Piezoelectric mimicry of flexoelectricity

The origin of "giant" flexoelectricity, orders of magnitude larger than theoretically predicted, yet frequently observed, is under intense scrutiny. There is mounting evidence correlating giant flexoelectric-like effects with parasitic piezoelectricity, but it is not clear how piezoelectricity (polarization generated by strain) manages to imitate flexoelectricity (polarization generated by strain gradient) in typical beam-bending experiments, since in a bent beam the net strain is zero. In addition, and contrary to flexoelectricity, piezoelectricity changes sign under space inversion, and this criterion should be able to distinguish the two effects and yet "giant" flexoelectricity is insensitive to space inversion, seemingly contradicting a piezoelectric origin. Here we show that, if a piezoelectric material has its piezoelectric coefficient be asymmetrically distributed across the sample, it will generate a bending-induced polarization impossible to distinguish from true flexoelectricity even by inverting the sample. The effective flexoelectric coefficient caused by piezoelectricity is functionally identical to, and often larger than, intrinsic flexoelectricity: the calculations show that, for standard perovskite ferroelectrics, even a tiny gradient of piezoelectricity (1% variation of piezoelectric coefficient across 1 mm) is sufficient to yield a giant effective flexoelectric coefficient of 1 $\mu$C/m, three orders of magnitude larger than the intrinsic expectation value

Enhanced flexoelectric-like response in oxide semiconductors

Flexoelectricity is a property of all dielectric materials whereby they polarize in response to deformation gradients such as those produced by bending. Although it is generally thought of as a property of dielectric insulators, insulation is not a formal requirement: in principle, semiconductors can also redistribute their free charge in response to strain gradients. Here we show that bending a semiconductor not only generates a flexoelectric-like response, but that this response can in fact be much larger than in insulators. By doping single crystals of wide-bandgap oxides to increase their conductivity, their effective flexoelectric coefficient was increased by orders of magnitude. This large response can be explained by a barrier-layer mechanism that remains important even at the macroscale, where conventional (insulator) flexoelectricity otherwise tends to be small. Our results open up the possibility of using semiconductors as active ingredients in electromechanical transducer applications.This research was funded by an ERC Starting grant from the EU (ERC 308023) and by a national research grant (FIS2013-48668-C2-1-P) from the Spanish MINECO. All research in ICN2 is supported by the Severo Ochoa Excellence Programme (SEV-2013-0295). F.V.-S. thanks MICITT and CONICIT for support during his PhD.Peer Reviewe

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care