Phase change memory (PCM) is a rapidly growing technology that not only offers advancements in storage-class memories but also enables in-memory data processing to overcome the von Neumann ...bottleneck. In PCMs, data storage is driven by thermal excitation. However, there is limited research regarding PCM thermal properties at length scales close to the memory cell dimensions. Our work presents a new paradigm to manage thermal transport in memory cells by manipulating the interfacial thermal resistance between the phase change unit and the electrodes without incorporating additional insulating layers. Experimental measurements show a substantial change in interfacial thermal resistance as GST transitions from cubic to hexagonal crystal structure, resulting in a factor of 4 reduction in the effective thermal conductivity. Simulations reveal that interfacial resistance between PCM and its adjacent layer can reduce the reset current for 20 and 120 nm diameter devices by up to ~ 40% and ~ 50%, respectively. These thermal insights present a new opportunity to reduce power and operating currents in PCMs.
Previous trials suggesting that high-frequency oscillatory ventilation (HFOV) reduced mortality among adults with the acute respiratory distress syndrome (ARDS) were limited by the use of outdated ...comparator ventilation strategies and small sample sizes.
In a multicenter, randomized, controlled trial conducted at 39 intensive care units in five countries, we randomly assigned adults with new-onset, moderate-to-severe ARDS to HFOV targeting lung recruitment or to a control ventilation strategy targeting lung recruitment with the use of low tidal volumes and high positive end-expiratory pressure. The primary outcome was the rate of in-hospital death from any cause.
On the recommendation of the data monitoring committee, we stopped the trial after 548 of a planned 1200 patients had undergone randomization. The two study groups were well matched at baseline. The HFOV group underwent HFOV for a median of 3 days (interquartile range, 2 to 8); in addition, 34 of 273 patients (12%) in the control group received HFOV for refractory hypoxemia. In-hospital mortality was 47% in the HFOV group, as compared with 35% in the control group (relative risk of death with HFOV, 1.33; 95% confidence interval, 1.09 to 1.64; P=0.005). This finding was independent of baseline abnormalities in oxygenation or respiratory compliance. Patients in the HFOV group received higher doses of midazolam than did patients in the control group (199 mg per day interquartile range, 100 to 382 vs. 141 mg per day interquartile range, 68 to 240, P<0.001), and more patients in the HFOV group than in the control group received neuromuscular blockers (83% vs. 68%, P<0.001). In addition, more patients in the HFOV group received vasoactive drugs (91% vs. 84%, P=0.01) and received them for a longer period than did patients in the control group (5 days vs. 3 days, P=0.01).
In adults with moderate-to-severe ARDS, early application of HFOV, as compared with a ventilation strategy of low tidal volume and high positive end-expiratory pressure, does not reduce, and may increase, in-hospital mortality. (Funded by the Canadian Institutes of Health Research; Current Controlled Trials numbers, ISRCTN42992782 and ISRCTN87124254, and ClinicalTrials.gov numbers, NCT00474656 and NCT01506401.).
Amorphous chalcogenide alloys are key materials for data storage and energy scavenging applications due to their large non-linearities in optical and electrical properties as well as low vibrational ...thermal conductivities. Here, we report on a mechanism to suppress the thermal transport in a representative amorphous chalcogenide system, silicon telluride (SiTe), by nearly an order of magnitude via systematically tailoring the cross-linking network among the atoms. As such, we experimentally demonstrate that in fully dense amorphous SiTe the thermal conductivity can be reduced to as low as 0.10 ± 0.01 W m
K
for high tellurium content with a density nearly twice that of amorphous silicon. Using ab-initio simulations integrated with lattice dynamics, we attribute the ultralow thermal conductivity of SiTe to the suppressed contribution of extended modes of vibration, namely propagons and diffusons. This leads to a large shift in the mobility edge - a factor of five - towards lower frequency and localization of nearly 42% of the modes. This localization is the result of reductions in coordination number and a transition from over-constrained to under-constrained atomic network.
The aim of this study was to compare radiology-based prediction models in rheumatoid arthritis-related interstitial lung disease (RAILD) to identify patients with a progressive fibrosis ...phenotype.RAILD patients had computed tomography (CT) scans scored visually and using CALIPER and forced vital capacity (FVC) measurements. Outcomes were evaluated using three techniques, as follows. 1) Scleroderma system evaluating visual interstitial lung disease extent and FVC values; 2) Fleischner Society idiopathic pulmonary fibrosis (IPF) diagnostic guidelines applied to RAILD; and 3) CALIPER scores of vessel-related structures (VRS). Outcomes were compared to IPF patients.On univariable Cox analysis, all three staging systems strongly predicted outcome (scleroderma system hazard ratio (HR) 3.78, p=9×10
; Fleischner system HR 1.98, p=2×10
; and 4.4% VRS threshold HR 3.10, p=4×10
). When the scleroderma and Fleischner systems were combined, termed the progressive fibrotic system (C-statistic 0.71), they identified a patient subset (n=36) with a progressive fibrotic phenotype and similar 4-year survival to IPF. On multivariable analysis, with adjustment for patient age, sex and smoking status, when analysed alongside the progressive fibrotic system, the VRS threshold of 4.4% independently predicted outcome (model C-statistic 0.77).The combination of two visual CT-based staging systems identified 23% of an RAILD cohort with an IPF-like progressive fibrotic phenotype. The addition of a computer-derived VRS threshold further improved outcome prediction and model fit, beyond that encompassed by RAILD measures of disease severity and extent.
During carrier multiplication (CM), also known as multiexciton generation (MEG), absorption of a single photon produces multiple electron-hole pairs, or excitons. This process can appreciably ...increase the efficiency of photoconversion, which is especially beneficial in photocatalysis and photovoltaics. This Account reviews recent progress in understanding the CM process in semiconductor nanocrystals (NCs), motivated by the challenge researchers face to quickly identify candidate nanomaterials with enhanced CM. We present a possible solution to this problem by showing that, using measured biexciton Auger lifetimes and intraband relaxation rates as surrogates for, respectively, CM time constants and non-CM energy-loss rates, we can predict relative changes in CM yields as a function of composition. Indeed, by studying PbS, PbSe, and PbTe NCs of a variety of sizes we determine that the significant difference in CM yields for these compounds comes from the dissimilarities in their non-CM relaxation channels, i.e., the processes that compete with CM. This finding is likely general, as previous observations of a material-independent, “universal” volume-scaling of Auger lifetimes suggest that the timescale of the CM process itself is only weakly affected by NC composition. We further explore the role of nanostructure shape in the CM process. We observe that a moderate elongation (aspect ratio of 6–7) of PbSe NCs can cause up to an approximately two-fold increase in the multiexciton yield compared to spherical nanoparticles. The increased Auger lifetimes and improved charge transport properties generally associated with elongated nanostructures suggest that lead chalcogenide nanorods are a promising system for testing CM concepts in practical photovoltaics. Historically, experimental considerations have been an important factor influencing CM studies. To this end, we discuss the role of NC photocharging in CM measurements. Photocharging can distort multiexciton dynamics, leading to erroneous estimations of the CM yield. Here, we show that in addition to distorting time-resolved CM signals, photocharging also creates spectral signatures that mimic CM. This re-emphasizes the importance of a careful analysis of the potential effect of charged species in both optical and photocurrent-based measurements of this process.
The Imaging Ultraviolet Spectrograph (IUVS) is one of nine science instruments aboard the Mars Atmosphere and Volatile and EvolutioN (MAVEN) spacecraft. MAVEN, launched in November 18, 2013 and ...arriving at Mars in September 2014, is designed to explore the planet’s upper atmosphere and ionosphere and examine their interaction with the solar wind and solar ultraviolet radiation. IUVS is one of the most powerful spectrographs sent to another planet, with several key capabilities: (1) separate Far-UV & Mid-UV channels for stray light control, (2) a high resolution echelle mode to resolve deuterium and hydrogen emission, (3) internal instrument pointing and scanning capabilities to allow complete mapping and nearly-continuous operation, and (4) optimization for airglow studies.
Dementia with Lewy bodies (DLBs) is a common cause of dementia but has higher mortality than Alzheimer's disease (AD). The reasons for this are unclear, but antidementia drugs (including ...acetylcholinesterase inhibitors AChEIs and memantine) symptomatically benefit people with DLB and might improve outcomes. We investigated whether AChEIs and/or memantine were associated with reduced hospital admissions and mortality.
We performed a retrospective cohort study of those diagnosed with DLB between 1 January 2005 and 31 December 2019, using data from electronic clinical records of secondary care mental health services in Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), United Kingdom (catchment area population approximately 0.86 million), as well as linked records from national Hospital Episode Statistics (HES) data. Eligible patients were those who started AChEIs or memantine within 3 months of their diagnosis (cases) and those who never used AChEIs or memantine (controls). Outcomes included admission, length of stay, and mortality. Cox proportional hazard and linear regression models were used. Of 592 patients with DLB, 219 never took AChEIs or memantine, 100 took AChEIs only, and 273 took both AChEIs and memantine. The cohorts were followed up for an average of 896 days, 981 days, and 1,004 days, respectively. There were no significant differences in the cohorts' baseline characteristics, except for socioeconomic status that was lower in patients who never took AChEIs or memantine (χ2 = 23.34, P = 0.003). After controlling for confounding by sociodemographic factors (age, sex, marital status, ethnicity, socioeconomic status), antipsychotic use, antidepressant use, cognitive status, physical comorbidity, anticholinergic burden, and global health performance, compared with patients who never took AChEIs or memantine, patients taking AChEIs only or taking both had a significantly lower risk of death (adjusted hazard ratio (HR) = 0.67, 95% CI = 0.48 to 0.93, p = 0.02; adjusted HR = 0.64, 95% CI = 0.50 to 0.83, P = 0.001, respectively). Those taking AChEIs or both AChEIs and memantine had significantly shorter periods of unplanned hospital admission for physical disorders (adjusted coefficient -13.48, 95% CI = -26.87, -0.09, P = 0.049; adjusted coefficient -14.21, 95% CI = -24.58, -3.85, P = 0.007, respectively), but no difference in length of stay for planned admissions for physical disorders, or for admissions for mental health disorders. No significant additional associations of memantine on admission, length of stay, and mortality were found (all P > 0.05). The main limitation was that this was a naturalistic study and possible confounds cannot be fully controlled, and there may be selection bias resulting from nonrandom prescription behaviour in clinical practice. However, we mimicked the intention-to-treat design of clinical trials, and the majority of baseline characters were balanced between cohorts. In addition, our series of sensitivity analyses confirmed the consistency of our results.
In this study, we observed that use of AChEIs with or without memantine in DLB was associated with shorter duration of hospital admissions and decreased risk of mortality. Although our study was naturalistic, it supports further the use of AChEIs in DLB.
Nanomaterials with efficient carrier multiplication (CM), that is, generation of multiple electron–hole pairs by single photons, have been the object of intense scientific interest as potential ...enablers of high efficiency generation-III photovoltaics. In this work, we explore nanocrystal shape control as a means for enhancing CM. Specifically, we investigate the influence of aspect ratio (ρ) of PbSe nanorods (NRs) on both CM and the inverse of this process, Auger recombination. We observe that Auger lifetimes in NRs increase with increasing particle volume and for a fixed cross-sectional size follow a linear dependence on the NR length. For a given band gap energy, the CM efficiency in NRs shows a significant dependence on aspect ratio and exhibits a maximum at ρ ∼ 6–7 for which the multiexciton yields are a factor of ca. 2 higher than those in quantum dots with a similar bandgap energy. To rationalize our experimental observations, we analyze the influence of dimensionality on both CM and non-CM energy-loss mechanisms and offer possible explanations for the seemingly divergent effects the transition from zero- to one-dimensional confinement has on the closely related processes of Auger recombination and CM.
Previous trials of higher positive end-expiratory pressure (PEEP) for acute respiratory distress syndrome (ARDS) failed to demonstrate mortality benefit, possibly because of differences in lung ...recruitability among patients with ARDS.
To determine whether the physiological response to increased PEEP is associated with mortality.
In a secondary analysis of the Lung Open Ventilation Study (LOVS, n = 983), we examined the relationship between the initial response to changes in PEEP after randomization and mortality. We sought to corroborate our findings using data from a different trial of higher PEEP (ExPress, n = 749).
The oxygenation response (change in ratio of arterial partial pressure of oxygen to fraction of inspired oxygen: P/F) after the initial change in PEEP after randomization varied widely (median, 9.5 mm Hg; interquartile range, -16 to 47) and was only weakly related to baseline P/F or the magnitude of PEEP change. Among patients in whom PEEP was increased after randomization, an increase in P/F was associated with reduced mortality (multivariable logistic regression; adjusted odds ratio, 0.80 95% confidence interval, 0.72-0.89 per 25-mm Hg increase in P/F), particularly in patients with severe disease (baseline P/F less-than-or-equal-to 150 mm Hg). Changes in compliance and dead space were not associated with mortality. These findings were confirmed by a similar analysis of data from the ExPress trial.
Patients with ARDS who respond to increased PEEP by improved oxygenation have a lower risk of death. The oxygenation response to PEEP might be used to predict whether patients will benefit from higher versus lower PEEP.
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