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To investigate previously identified and novel correlates of acute calcium pyrophosphate (CPP) crystal arthritis among well-characterized cases.In this case-control study, we identified cases of acute CPP crystal arthritis using a validated algorithm (positive predictive value 81%) applied in the Partners HealthCare electronic health record (EHR). Cases were matched to general patient controls on the year of first EHR encounter and index date. Prespecified potential correlates included sex, race, and comorbidities and medications previously associated with CPP deposition/acute CPP crystal arthritis in the literature. We estimated odds ratios (ORs) and 95% confidence intervals using conditional logistic regression models adjusted for demographic characteristics, comorbidities, medications prescribed in the past 90 days, health care utilization, and multimorbidity score.We identified 1,697 cases matched to 6,503 controls. Mean ± SD age was 73.7 ± 11.8 years, 56.7% were female, 80.8% were White, and 10.3% were Black. All prespecified covariates were more common in cases than controls. Osteoarthritis (OR 3.08), male sex (OR 1.35), rheumatoid arthritis (OR 2.09), gout (OR 2.83), proton pump inhibitors (OR 1.94), loop diuretics (OR 1.60), and thiazides (OR 1.46) were significantly associated with acute CPP crystal arthritis after full adjustment. Black race was associated with lower odds for acute CPP crystal arthritis compared to White race (OR 0.47).Using a validated algorithm to identify nearly 1,700 patients with acute CPP crystal arthritis, we confirmed important correlates of this acute manifestation of CPP deposition. This is the first study to report higher odds for acute CPP crystal arthritis among males.

ObjectivesCalcium pyrophosphate deposition (CPPD) disease, broadly defined, has been associated with increased risk of cardiovascular (CV) events. We investigated risk of CV events in patients with acute CPP crystal arthritis, the acute manifestation of CPPD.MethodsCohort study using Mass General Brigham electronic health record (EHR) data, 1991–2017. Patients with acute CPP crystal arthritis were identified using a published machine learning algorithm with positive predictive value 81%. Comparators were matched on year of EHR entry and index date of patients with acute CPP crystal arthritis (first positive synovial fluid CPP result or mention of ‘pseudogout’, or matched encounter). Major adverse cardiovascular event (MACE) was a composite of non-fatal CV event (myocardial infarction, acute coronary syndrome, coronary revascularisation, stroke) and death. We estimated incidence rates (IRs) and adjusted hazard ratios for MACE, non-fatal CV event and death, allowing for differential estimates during years 0–2 and 2–10. Sensitivity analyses included: (1) patients with acute CPP crystal arthritis diagnosed during outpatient visits, (2) patients with linked Medicare data, 2007–2016 and (3)patients matched on number of CV risk factors.ResultsWe matched 1200 acute CPP crystal arthritis patients to 3810 comparators. IR for MACE in years 0–2 was 91/1000 person-years (p-y) in acute CPP crystal arthritis and 59/1000 p-y in comparators. In years 2–10, IR for MACE was 58/1000 p-y in acute CPP crystal arthritis and 53/1000 p-y in comparators. Acute CPP crystal arthritis was significantly associated with increased risk for MACE in years 0–2 (HR 1.32, 95% CI 1.01 to 1.73) and non-fatal CV event in years 0–2 (HR 1.92, 95% CI 1.12 to 3.28) and years 2–10 (HR 2.18, 95% CI 1.27 to 3.75), but not death. Results of sensitivity analyses were similar to the primary analysis; in the outpatient-only analysis, risk of non-fatal CVE was significantly elevated in years 2–10 but not in years 0–2.ConclusionsAcute CPP crystal arthritis was significantly associated with elevated short and long-term risk for non-fatal CV event.

Ferroelectric vertical gate-all-around field-effect-transistor (Fe-VGAAFET) suits a memory cell with a 5 nm technology node and beyond since it is less constrained by gate length, thereby providing sufficient space for the ferroelectric film compared with ferroelectric FinFET (Fe-FinFET) and ferroelectric lateral gate-all-around field-effect-transistors (Fe-LGAAFET). Also, Fe-VGAAFET achieves multilayer vertical stacking, which further increases the integrated density of devices. Here, we develop ferroelectric vertical sandwich gate-all-around field-effect-transistors (Fe-VSAFETs) with large memory windows (the maximum 2.3 V), high program/erase speeds (100 ns), and excellent retention properties using a self-aligned high-k metal gate process. Furthermore, vertical nanosheet devices with two channel thicknesses of approximately 16 and 42 nm and nanowire devices with a channel diameter of 30 nm were successfully fabricated, and excellent device characteristics were obtained.

Source engineering is an emerging technique to achieve steep-slope switching FET. To bridge the new carrier filtering mechanism and device performance, a multiscale simulation framework is presented in this article and is applied in Si nanowire (NW) cold source FET (CSFET). By the fit-parameter-free density functional theory (DFT) method, the key component of cold source (CS) design for broken-gap-like band alignment and high cold carrier injection is demonstrated. The novel device switching mechanism is also verified in the entire device scale with fully quantum atomistic tight-binding (TB) and nonequilibrium Green’s function (NEGF) methods. Although these tools are physics-based and accurate, the device scale is limited, and the computation burden is heavy. Thus, half-empirical TCAD simulation is suitable for device design and path-finding in realistic geometry. Key components of the CS and energy filtering effect can be verified by DFT-NEGF and TB-NEGF methods. Based on TCAD results, we implement a circuit-level benchmark for early stage path-finding. The results show that gate-all-around (GAA) Si NW CSFET is a potential candidate for low-power application, which enables supply voltage scaling.

ObjectiveWe aimed to determine whether specific respiratory tract diseases are associated with increased rheumatoid arthritis (RA) risk.MethodsThis case-control study within the Mass General Brigham Biobank matched newly diagnosed RA cases to 3 controls on age, sex, and electronic health record history. We identified RA using a validated algorithm and confirmed by medical record review. Respiratory tract disease exposure required 1 inpatient or 2 outpatient codes at least 2 years before the index date of RA clinical diagnosis or matched date. Logistic regression models calculated ORs for RA with 95% CIs, adjusting for confounders. We then stratified by serostatus (“seropositive” was positive rheumatoid factor and/or anticitrullinated protein antibodies) and smoking.ResultsWe identified 741 RA cases and 2223 controls (both median age 55, 76% female). Acute sinusitis (OR 1.61, 95% CI 1.05–2.45), chronic sinusitis (OR 2.16, 95% CI 1.39–3.35), and asthma (OR 1.39, 95% CI 1.03–1.87) were associated with increased risk of RA. Acute respiratory tract disease burden during the preindex exposure period was also associated with increased RA risk (OR 1.30 per 10 codes, 95% CI 1.08–1.55). Acute pharyngitis was associated with seronegative (OR 1.68, 95% CI 1.02–2.74) but not seropositive RA; chronic rhinitis/pharyngitis was associated with seropositive (OR 2.46, 95% CI 1.01–5.99) but not seronegative RA. Respiratory tract diseases tended towards higher associations in smokers, especially > 10 pack-years (OR 1.52, 95% CI 1.02–2.27, P = 0.10 for interaction).ConclusionAcute and chronic sinusitis, pharyngitis, and acute respiratory burden increased RA risk. The mucosal paradigm of RA pathogenesis may involve the upper respiratory tract.

Gaseous inhibitors are used in many industries for the explosion prevention of combustible dusts, mitigating the potential hazard to humans, properties and environments. This work experimentally and theoretically studied the inerting effect of gaseous inhibitors on the ignition process of dust clouds in O2/N2/CO2 atmospheres, with an emphasis on the role of the CO2/N2 ratio. 10 different combustible carbonaceous dusts were selected, including grain dust, biomass dust and coal dust. Experimental results showed that the inhibition effect of CO2/N2 is closely related to the ignition mechanism of dust clouds. Specifically, a higher ratio of CO2/N2 yields a stronger inhibition effect on the ignition process of dust samples with relatively low volatile matter contents predominated by heterogeneous ignition. In addition, two novel steady-state ignition mechanism models were developed to interpret the experimental observations. Maxwell-Stefan equations were used to describe the diffusivity in the ternary O2/N2/CO2 gas mixtures. The analytical results were in good agreement with the experimental data of the minimum ignition temperature of dust cloud (MITC) in oxygen-lean atmospheres. The mechanism modelling can be used to estimate the critical ignition temperature of all carbonaceous dust clouds with a wide range of volatile matter content under different inert atmospheres, which will provide a reference for the explosion hazard assessment of dust posed by a hot surface in the process industries.

A multivalued logic (MVL) device can achieve greater data density with a smaller footprint than a traditional binary logic device. In this study, a ternary logic inverter based on negative capacitance FETs (NCFETs) without additional footprints has been realized. By enhancing the amplification in surface potential owing to the utilization of the negative capacitance, the third intermediate state can be successfully obtained at ${V}_{\text {DD}}$ /2 in the conventional binary CMOS inverter. The third intermediate state arises due to no-saturation effect of drain current, and the noise margin of the third intermediate state (NM $_{M}$ ) can be optimized by changing ferroelectric thickness or annealing temperature of ferroelectric material. The influence of remnant polarization ( ${P}_{r}$ ) and coercive electric ( ${E}_{C}$ ) variation on the ternary logic inverter was investigated based on experimental data. Moreover, a ternary logic 8T SRAM with transmission gate logic (TGL) was proposed, and the results show that the proposed 8T SRAM cell exhibits nondestructive read and reliable write operations for all three states.

OBJECTIVES: Giant cell arteritis (GCA) can manifest in cranial and/or extracranial arteries. We investigated the distribution of affected arteries on vascular ultrasound (VUS) among patients with new-onset or prior-onset GCA. METHODS: We retrospectively studied patients with either new-onset or prior-onset GCA and an abnormal VUS, 2013–2017. Trained vascular technologists imaged the bilateral temporal arteries and carotid, axillary, and subclavian arteries. Vascular medicine physicians interpreted the images. Vasculitis-related abnormalities in individual vessels and their distribution (temporal artery, large artery, or both) were evaluated. Phi coefficients (φ) and Fisher’s exact test were used to assess correlations among individual abnormal arteries. RESULTS: Among 66 GCA patients, 28.8% had prior-onset GCA (median duration 17.8 months). Acute arteritis on VUS was observed in the majority of patients with both new-onset GCA (72.3%) and prior-onset GCA (68.4%); the remainder had hyperechoic wall thickening without acute arteritis. Involvement of the temporal arteries only (45.5%) or large arteries only (34.8%) was more common than involvement of both (19.7%); this finding was similar in new-onset and prior-onset GCA. There were moderate positive correlations among temporal artery branches (φ=0.51–0.58, p

To get reliable computational results, the RNG k-e turbulence model with enhanced wall treatment was validated to solve the heat transfer of supercritical RP-3 in a helically coiled tube, and models of the thermo-physical properties of RP-3 were optimally chosen. Most significantly, the grid independence was validated by two-step procedure, and the effect of boundary grids of the supercritical-temperature wall on the computational accuracy was well studied. Through adjusting boundary-layer girds’ size, four regions (increased, pseudo-convergence, decreased and convergence) of the outlet temperature Tout were obtained and analyzed. The results showed that the maximum computation errors of Tout and the pressure differential between the inlet and outlet ΔP reached 20.65% and 98.15%, respectively, indicating that boundary grids have a significant influence on computation of flow and heat transfer. Based on this, a dimensionless distance from the wall-adjacent cell to the wall y+ = Prw−1/1.78 (Prw denotes Wall Prandtl number) was recommended as a convergence point. The variation laws of viscous length scale y were discussed under different structural parameters, operation parameters, and helical lengths. An explicit model of y* was proposed to calculate the height (y) of the first boundary layer grids and refine boundary grids efficiently. A modified model for coefficient of friction factor Cf was proposed based on Rogers’s, and Nusselt number Nu was proposed based on an analogy of momentum and heat transfer. The above models about y*, Cf and Nu could apply to both the entrance region and the whole tube length, and showed good performance when Reynolds number was extended to above 70 000, or whenever the outlet temperature is below or above the critical point.

Objective We aimed to determine the real-world prevalence and investigate risk factors for rheumatoid arthritis (RA)-related lung disease on chest computed tomography (CT) imaging. We also investigated the impact of RA-related lung disease on mortality. Methods We studied chest CT imaging abnormalities among RA patients. We determined the presence and type of abnormalities using the chest CT imaging radiologic report. RA-related lung disease was defined as interstitial lung disease (ILD), bronchiectasis, or pleural disease. We examined whether demographics and RA characteristics were associated with RA-related lung disease using logistic regression. RA-related lung disease and mortality was described using survival curves and Cox regression. Results We analyzed 190 patients who had chest CT imaging performed for clinical indications. Mean age was 64.2 years (SD 11.8), 80.0% were female, and 75.3% were seropositive. RA-related lung disease was detected in 54 patients (28.4%); 30 (15.8%) had ILD, 27 (14.2%) had bronchiectasis, and 18 (9.5%) had pleural disease. RA-related lung disease was reported in both seropositive and seronegative RA (28.7% vs. 27.7%, p = 1.00). Male sex (OR 2.62, 95%CI 1.17–5.88) and current methotrexate use (OR 2.73, 95%CI 1.27–5.61 vs. not current) were associated with RA-related lung disease. Twenty-four (44.4%) patients with RA-related lung disease died during mean 7.0 years of follow-up. RA-related lung disease had HR of 5.35 (95%CI 0.72–39.9) for mortality compared to normal chest CT. Conclusions In this real-world study, RA-related lung disease was commonly detected on chest CT imaging regardless of RA serostatus. RA-related lung disease had high mortality, emphasizing the importance in close monitoring of these patients.

Summary Here, we develop a freestanding ladder-like ZnO surface with abundant unsaturated step defects, which could efficiently anchor Au1 sites with one-dimensional assembling for the ultrasensitive NO2 detection. The dimension of the obtained ZnO hexagonal ladder could be precisely controlled through reasonably regularizing the nucleation and growth rate. Following a layer-by-layer growth mode, the obtained ZnO would adopt the step-rich evolution. These ladder-like structures could provide abundant unsaturated step defects along with their curved edge profiles to serve as susceptible centers to site-selectively immobilize isolated Au1 species (Au1-ZnO). The obtained Au1-ZnO catalysts exhibit an outstanding NO2-sensing response (12.6 to 300 ppb) at a low operating temperature (150°C). The proposed step-induced strategy will broaden the rational design of special site-trapped supported metal catalysis for gas sensors.

Objective.To investigate demographic, lifestyle, and serologic risk factors for isolated rheumatoid arthritis (RA)–associated bronchiectasis (RA-BR) that is not a result of interstitial lung disease (ILD).Methods.We performed a case-control study using patients with RA from the Mass General Brigham Biobank. We reviewed the records of all patients with RA meeting the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria with computed tomography (CT) chest imaging to identify RA-BR cases and controls with RA and RA-related lung disease. For each patient, the CT chest imaging that was performed closest to enrollment was independently reviewed by 2 radiologists for the presence of RA-related lung diseases. Cases had clinical and radiologic evidence of RA-BR without interstitial lung abnormalities on imaging. Controls had RA and no evidence of bronchiectasis or ILD. We examined the associations between demographic, lifestyle, and serologic factors with RA-BR using multivariable logistic regression.Results.We identified 57 cases of isolated RA-BR and 360 RA controls without RA-related lung disease. In multivariable models, RA-BR was associated with older age at RA onset (OR 1.37 per 10 years, 95% CI 1.02–1.82), lower BMI at RA diagnosis (OR 0.94 per kg/m2, 95% CI 0.89–0.99), seropositive RA (OR 3.96, 95% CI 1.84–8.53), positive rheumatoid factor (OR 4.40, 95% CI 2.14–9.07), and positive anticyclic citrullinated peptide (OR 3.47, 95% CI 1.65–7.31). Higher titers of RA-related autoantibodies were associated with higher odds of RA-BR.Conclusion.Seropositivity, older age at RA diagnosis, and lower BMI at RA onset were associated with isolated bronchiectasis in RA that was not a result of ILD. These findings expand the list of potential risk factors for RA-BR and suggest a pathogenic link between airway inflammation and RA-related autoantibodies.

Objectives To investigate the associations of the common MUC5B promoter variant with timing of RA-associated interstitial lung disease (RA-ILD) and RA onset. Methods We identified patients with RA meeting 2010 ACR/EULAR criteria and available genotype information in the Mass General Brigham Biobank, a multihospital biospecimen and clinical data collection research study. We determined RA-ILD presence by reviewing all RA patients who had CT imaging, lung biopsy or autopsy results. We determined the dates of RA and RA-ILD diagnoses by manual records review. We examined the associations of the MUC5B promoter variant (G>T at rs35705950) with RA-ILD, RA-ILD occurring before or within 2 years of RA diagnosis and RA diagnosis at age >55 years. We used multivariable logistic regression to estimate odds ratios (ORs) for each outcome by MUC5B promoter variant status, adjusting for potential confounders including genetic ancestry and smoking. Results We identified 1005 RA patients with available genotype data for rs35705950 (mean age 45 years, 79% female, 81% European ancestry). The MUC5B promoter variant was present in 155 (15.4%) and was associated with RA-ILD [multivariable OR 3.34 (95% CI 1.97, 5.60)], RA-ILD before or within 2 years of RA diagnosis [OR 4.01 (95% CI 1.78, 8.80)] and RA onset after age 55 years [OR 1.52 (95% CI 1.08, 2.12)]. Conclusions The common MUC5B promoter variant was associated with RA-ILD onset earlier in the RA disease course and older age of RA onset. These findings suggest that the MUC5B promoter variant may impact RA-ILD risk early in the RA disease course, particularly in patients with older-onset RA.

This article presents a comprehensive assessment on the 6T static random access memory (SRAM) cell with 7-nm FinFET technology by implementing quantum physics-based device-circuit cooptimization. Seven key device design parameters and their multiple impacts on a 6T SRAM cell are systematically evaluated, focusing on materials band engineering, device design, circuit parameters tradeoff, and variation control. The area of SRAM cell under the same Fin quantization scheme remains constant in all evaluations. To the best of our knowledge, the most comprehensive discussion about circuit optimization from multiple device design parameters perspective is presented. Based on our cooptimization scheme, a SRAM cell is effectively designed. For a low-power and robust SRAM cell design, we achieve 56.7% reduction in leakage, 7.9% improvement in hold noise margin (HNM), 8.6% improvement in read noise margin (RNM), and 10.8% improvement in write margin (WM) at the expense of 19.3% increase in delay under design space of gate length (Lg) and spacer thickness (TSPC). For a high-speed SRAM cell design, we recommend focusing on the optimization of architecture and peripheral circuits. This framework not only has the advantages of easy implementation, technology-friendly, and high accuracy, but also suitable for path-finding researches on 5-nm node and beyond.

A phytochemical investigation of the barks of Eucommia ulmoides Oliv. resulted in the isolation of 18 flavonoids (1-18). The new compound, eucommiaflavone (1) was structurally elucidated by various...

A new type of vertical nanowire (NW)/ nanosheet (NS) field-effect transistors (FETs), termed vertical sandwich gate-all-around (GAA) FETs (VSAFETs), is presented in this work. Moreover, an integration flow that is compatible with processes used in the mainstream industry is proposed for the VSAFETs. Si/SiGe epitaxy, isotropic quasi-atomic-layer etching (qALE), and gate replacement were used to fabricate pVSAFETs for the first time. Vertical GAA FETs with self-aligned high-k metal gates and a small effective-gate-length variation were obtained. Isotropic qALE, including Si-selective etching of SiGe, was developed to control the diameter/thickness of the NW/NS channels. NWs with a diameter of 10 nm and NSs with a thickness of 20 nm were successfully fabricated, and good device characteristics were obtained. Finally, the device performance was investigated and is discussed in this work.