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Introduction: The recent White House Conference on Hunger, Nutrition, and Health in October 2022 made it a national priority to address food and nutrition insecurity and reduce inequities in nutrition-related chronic conditions such as heart diease. ‘Food as Medicine’ is increasing implemented to address the dual challenge of food/nutrition insecurity and chronic disease. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited rigorous evidence of the impact of Food as Medicine on heart health. Methods: We examined the effectiveness of Recipe4Health, a Food as Medicine program, for improving food insecurity and indicators of heart health among patients who accessed care in Federally Qualified Health Centers (FQHCs). Recipe4Health was implemented in 4 FQHCs and included a ‘Food Farmacy’ that provided 16 weekly deliveries of produce with or without a ‘Behavioral Pharmacy’ which was 16 weekly group medical visits. We examined pre/post changes over 4 months in outcomes assessed by surveys (e.g., produce intake, physical activity, food insecurity). We also compared outcomes (e.g., lipids, Body Mass Index [BMI], blood pressure [BP], HbA1c) in the Electronic Health Record (EHR) between Recipe4Health patients and controls over 12 months. Control patients were identified using propensity score matching with patients from similar clinics that had not implemented Recipe4Health. We used linear mixed effects models with repeated measures, adjusting for baseline of each outcome. Results: Study participants (n=5,286) were middle-aged (mean age 51.2 SD [13.9]) primarily women (68%), and from diverse racial/ethnic backgrounds with 51% Latinx, 21% Black, and 8% Asian American/Pacific Islander. Based on pre/post surveys, Recipe4Health participants significantly increased their produce consumption (0.41 servings [0.11, 0.72], p=007) and physical activity (41.98 minutes/week [22.33, 61.63], p

Objective. To describe the landscape of well-being content inclusion across schools and colleges of pharmacy in the United States and Canada through identification of content implementation, incorporation, and assessment.Methods. A cross-sectional survey was distributed to all accredited schools and colleges of pharmacy in the United States (n=143) and Canada (n=10). Survey questions included curricular and cocurricular timing, frequency, assessment strategies, and support for well-being initiatives, using a framework of eight dimensions (pillars) of wellness to categorize content.Results. Descriptive data analyses were applied to 99 completed surveys (65%), 89 (62%) in the United States and 10 (100%) in Canada. Well-being content was most prevalent within the cocurricular realm and incorporated into didactic and elective more than experiential curricula. The most content came from intellectual, emotional, and physical pillars, and the least content came from financial, spiritual, and environmental pillars. Less than 50% of schools and colleges of pharmacy include well-being within their strategic plans or core values. Funding is primarily at the level of the university (59%) or the school or college of pharmacy (59%). Almost half of respondents reported inclusion of some assessment, with a need for more training, expertise, and standardization.Conclusion. Survey results revealed a wide range of implementation and assessment of well-being programs across the United States and Canada. These results provide a reference point for the state of well-being programs that can serve as a call to action and research across the Academy.

IntroductionChronic conditions, such as diabetes, obesity, heart disease and depression, are highly prevalent and frequently co-occur with food insecurity in communities served by community health centres in the USA. Community health centres are increasingly implementing 'Food as Medicine' programmes to address the dual challenge of chronic conditions and food insecurity, yet they have been infrequently evaluated.Methods and analysisThe goal of this quasi-experimental study was to evaluate the effectiveness of Recipe4Health, a 'Food as Medicine' programme. Recipe4Health includes two components: (1) a 'Food Farmacy' that includes 16 weekly deliveries of produce and (2) a 'Behavioural Pharmacy' which is a group medical visit. We will use mixed models to compare pre/post changes among participants who receive the Food Farmacy alone (n=250) and those who receive the Food Farmacy and Behavioural Pharmacy (n=140). The primary outcome, fruit and vegetable consumption, and secondary outcomes (eg, food security status, physical activity, depressive symptoms) will be collected via survey. We will also use electronic health record (EHR) data on laboratory values, prescriptions and healthcare usage. Propensity score matching will be used to compare Recipe4Health participants to a control group of patients in clinics where Recipe4Health has not been implemented for EHR-derived outcomes. Data from surveys, EHR, group visit attendance and produce delivery is linked with a common identifier (medical record number) and then deidentified for analysis with use of an assigned unique study ID. This study will provide important preliminary evidence on the effectiveness of primary care-based strategies to address food insecurity and chronic conditions.Ethics and disseminationThis study was approved by the Stanford University Institutional Review Board (reference protocol ID 57239). Appropriate study result dissemination will be determined in partnership with the Community Advisory Board.

Ferroelectric tunnel junctions (FTJs) utilizing hafnium zirconium oxide (HZO) have attracted interest as non-volatile memory for microelectronics due to ease of integration into back-end-of-line (BEOL) complementary metal oxide semiconductor fabrication. This work examines asymmetric electrode NbN/HZO/Nb devices with 7 nm thick HZO as FTJs in a memory structure, with an output resistance that can be controlled by read and write voltages. The individual FTJs are measured to have a tunneling electroresistance of 10 during the read state without significant filament conduction formation and reasonable ferroelectric performance. Endurance and remanent polarizations of up to 105 cycles and 20 μC/cm2, respectively, are measured and are shown to be dependent on the cycling voltage. Electrical measurements demonstrate how magnitude of the write pulse can modulate the high state resistance and the read pulse influences both resistance values as well as separation of resistance states. Then, by using two opposite switching FTJ devices in series, a programmable nonvolatile resistor divider is demonstrated. Measurements of these two FTJ unit memory cells show wide applicability to a BEOL microfabrication process for a re-readable, rewritable, and nonvolatile memory cell. [ABSTRACT FROM AUTHOR]

Background: Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims: This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes. Method: The Maawaji idi-oog mino-ayaawin (Gathering for Health) study was a community-based participatory research collaboration with five American Indian tribes. Participants, randomly recruited from clinic records, shared information during computer-assisted personal interviews. This study includes the 166 participants who reported using medications to treat their diabetes. The relationship between gender, DD, DS, and medication adherence are explored. Possible mediating and moderating effects on medication were tested using regression and path analysis. Results: Females had higher levels of DD and DS and lower levels of medication adherence. Higher levels of DD and DS were both associated with lower medication adherence. No evidence was found that gender moderates the relationship between DD or DS and medication adherence. Instead, DD and DS mediated the relationship between gender and medication adherence. Conclusions: Medication adherence differences in male and female patients may be attributable to DD and DS. The present research highlights both DD and DS as targets for clinicians and researchers alike.

κ-Ga2O3 has been predicted to be a potential ferroelectric material. In this work, undoped Ga2O3 films were grown by either plasma-enhanced atomic layer deposition (PEALD) or metal organic chemical vapor deposition (MOCVD) on platinized sapphire substrates. 50 nm thick PEALD films with a mixture of κ-Ga2O3 and β-Ga2O3 had a relative permittivity of ∼27, a loss tangent below 2%, and high electrical resistivity up to ∼1.5 MV/cm. 700 nm thick MOCVD films with predominantly the κ-Ga2O3 phase had relative permittivities of ∼18 and a loss tangent of 1% at 10 kHz. Neither film showed compelling evidence for ferroelectricity measured at fields up to 1.5 MV/cm, even after hundreds of cycles. Piezoresponse force microscopy measurements on bare κ-Ga2O3 showed a finite piezoelectric response that could not be reoriented for electric fields up to 1.33 MV/cm. [ABSTRACT FROM AUTHOR]

Biaxial stress is identified to play an important role in the polar orthorhombic phase stability in hafnium oxide‐based ferroelectric thin films. However, the stress state during various stages of wake‐up has not yet been quantified. In this work, the stress evolution with field cycling in hafnium zirconium oxide capacitors is evaluated. The remanent polarization of a 20 nm thick hafnium zirconium oxide thin film increases from 9.80 to 15.0 µC cm−2 following 106 field cycles. This increase in remanent polarization is accompanied by a decrease in relative permittivity that indicates that a phase transformation has occurred. The presence of a phase transformation is supported by nano‐Fourier transform infrared spectroscopy measurements and scanning transmission electron microscopy that show an increase in ferroelectric phase content following wake‐up. The stress of individual devices field cycled between pristine and 106 cycles is quantified using the sin2(ψ) technique, and the biaxial stress is observed to decrease from 4.3 ± 0.2 to 3.2 ± 0.3 GPa. The decrease in stress is attributed, in part, to a phase transformation from the antipolar Pbca phase to the ferroelectric Pca21 phase. This work provides new insight into the mechanisms controlling and/or accompanying polarization wake‐up in hafnium oxide‐based ferroelectrics. [ABSTRACT FROM AUTHOR]

An erratum published in the journal Applied Physics Letters corrects an error in the equation used to fit oxygen diffusion coefficients in ferroelectric hafnium zirconium oxide thin films. The corrected equation improves the coefficient of determination for most conditions, with a slightly lower activation energy and a larger extrapolated room temperature oxygen diffusion coefficient. The overall findings of the study, indicating low oxygen diffusion coefficients in the ferroelectric phase of the thin films, remain unchanged. The research was supported by the Semiconductor Research Corporation and conducted at the Analytical Instrumentation Facility at North Carolina State University. [Extracted from the article]

Oxygen diffusion coefficients in the metastable ferroelectric phase of polycrystalline hafnium zirconium oxide (HZO) thin films have been quantified using 18O tracers and time-of-flight secondary ion mass spectrometry. 11.5 nm thick HZO films containing 16O were deposited by plasma-enhanced atomic layer deposition followed by post-metallization annealing to crystallize into the ferroelectric phase. A 1.2 nm thick HZO layer containing 18O was then deposited using thermal atomic layer deposition with H218O as a reactant. Thermal anneals were conducted at 300, 350, and 400 °C and the ferroelectric phase confirmed after the anneals by x-ray diffraction, infrared spectroscopy, and electrical property measurements. 18O depth profiles were measured and fit with a thin film diffusion equation to determine the oxygen diffusion coefficients. Oxygen diffusion coefficients ranged from approximately 2 × 10−18 cm2/s at 300 °C to 5 × 10−17 cm2/s at 400 °C with an activation energy of 1.02 ± 0.24 eV. [ABSTRACT FROM AUTHOR]

Photoinduced reductions in the oxygen vacancy concentration were leveraged to increase the ferroelectric phase fraction of Hf0.5Zr0.5O2 thin-films. Modest (∼ 2 − 77 pJ / cm 2 ) laser doses of visible light (488 nm, 2.54 eV) spatially patterned the concentration of oxygen vacancies as monitored by photoluminescence imaging. Local, tip-based, near-field, nanoFTIR measurements showed that the photoinduced oxygen vacancy concentration reduction promoted formation of the ferroelectric phase (space group Pca 2 1 ), resulting in an increase in the piezoelectric response measured by piezoresponse force microscopy. Photoinduced vacancy tailoring provides, therefore, a spatially prescriptive, post-synthesis, and low-entry method to modify phase in HfO2-based materials. [ABSTRACT FROM AUTHOR]

The possibility of ferroelectricity in orthorhombic V2O5 thin films was investigated. Films were deposited via either a chemical solution deposition (CSD) route or by RF magnetron sputtering. Highly (001) oriented V2O5 films were achieved with both deposition routes at temperatures as low as 300°C. No evidence for ferroelectricity was observed, even in films which had been doped to provide local nuclei for polarization reversal. Loss originated from mid-gap trap states stemming from oxygen vacancies that were observed with photoluminescence, supplemented by piezoresponse force microscopy measurements. These trap states may have helped mimic ferroelectricity in previous reports on V2O5. [ABSTRACT FROM AUTHOR]

Author(s): Benjamin D. Aronson[sup.1] , Laura C. Palombi[sup.1] , Melissa L. Walls[sup.2] Author Affiliations: (1) Department of Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota College of Pharmacy, 232 Life [...], This study examined the prevalence of screened posttraumatic stress disorder (PTSD) and associated diabetes-related outcomes. A sample of American Indian adults with type 2 diabetes (n = 218) participated in interviewer-administered surveys. Using a cutoff of 3 on the Primary Care PTSD screener, 21.8 % of participants screened positive for PTSD. PTSD symptoms were negatively associated with self-rated health status and positively associated with past year hospitalization after controlling for several demographic factors, but not after controlling for depressive symptoms. Past month frequency of hyperglycemia symptoms was not related to PTSD symptoms. When grouped by mental health conditions (neither screened PTSD nor depressive symptoms, screened PTSD only, depressive symptoms only, and both), those with both screened PTSD and depressive symptoms reported the highest proportion of any past month hyperglycemia, past year hospitalization, and low self-rated health status. Screened PTSD, especially in those with comorbid depressive symptoms, is an important consideration in diabetes care.