COVID-19 patients. TRIAL REGISTRATION: Clinicaltrials.gov Identifier NCT03991611, registered on June 19, 2019.

Quantum chemical and experimental thermodynamic studies of HfO(g).

Hafnium dioxide vaporizes primarily to HfO(g) in a reducing environment. The thermochemistry of HfO(g) is calculated from quantum methods and measured via Knudsen effusion mass spectrometry. For the computations, all-electron and relativistic effective core potential calculations are used. The calculation of an accurate dissociation energy and an entire potential energy curve is reported. These calculations lead to ΔfH°(298) = 63.19 ± 10 kJ/mol, S°(298) = 235.52 J/mol K, and Cp(298-2500 K) = (2.741 × 10-9)T3 - (9.853 × 10-6)T2 + (1.295 × 10-2)T + 2.761 × 10-1 J/mol K. Experimentally, HfO(g) is generated from the reaction of Hf(s) and HfO2(s) in a specially made Hf Knudsen cell. A third law treatment of the data leads to ΔfH°(298) of 58.4 ± 12.3 kJ/mol, in good agreement with the calculated value.

Holographic Photopolymer Material with High Dynamic Range (Δn) via Thiol-Ene Click Chemistry.

A high-performance holographic recording medium was developed based on a unique combination of photoinitiated thiol-ene click chemistry and functional, linear polymers used as binders. Allyl reactive sites were incorporated along the backbone of the linear polymer binder to enable facile film casting and to facilitate cross-linking by photopolymerization of the thiol-ene monomers that also serve as the writing monomers in this distinctive approach to holographic materials. The allyl content and the ratio of the linear polymer to the writing monomers were varied to maximize and control the refractive index contrast. A blade-coating-based film preparation method was developed to form films from the mixture of linear polymer and the thiol-ene monomers. This approach results in a holographic material with a peak to mean index contrast (Δn) that reaches 0.04. The refractive index contrast was stable for at least two weeks. Haze in holograms with a high writing monomer loading was significantly reduced when a higher allyl content was incorporated into the binder, resulting in the lowest haze around 0.2%. Finally, the media exhibit high resolution as demonstrated by the ability to record reflection holograms with 140 nm pitch and diffraction efficiency in excess of 90%.

Enabling and Localizing Omnidirectional Nonlinear Deformation in Liquid Crystalline Elastomers.

Liquid crystalline elastomers (LCEs) are widely recognized for their exceptional promise as actuating materials. Here, the comparatively less celebrated but also compelling nonlinear response of these materials to mechanical load is examined. Prior examinations of planarly aligned LCEs exhibit unidirectional nonlinear deformation to mechanical loads. A methodology is presented to realize surface-templated homeotropic orientation in LCEs and omnidirectional nonlinearity in mechanical deformation. Inkjet printing of the homeotropic alignment surface localizes regions of homeotropic and planar orientation within a monolithic LCE element. The local control of the self-assembly and orientation of the LCE, when subject to rational design, yield functional materials continuous in composition with discontinuous mechanical deformation. The variation in mechanical deformation in the film can enable the realization of nontrivial performance. For example, a patterned LCE is prepared and shown to exhibit a near-zero Poisson's ratio. Further, it is demonstrated that the local control of deformation can enable the fabrication of rugged, flexible electronic devices. An additively manufactured device withstands complex mechanical deformations that would normally cause catastrophic failure.

Layered liquid crystal elastomer actuators.

Liquid crystalline elastomers (LCEs) are soft, anisotropic materials that exhibit large shape transformations when subjected to various stimuli. Here we demonstrate a facile approach to enhance the out-of-plane work capacity of these materials by an order of magnitude, to nearly 20 J/kg. The enhancement in force output is enabled by the development of a room temperature polymerizable composition used both to prepare individual films, organized via directed self-assembly to retain arrays of topological defect profiles, as well as act as an adhesive to combine the LCE layers. The material actuator is shown to displace a load >2500× heavier than its own weight nearly 0.5 mm.

Experimental search for high-temperature ferroelectric perovskites guided by two-step machine learning.

Experimental search for high-temperature ferroelectric perovskites is a challenging task due to the vast chemical space and lack of predictive guidelines. Here, we demonstrate a two-step machine learning approach to guide experiments in search of xBi[Formula: see text]O3-(1 - x)PbTiO3-based perovskites with high ferroelectric Curie temperature. These involve classification learning to screen for compositions in the perovskite structures, and regression coupled to active learning to identify promising perovskites for synthesis and feedback. The problem is challenging because the search space is vast, spanning ~61,500 compositions and only 167 are experimentally studied. Furthermore, not every composition can be synthesized in the perovskite phase. In this work, we predict x, y, Me', and Me″ such that the resulting compositions have both high Curie temperature and form in the perovskite structure. Outcomes from both successful and failed experiments then iteratively refine the machine learning models via an active learning loop. Our approach finds six perovskites out of ten compositions synthesized, including three previously unexplored {Me'Me″} pairs, with 0.2Bi(Fe0.12Co0.88)O3-0.8PbTiO3 showing the highest measured Curie temperature of 898 K among them.

Patterning nonisometric origami in nematic elastomer sheets.

Nematic elastomers dramatically change their shape in response to diverse stimuli including light and heat. In this paper, we provide a systematic framework for the design of complex three dimensional shapes through the actuation of heterogeneously patterned nematic elastomer sheets. These sheets are composed of nonisometric origami building blocks which, when appropriately linked together, can actuate into a diverse array of three dimensional faceted shapes. We demonstrate both theoretically and experimentally that the nonisometric origami building blocks actuate in the predicted manner, and that the integration of multiple building blocks leads to complex, yet predictable and robust, shapes. We then show that this experimentally realized functionality enables a rich design landscape for actuation using nematic elastomers. We highlight this landscape through examples, which utilize large arrays of these building blocks to realize a desired three dimensional origami shape. In combination, these results amount to an engineering design principle, which provides a template for the programming of arbitrarily complex three dimensional shapes on demand.

Electrical Control of Shape in Voxelated Liquid Crystalline Polymer Nanocomposites.

Liquid crystal elastomers (LCEs) exhibit anisotropic mechanical, thermal, and optical properties. The director orientation within an LCE can be spatially localized into voxels [three-dimensional (3-D) volume elements] via photoalignment surfaces. Here, we prepare nanocomposites in which both the orientation of the LCE and single-walled carbon nanotube (SWNT) are locally and arbitrarily oriented in discrete voxels. The addition of SWNTs increases the stiffness of the LCE in the orientation direction, yielding a material with a 5:1 directional modulus contrast. The inclusion of SWNT modifies the thermomechanical response and, most notably, is shown to enable distinctive electromechanical deformation of the nanocomposite. Specifically, the incorporation of SWNTs sensitizes the LCE to a dc field, enabling uniaxial electrostriction along the orientation direction. We demonstrate that localized orientation of the LCE and SWNT allows complex 3-D shape transformations to be electrically triggered. Initial experiments indicate that the SWNT-polymer interfaces play a crucial role in enabling the electrostriction reported herein.

Voxel resolution in the directed self-assembly of liquid crystal polymer networks and elastomers.

Monomeric mixtures formulated to prepare a liquid crystal polymer network (LCN) or elastomer (LCE) can be "programmed" by surface alignment to retain complex and arbitrary spatial distributions of the director orientation upon polymerization. The localized control of orientation in a given volume (voxel) within these materials is the subject of intense research, currently motivated by the prospect of distinctive mechanical responses (both active and passive). Here, we report on a rapid and scalable photopatterning method to prepare alignment surfaces with a throughput of 10 mm2 s-1, using a commercial spatial light modulator and projection optics. Enabled by this method, we detail that the resolution limit of the inscribed director profile is not dictated by the optical system but is determined by the elastic-mediated orientational relaxation of the liquid crystalline materials. A simple model is experimentally validated and the implications for device design are discussed.

Pixelated Polymers: Directed Self Assembly of Liquid Crystalline Polymer Networks.

Polymeric materials are pervasive in modern society, in part attributable to the diverse range of properties that are accessible in these materials. Polymers can be stiff or soft, dissipative or elastic, adhesive or nonstick. Localizing the properties of polymeric materials can be achieved by a number of methods, including self-assembly, lithography, or 3-d printing. Here, we detail recent advances in the preparation of "pixelated" polymers prepared by the directed self-assembly of liquid crystalline monomers to yield cross-linked polymer networks (liquid crystalline polymer networks, LCN, or liquid crystalline elastomers, LCE). Through the local and arbitrary control of the orientation of the liquid crystalline units, monolithic elements can be realized with spatial variation in mechanical, thermal, electrical, optical, or acoustic properties. Stimuli-induced variation of these properties may enable paradigm-shifting end uses in a diverse set of applications.

Synthesis of Elastomeric Liquid Crystalline Polymer Networks via Chain Transfer.

Materials capable of complex shape changes have broad reaching applications spanning biomimetic devices, componentless actuators, artificial muscles, and haptic displays. Liquid crystal elastomers (LCE) are a class of shape programmable materials which display anisotropic mechanical deformations in response external stimuli. This work details a synthetic strategy to quickly and efficiently prepare LCEs through the usage of chain transfer agents (CTA). The polyacrylate materials described herein exhibit large, reversible shape changes with strains greater 475%, rivalling properties observed in polysiloxane-based networks. The approach reported here is distinguished in that the materials chemistry is readily amenable to surface alignment techniques. The facile nature of the materials chemistry and the compatibility of these materials with directed self-assembly methods could further enable paradigm shifting end uses as designer substrates for flexible electronics or as actuating surfaces.

Two-color single-photon photoinitiation and photoinhibition for subdiffraction photolithography.

Controlling and reducing the developed region initiated by photoexposure is one of the fundamental goals of optical lithography. Here, we demonstrate a two-color irradiation scheme whereby initiating species are generated by single-photon absorption at one wavelength while inhibiting species are generated by single-photon absorption at a second, independent wavelength. Co-irradiation at the second wavelength thus reduces the polymerization rate, delaying gelation of the material and facilitating enhanced spatial control over the polymerization. Appropriate overlapping of the two beams produces structures with both feature sizes and monomer conversions otherwise unobtainable with use of single- or two-photon absorption photopolymerization. Additionally, the generated inhibiting species rapidly recombine when irradiation with the second wavelength ceases, allowing for fast sequential exposures not limited by memory effects in the material and thus enabling fabrication of complex two- or three-dimensional structures.