As a result of recent investigations on nanocrystalline (nc) materials, extensive experimental data on the deformation behavior of these materials have become available. In this article, an analysis of these data was performed to identify the requirements that a viable deformation mechanism should meet in terms of accounting for the mechanical characteristics and trends that are revealed by the data. The results of the analysis show that a viable deformation mechanism is required to account for the following: (1) an activation volume the value of which is in the range 10 to 40 b 3; (2) an activation energy that is close to the activation energy for boundary diffusion but that decreases with increasing applied stress; (3) the magnitudes of deformation rates that cover wide ranges of temperatures, stresses, and grain sizes; (4) inverse Hall–Petch behavior; and (5) limited ductility. The validity of available deformation mechanisms for nc materials is closely examined in the light of these requirements.

Experiments on hardness and the modulus of elasticity were conducted at room temperature on samples of electrodeposited (ED) nanocrystalline (nc) Ni that were annealed at temperatures ranging from 323 to 693 K (50 to 420 °C). The results showed the presence of three regions: I, II, and III. In region I (300 K (27 °C) < T < 350 K (77 °C)), the hardness and the elastic modulus remained essentially constant. In region II (350 K (77 °C) < T < 500 K (227 °C)), both the hardness and the elastic modulus increased. In region III (T > 500 K (227 °C)), the hardness dropped and then decreased with increasing grain size, whereas the modulus of elasticity approached a maximum plateau of ~240 GPa. It is suggested that while the increase in hardness in region II can be attributed in part to the formation of annealing twins, which serve as a source of strengthening, the decrease in hardness above 500 K (227 °C) is due to the occurrence of significant grain growth. The increase in the modulus of elasticity with increasing temperature in region II was attributed to the preferred orientation along (200) that was observed in the as-received samples and that continuously diminished with increasing temperature. In region III (T > 500 K (227 °C)), the preferred orientation disappeared and, a result, the modulus of elasticity approached a constant value of approximately 240 GPa.

This research examines the development of confidence and accuracy over time in the context of forecasting. Although overconfidence has been studied in many contexts, little research examines its progression over long periods of time or in consequential policy domains. This study employs a unique data set from a geopolitical forecasting tournament spanning three years in which thousands of forecasters predicted the outcomes of hundreds of events. We sought to apply insights from research to structure the questions, interactions, and elicitations to improve forecasts. Indeed, forecasters' confidence roughly matched their accuracy. As information came in, accuracy increased. Confidence increased at approximately the same rate as accuracy, and good calibration persisted. Nevertheless, there was evidence of a small amount of overconfidence (3%), especially on the most confident forecasts. Training helped reduce overconfidence, and team collaboration improved forecast accuracy. Together, teams and training reduced overconfidence to 1%. Our results provide reason for tempered optimism regarding confidence calibration and its development over time in consequential field contexts.

Rationale & objective

Underlying kidney disease is an emerging risk factor for more severe coronavirus disease 2019 (COVID-19) illness. We examined the clinical courses of critically ill COVID-19 patients with and without pre-existing chronic kidney disease (CKD) and investigated the association between the degree of underlying kidney disease and in-hospital outcomes.

Study design

Retrospective cohort study.

Settings & participants

4,264 critically ill patients with COVID-19 (143 patients with pre-existing kidney failure receiving maintenance dialysis; 521 patients with pre-existing non-dialysis-dependent CKD; and 3,600 patients without pre-existing CKD) admitted to intensive care units (ICUs) at 68 hospitals across the United States.

Predictor(s)

Presence (vs absence) of pre-existing kidney disease.

Outcome(s)

In-hospital mortality (primary); respiratory failure, shock, ventricular arrhythmia/cardiac arrest, thromboembolic events, major bleeds, and acute liver injury (secondary).

Analytical approach

We used standardized differences to compare patient characteristics (values>0.10 indicate a meaningful difference between groups) and multivariable-adjusted Fine and Gray survival models to examine outcome associations.

Results

Dialysis patients had a shorter time from symptom onset to ICU admission compared to other groups (median of 4 [IQR, 2-9] days for maintenance dialysis patients; 7 [IQR, 3-10] days for non-dialysis-dependent CKD patients; and 7 [IQR, 4-10] days for patients without pre-existing CKD). More dialysis patients (25%) reported altered mental status than those with non-dialysis-dependent CKD (20%; standardized difference=0.12) and those without pre-existing CKD (12%; standardized difference=0.36). Half of dialysis and non-dialysis-dependent CKD patients died within 28 days of ICU admission versus 35% of patients without pre-existing CKD. Compared to patients without pre-existing CKD, dialysis patients had higher risk for 28-day in-hospital death (adjusted HR, 1.41 [95% CI, 1.09-1.81]), while patients with non-dialysis-dependent CKD had an intermediate risk (adjusted HR, 1.25 [95% CI, 1.08-1.44]).

Limitations

Potential residual confounding.

Conclusions

Findings highlight the high mortality of individuals with underlying kidney disease and severe COVID-19, underscoring the importance of identifying safe and effective COVID-19 therapies in this vulnerable population.