Pulmonary Rehabilitation Is Associated With Decreased Exacerbation and Mortality in Patients With COPD: A Nationwide Korean Study.

BACKGROUND: Poor uptake to pulmonary rehabilitation (PR) is still challenging around the world. There have been few nationwide studies investigating whether PR impacts patient outcomes in COPD. We investigated the change of annual PR implementation rate, medical costs, and COPD outcomes including exacerbation rates and mortality between 2015 and 2019. RESEARCH QUESTION: Does PR implementation improve outcomes in patients with COPD in terms of direct cost, exacerbation, and mortality? STUDY DESIGN AND METHODS: Data of patients with COPD extracted from a large Korean Health Insurance Review and Assessment service database (2015-2019) were analyzed to determine the trends of annual PR implementation rate and direct medical costs of PR. Comparison of COPD exacerbation rates between pre-PR and post-PR, and the time to first exacerbation and mortality rate according to PR implementation, were also assessed. RESULTS: Among all patients with COPD in South Korea, only 1.43% received PR. However, the annual PR implementation rate gradually increased from 0.03% to 1.4% during 4 years, especially after health insurance coverage commencement. The direct medical cost was significantly higher in the PR group than the non-PR group, but the costs in these groups showed decreasing and increasing trends, respectively. Both the incidence rate and frequency of moderate-to-severe and severe exacerbations were lower during the post-PR period compared with the pre-PR period. The time to the first moderate-to-severe and severe exacerbations was longer in the PR group than the non-PR group. Finally, PR implementation was associated with a significant decrease in mortality. INTERPRETATION: We concluded that health insurance coverage increases PR implementation rates. Moreover, PR contributes toward improving outcomes including reducing exacerbation and mortality in patients with COPD. However, despite the well-established benefits of PR, its implementation rate remains suboptimal.

Utilization of 2D materials in aqueous zinc ion batteries for safe energy storage devices.

Aqueous rechargeable battery has been an intense topic of research recently due to the significant safety issues of conventional Li-ion batteries (LIBs). Amongst the various candidates of aqueous batteries, aqueous zinc ion batteries (AZIBs) hold great promise as a next generation safe energy storage device due to its low cost, abundance in nature, low toxicity, environmental friendliness, low redox potential, and high theoretical capacity. Yet, the promise has not been realized due to their limitations, such as lower capacity compared to traditional LIB, dendrite growth, detrimental degradation of electrode materials structure as ions intercalate/de-intercalate, and gas evolution/corrosion at the electrodes, which remains a significant challenge. To address the challenges, various 2D materials with different physiochemical characteristics have been utilized. This review explores fundamental physiochemical characteristics of widely used 2D materials in AZIBs, including graphene, MoS2, MXenes, 2D metal organic framework, 2D covalent organic framework, and 2D transition metal oxides, and how their characteristics have been utilized or modified to address the challenges in AZIBs. The review also provides insights and perspectives on how 2D materials can help to realize the full potential of AZIBs for next-generation safe and reliable energy storage devices.

Near-UV light emitting diode with on-chip photocatalysts for purification applications.

A new design for light-emitting diodes (LEDs) with on-chip photocatalysts is presented for purification applications. An array of disk-shaped TiO2, with a diameter of several hundred nanometers, combined with SiO2 pedestals was fabricated directly on the surface of an InGaN-based near-ultraviolet (UV) LED using a dry etching process. The high refractive-index contrast at the boundary and the circular shape can effectively confine the near-UV light generated from the LED through multiple internal reflections inside the TiO2 nanodisks. Such a feature results in the enhancement of light absorption by the photocatalytic TiO2. The degradation of the organic dye malachite green was monitored as a model photocatalytic reaction. The proposed structure of LEDs with TiO2/SiO2 nanodisk/pedestal array exhibited a photocatalytic activity that was three times higher than the activity of LEDs with a TiO2 planar layer. The integration of photocatalytic materials with near-UV LEDs in a single system is promising for various purification applications, such as sterilization and disinfection.

Polarized ultraviolet emitters with Al wire-grid polarizers fabricated by solvent-assisted nanotransfer process.

Polarized ultraviolet (UV) emitters are essential for various applications, such as photoalignment devices for liquid crystals, high-resolution imaging devices, highly sensitive sensors, and steppers. To increase the high polarization ratio (PR) of a UV emitter, the grating period should be decreased than that of the visible emitter. However, the fabrication of the short period grating directly on UV emitters is still limited. In this study, we demonstrate that 200, 100, and 50 nm period aluminum (Al)-based wire-grid polarizers (WGPs) can be fabricated directly on UV emitters by a solvent-assisted nanotransfer process. The UV emitter with a grating period of 100 nm shows a PR of 84%, and an electroluminescence efficiency that is 22.5% and 48% higher than those of UV emitters with 50 nm and 200 nm period WGPs, respectively, due to the increased photon extraction efficiency (PEE). The higher PEE is attributed to the optical cavity property of the Al metal reflector with low light loss and the surface plasmon effect of the Al grating layer.

Magnetically enhanced luminescence of CdSe/ZnS quantum dot light-emitting diodes using circular ferromagnetic Co/Pt multilayer disks.

We investigate the effect of a magnetic field on red, green, and blue CdSe/ZnS quantum dot light-emitting diodes (QDLEDs). Circular multilayer ferromagnetic cobalt/platinum (Co/Pt) disks are deposited on a MgF2 layer covering an Al electrode, and a perpendicular magnetic field is applied to the QDs in the active layer. Carriers injected into the active layer are then trapped and efficiently recombined inside the QDs because of strong carrier localization caused by the perpendicular magnetic field. The luminescence of the QDLEDs in the multilayer increases by 33.31% at 7.5 V, 22.34% at 7.5 V, and 16.73% at 7.0 V compared with that of QDLEDs without the multilayer. The time-resolved photoluminescence of all the QDLEDs also indicates that their increased luminescence results from improved radiative recombination through the stronger carrier localization in the QDs.

Improved efficiency of InGaN/GaN light-emitting diodes with perpendicular magnetic field gradients.

The effect of magnetic fields on the optical output power of flip-chip light-emitting diodes (LEDs) with InGaN/GaN multiple quantum wells (MQWs) was investigated. Films and circular disks comprising ferromagnetic cobalt/platinum (Co/Pt) multilayers were deposited on a p-ohmic reflector to apply magnetic fields in the direction perpendicular to the MQWs of the LEDs. At an injection current of 20 mA, the ferromagnetic Co/Pt multilayer film increased the optical output power of the LED by 20% compared to an LED without a ferromagnetic Co/Pt multilayer. Furthermore, the optical output power of the LED with circular disks was 40% higher at 20 mA than the output of the LED with a film. The increase of the optical output power of the LEDs featuring ferromagnetic Co/Pt multilayers is attributed to the magnetic field gradient in the MQWs, which increases the carrier path in the MQWs. The time-resolved photoluminescence measurement indicates that the improvement of optical output power is owing to an enhanced radiative recombination rate of the carriers in the MQWs as a result of the magnetic field gradient from the ferromagnetic Co/Pt multilayer.

Enhanced optical output in InGaN/GaN light-emitting diodes by tailored refractive index of nanoporous GaN.

The light to be trapped inside light-emitting diodes (LEDs) greatly affects the luminous efficiency and device lifetime. Abrupt difference in refractive index between the sapphire substrate and GaN-based LEDs causes light trapping by total internal reflection, however, its optical loss has been taken for granted. In this study, we demonstrate that nanoporous GaN can be used as a refractive-index-matching layer to enhance the light transmittance at the sapphire-GaN interface in InGaN/GaN flip-chip light-emitting diodes (FCLEDs). The porosity and the refractive index of the nanoporous GaN layer are controlled by electrochemical etching of n-type GaN layer. The optical output power of FCLEDs with the nanoporous GaN layer grown on flat and patterned sapphire substrates is increased by 355% and 65% at an injection current of 20 mA, respectively, compared with that of an FCLED without the nanoporous GaN layer. The remarkable enhancement of optical output is mostly attributed to the nanoporous GaN layer which drastically increases the light extraction efficiency by decreasing the reflection of light at the sapphire-GaN interface.

Enhanced performance of InGaN/GaN MQW LED with strain-relaxing Ga-doped ZnO transparent conducting layer.

We report the enhanced optical and electrical properties of InGaN/GaN multiple quantum well (MQW) light-emitting diodes (LEDs) with strain-relaxing Ga-doped ZnO transparent conducting layers (TCLs). Ga-doped ZnO was epitaxially grown on p-GaN by metal-organic chemical vapor deposition. The optical output power of a LED with a 500-nm- thick-Ga-doped ZnO TCL increased by 30.9% at 100 mA, compared with that of an LED with an indium tin oxide (ITO) TCL. Raman spectroscopy measurement and the simulation of wavefunction overlap of electron and hole in MQWs revealed that the enhanced optical output power was attributed to the increased internal quantum efficiency due to the decreased compressive strain in the active region. The increase of optical output was also attributed to the increased optical transmittance of the Ga-doped ZnO TCL owing to its higher refractive index compared to that of ITO TCL. Furthermore, the forward voltage of LED with a Ga-doped ZnO TCL was lower than that of LED with an ITO TCL because of the increased carrier concentration and mobility in the Ga-doped ZnO TCL.

Room temperature polariton lasing in quantum heterostructure nanocavities.

Ultralow-threshold coherent light emitters can be achieved through lasing from exciton-polariton condensates, but this generally requires sophisticated device structures and cryogenic temperatures. Polaritonic nanolasers operating at room temperature lie on the crucial path of related research, not only for the exploration of polariton physics at the nanoscale but also for potential applications in quantum information systems, all-optical logic gates, and ultralow-threshold lasers. However, at present, progress toward room temperature polariton nanolasers has been limited by the thermal instability of excitons and the inherently low quality factors of nanocavities. Here, we demonstrate room temperature polaritonic nanolasers by designing wide-gap semiconductor heterostructure nanocavities to produce thermally stable excitons coupled with nanocavity photons. The resulting mixed states of exciton polaritons with Rabi frequencies of approximately 370 meV enable persistent polariton lasing up to room temperature, facilitating the realization of miniaturized and integrated polariton systems.

Phenotypes of Severe Cutaneous Adverse Reactions Caused by Nonsteroidal Anti-inflammatory Drugs.

PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) are common cause of severe cutaneous adverse reactions (SCARs). The present study aimed to investigate the characteristics of SCARs induced by NSAIDs in the Korean SCAR registry. METHODS: A retrospective survey of NSAID-induced SCARs recorded between 2010 and 2015 at 27 university hospitals in Korea was conducted. Clinical phenotypes of SCARs were classified into Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), SJS-TEN overlap syndrome and drug reaction with eosinophilia and systemic symptoms (DRESS). Causative NSAIDs were classified into 7 groups according to their chemical properties: acetaminophen, and propionic, acetic, salicylic, fenamic and enolic acids. RESULTS: A total of 170 SCARs, consisting of 85 SJS, 32 TEN, 17 SJS-TEN overlap syndrome and 36 DRESS reactions, were induced by NSAIDs: propionic acids (n=68), acetaminophen (n=38), acetic acids (n=23), salicylic acids (n=16), coxibs (n=8), fenamic acids (n=7), enolic acids (n=5) and unclassified (n=5). Acetic acids (22%) and coxibs (14%) accounted for higher portions of DRESS than other SCARs. The phenotypes of SCARs induced by both propionic and salicylic acids were similar (SJS, TEN and DRESS, in order). Acetaminophen was primarily associated with SJS (27%) and was less involved in TEN (10%). DRESS occurred more readily among subjects experiencing coxib-induced SCARs than other NSAID-induced SCARs (62.5% vs. 19.7%, P = 0.013). The mean time to symptom onset was longer in DRESS than in SJS or TEN (19.1 ± 4.1 vs. 6.8 ±1.5 vs. 12.1 ± 3.8 days). SCARs caused by propionic salicylic acids showed longer latency, whereas acetaminophen- and acetic acid-induced SCARs appeared within shorter intervals. CONCLUSIONS: The present study indicates that the phenotypes of SCARs may differ according to the chemical classifications of NSAIDs. To establish the mechanisms and incidences of NSAID-induced SCARs, further prospective studies are needed.

Crystal-Structure-Dependent Piezotronic and Piezo-Phototronic Effects of ZnO/ZnS Core/Shell Nanowires for Enhanced Electrical Transport and Photosensing Performance.

We report the crystal-structure-dependent piezotronic and piezo-phototronic effects of ZnO/ZnS core/shell nanowires (CS NWs) having different shell layer crystalline structures. The wurtzite (WZ) ZnO/WZ ZnS CS NWs showed higher electrical transport and photosensing properties under external strain than the WZ ZnO/zinc blende (ZB) ZnS CS NWs. The WZ ZnO/WZ ZnS CS NWs under a compressive strain of -0.24% showed 4.4 and 8.67 times larger increase in the output current (1.93 × 10-4 A) and photoresponsivity (8.76 × 10-1 A/W) than those under no strain. However, the WZ ZnO/ZB ZnS CS NWs under the same strain condition showed 3.2 and 2.16 times larger increase in the output current (1.13 × 10-4 A) and photoresponsivity (2.16 × 10-1 A/W) than those under no strain. This improvement is ascribed to strain-induced piezopolarization charges at both the WZ ZnO NWs and the grains of the WZ ZnS shell layer in WZ ZnO/WZ ZnS CS NWs, whereas piezopolarization charges are induced only in the ZnO core region of the WZ ZnO/ZB ZnS CS NWs. These charges can change the type-II band alignment in the ZnO and ZnS interfacial region as well as the Schottky barrier height at the junction between the semiconductor and the metal, thus facilitating electrical transport and reducing the recombination probability of charge carriers under UV irradiation.

Radial multi-quantum well ZnO nanorod arrays for nanoscale ultraviolet light-emitting diodes.

Since semiconducting ZnO has attractive properties such as wide bandgap and large exciton binding energy, it has motivated us to realize efficient ultraviolet (UV) light-emitting diodes (LEDs). Furthermore, facile growth of ZnO nanostructures has triggered numerous research studies to examine them as nanoscale building blocks for optoelectronic devices. Here, we demonstrate the growth of ZnO-based core-shell p-n homojunction nanorod arrays with radial MgZnO/ZnO multiple quantum wells (MQWs) and report the characteristics of a core-shell ZnO nanorod LED. The shell layers of MgZnO/ZnO MQWs and p-type antimony-doped MgZnO were epitaxially grown on the surface of ZnO core nanorod arrays. By introducing the radial MQWs, the photoluminescence intensity was greatly increased by 4 times, compared to that of the bare ZnO nanorod array, suggesting that the core-shell MQWs can be used to realize the nanoscale ZnO LEDs with high internal quantum efficiency. As the injection current increased, the EL intensity of UV emission at 375 nm from the MgZnO/ZnO MQWs strongly increased without shifting of the emission peak because of the non-polar nature of MQWs grown on the side walls of the ZnO nanorods. These results highlight the potential of an integrated nanoscale UV light emitter in various photonic devices.

Spontaneous and Selective Nanowelding of Silver Nanowires by Electrochemical Ostwald Ripening and High Electrostatic Potential at the Junctions for High-Performance Stretchable Transparent Electrodes.

Metal nanowires have been gaining increasing attention as the most promising stretchable transparent electrodes for emerging field of stretchable optoelectronic devices. Nanowelding technology is a major challenge in the fabrication of metal nanowire networks because the optoelectronic performances of metal nanowire networks are mostly limited by the high junction resistance between nanowires. We demonstrate the spontaneous and selective welding of Ag nanowires (AgNWs) by Ag solders via an electrochemical Ostwald ripening process and high electrostatic potential at the junctions of AgNWs. The AgNWs were welded by depositing Ag nanoparticles (AgNPs) on the conducting substrate and then exposing them to water at room temperature. The AgNPs were spontaneously dissolved in water to form Ag+ ions, which were then reduced to single-crystal Ag solders selectively at the junctions of the AgNWs. Hence, the welded AgNWs showed higher optoelectronic and stretchable performance compared to that of as-formed AgNWs. These results indicate that electrochemical Ostwald ripening-based welding can be used as a promising method for high-performance metal nanowire electrodes in various next-generation devices such as stretchable solar cells, stretchable displays, organic light-emitting diodes, and skin sensors.

Development of Prediction Equation of Diffusing Capacity of Lung for Koreans.

BACKGROUND: The diffusing capacity of the lung is influenced by multiple factors such as age, sex, height, weight, ethnicity and smoking status. Although a prediction equation for the diffusing capacity of Korea was proposed in the mid-1980s, this equation is not used currently. The aim of this study was to develop a new prediction equation for the diffusing capacity for Koreans. METHODS: Using the data of the Korean National Health and Nutrition Examination Survey, a total of 140 nonsmokers with normal chest X-rays were enrolled in this study. RESULTS: Using linear regression analysis, a new predicting equation for diffusing capacity was developed. For men, the following new equations were developed: carbon monoxide diffusing capacity (DLco)=-10.4433-0.1434×age (year)+0.2482×heights (cm); DLco/alveolar volume (VA)=6.01507-0.02374×age (year)-0.00233×heights (cm). For women the prediction equations were described as followed: DLco=-12.8895-0.0532×age (year)+0.2145×heights (cm) and DLco/VA=7.69516-0.02219×age (year)-0.01377×heights (cm). All equations were internally validated by k-fold cross validation method. CONCLUSION: In this study, we developed new prediction equations for the diffusing capacity of the lungs of Koreans. A further study is needed to validate the new predicting equation for diffusing capacity.

Self-standing ZnO nanotube/SiO2 core-shell arrays for high photon extraction efficiency in III-nitride emitter.

Self-standing ZnO nanotube (ZNT) arrays were fabricated on the surface of a GaN-based emitter with an indium tin oxide (ITO) transparent layer using a hydrothermal method and temperature cooling down process. For the greater enhancement of photon extraction efficiency, ZNT/SiO2 core-shell nanostructure arrays were fabricated on the emitter with a 430 nm wavelength. The optical output power of ZNT/SiO2 core-shell arrays on the emitter with ITO electrode was remarkably enhanced by 18.5%, 28.1%, and 55.9%, compared to those of ZNTs, ZNRs on an ITO film on an emitter and ITO film on an emitter as a conventional emitter, respectively. The large enhancement in optical output is attributable to the synergistic effect of efficient photon injection from the ITO/GaN layer to ZNTs because of the well-matched refractive indices and wave-guiding, in addition to the superior photon extraction by the SiO2 coating layer on the ZNTs.

Self-assembled indium tin oxide nanoball-embedded omnidirectional reflectors for high photon extraction efficiency in III-nitride ultraviolet emitters.

The control of the refractive index and electrical conductivity in the dielectric layer of omnidirectional reflectors (ODRs) is essential to improve the low efficiency of AlGaN-based UV emitters. Here, we report self-assembled indium tin oxide (ITO) nanoball-embedded omnidirectional reflectors (NODRs) for use in high-efficiency AlGaN-based UV emitters at 365 nm. These NODRs consisted of a reflective Al layer, a self-assembled conducting ITO nanoball layer for current injection and spreading, and nanovoids that provided a low refractive index to achieve highly efficient UV emitters. The NODR was able to realize both high electrical conductivity and reflectivity by decreasing the average refractive index of the ITO nanoball layers. We observed diffuse reflection as well as omnidirectional reflection from the NODR UV emitters because of the corrugated interfaces of the nanovoids, ITO nanoball layer, and Al layer. These structural and optical properties of the NODRs remarkably increased the output power of a UV emitter by a Lambertian enhancement factor of 57% at an injection current of 50 mA at all emission angles compared with that of an ITO film/Al UV emitter.

Enhanced optical output and reduction of the quantum-confined Stark effect in surface plasmon-enhanced green light-emitting diodes with gold nanoparticles.

We report the optical properties of localized surface plasmon (LSP)-enhanced green light-emitting diodes (LEDs) containing gold (Au) nanoparticles embedded in a p-GaN layer. The photoluminescence (PL) and electroluminescence (EL) intensities of a green LED with Au nanoparticles were enhanced by the coupling between excitons and LSPs. Excitation power-dependent PL and injection current-dependent EL measurements revealed that the blue-shift of PL and EL peaks with increasing carrier density was smaller for the LSP-enhanced LED compared with that for a conventional LED. The increased optical output power and decrease in blue-shift of the LED with Au nanoparticles were attributed to the increased radiative recombination efficiency of carriers induced by the LSP-coupling process and the compensation of the polarization-induced electric fields with LSP-enhanced local fields, both of which suppressed the quantum-confined Stark effect.

Titanium oxide nanotube arrays for high light extraction efficiency of GaN-based vertical light-emitting diodes.

TiO2 nanotube (NT) arrays were fabricated on the surface of n-GaN through a liquid-phase conversion process using ZnO nanorods (NRs) as a template for high-efficiency InGaN/GaN multiple quantum well (MQW) vertical light-emitting diodes (VLEDs). The optical output power of the VLEDs with TiO2 NTs was remarkably enhanced by 23% and 189% at an injection current of 350 mA compared to those of VLEDs with ZnO NRs and planar VLEDs, respectively. The large enhancement in optical output is attributed to a synergistic effect of efficient light injection from the n-GaN layer of the VLED to TiO2 NTs because of the well-matched refractive indices and superior light extraction into air at the end of the TiO2 NTs. Light propagation along various configurations of TiO2 NTs on the VLEDs was investigated using finite-difference time domain simulations and the results indicated that the wall thickness of the TiO2 NTs should be maintained close to 20 nm for superior light extraction from the VLEDs.

MgxZn1-xO/Ag/MgxZn1-xO Multilayers As High-Performance Transparent Conductive Electrodes.

We report on the optical and electrical properties of MgxZn1-xO/Ag/MgxZn1-xO transparent conductive electrodes. The transmittance and sheet resistance of MgxZn1-xO/Ag/MgxZn1-xO multilayers deposited at room temperature were strongly dependent on the thickness and surface morphology of Ag layer. The optical absorption edge of MgxZn1-xO/Ag/MgxZn1-xO showed a blue shift with increasing Mg composition due to the increased band gap of MgxZn1-xO. The Haack figure of merit value of Mg0.28Zn0.72O/Ag/Mg0.28Zn0.72O with a 14 nm-thick Ag layer, which has a sheet resistance of 6.36 Ω/sq and an average transmittance of 89.2% at wavelengths in the range from 350 to 780 nm, was 69% higher than that of a ZnO/Ag/ZnO multilayer electrode. These results indicate that MgxZn1-xO/Ag/MgxZn1-xO multilayers, which also show low surface roughness, can be used as highly conductive transparent electrodes in various optoelectronic devices operating over a wide wavelength region.