Recent Decisions

Comments on recent decisions by John A. Vuono, Robert D. LeMense, Louis G. Basso, Harry D. Snyder, Jr., Wilbur L. Pollard, and Paul R. Jackiwicz

Recent Decisions

Comments on recent decisions by Harry D. Snyder, John A. Vuono, Leonard J. Kamer, John A. Young, Allan C. Schmid, William B. McFadden, David N. McBride, and Thomas J. Griffin

Properties of Bulk Sintered Silver As a Function of Porosity

This report summarizes a study where various properties of bulk-sintered silver were investigated over a range of porosity. This work was conducted within the National Transportation Research Center's Power Device Packaging project that is part of the DOE Vehicle Technologies Advanced Power Electronics and Electric Motors Program. Sintered silver, as an interconnect material in power electronics, inherently has porosity in its produced structure because of the way it is made. Therefore, interest existed in this study to examine if that porosity affected electrical properties, thermal properties, and mechanical properties because any dependencies could affect the intended function (e.g., thermal transfer, mechanical stress relief, etc.) or reliability of that interconnect layer and alter how its performance is modeled. Disks of bulk-sintered silver were fabricated using different starting silver pastes and different sintering conditions to promote different amounts of porosity. Test coupons were harvested out of the disks to measure electrical resistivity and electrical conductivity, thermal conductivity, coefficient of thermal expansion, elastic modulus, Poisson's ratio, and yield stress. The authors fully recognize that the microstructure of processed bulk silver coupons may indeed not be identical to the microstructure produced in thin (20-50 microns) layers of sintered silver. However, measuring these same properties with such a thin actual structure is very difficult, requires very specialized specimen preparation and unique testing instrumentation, is expensive, and has experimental shortfalls of its own, so the authors concluded that the herein measured responses using processed bulk sintered silver coupons would be sufficient to determine acceptable values of those properties. Almost all the investigated properties of bulk sintered silver changed with porosity content within a range of 3-38% porosity. Electrical resistivity, electrical conductivity, thermal conductivity, elastic modulus, Poisson's ratio, and yield stress all depended on the porosity content in bulk-sintered silver. The only investigated property that was independent of porosity in that range was coefficient of thermal expansion

The coding and non-coding RNA single-cell atlas of the human fetal striatum

peer reviewedDeciphering how the human striatum develops is paramount to understand diseases affecting this region. To decode the transcriptional modules that regulate this structure during development we first catalogued 1116, de novo identified, lincRNAs and then profiled 96,789 single-cells from the early human fetal striatum. We found that D1 and D2 medium spiny neurons (MSNs) arise from a common progenitor and that lineage commitment is established during the post-mitotic transition, across a pre-MSN phase that exhibits a continuous spectrum of fate determinants. We then uncovered cell type-specific gene regulatory networks that we validated through in silico perturbation. Finally, we identified human-specific lincRNAs that contribute to the phylogenetic divergence of this structure in humans. In conclusion, our study has delineated the cellular hierarchies governing MSN lineage commitment

Frequency of left ventricular hypertrophy in non-valvular atrial fibrillation

Left ventricular hypertrophy (LVH) is significantly related to adverse clinical outcomes in patients at high risk of cardiovascular events. In patients with atrial fibrillation (AF), data on LVH, that is, prevalence and determinants, are inconsistent mainly because of different definitions and heterogeneity of study populations. We determined echocardiographic-based LVH prevalence and clinical factors independently associated with its development in a prospective cohort of patients with non-valvular (NV) AF. From the "Atrial Fibrillation Registry for Ankle-brachial Index Prevalence Assessment: Collaborative Italian Study" (ARAPACIS) population, 1,184 patients with NVAF (mean age 72 \ub1 11 years; 56% men) with complete data to define LVH were selected. ARAPACIS is a multicenter, observational, prospective, longitudinal on-going study designed to estimate prevalence of peripheral artery disease in patients with NVAF. We found a high prevalence of LVH (52%) in patients with NVAF. Compared to those without LVH, patients with AF with LVH were older and had a higher prevalence of hypertension, diabetes, and previous myocardial infarction (MI). A higher prevalence of ankle-brachial index 640.90 was seen in patients with LVH (22 vs 17%, p = 0.0392). Patients with LVH were at significantly higher thromboembolic risk, with CHA2DS2-VASc 652 seen in 93% of LVH and in 73% of patients without LVH (p <0.05). Women with LVH had a higher prevalence of concentric hypertrophy than men (46% vs 29%, p = 0.0003). Logistic regression analysis demonstrated that female gender (odds ratio [OR] 2.80, p <0.0001), age (OR 1.03 per year, p <0.001), hypertension (OR 2.30, p <0.001), diabetes (OR 1.62, p = 0.004), and previous MI (OR 1.96, p = 0.001) were independently associated with LVH. In conclusion, patients with NVAF have a high prevalence of LVH, which is related to female gender, older age, hypertension, and previous MI. These patients are at high thromboembolic risk and deserve a holistic approach to cardiovascular prevention

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys