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Objectives: To describe the built environment in long-term care facilities (LTCF) and its association with introduction and transmission of SARS-CoV-2 infection., Design: Cross-sectional survey with linkage to routine surveillance data., Setting and Participants: LTCFs in England caring for adults ≥65 years old, participating in the VIVALDI study (ISRCTN14447421) were eligible. Data were included from residents and staff., Methods: Cross-sectional survey of the LTCF built environment with linkage to routinely collected asymptomatic and symptomatic SARS-CoV-2 testing and vaccination data between September 1, 2020, and March 31, 2022. We used individual and LTCF level Poisson and Negative Binomial regression models to identify risk factors for 4 outcomes: incidence rate of resident infections and outbreaks, outbreak size, and duration. We considered interactions with variant transmissibility (pre vs post Omicron dominance)., Results: A total of 134 of 151 (88.7%) LTCFs participated in the survey, contributing data for 13,010 residents and 17,766 staff. After adjustment and stratification, outbreak incidence (measuring infection introduction) was only associated with SARS-CoV-2 incidence in the community [incidence rate ratio (IRR) for high vs low incidence, 2.84; 95% CI, 1.85-4.36]. Characteristics of the built environment were associated with transmission outcomes and differed by variant transmissibility. For resident infection incidence, factors included number of storeys (0.64; 0.43-0.97) and bedrooms (1.04; 1.02-1.06), and purpose-built vs converted buildings (1.99; 1.08-3.69). Air quality was associated with outbreak size (dry vs just right 1.46; 1.00-2.13). Funding model (0.99; 0.99-1.00), crowding (0.98; 0.96-0.99), and bedroom temperature (1.15; 1.01-1.32) were associated with outbreak duration., Conclusions and Implications: We describe previously undocumented diversity in LTCF built environments. LTCFs have limited opportunities to prevent SARS-CoV-2 introduction, which was only driven by community incidence. However, adjusting the built environment, for example by isolating infected residents or improving airflow, may reduce transmission, although data quality was limited by subjectivity. Identifying LTCF built environment modifications that prevent infection transmission should be a research priority., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Air-channel devices have a special advantage due to the promise of vacuum-like ballistic transport in air, radiation insensitivity, and nanoscale size. Here, achieving high current at low voltage along with considerable mechanical stability is a primary issue. The comparative analysis of four planar and metallic electrode-pair geometries at 10 nm channel length is presented. The impact of nano-electrode-pair geometries on overall device performance is investigated. Air-channel devices are operated at the ultra-low voltage of 5 mV to demonstrate the device dynamics of air-channel devices at low power. Investigations focus on the direct tunneling (DT) mechanism which is dominant in the low-voltage regime. Comparative analysis of different electrode-pair geometries reveals two orders of magnitude increment in the current just by modulating the electrode-pair structure. Theoretical analysis suggests that the emission current is directly related to the active junction area within the metal-air-metal interface at the direct tunneling regime. The geometry-dependent mechanical stability of different electrode pairs is compared by imaging biasing triggered nanoscale structural changes and pulsed biasing stress analysis. The results and claims are confirmed and consolidated with the statistical analysis. Experimental investigations provide strong directions for high-performance and stable devices. In-depth theoretical discussions will enable the accurate modeling of emerging low-power, high-speed, radiation-hardened nanoscale vacuum electronics., (© 2022 The Authors. Small published by Wiley-VCH GmbH.)