Disentangling Associations Between Frequency of Specific Social Networking Site Platform Use, Normative Discrepancies, and Alcohol Use Among Adolescents and Underage Young Adults

Although there is a robust literature examining normative discrepancies for drinking, less is known related to normative discrepancies related to alcohol-posting behavior on social networking sites (SNS). Given that SNS are posited to be an important risk factor for adolescent and young adult alcohol use, the aims of the present study were to: (1) document descriptive and injunctive normative discrepancies for number of alcohol-related posts on SNS, (2) examine associations between frequency of using SNS platforms (Facebook, Instagram, Snapchat) and descriptive and injunctive normative discrepancies, and (3) to examine whether descriptive and injunctive normative discrepancies are associated with willingness to use alcohol and drinking among adolescents and young adults. Data were drawn from the baseline assessment of a larger longitudinal experimental study (N= 306, age 15-20). Overall, participants perceived that their peers are more approving of and post about alcohol use more often than they do themselves, thus indicating significant descriptive and injunctive normative discrepancies. More frequent use of Facebook was associated with having greater descriptive normative discrepancies, whereas frequency of both Facebook and Instagram use were associated with greater injunctive normative discrepancies. Results further indicated that controlling for frequency of SNS use, descriptive normative discrepancies, but not injunctive, were associated with greater willingness to drink and drinks per week. Results provide evidence that in particular, descriptive normative discrepancies for SNS use may be important to target when planning intervention programs to reduce the impact of SNS use on adolescent and young adult alcohol use

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Strain Mapping of Two-Dimensional Heterostructures with Subpicometer Precision

Next-generation, atomically thin devices require in-plane, one-dimensional heterojunctions to electrically connect different two-dimensional (2D) materials. However, the lattice mismatch between most 2D materials leads to unavoidable strain, dislocations, or ripples, which can strongly affect their mechanical, optical, and electronic properties. We have developed an approach to map 2D heterojunction lattice and strain profiles with subpicometer precision and the ability to identify dislocations and out-of-plane ripples. We collected diffraction patterns from a focused electron beam for each real-space scan position with a high-speed, high dynamic range, momentum-resolved detector–the electron microscope pixel array detector (EMPAD). The resulting four-dimensional (4D) phase space data sets contain the full spatially resolved lattice information on the sample. By using this technique on tungsten disulfide (WS₂) and tungsten diselenide (WSe₂) lateral heterostructures, we have mapped lattice distortions with 0.3 pm precision across multimicron fields of view and simultaneously observed the dislocations and ripples responsible for strain relaxation in 2D laterally epitaxial structures