bluuebunny/crossref_metadata_2025 huggingface dataset:
Einstein, Equipartition, Fluctuations, and Quanta
Authors: Duncan Anthony , Janssen Michel
Published: October 2019

After three papers on statistical mechanics, mostly duplicating work by Boltzmann and Gibbs, Einstein relied heavily on arguments from statistical mechanics in the most revolutionary of his famous 1905 papers, the one introducing the light‐quantum hypothesis. He showed that the equipartition theorem inescapably leads to the classical Rayleigh‐Jeans law for black‐body radiation and the ultraviolet catastrophe (as Ehrenfest later called it). Einstein and Ehrenfest were the first to point this out but the physics community only accepted it after the venerable H.A. Lorentz, came to the same conclusion in 1908. The central argument for light quanta in Einstein’s 1905 paper involves a comparison between fluctuations in black‐body radiation in the Wien regime and fluctuations in an ideal gas. From this comparison Einstein inferred that black‐body radiation in the Wien regime behaves as a collection of discrete, independent, and localized particles. We show that the same argument works for non‐localized quantized wave modes. Although nobody noticed this flaw in Einstein’s reasoning at the time, his fluctuation argument, and several others like it, failed to convince anybody of the reality of light quanta. Even Millikan’s verification of Einstein formula for the photoelectric effect only led to the acceptance of the formula, not of the theory behind it. Einstein’s quantization of matter was better received, especially his simple model of a solid consisting of quantized oscillators. This model could explain why the specific heats of solids fall off sharply as the temperature is lowered instead of remaining constant as it should according to the well‐known Dulong‐Petit law, which is a direct consequence of the equipartition theorem. The confirmation of Einstein’s theory of specific heats by Nernst and his associates was an important milestone in the development of quantum theory and a central topic at the first Solvay conference of 1911, which brought the fledgling theory to the attention of a larger segment of the physics community. Returning to the quantum theory after spending a few years on the development of general relativity, Einstein combined his light‐quantum hypothesis with elements of Bohr’s model of the atom in a new quantum radiation theory.
The Birth of the Bohr Model
Authors: Duncan Anthony , Janssen Michel
Published: October 2019

We follow Niels Bohr from his 1911 dissertation on the electron theory of metals to his 1913 trilogy on the constitution of atoms and molecules. The dissertation shows that Bohr was thoroughly familiar with the early work of predominantly German physicists on quantum theory and that he suspected that the behavior of bound rather than free electrons called for new laws of physics. During postdoctoral work with Rutherford in Manchester, Bohr learned about the alpha-scattering experiments by Geiger and Marsden that led Rutherford to suggest that an atom consists of a nucleus containing most of its mass with a cloud of electrons swirling around it. Bohr tried to infer the atomic structure in more detail from these and further alpha-scattering experiments. Bohr’s models are in the tradition of British atomic modeling of J.J. Thomson and others but Bohr also borrowed from Planck the notion that energy is proportional to frequency. These early ideas have been preserved in the so-called Manchester memorandum, a set of notes Bohr prepared for Rutherford before returning to Copenhagen in July 1912. In this memorandum, Bohr only considered the ground state of an atom and focused on chemical rather than spectroscopic phenomena. He first started thinking about excited states when he encountered models similar to his own by another British model builder, Nicholson. His interest shifted from chemistry to spectroscopy when a Danish colleague, Hansen, alerted him to the Balmer formula. Within a month of first laying eyes on Balmer’s formula, Bohr submitted the first installment of his trilogy, which contains his famous model of the hydrogen atom. In the following months he completed the trilogy, dealing with more complicated atoms and molecules and presenting results directly coming out of the research recorded in the Manchester memorandum.
Guiding Principles
Authors: Duncan Anthony , Janssen Michel
Published: October 2019

The development of the complex of assumptions and methods now referred to as the “old quantum theory” mainly took place in the first five years following the introduction of the Bohr atomic model in 1913. Three guiding principles emerged that were used, sometimes in overlapping ways, to explain the flood of spectroscopic data that needed to be explained. First, quantization rules (or conditions) were proposed to single out the allowed orbital motions of electrons in atoms. These rules were derived in various forms by Planck, Sommerfeld, and Wilson, but were put into their most general form by Schwarzschild, who recognized the underlying principle as the quantization of the action variables of a multiply periodic classical system. Second, the special role of the action variables in quantization was given convincing support by the transfer of the adiabatic principle of mechanics to quantum theory (work primarily due to Paul Ehrenfest). Third, the correspondence principle, or statement of asymptotic coincidence of quantum and classical theory in the limit of large quantum numbers, originally introduced by Bohr in 1913 as a supporting argument for his quantization of angular momentum in his theory of the hydrogen atom, was extended by Bohr and Kramers to provide selection rules and approximate intensity predictions evening the regime low quantum numbers.
Privation in the Problem of Evil
Authors: Pruss Alexander R. , Yancey Hilary
Published: October 2019

Privative evils are evils that deprive someone of a due good. Chapter 1 considers a special but widespread type of a privative evil, namely impairment. It argues that even though an impairment may deprive someone of a significant and due good, impairments as such do not make for a significant case against theism. The argument is based on thought experiments suggesting that it does not make one significantly worse off when one is lacking a due good as opposed to when one is merely lacking a good, even when the good is itself significant. It is suggested that the point generalizes beyond impairment to at least some other forms of privative evils. And if St. Augustine is right that all evils are privative, then this could form a significant component of a general theodicy.
Why Did The One Not Remain Within Itself?
Authors: Johnston Mark
Published: October 2019

God’s creative act, if genuinely free, would ground the existence of creatures without necessitating them. Since God is perfectly responsive to reason, his freely creating requires that he have an adequate but non-coercive reason to create. A coercive reason for an act is one that outweighs the reasons for any alternative act, whereas an adequate reason is one that is not outweighed by the reasons in favor of any alternative act. How, in the absence of an offsetting reason not to create, is God’s adequate reason not also a coercive reason, i.e., one that would necessitate creation? Chapter 7 argues that God’s creating and God’s remaining within himself each have to be understood as determinate manners in which God may affirm his own unsurpassable goodness. Cantorian reflections are then deployed to explain how God’s extra, i.e., un-offset, reason to create does not give him more of a reason to create than to not create. Finally, God’s actual reason to create is identified.
Aquinas on the Intension and Remission of Accidental Forms
Authors: Frost Gloria
Published: October 2019

The metaphysics underlying differences in degree of qualitative intensity was widely debated in the medieval period. Medieval Aristotelians agreed that subjects possess qualities in virtue of inherent accidental forms. Yet, there was considerable disagreement about what happens at the level of form when a quality increases or decreases in its intensity. For instance, what happens when a pot of water on the stove gets hotter? Is the water’s previous form of heat replaced by a new one, or does the same form of heat persist? Does the form of heat itself undergo a change, or does only the water undergo a change? While there have been several important studies on the medieval debate about the “intension and remission of forms,” little attention has been paid to Thomas Aquinas’s intriguing theory. Aquinas claims that a subject’s quality increases in intensity in virtue of the subject “participating” more perfectly in an invariable form. This paper examines Aquinas’s conception of the participation relationship between a substance and its accidental forms; and his metaphysical analysis of changes of intensification.
Scotus versus Aquinas on Instrumental Causality
Authors: Solère Jean-Luc
Published: October 2019

The medieval notion of instrumental cause is not limited to what we call today “instruments” or “tools.” It extends way beyond the realm of technology and includes natural entities, for instance, the accidents by which a substance acts on another substance, sensible species in the air acting on a visual faculty, sacraments, bodily organs, and sometimes creatures with respect to God’s action. In all these cases, instrumental causes, like secondary causes in general, are subordinated to a principal cause and contribute to its action and effects. However, the manner in which they do so makes them different from regular secondary causes, and the specifics are not easy to pinpoint. At the occasion of discussions about creation ex nihilo and sacraments, John Duns Scotus challenges Thomas Aquinas’s theory of instrumental causality. Whereas Aquinas does not strongly distinguish between artifacts and natural agents, and postulates a complex superposition of layers of causation, Scotus offers a novel view that clearly separates artificial instrumentality and natural instrumentality, and in both cases explains causation with great economy. Scotus’s in-depth discussion has far-reaching implications. It completely transforms the understanding of instrumental causality in general.
The Relation-Theory of Mental Acts
Authors: Hartman Peter John
Published: October 2019

The relation-theory of mental acts proposes that a mental act is a kind of relative entity founded upon the mind and directed at the object of perception or thought. While most medieval philosophers recognized that there is something importantly relational about thought, they nevertheless rejected the view that mental acts are wholly relations. Rather, the dominant view was that a mental act is either in whole or part an Aristotelian quality added to the mind upon which such a relation to the object can be founded. This paper examines Durand of St.-Pourçain’s defense of the relation-theory of mental acts against two objections raised against it: the first from John Duns Scotus, among others, and the second from an anonymous Thomist and Adam Wodeham
Ethics, Insurance Pricing, Genetics, and Big Data
Authors: Klitzman Robert
Published: October 2019

Insurers are rapidly gaining access to consumers’ genetic information. In the U.S., federal law bars using genetic information in health insurance, but not in life, disability, or long-term care insurance. Accordingly, insurers may fear adverse selection: individuals could undergo testing, learn they have risky genes, and purchase insurance without revealing test results. While other countries have established moratoria on insurers’ use of genetic information, there is no consensus in the U.S. regarding how to avoid ‘unfair discrimination.’ The chapter discusses alternative solutions, including government bans of insurers’ use of genetic information, or limiting insurer information to only high-risk genes.
Boom and Bust Driven by Value-at-Risk
Authors: Shin Hyun Song
Published: October 2019

An example of a hedge fund illustrates a long-short strategy that maximises expected returns subject to a Value-at-Risk strategy. Balance sheet capacity depends on the measured volatility of asset returns and the book equity of the long-short hedge fund. The principles are illustrated by the case of Long Term Capital Management (LTCM).
Dynamic Hedging
Authors: Shin Hyun Song
Published: October 2019

Dynamic hedging can replicate the payoffs of state-contingent assets such as options. Delta hedging aligns the portfolio of risky and safe assets in line with the delta of the option. However, when risk is endogenous, delta hedging can inject feedback loops into market prices, so that delta hedging can lead to large market moves. The 1987 stock market crash is brought in as an illustration.
Lending Booms
Authors: Shin Hyun Song
Published: October 2019

A system of interlinked balance sheets of intermediaries that follow the Value-at-risk rule has the feature that an increase in house prices transmits valuation changes through the value of debt instruments. The analysis uses the Vasicek credit risk model for the diversification of individual credit risks in the loan portfolio. Leverage and wholesale funding is key to understanding lending booms.
Securitization and the Financial System
Authors: Shin Hyun Song
Published: October 2019

Mortgage securitisations rose rapidly in the early 2000s through the private label securitisation vehicles that packaged subprime mortgages. The size of the asset-backed securities sector in the United States traces well the overall leverage of the financial system in the run-up to the Great Financial Crisis.
Introduction
Authors: Brighouse Harry , Schmidtz David
Published: October 2019

The evolution of educational institutions has been shaped by an uneasy mix of standards-based and market-based reforms. How we understand education’s outcomes for students and for society at large will shape how we think about the general idea of market-based reforms. Yet any given reform is a particular intervention in a particular time and place, so a responsible evaluation of reform ultimately must be an analysis of particular observations. General principles of philosophy and economics can illuminate, but real cases have a way of turning out to be special cases. So while this is a debate about the role of market-based reforms in education, we want to avoid engaging in a duel of rival theories and instead speak on behalf of real children, real parents, and real teachers.
Society Is Not a Race
Authors: Altman Andrew
Published: October 2019

We observed that educators and educational institutions have a twofold mission. Here is an implication: If we perform well in our role as educators, we make our classroom a society—a cooperative venture for mutual advantage. If we perform well as certifiers, we turn our classroom into something else: a race, albeit a fair one. Society, in any case, is not a race. No one needs to win. Therefore, no one needs an equal opportunity to win either. To prepare students for membership in society, the exact thing students need, no more and no less, is a genuine chance to make something of whatever potential they have.
Epilogue
Authors: Brighouse Harry , Schmidtz David
Published: October 2019

We have learned from progress in the field of psychology that certain biases are baked into the human condition. However, the fact that we live and process information in real time, in a temporal order, is not a mistake. It affects what we end up thinking, so it is a bias in a way; yet it is not a mistake, and there is no way for human information processors to avoid it. Even so, open-mindedness pays dividends. Because each of us set out to defend children rather than to defend theories, in the course of our back-and-forth each of us ended up learning something about what serves that more or less common aim. In particular, we understand that one of society’s legitimate aspirations is to be a place of opportunity, and above all a place of opportunity for its least advantaged citizens. We also understand what this overarching aspiration leaves open. It does not determine the particular missions of more specialized institutions within society, including institutions of education. We leave that as a question for the reader, but we hope to have shed some light on how to think about it.
Introduction
Authors: Mate C. Mathew , Carpick Robert W.
Published: October 2019

This chapter discusses why the scientific field encompassing friction, lubrication, adhesion, and wear is called tribology and how recent scientific advances are now enabling us to understand the rich interactions occurring between the atoms and molecules at contacting surfaces. This chapter also outlines the history of tribological science and tribology’s impact on technology, the economy, and everyday life. Success stories from MEMS, disk drives, automotive, and nanoimprinting industries are used to illustrate how nanoscale tribological science (often referred to as nanotribology) is helping to develop important new technologies. Examples considered include nanoscale contact switches and mechanical relays. The chapter concludes with a discussion around Feynman’s caveats on how friction and adhesion at the atomic and molecular level present major challenges for developing atomic scale machines.
Mechanical Properties of Solids and Real Area of Contact
Authors: Mate C. Mathew , Carpick Robert W.
Published: October 2019

This chapter covers how the material around contacting asperities deforms when two surfaces touch and the resulting stresses in the materials. The beginning portion of the chapter is devoted to how these stresses and deformations originate at the atomic level. Next, discussed are the elastic and plastic deformations that can occur when a single asperity contacts a flat surface, such as a Hertzian contact. The discussion of plasticity leads naturally to the discussion of hardness. A major portion of this chapter is devoted to estimating the solid–solid contact area between rough contacting surfaces, which can be due to both elastic and plastic deformations. This discussion of contact area is centered around the Greenwood and Williamson model and the Persson theory of the contact mechanics of rough surfaces.
Surface Forces Derived from Surface Energies
Authors: Mate C. Mathew , Carpick Robert W.
Published: October 2019

As it more practical to measure the forces acting between two contacting surfaces then the energies of surfaces, this chapter covers those surface forces that are derived from surface energies. The starting point is Derjaguin’s approximation, which relates the energy between two flat surfaces to the force in other geometries: sphere/flat, sphere/sphere, and crossed cylinders. Next is a discussion of the surface forces in dry contacts with no liquid menisci around the contact points. This discussion covers the cases where adhesion causes significant deformation (JKR theory), where deformation is insignificant (DMT theory), and the cases in between. How surface roughness impacts adhesion is also discussed. The second half of this chapter deals with how liquid menisci around contacts contribute to adhesion forces, both for the sphere-on-flat geometry and for contacting rough surfaces.
Measuring Surface Forces
Authors: Mate C. Mathew , Carpick Robert W.
Published: October 2019

This chapter focuses on the two experimental techniques—the surface force apparatus (SFA) and the atomic force microscope (AFM)—that are commonly used for measuring molecular level forces that act between two surfaces at small separation distances. The first part of this chapter covers the fundamental principles of SFA and AFM design. The second half of this chapter illustrates the application of AFM to measuring surface forces with examples the measurement of van der Waals forces, atomic level repulsive forces, frictional forces, electrostatic double-layer forces, and meniscus forces from liquid films and from capillary condensation.
Atomistic Origins of Friction
Authors: Mate C. Mathew , Carpick Robert W.
Published: October 2019

This chapter covers the current state of knowledge about how the shear strength (the force needed to slide one surface over another) originates at the atomic level. For adhesive friction, friction originates from the forces needed to move the atoms on one surface over the atomic structure of the opposing surface; the simplest model for adhesive friction is the cobblestone model. The Frenkel–Kontorova model, the Prandtl–Tomlinson model, and molecular dynamic simulations are typically used to show how the atomic structure of the surfaces leads to static friction. One exciting aspect of these friction models is the prediction of superlubricity or negligible friction for incommensurate sliding surfaces, which is now being realized in experiments. Also discussed is why superlubricity is not observed in real-life situations. As atoms and molecules slide over surfaces, kinetic friction originates from phonon and electronic excitations, which are typically studied using the quartz crystal microbalance (QCM).
Wear
Authors: Mate C. Mathew , Carpick Robert W.
Published: October 2019

This chapter outlines common mechanisms that contribute to wear, which is broadly defined to be any form of surface damage caused by rubbing one surface against another. Such wear mechanisms include delamination wear, adhesive wear (where adhesion followed by plastic shearing plucks the ends off the softer asperities, typically described by Archard’s law), abrasive wear (where hard particles or asperities gouge a surface and displace material), and oxidative wear (where surfaces react with atmospheric oxygen prior to being worn). Sliding conditions often determine which wear mechanism dominates, with the main factors being temperature, sliding velocity, oxidation, plasticity, loading force, and mechanical stresses. How wear rates respond to changes to these factors can be diagramed on a wear map. The last part of the chapter discusses how transition state theory can describe nanoscale wear by atomic attrition, and how plasticity and fracture occur at the nanoscale.
The No Alternatives Argument
Authors: Sprenger Jan , Hartmann Stephan
Published: October 2019

Convincing scientific theories are often hard to find, especially when empirical evidence is scarce (e.g., in particle physics). Once scientists have found a theory, they often believe that there are not many distinct alternatives to it. Is this belief justified? We model how the failure to find a feasible alternative can increase the degree of belief in a scientific theory—in other words, we establish the validity of the No Alternatives Argument and the possibility of non-empirical theory confirmation from a Bayesian point of view. Then we evaluate scope and limits of this argument (e.g., by calculating the degree of confirmation it provides) and relate it to other argument forms such as Inference to the Best Explanation (IBE) or “There is No Alternative” (TINA).
Scientific Realism and the No Miracles Argument
Authors: Sprenger Jan , Hartmann Stephan
Published: October 2019

The No Miracles Argument (NMA) is perhaps the most prominent argument in the debate about scientific realism. It contends that the truth of our best scientific theories is the only hypothesis that does not make the astonishing predictive and explanatory success of science a mystery. However, the argument has been criticized from a Bayesian point of view as committing the base rate fallacy. We provide two Bayesian models (one related to the individual-theory-based NMA and one related to the frequency-based NMA) that respond to that objection. The first model takes into account the observed stability of mature scientific theories, the second the success frequency of theories within a scientific discipline. We conclude that the NMA can be used to defend the realist thesis and that its validity is a highly context-sensitive matter.
Causal Strength
Authors: Sprenger Jan , Hartmann Stephan
Published: October 2019

The question “When is C a cause of E?” is well-studied in philosophy—much more than the equally important issue of quantifying the causal strength between C and E. In this chapter, we transfer methods from Bayesian Confirmation Theory to the problem of explicating causal strength. We develop axiomatic foundations for a probabilistic theory of causal strength as difference-making and proceed in three steps: First, we motivate causal Bayesian networks as an adequate framework for defining and comparing measures of causal strength. Second, we demonstrate how specific causal strength measures can be derived from a set of plausible adequacy conditions (method of representation theorems). Third, we use these results to argue for a specific measure of causal strength: the difference that interventions on the cause make for the probability of the effect. An application to outcome measures in medicine and discussion of possible objections concludes the chapter.
Explanatory Power
Authors: Sprenger Jan , Hartmann Stephan
Published: October 2019

This chapter motivates why, and under which circumstances, the explanatory power of a scientific hypothesis with respect to a body of evidence can be explicated by means of statistical relevance. This account is traced back to its historic roots in Peirce and Hempel and defended against its critics (e.g., contrasting statistical relevance to purely causal accounts of explanation). Then we derive various Bayesian explications of explanatory power using the method of representation theorems and we compare their properties from a normative point of view. Finally we evaluate how such measures of explanatory power can ground a theory of Inference to the Best Explanation (IBE).
Models, Idealizations and Objective Chance
Authors: Sprenger Jan , Hartmann Stephan
Published: October 2019

How does Bayesian inference handle the highly idealized nature of many (statistical) models in science? The standard interpretation of probability as degree of belief in the truth of a model does not seem to apply in such cases since all candidate models are most probably wrong. Similarly, it is not clear how chance-credence coordination works for the probabilities generated by a statistical model. We solve these problems by developing a suppositional account of degree of belief where probabilities in scientific modeling are decoupled from our actual (unconditional) degrees of belief. This explains the normative pull of chance-credence coordination in Bayesian inference, uncovers the essentially counterfactual nature of reasoning with Bayesian models, and squares well with our intuitive judgment that statistical models provide “objective” probabilities.
What Aspects of Formality Do Workers Value? Evidence from a Choice Experiment in Bangladesh
Authors: Mahmud Minhaj , Gutierrez Italo A , Kumar Krishna B , Nataraj Shanthi
Published: October 2019

This study uses a choice experiment among 2,000 workers in Bangladesh to elicit willingness to pay (WTP) for job attributes: a contract, termination notice, working hours, paid leave, and a pension fund. Using a stated preference method allows calculation of WTP for benefits in this setting, despite the lack of data on worker transitions, and the fact that many workers are self-employed, which makes it difficult to use revealed preference methods. Workers highly value job stability: the average worker would be willing to forgo a 27 percent increase in income to obtain a one-year contract (relative to no contract), or to forgo a 12 percent increase to obtain thirty days of termination notice. There is substantial heterogeneity in WTP by type of employment and gender: women value shorter working hours more than men, while government workers place a higher value on contracts than do private-sector employees.
ATG7 regulates hepatic Akt phosphorylation through the c‐JUN/PTEN pathway in high fat diet‐induced metabolic disorder
Authors: Zhao Daina , Zhang Shuangxi , Wang Xueqiang , Gao Dan , Liu Jing , Cao Ke , Chen Lei , Liu Run , Liu Jiankang , Long Jiangang
Published: October 2019

Growing evidence has suggested that autophagy‐related protein 7 (ATG7) plays an important role in insulin signaling, but the mechanism of ATG7 in hepatic insulin sensitivity is not fully understood. The purpose of the present study is to clarify the underlying molecular mechanisms of ATG7 in obesity development. Serum and liver samples from mice fed a high fat diet (HFD) were evaluated for metabolic profile data and ATG expressions during obesity development. We found that compared with other ATGs, ATG7 expression increased earlier with lower hepatic insulin sensitivity in the 4‐wk HFD‐fed mice. For in vitro analyses, silencing ATG7 significantly up‐regulated insulin‐stimulated phosphorylation of protein kinase B (Akt) and down‐regulated phosphatase and tension homolog deleted on chromosome ten (PTEN) in HepG2 cells. Replenishing PTEN to ATG7‐silenced hepatocytes restored the phosphorylated Akt level. Furthermore, ATG7 silencing led to higher c‐JUN expression, which transcriptionally reduced PTEN expression. These results reveal a novel mechanism by which ATG7 regulates Akt phosphorylation via the c‐JUN/PTEN pathway at the early stage of HFD‐induced metabolic disorder.—Zhao, D., Zhang, S., Wang, X., Gao, D., Liu, J., Cao, K., Chen, L., Liu, R., Liu, J., Long, J. ATG7 regulates hepatic Akt phosphorylation through the c‐JUN/PTEN pathway in high fat diet‐induced metabolic disorder. FASEB J. 33, 14296‐14306 (2019). www.fasebj.org
Maternal and Perinatal Mortality and Complications Associated With Cesarean Delivery in Low-Income and Middle-Income Countries: A Systematic Review and Meta-analysis
Authors: Sobhy Soha , Arroyo-Manzano David , Murugesu Nilaani , Karthikeyan Gayathri , Kumar Vinoth , Kaur Inderjeet , Fernandez Evita , Gundabattula Sirisha Rao , Betran Ana Pilar , Khan Khalid , Zamora Javier , Thangaratinam Shakila
Published: October 2019

(Abstracted from Lancet 2019;393(10184):1973–1982)

Around the world every year, 300,000 women die during childbirth, with 99% of these cases occurring in low- and middle-income countries (LMICs). One potential cause is accessibility to cesarean deliveries in these countries, which are both overutilized and underutilized and contribute to maternal and perinatal adverse outcomes.
Anesthesia During Positive-pressure Myelogram: A New Role for Cerebral Oximetry
Authors: Gatica-Moris Sebastian R. , Welch Tasha L. , Abcejo Arnoley S. , Carr Carrie M. , Pasternak Jeffrey J.
Published: October 2019

Background:

Positive-pressure myelogram (PPM) is an emerging radiologic study used to localize spinal dural defects. During PPM, cerebrospinal fluid pressure (CSFp) is increased by injecting saline with contrast into the cerebrospinal fluid. This has the potential to increase intracranial pressure and compromise cerebral perfusion.

Methods:

We performed a retrospective chart review and analysis of 11 patients. The aim was to describe the periprocedural anesthetic management of patients undergoing PPM.

Results:

All patients underwent PPM with general anesthesia and intra-arterial blood pressure and near-infrared spectroscopy monitoring of regional cerebral tissue oxygen saturation. Mean±SD maximum lumbar CSFp was 58±12 mm Hg. Upon intrathecal injection, mean systolic blood pressure increased from 115±21 to 142±32 mm Hg (P<0.001), diastolic blood pressure from 68±12 to 80±20 mm Hg (P≤0.001), and mean blood pressure from 87±10 to 98±14 mm Hg (P=0.02). Ten of 11 patients received blood pressure augmentation with phenylephrine to minimize the risk of reduced cerebral perfusion secondary to increased CSFp after intrathecal injection. The mean heart rate before and following injection was similar (68±15 vs. 70±15 bpm, respectively; P=0.16). There was a decrease in regional cerebral oxygen saturation after positioning from supine to prone position (79±10% to 74±9%, P=0.02) and a further decrease upon intrathecal injection (75±10% to 69±9%, P≤0.01).

Conclusions:

Systemic blood pressure increased following intrathecal injection during PPM, possibly due to a physiologic response to intracranial hypertension/reduced cerebral perfusion or administration of phenylephrine. Regional cerebral oxygen saturation decreased with the change to prone position and further decreased upon intrathecal injection. Cerebral near-infrared spectroscopy has a potential role to monitor the adequacy of cerebral perfusion and guide adjustment of systemic blood pressure during PPM.
A pediatric medial epicondyle fracture study using fresh frozen adult cadavers comparing fracture displacement and loss of terminal elbow extension
Authors: Cao Jue , Smetana Brandon S. , Carry Patrick , Peck Kathryn M. , Merrell Gregory A.
Published: October 2019

Medial epicondyle fractures are the 3rd most common pediatric elbow fractures. Regardless of treatment method, some degree of elbow motion loss has been reported. The purpose of our study was to determine the relationship between the amount of anterior fracture displacement and loss of elbow passive extension in an adult cadaveric medial epicondyle fracture model. Fifteen fresh frozen adult cadavers were procured to create fracture models at scenarios of 2, 5, 10 mm, and maximum displacement. Terminal elbow extension was recorded for each cadaveric model at each fracture scenario. A linear mixed model regression analysis was used to test the association between fracture displacement and loss of terminal elbow passive extension. At 2 mm of displacement, the average loss of terminal extension was 3.89°; at 5 mm, it was 7°; at 10 mm, it was 10.7°; at maximum displacement (~15 mm), it was 17°. A statistically significant positive linear association between fracture displacement and loss of terminal elbow extension was observed (5 mm of displacement = loss of ~4.7°). In our fracture model, when the medial epicondyle displaced anteriorly, we noticed a change in the tension of the medial collateral ligaments which lead to a decrease in terminal elbow extension. However, this only contributed partially to the loss of motion observed clinically in the literature. Even though our findings did not support the recommendation of surgical intervention to prevent loss of elbow motion in medial epicondyle fractures, we still encourage physicians to consider the consequence of displacement and its potential influence of elbow range of motion.
Clinical, radiographic and pedobarographic analysis of skeletally immature patients with surgically treated distal metaphyseal fractures of the tibia: is concomitant fixation of the fibula necessary?
Authors: Wang Wentao , Canavese Federico , Lin Ran , Pan Yuancheng , Huang Dianhua , Xiong Zhu , Chen Shunyou
Published: October 2019

This study evaluated the outcomes of distal tibia metaphyseal fractures (DTMFs) managed surgically and compared the outcomes of patients with and without associated fibula fracture fixation. Thirty-two consecutive patients (14 males; mean age at the time of injury: 7.8 years) with closed displaced DTMFs, with (22 patients; group A) or without associated fibula fractures fixation (10 patients; group B), were included. Besides standard radiographic measurements, the following static and dynamic pedobarographic parameters were evaluated: foot total static plantar pressure percentage (PP%tot), static plantar pressure percentage of the forefoot (PP%ff) and of the rear foot (PP%rf), landing sequence of the metatarsals during contact with the ground (MTland), and impulse percentage of the metatarsal heads (MT%imp) and the medial and lateral heel (MH%imp and LH%imp). All patients were followed for at least 2 years (range: 2–4.5 years). Functional outcomes were excellent to good in all but two patients (93.8%) at the last follow-up visit using the Johner-Wruths criteria’. Radiographic measurements, PP%tot, PP%ff, PP%rf, MT%imp, MH%imp and LH%imp were not significantly different between two groups as well as between injured and uninjured side of patients within the same group (P > 0.05). Abnormal MTland sequence was found in 40.9% of group A (9/22) and in 40% of group B patients (4/10) (P > 0.05). Stabilization of associated fibula fractures did not significantly impact the clinical, radiographic and pedobarographic outcomes of the children with displaced DTMFs who were surgically treated. Level of evidence: Level III.
The Risk of Cardiovascular Disease in Prostate Cancer Patients Receiving Androgen Deprivation Therapies
Authors: Cardwell Chris R. , O’Sullivan Joe M. , Jain Suneil , Harbinson Mark T. , Cook Michael B. , Hicks Blánaid M. , McMenamin Úna C.
Published: October 2019

Background:

Androgen deprivation therapy (ADT), with a proven role in prostate cancer management, has been associated with various cardiovascular diseases. However, few studies have investigated these associations by type of ADT, particularly for newer ADTs such as the gonadotropin-releasing hormone (GnRH) antagonist degarelix. We investigated the risk of cardiovascular disease by type of ADT in a real-world setting.

Methods:

We identified men newly diagnosed with prostate cancer, from 2009 to 2015, from the Scottish Cancer Registry and ADTs from the nationwide Prescribing Information System. Cardiovascular events were based upon hospitalization (from hospital records) or death from cardiovascular disease (from death records). We used Cox regression to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular events with time-varying ADT exposure, comparing ADT users with untreated patients, after adjusting for potential confounders, including prior cardiovascular disease.

Results:

The cohort contained 20,216 prostate cancer patients, followed for 73,570 person-years, during which there were 3,853 cardiovascular events. ADT was associated with a 30% increase in cardiovascular events (adjusted HR = 1.3; 95% CI = 1.2, 1.4). This reflected increases in cardiovascular events associated with GnRH agonists (adjusted HR = 1.3; 95% CI = 1.2, 1.4), degarelix (adjusted HR = 1.5; 95% CI = 1.2, 1.9), but not bicalutamide monotherapy (adjusted HR = 1.0; 95% CI = 0.82, 1.3).

Conclusions:

There were increased risks of cardiovascular disease with the use of GnRH agonists and degarelix, but not with bicalutamide monotherapy. This is the first study to observe increased cardiovascular risks with degarelix, but the cause of this association is unclear and merits further investigation.
Harnessing Tweets for Early Detection of an Acute Disease Event
Authors: Joshi Aditya , Sparks Ross , McHugh James , Karimi Sarvnaz , Paris Cecile , MacIntyre C. Raina
Published: October 2019

Background:

Melbourne, Australia, witnessed a thunderstorm asthma outbreak on 21 November 2016, resulting in over 8,000 hospital admissions by 6 p.m. This is a typical acute disease event. Because the time to respond is short for acute disease events, an algorithm based on time between events has shown promise. Shorter the time between consecutive incidents of the disease, more likely the outbreak. Social media posts such as tweets can be used as input to the monitoring algorithm. However, due to the large volume of tweets, a large number of alerts may be produced. We refer to this problem as alert swamping.

Methods:

We present a four-step architecture for the early detection of the acute disease event, using social media posts (tweets) on Twitter. To curb alert swamping, the first three steps of the algorithm ensure the relevance of the tweets. The fourth step is a monitoring algorithm based on time between events. We experiment with a dataset of tweets posted in Melbourne from 2014 to 2016, focusing on the thunderstorm asthma outbreak in Melbourne in November 2016.

Results:

Out of our 18 experiment combinations, three detected the thunderstorm asthma outbreak up to 9 hours before the time mentioned in the official report, and five were able to detect it before the first news report.

Conclusions:

With appropriate checks against alert swamping in place and the use of a monitoring algorithm based on time between events, tweets can provide early alerts for an acute disease event such as thunderstorm asthma.
Radiation Safety Observations Associated with 177Lu Dotatate Patients
Authors: Nelson Kevin L. , Sheetz Michael A.
Published: October 2019

Lutetium-177 dotatate, marketed under the name Lutathera®, is proving to be a valuable tool for physicians treating patients with neuroendocrine somatostatin-receptive tumors. Treatment consists of four cycles of 7.4 GBq of 177Lu dotatate infused intravenously over 30 to 40 minutes. This paper focuses on the radiation safety implications of patients undergoing 177Lu dotatate treatments at two large medical centers in the United States under the manufacturer’s Expanded Access Protocol. Radiation safety precautions are described for the treatment of patients to control for radiation exposure and potential contamination. Ideally, the room used for administration should have a toilet, or one that is in close proximity, and covering should be provided to minimize contamination and clean up. The patient will meet the requirements in 10 CFR Part 35.75 for immediate release based on administered activity or measured exposure rate, but will need to be provided with written instruction on how to keep doses to other individuals ALARA. Disposal of the radioactive waste from 177Lu dotatate therapy can present some hazard control issues due to the long-lived 177mLu contaminant.

Based on our experience, 177Lu dotatate therapy is an effective outpatient procedure that can safely occur in any hospital procedural room without the need for additional local shielding. Administration can be accomplished safely with attention paid to the administration set-up and proper administration procedures. Exposure to staff or to adjacent areas is minimal.
Hospital Response to CMS Public Reports of Hospital Charge Information
Authors: Carey Kathleen , Dor Avi
Published: October 2019

Background:

In an effort to increase price transparency, the Centers for Medicare and Medicaid Services (CMS) began reporting charges for Medicare inpatients treated in ∼3400 hospitals online in 2013. As of 2019, CMS began to require hospitals themselves to publicize a more comprehensive list of their underlying procedure charges.

Objective:

The objective of this study was to assess the responses of hospitals to broad-scale public reporting of their charges for inpatient services.

Research Design:

We used descriptive analysis to examine the trend in CMS charge data for high charge hospitals before and after the 2013 intervention. We also applied difference-in-differences analysis to comprehensive inpatient charge data from New York and Florida for the years 2011–2016, defining the reported high-volume diagnosis-related groups (DRGs) as the intervention group.

Results:

At the national level, the CMS charge data showed relatively lower growth in high charge hospitals following the intervention. From the state data, we found that after 3 years, the growth in charges for reported DRGs in New York hospitals was 4%–9% lower than for unreported diagnosis-related groups. In Florida, it was 2%–8% lower.

Conclusion:

Public reports of hospital inpatient charges by DRG appear to influence subsequent charges, slowing their growth.
Standardized and Individualized Parenteral Nutrition Mixtures in a Pediatric Home Parenteral Nutrition Population
Authors: Nagelkerke Sjoerd C.J. , Jonkers‐Schuitema Cora F. , Kastelijn Wendy L.M. , Gerards Anne‐Loes E. , Benninga Marc A. , de Koning Barbara A.E. , Tabbers Merit M.
Published: October 2019

Objectives:

Studies evaluating efficacy or safety of standardized parenteral nutrition (PN) versus individualized PN are lacking. We aimed to assess effects on growth and safety of standardized PN compared with individualized PN in our Home PN group.

Methods:

Descriptive cohort study in Dutch children on Home PN, in which standardized PN was compared with individualized PN. Both groups received similar micronutrient‐supplementation. Primary outcome was growth over 2 years, secondary outcomes were electrolyte disturbances and biochemical abnormalities. Additionally, patients were matched for age to control for potential confounding characteristics.

Results:

Fifty patients (50% girls, median age 6.5 years) were included, 16 (32%) received standardized PN mixtures. Age (11 vs 5 years), gestational age (39.2 vs 36.2 weeks) and PN duration (97 vs 39 months) were significantly higher in the group receiving standardized PN (P: ⩽0.001; 0.027; 0.013 respectively). The standardized PN group showed an increase in weight‐for‐age (WFA), compared with a decrease in the individualized PN group (+0.38 SD vs −0.55 SD, P: 0.003). Electrolyte disturbances and biochemical abnormalities did not differ. After matching for age, resulting in comparable groups, no significant differences were demonstrated in WFA, height‐for‐age, or weight‐for‐height SD change.

Conclusions:

In children with chronic IF, over 2,5 years of age, standardized PN mixtures show a comparable effect on weight, height, and weight for height when compared with individualized PN mixtures. Also, standardized PN mixtures (with added micronutrients) seem noninferior to individualized PN mixtures in terms of electrolyte disturbances and basic biochemical abnormalities. Larger studies are needed to confirm these conclusions.

Trial Registration: Academical Medical Center medical ethics committee number W18_079 #18.103.
Factors Associated With Uncertainty in Patients Scheduled to Undergo Hematopoietic Stem Cell Transplantation
Authors: Adarve Sandra E. , Osorio Jhon H.
Published: October 2019

Background

Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation.

Objective

To identify the frequency of uncertainty and its associated factors in adults scheduled to undergo hematopoietic stem cell transplantation.

Methods

In this cross-sectional study with analytical purposes, information on sociodemographic and clinical variables was collected. Fifty patients were diagnosed with lymphoma, myeloma, or leukemia from a high-complexity hospital. Mishel’s Scale of Uncertainty in Illness validated in Spanish was applied. A multivariate analysis was performed through logistic regression.

Results

Approximately 74% of participants had a high level of uncertainty. The education level (odds ratio [OR], 4.1; 95% confidence interval [CI], 1.11–15.3), family history of cancer (OR, 30.7; 95% CI, 2.7–349), and previous radiotherapy treatment (OR, 0.04; 95% CI, 0.004–0.48) were associated with the uncertainty level.

Conclusions

Uncertainty is experienced by patients with hematologic cancer, and factors associated should be recognized to diminish the negative effects produced by this.

Implications for Practice

This experience of uncertainty and its associated factors must be visible in patients scheduled to undergo transplantation. This allows nurses to carry out interventions that have an impact on the cognitive ability mediated by information and education. Reducing the effects that uncertainty has on the overall experience of patients, it is vital for nursing.
Competency-based Professional Advancement Model for Advanced Practice RNs
Authors: Paul Fiona , Abecassis Leah , Freiberger Dawn , Hamilton Susan , Kelly Pamela , Klements Elizabeth , LaGrasta Christine , Lemire Lindsay , O'Donnell Ellen , Patisteas Erin , Phinney Caitlin , Conwell Karen , Saia Theresa , Whelan Katherine , Wood Laura J. , O'Brien Patricia
Published: October 2019

The process of developing a 3-tiered advanced practice RN (APRN) competency-based professional advancement model at Boston Children's Hospital is described. The model recognizes the contributions of entry-level and expert APRNs to advanced clinical practice and outcomes, impact, and leadership, while incorporating the tenets of Patricia Benner's Novice to Expert Model and the American Association of Critical- Care Nurses Synergy Model of Care.