WHAT'S KNOWN ON THIS SUBJECT: Pulmonary hypertension is associated with bronchopulmonary dysplasia in extremely low birth weight infants and contributes to morbidity and mortality. WHAT THIS STUDY ADDS:Pulmonary hypertension affects at least 1 in 6 extremely low birth weight infants and persists to discharge in most survivors. Routine screening of these infants with echocardiography at 4 weeks of age identifies only one-third of those affected. abstract OBJECTIVES: Pulmonary hypertension is associated with bronchopulmonary dysplasia in extremely low birth weight (ELBW) infants and contributes to morbidity and mortality. The objective was to determine the prevalence of pulmonary hypertension among ELBW infants by screening echocardiography and evaluate subsequent outcomes.METHODS: All ELBW infants admitted to a regional perinatal center were evaluated for pulmonary hypertension with echocardiography at 4 weeks of age and subsequently if clinical signs suggestive of right-sided heart failure or severe lung disease were evident. Management was at discretion of the clinician, and infants were evaluated until discharge from the hospital or pre-discharge death occurred. RESULTS:One hundred forty-five ELBW infants (birth weight: 755 6 144 g; median gestational age: 26 weeks [interquartile range: 24-27]) were screened from December 2008 to February 2011. Overall, 26 (17.9%) were diagnosed with pulmonary hypertension at any time during hospitalization (birth weight: 665 6 140 g; median gestational age: 26 weeks [interquartile range: 24-27]): 9 (6.2%) by initial screening (early pulmonary hypertension) and 17 (11.7%) who were identified later (late pulmonary hypertension). Infants with pulmonary hypertension were more likely to receive oxygen treatment on day 28 compared with those without pulmonary hypertension (96% vs 75%, P , .05). Of the 26 infants, 3 died (all in the late group because of cor pulmonale) before being discharged from the hospital.CONCLUSIONS: Pulmonary hypertension is relatively common, affecting at least 1 in 6 ELBW infants, and persists to discharge in most survivors. Routine screening of ELBW infants with echocardiography at 4 weeks of age identifies only one-third of the infants diagnosed with pulmonary hypertension. Further research is required to determine optimal detection and intervention strategies.

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Possible domain patterns are developed for (001) oriented (pseudocubic indexing) epitaxial rhombohedral perovskite ferroelectric (FR) films. We assume that the films are grown above their Curie temperature (TC) in a cubic paraelectric (PC) state. The rhombohedral distortion consists of a “stretch” along one of the four 〈111〉 crystallographic directions of the cubic perovskite unit cell. Domain pattern formation is concurrent with the PC→FR transformation on cooling from the growth temperature. The domain patterns form to minimize elastic energy in the film, at the energetic expense of both forming domain boundaries and developing local stresses in the substrate. Eight possible domains may form, half of which are related by inversion, thus leading to four mechanically distinct variants. The possible domain walls are determined by mechanical and charge compatibility and follow closely from the analysis of Fousek and Janovec [J. Appl. Phys. 40, 135 (1969)]. Domain patterns may develop with either {100} or {101} boundaries. In both cases, the individual domains in the patterns are energetically degenerate and thus equal width lamellar patterns are predicted. When polarization is included in the analysis, the {100} boundary patterns have no normal component of the net polarization, whereas the {101} boundary patterns correspond to the fully poled state. We report on experimental observation of {100} domain patterns in epitaxial PbZr0.80Ti0.20O3 and PbZr0.65Ti0.35O3 films.

Single-crystal thin films of Pb(ZrxTi1−x)O3 (PZT) covering the full compositional range (0⩽x⩽1) were deposited by metal-organic chemical vapor deposition. Epitaxial SrRuO3(001) thin films grown on SrTiO3(001) substrates by rf-magnetron sputter deposition served as template electrode layers to promote the epitaxial growth of PZT. X-ray diffraction, energy-dispersive x-ray spectroscopy, atomic force microscopy, transmission electron microscopy, and optical waveguiding were used to characterize the crystalline structure, composition, surface morphology, microstructure, refractive index, and film thickness of the deposited films. The PZT films were single crystalline for all compositions exhibiting cube-on-cube growth epitaxy with the substrate and showed very high degrees of crystallinity and orientation. The films exhibited typical root mean square surface roughness of ∼1.0–2.5 nm. For tetragonal films, the surface morphology was dominated by grain tilting resulting from ferroelectric domain formation. We report the systematic compositional variation of the optical, dielectric, polarization, and electronic transport properties of these single-crystalline PZT thin films. We show that the solid-solution phase diagram of the PZT system for thin films differs from the bulk due to epitaxy-induced strains and interfacial defect formation. High values of remanant polarization (30–55 μC/cm2) were observed for ferroelectric compositions in the range of 0.8⩽x⩽0.2. Unlike previous studies, the dielectric constant exhibited a clear dependence on composition with values ranging from 225 to 650. The coercive fields decreased with increasing Zr concentration to a minimum of 20 kV/cm for x=0.8. The undoped films exhibited both high resistivity and dielectric-breakdown strength (1013–1014 Ω cm at 100 kV/cm and 300–700 kV/cm, respectively).

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