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1.
Adv Sci (Weinh) ; 11(16): e2308797, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38355302

RESUMEN

Ferroelectric wurtzite-type aluminum scandium nitride (Al1-xScxN) presents unique properties that can enhance the performance of non-volatile memory technologies. The realization of the full potential of Al1-xScxN requires a comprehensive understanding of the mechanism of polarization reversal and domain structure dynamics involved in the ferroelectric switching process. In this work, transient current integration measurements performed by a pulse switching method are combined with domain imaging by piezoresponse force microscopy (PFM) to investigate the kinetics of domain nucleation and wall motion during polarization reversal in Al0.85Sc0.15N capacitors. In the studied electric field range (from 4.4 to 5.6 MV cm-1), ferroelectric switching proceeds via domain nucleation and wall movement. The currently available phenomenological models are shown to not fully capture all the details of the complex dynamics of polarization reversal in Al0.85Sc0.15N. PFM reveals a non-linear increase of both domain nucleation rate and lateral wall velocity during the switching process, as well as the dependency of the domain pattern on the polarization reversal direction. A continuously faster N- to M-polar switching upon cycling is reported and ascribed to an increasing number of M-polar nucleation sites and density of domain walls.

2.
JAMA Netw Open ; 7(2): e240209, 2024 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-38376839

RESUMEN

Importance: Transportation barriers have long been associated with poorer health outcomes; this burden is especially acute for individuals with opioid use disorder (OUD), a chronic disease often associated with low socioeconomic status. Conventional travel time analyses may not fully account for experiential components of travel, thereby understating the true travel burden and overstating treatment accessibility to opioid treatment programs (OTPs). Objective: To develop a metric of feels-like accessibility for those using public transit to access OTPs that accounts for the realistic travel burden on individuals with OUD. Design, Setting, and Participants: This cross-sectional study integrated high-resolution transit schedules and operating hours of OTPs to measure feels-like accessibility. Feels-like accessibility considers the differential outcomes of out-of-vehicle travel components and more realistically reflects individuals' transportation burden than conventional accessibility measures. Gini indices and spatial regression models were used to investigate inequities in accessibility. Geocoded data for residential addresses of 1018 overdose fatalities in Connecticut in 2019 were used as a proxy for the treatment needs of individuals with OUD. Data were analyzed between May and August 2023. Main Outcomes and Measures: Conventional and feels-like accessibility scores. Exposures: Fluctuations in public transit frequencies over the course of the day and the limited operating hours of the OTPs. Results: Of the 1018 individuals in the study, the mean (SD) age at death was 43.7 (12.6) years, 784 individuals (77%) were men, 111 (11%) were African American, and 889 (87%) were White, with other racial and ethnic categories including 18 individuals (2%). A total of 264 individuals in the sample (26%) could not access an OTP within 180 minutes. For those who could access these facilities, the average 1-way travel time was 45.6 minutes, with individuals spending approximately 70% of their trip duration on out-of-vehicle travel components. The conventional accessibility metric underestimates individuals' travel burden to OTPs as well as the inequity in accessibility compared with the feels-like accessibility metric. For example, the median (range) conventional accessibility score, defined as the number of OTPs within 120 minutes of transit travel time, was 5.0 (0.0-17.0); the median (range) feels-like accessibility score, defined as the number of OTPs within 120 minutes of transit travel time weighted to account for in- and out-of-vehicle segments, was 1.0 (0.0-10.0). There is a considerable temporal variation in travel time and accessibility depending on the departure times. Conclusions and Relevance: In this cross-sectional study of travel burdens, the calculated feels-like accessibility scores, which consider the differential outcomes of out-of-vehicle travel components (eg, walking and waiting), could better and more realistically reflect passengers' transportation burden. Policy recommendations derived from the conventional accessibility metric could be misleading, and decision-makers should use feels-like accessibility metrics that adequately capture individuals' travel burdens. In the context of access to OTPs, the findings from this study suggest that opening new OTP sites to address gaps in access due to distance to services or extending hours of operation at existing sites may ameliorate the travel burden for individuals.


Asunto(s)
Analgésicos Opioides , Trastornos Relacionados con Opioides , Masculino , Humanos , Femenino , Analgésicos Opioides/uso terapéutico , Estudios Transversales , Viaje , Transportes , Trastornos Relacionados con Opioides/epidemiología
3.
Opt Lett ; 49(3): 566-569, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38300060

RESUMEN

We introduce a method for the analysis and simulation of transient images of laser-produced plasma (LPP) plumes. This method comprises three steps: (i) calculating the two-dimensional distribution of plasma parameters using a radiation hydrodynamics model, (ii) constructing radiation paths through ray tracing, and (iii) solving the radiation transport equation along these paths. In our simulations, we have meticulously considered factors that could influence the imaging results, including the quantum efficiency to different radiation wavelengths, the imaging lens' transmittance, the target surface's reflectivity, and the absorption, emission, and scattering quantum effect of the detector processes occurring in the plasma. We applied this method to analyze and simulate the transient images of aluminum plasma plumes in a background air environment at a pressure of 2000 Pa. The results demonstrate that our method not only produces simulated images that align with experimental results but also provides a reliable distribution of plasma state parameters and clearly identifies the ion species radiating in different bands. Given its capability in transient image reconstruction and its adaptability as a tool for spectral simulation and analysis of LPPs, we believe this method holds significant potential for spectral diagnostics in fields such as laser-induced breakdown spectroscopy, extreme ultraviolet lithography sources, and high-energy-density physics, among others.

4.
Nat Commun ; 15(1): 860, 2024 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-38287021

RESUMEN

HfO2-based thin films hold huge promise for integrated devices as they show full compatibility with semiconductor technologies and robust ferroelectric properties at nanometer scale. While their polarization switching behavior has been widely investigated, their electromechanical response received much less attention so far. Here, we demonstrate that piezoelectricity in Hf0.5Zr0.5O2 ferroelectric capacitors is not an invariable property but, in fact, can be intrinsically changed by electrical field cycling. Hf0.5Zr0.5O2 capacitors subjected to ac cycling undergo a continuous transition from a positive effective piezoelectric coefficient d33 in the pristine state to a fully inverted negative d33 state, while, in parallel, the polarization monotonically increases. Not only can the sign of d33 be uniformly inverted in the whole capacitor volume, but also, with proper ac training, the net effective piezoresponse can be nullified while the polarization is kept fully switchable. Moreover, the local piezoresponse force microscopy signal also gradually goes through the zero value upon ac cycling. Density functional theory calculations suggest that the observed behavior is a result of a structural transformation from a weakly-developed polar orthorhombic phase towards a well-developed polar orthorhombic phase. The calculations also suggest the possible occurrence of a non-piezoelectric ferroelectric Hf0.5Zr0.5O2. Our experimental findings create an unprecedented potential for tuning the electromechanical functionality of ferroelectric HfO2-based devices.

5.
Am J Epidemiol ; 193(3): 407-409, 2024 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-37939152

RESUMEN

In epidemiology, collider stratification bias, the bias resulting from conditioning on a common effect of two causes, is oftentimes considered a type of selection bias, regardless of the conditioning methods employed. In this commentary, we distinguish between two types of collider stratification bias: collider restriction bias due to restricting to one level of a collider (or a descendant of a collider) and collider adjustment bias through inclusion of a collider (or a descendant of a collider) in a regression model. We argue that categorizing collider adjustment bias as a form of selection bias may lead to semantic confusion, as adjustment for a collider in a regression model does not involve selecting a sample for analysis. Instead, we propose that collider adjustment bias can be better viewed as a type of overadjustment bias. We further provide two distinct causal diagram structures to distinguish collider restriction bias and collider adjustment bias. We hope that such a terminological distinction can facilitate easier and clearer communication.


Asunto(s)
Sesgo de Selección , Humanos , Sesgo , Causalidad
6.
Front Psychol ; 14: 1275582, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37920744

RESUMEN

Introduction: With social changes, the realization of smooth and satisfactory employment of college students is an issue that requires deep thought. Basic psychological needs satisfaction play an important role as a guiding factor that affects students' career adaptability. This study aims to explore the relationship and mechanism between the satisfaction of students' basic psychological needs satisfaction and their career adaptability. Methods: A survey is conducted among students from six different universities across the country, using the Basic Psychological Needs Satisfaction Scale, the Career Adaptability Scale, the Career Decision Self-Efficacy Scale, and the Career Outcome Expectations Scale. Results: The satisfaction of basic psychological needs, career decision self-efficacy, and career outcome expectations are all significantly positively correlated with career adaptability.Career decision self-efficacy plays a partial mediating role between basic psychological needs satisfaction and career adaptability among college students. The moderated mediation model found that career outcome expectations play a regulatory role in the effect of career decision self-efficacy on career adaptability. Discussion: College students' basic psychological need satisfaction can positively predict career adaptability directly and indirectly affect career adaptability through career decision self-efficacy, and career outcome expectations have a moderating role between career decision self-efficacy and career adaptability.

7.
Nat Med ; 29(9): 2241-2247, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37640859

RESUMEN

Pay-it-forward incentives involve having a person receive a free test with community-generated messages and then asking if those who received a free test would like to donate money to support others to receive free testing. Here we undertook a two-arm cluster-randomized trial to evaluate pay-it-forward incentives with active community participation to promote hepatitis B virus (HBV) and hepatitis C virus (HCV) testing among men who have sex with men in China. Men randomized to the pay-it-forward arm received free HBV and HCV testing and were offered a chance to pay-it-forward by donating money to support the testing of another anonymous person. Each participant paid for their HCV and HBV test at 7.7 USD per test in the standard-of-care arm. The primary outcome was the proportion of men who tested for HBV and HCV. Between 28 March and 6 November 2021, 32 groups (10 men per group) of men were randomized to the pay-it-forward (n = 160, 16 clusters) and standard-of-care (n = 162, 16 clusters) arms, respectively. HBV and HCV rapid testing were higher in the pay-it-forward arm (59.4%) than in the standard-of-care arm (25.3%) (proportion difference 35.2%, 95% confidence interval 24.1-46.3%). No adverse events were reported. The community-led pay-it-forward incentives improved HBV and HCV testing among men who have sex with men. Clinical Trial registration: ChiCTR 2100046140.


Asunto(s)
Hepatitis C , Minorías Sexuales y de Género , Masculino , Humanos , Homosexualidad Masculina , Motivación , Virus de Hepatitis , Hepacivirus , Virus de la Hepatitis B , Hepatitis C/diagnóstico , Hepatitis C/epidemiología
9.
Am J Clin Nutr ; 118(1): 264-272, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37146758

RESUMEN

BACKGROUND: Although increasing evidence suggests that polyphenol helps regulate blood pressure (BP), evidence from large-scale and long-term population-based studies is still lacking. OBJECTIVES: This study aimed to investigate the association between dietary polyphenol and hypertension risk in the China Health and Nutrition Survey (N = 11,056). METHODS: Food intake was assessed using 3-d, 24-h dietary recalls and household weighing method; polyphenol intake was calculated by multiplying consumption of each food and its polyphenol content. Hypertension was defined as BP ≥ 140/90 mmHg, physicians' diagnosis, or taking antihypertension medications. HR and 95% CI were estimated using mixed-effects Cox models. RESULTS: During 91,561 person-years of follow-up, a total of 3866 participants developed hypertension (35%). The lowest multivariable-adjusted HR (95% CI) of hypertension risk occurred in the third quartile intake, which was 0.63 (0.57, 0.70) for total polyphenol, 0.61 (0.55, 0.68) for flavonoid, 0.62 (0.56, 0.69) for phenolic acid, 0.46 (0.42, 0.51) for lignan, and 0.58 (0.52, 0.64) for stilbene, compared with the lowest quartile. The polyphenol-hypertension associations were nonlinear (all Pnonlinearity < 0.001), and different patterns were observed. U-shaped relations with hypertension were observed for total polyphenol, flavonoid, and phenolic acid, whereas L-shaped associations were observed for lignan and stilbene. Moreover, higher fiber intake strengthened the polyphenol-hypertension association, especially for lignan (P-interaction = 0.002) and stilbene (P-interaction = 0.004). Polyphenol-containing food, particularly vegetables and fruits rich in lignan and stilbene, were significantly associated with lower hypertension risk. CONCLUSIONS: This study demonstrated an inverse and nonlinear association between dietary polyphenol, especially lignan and stilbene, and hypertension risk. The findings provide implications for hypertension prevention.


Asunto(s)
Hipertensión , Lignanos , Humanos , Polifenoles/análisis , Estudios de Cohortes , Dieta/métodos , Flavonoides , Hipertensión/epidemiología , Hipertensión/etiología , Ingestión de Alimentos , China/epidemiología
10.
Plant Physiol Biochem ; 200: 107762, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37207493

RESUMEN

Global warming causes topsoil temperatures to increase, which potentially leads to maize yield loss. We explored the effects of soil warming/cooling on root-shoot growth and maize grain yields by performing pot experiments with a heat-sensitive maize hybrid (HS208) and a normal maize hybrid (SD609) in warm temperate climate in 2019 and 2020. Our results reveal, for the first time, differences in root characteristics, leaf photosynthetic physiology, and yield responses to soil warming and cooling between normal and heat-sensitive maize varieties under a warm temperate climate. Soil warming (+2 and 4 °C) inhibited whole root growth by decreasing root length, volume, and dry mass weight, which indirectly reduced leaf photosynthetic capacity and decreased grain yield/plant by 15.10-24.10% versus control plants exposed to ambient temperature. Soil cooling (-2 °C) promoted root growth and leaf photosynthesis, and significantly increased grain yield of HS208 by 12.61%, although no significant change was found with SD609. It can be seen that under unfavorable conditions of global warming, selection of excellent stress-resistant hybrids plays an important role in alleviating the soil heat stress of maize in warm temperate climate regions.


Asunto(s)
Suelo , Zea mays , Zea mays/fisiología , Grano Comestible , Fotosíntesis/fisiología , Hojas de la Planta
11.
Plant Physiol Biochem ; 198: 107694, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37062126

RESUMEN

Affected by climate warming, the impact of crop root zone warming (RZW) on maize seedling growth and nutrient uptake deserve attention. The characteristics of K uptake in maize under root zone warming and the combined impacts of potassium deficiency and RZW are still unclear. The present study aimed to investigate the effects of RZW on potassium absorption and photosynthesis of maize seedlings under the difference in potassium. The results showed that RZW and low potassium treatment significantly affected root shoot development and photosynthetic physiological characteristics of maize seedlings. Moreover, the interaction of RZW and potassium content had striking influence on maize seedlings. Under the normal potassium with root zone medium temperature treatment, the development of maize was the most vigorous. Under the dual stress of high root zone temperature and low potassium, the root absorption area, total potassium content and root activity were significantly reduced, which then influenced the light energy use efficiency and dry matter accumulation. Securing the supply of potassium fertilizer under high root zone temperature stress is useful to alleviate the impact of high temperature stress.


Asunto(s)
Potasio , Zea mays , Zea mays/fisiología , Temperatura , Fotosíntesis/fisiología , Plantones/fisiología
12.
Opt Express ; 31(5): 7249-7258, 2023 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-36859860

RESUMEN

We developed a post-processing optical imaging model based on two-dimensional axisymmetric radiation hydrodynamics. Simulation and program benchmarks were performed using laser-produced Al plasma optical images obtained via transient imaging. The emission profiles of a laser-produced Al plasma plume in air at atmospheric pressure were reproduced, and the influence of plasma state parameters on radiation characteristics were clarified. In this model, the radiation transport equation is solved on the real optical path, which is mainly used to study the radiation of luminescent particles during plasma expansion. The model outputs consist of the electron temperature, particle density, charge distribution, absorption coefficient, and corresponding spatio-temporal evolution of the optical radiation profile. The model helps with understanding element detection and quantitative analysis of laser-induced breakdown spectroscopy.

13.
Neuroimage ; 271: 120019, 2023 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-36914108

RESUMEN

Studies of resting-state functional connectivity (rsFC) have provided rich insights into the structures and functions of the human brain. However, most rsFC studies have focused on large-scale brain connectivity. To explore rsFC at a finer scale, we used intrinsic signal optical imaging to image the ongoing activity of the anesthetized macaque visual cortex. Differential signals from functional domains were used to quantify network-specific fluctuations. In 30-60 min resting-state imaging, a series of coherent activation patterns were observed in all three visual areas we examined (V1, V2, and V4). These patterns matched the known functional maps (ocular dominance, orientation, color) obtained in visual stimulation conditions. These functional connectivity (FC) networks fluctuated independently over time and exhibited similar temporal characteristics. Coherent fluctuations, however, were observed from orientation FC networks in different areas and even across two hemispheres. Thus, FC in the macaque visual cortex was fully mapped both on a fine scale and over a long range. Hemodynamic signals can be used to explore mesoscale rsFC in a submillimeter resolution.


Asunto(s)
Conectoma , Macaca fascicularis , Descanso , Corteza Visual , Macaca fascicularis/fisiología , Corteza Visual/irrigación sanguínea , Corteza Visual/fisiología , Corteza Visual/ultraestructura , Masculino , Animales , Descanso/fisiología , Estimulación Luminosa , Imagen Óptica , Hemodinámica
14.
Am J Epidemiol ; 192(8): 1341-1349, 2023 08 04.
Artículo en Inglés | MEDLINE | ID: mdl-36922393

RESUMEN

In first-line antiretroviral therapy (ART) for human immunodeficiency virus (HIV) treatment, some subgroups of patients may respond better to an efavirenz-based regimen than an integrase strand transfer inhibitor (InSTI)-based regimen, or vice versa, due to patient characteristics modifying treatment effects. Using data based on nearly 16,000 patients from the North American AIDS Cohort Collaboration on Research and Design from 2009-2016, statistical methods for precision medicine were employed to estimate an optimal treatment rule that minimizes the 5-year risk of the composite outcome of acquired immune deficiency syndrome (AIDS)-defining illnesses, serious non-AIDS events, and all-cause mortality. The treatment rules considered were functions that recommend either an efavirenz- or InSTI-based regimen conditional on baseline patient characteristics such as demographic information, laboratory results, and health history. The estimated 5-year risk under the estimated optimal treatment rule was 10.0% (95% confidence interval (CI): 8.6, 11.3), corresponding to an absolute risk reduction of 2.3% (95% CI: 0.9, 3.8) when compared with recommending an efavirenz-based regimen for all patients and 2.6% (95% CI: 1.0, 4.2) when compared with recommending an InSTI-based regimen for all. Tailoring ART to individual patient characteristics may reduce 5-year risk of the composite outcome compared with assigning all patients the same drug regimen.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Humanos , VIH , Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Medicina de Precisión , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico
15.
Ann Epidemiol ; 79: 32-38, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36669599

RESUMEN

PURPOSE: Since 2012 fentanyl-detected fatal overdoses have risen from 4% of all fatal overdoses in Connecticut to 82% in 2019. We aimed to investigate the geographic and temporal trends in fentanyl-detected deaths in Connecticut during 2009-2019. METHODS: Data on the dates and locations of accidental/undetermined opioid-detected fatalities were obtained from Connecticut Office of the Chief Medical Examiner. Using a Bayesian space-time binomial model, we estimated spatiotemporal trends in the proportion of fentanyl-detected deaths. RESULTS: During 2009-2019, a total of 6,632 opioid deaths were identified. Among these, 3234 (49%) were fentanyl-detected. The modeled spatial patterns suggested that opioid deaths in northeastern Connecticut had higher probability of being fentanyl-detected, while New Haven and its neighboring towns and the southwestern region of Connecticut, primarily Greenwich, had a lower risk. Model estimates also suggested fentanyl-detected deaths gradually overtook the preceding non-fentanyl opioid-detected deaths across Connecticut. The estimated temporal trend showed the probability of fentanyl involvement increased substantially since 2014. CONCLUSIONS: Our findings suggest that geographic variation exists in the probability of fentanyl-detected deaths, and areas at heightened risk are identified. Further studies are warranted to explore potential factors contributing to the geographic heterogeneity and continuing dispersion of fentanyl-detected deaths in Connecticut.


Asunto(s)
Sobredosis de Droga , Fentanilo , Humanos , Analgésicos Opioides , Connecticut/epidemiología , Teorema de Bayes
16.
Nanoscale ; 15(3): 1248-1259, 2023 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-36541680

RESUMEN

MXenes, two-dimensional transition metal carbides, nitrides, and carbonitrides, are known for their exceptional electronic and mechanical properties. Yet, the experimental efforts toward the realization of MXene-based nanoelectromechanical systems (NEMS) combining electrical and mechanical functionalities of MXenes at the nanoscale remain very limited. Here, we demonstrate a high-yield fabrication of the electromechanical devices based on individual suspended monolayer MXene flakes. We employed Ti3C2Tx, the most popular MXene material to date, that can be produced as high-quality micrometer-scale monolayer flakes with a high electrical conductivity of over 10 000 S cm-1 and a high effective Young's modulus of about 330 GPa. These Ti3C2Tx flakes can be transferred over prefabricated trenches in a Si/Si3N4 substrate at a high yield, potentially enabling fabrication of hundreds of electromechanical devices based on suspended MXene monolayers. We demonstrate very clean, uniform, and well-stretched membranes with different dimensions, with Ti3C2Tx flakes suspended over trenches with gaps ranging from 200 nm to 2 µm. The resulting Ti3C2Tx monolayer membranes were electrostatically actuated, while their vertical displacement was monitored using a tip of an atomic force microscope (AFM). The devices reliably responded to the electrostatic actuation in ambient conditions over multiple cycles and with different measurement parameters, such as AC frequency, AC voltage amplitude, and AFM tip loading force. The demonstration of the high-yield fabrication of working electromechanical devices based on suspended Ti3C2Tx MXene membranes at the ultimate monolayer limit paves the way for the future exploration of the potential of MXenes for NEMS applications.

17.
Sci Total Environ ; 862: 160738, 2023 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-36496024

RESUMEN

Temperature is a key factor in regulating and controlling several ecological processes. As there is a feedback relationship between many biogeochemical processes and climate change, their response to temperature changes is particularly important. Previously, a large volume of literature has extensively explored the impact of rising air temperature on shoot growth and maize yield, from enzymatic responses within the leaf to grain yield. As the global temperature continues to increase and the frequency, duration, and/or intensity of heat wave events increases, the soil temperature of the tilth is likely to rise sharply. As one of the most widely planted food crops in the world, maize may be subjected to additional soil temperature pressure. However, as a nutrient organ in direct contact with soil, the root plays a key role in adapting the whole plant to excessive soil temperature. Little research has been done on the effect of the soil microenvironment induced by higher soil temperature on maize root growth and root to shoot communication regulation. Therefore, this review summarizes (1) the effects of excessive soil temperature on the soil microenvironment, including soil respiration, microbial community composition, carbon mineralization, and enzyme activity; (2) the negative response of absorption of water and nutrients by roots and maize root-shoot growth to excessive soil temperature; and (3) potential cultivation strategies to improve maize yield, including improving tillage methods, adding biochar amendments, applying organic fertilizers, optimizing irrigation, and farmland mulching.


Asunto(s)
Suelo , Zea mays , Suelo/química , Biodiversidad , Temperatura , Carbono , Fertilizantes/análisis , Agricultura
18.
Front Psychiatry ; 13: 1092199, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36582257

RESUMEN

Background: The geriatric and health characteristics of older adults make them more susceptible to the effects of opioids than younger groups. The number of older adults in the United States visiting the emergency department (ED) and overusing opioids has increased in recent years. Research examining their relationship is, however, limited. Methods: Using information from the 2020 National Health Interview Survey (NHIS), we included older adults aged 65 and older. To investigate the relationship between prescribed opioid use and 12-months ED visits and hospitalizations, linear regression and logistic regression models were built while adjusting for age, sex, ethnicity, education, employment, general health status, history of depression, and living arrangement. Results: Our study population consisted of 8,631 participants (mean age 74.3). Most of them were females (58.3%) and Caucasian (81.6%). About 16% of the participants used prescribed opioids over the past 12 months. Of the participants with prescribed opioid use, 65.1% of them did so to treat chronic pain. The adjusted regression models revealed that prescribed opioid use was independently and positively associated with 12-months ED visits (ß = 0.22, 95% confidence interval [CI] 0.18, 0.26) and hospitalizations (Odds ratio [OR] = 3.78, 95% CI 3.29, 4.35). Other risk factors for 12-months ED visits and/or hospitalizations included advanced age, male gender, unemployment/retirement, African American ethnicity, living alone, fair or poor general health status, and history of depression. Discussions: Clinicians should screen older adults at high risk for ED visits and hospitalizations and explore multimodal pain management with them to help them reduce/stop using opioids. These efforts may decrease their chronic pain, opioid use, opioid use-related adverse health outcomes, ED visits, as well as hospitalizations.

19.
Adv Mater ; 34(47): e2206237, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36210741

RESUMEN

Piezoresponse force microscopy (PFM) is widely used for characterization and exploration of the nanoscale properties of ferroelectrics. However, quantification of the PFM signal is challenging due to the convolution of various extrinsic and intrinsic contributions. Although quantification of the PFM amplitude signal has received considerable attention, quantification of the PFM phase signal has not been addressed. A properly calibrated PFM phase signal can provide valuable information on the sign of the local piezoelectric coefficient-an important and nontrivial issue for emerging ferroelectrics. In this work, two complementary methodologies to calibrate the PFM phase signal are discussed. The first approach is based on using a standard reference sample with well-known independently measured piezoelectric coefficients, while the second approach exploits the electrostatic sample-cantilever interactions to determine the parasitic phase offset. Application of these methodologies to studies of the piezoelectric behavior in ferroelectric HfO2 -based thin-film capacitors reveals intriguing variations in the sign of the longitudinal piezoelectric coefficient, d33,eff . It is shown that the piezoelectric properties of the HfO2 -based capacitors are inherently sensitive to their thickness, electrodes, as well as deposition methods, and can exhibit wide variations including a d33,eff sign change within a single device.

20.
Adv Mater ; 34(45): e2203028, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36114716

RESUMEN

Ferroelectric domain walls provide a fertile environment for novel materials physics. If a polarization discontinuity arises, it can drive a redistribution of electronic carriers and changes in band structure, which often result in emergent 2D conductivity. If such a discontinuity is not tolerated, then its amelioration usually involves the formation of complex topological patterns, such as flux-closure domains, dipolar vortices, skyrmions, merons, or Hopfions. The degrees of freedom required for the development of such patterns, in which dipolar rotation is a hallmark, are readily found in multiaxial ferroelectrics. In uniaxial ferroelectrics, where only two opposite polar orientations are possible, it has been assumed that discontinuities are unavoidable when antiparallel components of polarization meet. This perception has been borne out by the appearance of charged conducting domain walls in systems such as hexagonal manganites and lithium niobate. Here, experimental and theoretical investigations on lead germanate (Pb5 Ge3 O11 ) reveal that polar discontinuities can be obviated at head-to-head and tail-to-tail domain walls by mutual domain bifurcation along two different axes, creating a characteristic saddle-point domain wall morphology and associated novel dipolar topology, removing the need for screening charge accumulation and associated conductivity enhancement.

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