bluuebunny/crossref_metadata_2025 huggingface dataset:
A sub kBT/q semimetal nanowire field effect transistor
Authors: Ansari L. , Fagas G. , Gity F. , Greer J. C.
Published: August 2016

The key challenge for nanoelectronics technologies is to identify the designs that work on molecular length scales, provide reduced power consumption relative to classical field effect transistors (FETs), and that can be readily integrated at low cost. To this end, a FET is introduced that relies on the quantum effects arising for semimetals patterned with critical dimensions below 5 nm, that intrinsically has lower power requirements due to its better than a “Boltzmann tyranny” limited subthreshold swing (SS) relative to classical field effect devices, eliminates the need to form heterojunctions, and mitigates against the requirement for abrupt doping profiles in the formation of nanowire tunnel FETs. This is achieved through using a nanowire comprised of a single semimetal material while providing the equivalent of a heterojunction structure based on shape engineering to avail of the quantum confinement induced semimetal-to-semiconductor transition. Ab initio calculations combined with a non-equilibrium Green's function formalism for charge transport reveals tunneling behavior in the OFF state and a resonant conduction mechanism for the ON state. A common limitation to tunnel FET (TFET) designs is related to a low current in the ON state. A discussion relating to the semimetal FET design to overcome this limitation while providing less than 60 meV/dec SS at room temperature is provided.
Silicon based solar cells using a multilayer oxide as emitter
Authors: Bao Jie , Wu Weiliang , Liu Zongtao , Shen Hui
Published: August 2016

In this work, n-type silicon based solar cells with WO3/Ag/WO3 multilayer films as emitter (WAW/n-Si solar cells) were presented via simple physical vapor deposition (PVD). Microstructure and composition of WAW/n-Si solar cells were studied by TEM and XPS, respectively. Furthermore, the dependence of the solar cells performances on each WO3 layer thickness was investigated. The results indicated that the bottom WO3 layer mainly induced band bending and facilitated charge-carriers separation, while the top WO3 layer degraded open-circuit voltage but actually improved optical absorption of the solar cells. The WAW/n-Si solar cells, with optimized bottom and top WO3 layer thicknesses, exhibited 5.21% efficiency on polished wafer with area of 4 cm2 under AM 1.5 condition (25 °C and 100 mW/cm2). Compared with WO3 single-layer film, WAW multilayer films demonstrated better surface passivation quality but more optical loss, while the optical loss could be effectively reduced by implementing light-trapping structures. These results pave a new way for dopant-free solar cells in terms of low-cost and facile process flow.
A planar nano-positioner driven by shear piezoelectric actuators
Authors: Dong W. , Li H. , Du Z.
Published: August 2016

A planar nano-positioner driven by the shear piezoelectric actuators is proposed in this paper based on inertial sliding theory. The performance of the nano-positioner actuated by different driving signals is analyzed and discussed, e.g. the resolution and the average velocity which depend on the frequency, the amplitude and the wave form of the driving curves. Based on the proposed design, a prototype system of the nano-positioner is developed by using a capacitive sensor as the measurement device. The experiment results show that the proposed nano-positioner is capable of outputting two-dimensional motions within an area of 10 mm × 10 mm at a maximum speed of 0.25 mm/s. The corresponding resolution can be as small as 21 nm. The methodology outlined in this paper can be employed and extended to shear piezoelectric actuators involved in high precision positioning systems.
Signal enhancement of neutral He emission lines by fast electron bombardment of laser-induced He plasma
Authors: Suyanto Hery , Pardede Marincan , Hedwig Rinda , Marpaung Alion Mangasi , Ramli Muliadi , Lie Tjung Jie , Abdulmadjid Syahrun Nur , Kurniawan Koo Hendrik , Tjia May On , Kagawa Kiichiro
Published: August 2016

A time-resolved spectroscopic study is performed on the enhancement signals of He gas plasma emission using nanosecond (ns) and picosecond (ps) lasers in an orthogonal configuration. The ns laser is used for the He gas plasma generation and the ps laser is employed for the ejection of fast electrons from a metal target, which serves to excite subsequently the He atoms in the plasma. The study is focused on the most dominant He I 587.6 nm and He I 667.8 nm emission lines suggested to be responsible for the He-assisted excitation (HAE) mechanism. The time-dependent intensity enhancements induced by the fast electrons generated with a series of delayed ps laser ablations are deduced from the intensity time profiles of both He emission lines. The results clearly lead to the conclusion that the metastable excited triplet He atoms are actually the species overwhelmingly produced during the recombination process in the ns laser-induced He gas plasma. These metastable He atoms are believed to serve as the major energy source for the delayed excitation of analyte atoms in ns laser-induced breakdown spectroscopy (LIBS) using He ambient gas.
Painlevé analysis, nonlocal symmetry and explicit interaction solutions for supersymmetric mKdVB equation
Authors: Ren Bo
Published: August 2016

The N=1 supersymmetric mKdVB system is transformed to a coupled bosonic system by using the bosonization approach. By a singularity structure analysis, the bosonized supersymmetric mKdVB (BSmKdVB) equation admits the Painlevé property. Starting from the standard truncated Painlevé method, the nonlocal symmetry for the BSmKdVB equation is obtained. To solve the first Lie’s principle related with the nonlocal symmetry, the nonlocal symmetry is localized to the Lie point symmetry by introducing multiple new fields. Thanks to localization processes, similarity reductions for the prolonged systems are studied by the Lie point symmetry method. The interaction solutions among solitons and other complicated waves including Painlevé II waves and periodic cnoidal waves are given through the reduction theorems. The soliton-cnoidal wave interaction solutions are explicitly given by using the mapping and deformation method. The concrete soliton-cnoidal interaction solutions are displayed both in analytical and graphical ways.
Adiabatic quenches and characterization of amplitude excitations in a continuous quantum phase transition
Authors: Hoang Thai M. , Bharath Hebbe M. , Boguslawski Matthew J. , Anquez Martin , Robbins Bryce A. , Chapman Michael S.
Published: August 2016

Significance

Symmetry-breaking phase transitions play important roles in many areas of physics, including cosmology, particle physics, and condensed matter. The freezing of water provides a familiar example: The translational and rotational symmetries of water are reduced upon crystallization. In this work, we investigate symmetry-breaking phase transitions of the magnetic properties of an ultracold atomic gas in the quantum regime. We measure the excitations of the quantum magnets in different phases and show that the excitation energy (gap) remains finite at the phase transition. We exploit the nonzero gap to demonstrate an adiabatic (reversible) quench across the phase transition. Adiabatic quantum quenches underlie proposals for generating massively entangled spin states and are fundamental to the ideas of adiabatic quantum computation.
Time-resolved 2-million-year-old supernova activity discovered in Earth’s microfossil record
Authors: Ludwig Peter , Bishop Shawn , Egli Ramon , Chernenko Valentyna , Deneva Boyana , Faestermann Thomas , Famulok Nicolai , Fimiani Leticia , Gómez-Guzmán José Manuel , Hain Karin , Korschinek Gunther , Hanzlik Marianne , Merchel Silke , Rugel Georg
Published: August 2016

Significance

Massive stars, which terminate their evolution in a cataclysmic explosion called a type-II supernova, are the nuclear engines of galactic nucleosynthesis. Among the elemental species known to be produced in these stars, the radioisotope
60
Fe stands out: This radioisotope has no natural, terrestrial production mechanisms; thus, a detection of
60
Fe atoms within terrestrial reservoirs is proof for the direct deposition of supernova material within our solar system. We report, in this work, the direct detection of live
60
Fe atoms in biologically produced nanocrystals of magnetite, which we selectively extracted from two Pacific Ocean sediment cores. We find that the arrival of supernova material on Earth coincides with the lower Pleistocene boundary (2.7 Ma) and that it terminates around 1.7 Ma.
Atom-scale depth localization of biologically important chemical elements in molecular layers
Authors: Schneck Emanuel , Scoppola Ernesto , Drnec Jakub , Mocuta Cristian , Felici Roberto , Novikov Dmitri , Fragneto Giovanna , Daillant Jean
Published: August 2016

Significance

Interfacial molecular layers are a major component of all biological matter and also play key roles in most biotechnological applications. The understanding of important biological processes involving molecular layers typically relies on detailed structural insight. We demonstrate that standing-wave X-ray fluorescence enables the label-free, element-specific structural investigation of molecular layers at atom-scale resolution perpendicular to the interface. The present work establishes a promising approach to the comprehensive structural analysis of complex biological and biotechnologically relevant surfaces.
Paraphrasing exercises and training for Chinese to English consecutive interpreting
Authors: Cheung Andrew K.F.
Published: August 2016

This study investigates the effectiveness of incorporating paraphrasing exercises into interpreter training, specifically in relation to interpreting from Chinese to English. owever, there is a lack of empirical data supporting the use of paraphrasing exercises in interpreter training. The quantitative and qualitative data collected from 85 interpreter trainees in this study suggest that paraphrasing may be an effective teaching approach, especially when trainees are learning to interpret from a high-context language to a low-context language. The data suggest that paraphrasing exercises benefit learners abilities to process the source language at both the structural and informational levels, as paraphrasing in interpreter training is not limited to semantic and syntactic changes. The articulation and checking of the paraphrased version also help to enhance source language comprehension and organization, leading to a better rendition in a different language.
Enseignement de la traduction et de l’interprétation par continent et par pays et recherche traductologique
Authors: Choi Jungwha
Published: August 2016

L’étude de l’enseignement de l’interprétation et de la traduction par continent et par pays, l’étude de la discipline par niveau de diplôme, le développement des études sur la théorie en interprétation et en traduction ainsi que le nombre de publications internationales croissant dans le domaine montre que la discipline connaît un nouvel essor sur le plan académique.

Et l’Europe possède également le plus grand nombre d’écoles d’interprétation et de traduction.   Avec le développement de la discipline, les écoles d’Europe, d’Amérique mais aussi d’Asie ne se contentent plus de formations de niveau licence ou master, elles visent désormais jusqu’au doctorat. Parmi les 3 principaux pays d’Asie que sont la Chine, le Japon et la Corée du Sud, deux pays, à savoir la Chine et la Corée du Sud, propose des formations de doctorat.

Et la Corée du Sud est pour le moment le seul pays en Asie à publier une revue internationale en la matière. La revue Forum jouera un rôle de pont accru entre l’Orient et l’Occident.
Exhaled Nitric Oxide in Pulmonary Arterial Hypertension Associated with Systemic Sclerosis
Authors: Cao Zeling , Mathai Stephen C. , Hummers Laura K. , Shah Ami A. , Wigley Fredrick M. , Lechtzin Noah , Hassoun Paul M. , Girgis Reda E.
Published: August 2016

The fractional exhaled concentration of nitric oxide (FENO) has been shown to be reduced in idiopathic pulmonary arterial hypertension (PAH) but has not been adequately studied in PAH associated with systemic sclerosis (SSc). We measured FENO at an expiratory flow rate of 50 mL/s in 21 treatment‐naive patients with SSc‐associated PAH (SSc‐PAH), 94 subjects with SSc without pulmonary involvement, and 84 healthy volunteers. Measurements of FENO at additional flow rates of 100, 150, and 250 mL/s were obtained to derive the flow‐independent nitric oxide exchange parameters of maximal airway flux (J′awNO) and steady‐state alveolar concentration (CANO). FENO at 50 mL/s was similar (P = 0.22) in the SSc‐PAH group (19 ± 12 parts per billion [ppb]) compared with the SSc group (17 ± 12 ppb) and healthy control group (21 ± 11 ppb). No change was observed after 4 months of targeted PAH therapy in 14 SSc‐PAH group patients (P = 0.9). J′awNO was modestly reduced in SSc group subjects without lung disease (1.2 ± 0.5 nl/s) compared with healthy controls (1.64 ± 0.9; P < 0.05) but was similar to that in the SSc‐PAH group. CANO was elevated in individuals with SSc‐PAH (4.8 ± 2.6 ppb) compared with controls with SSc (3.3 ± 1.4 ppb) and healthy subjects (2.6 ± 1.5 ppb; P < 0.001 for both). However, after adjustment for the diffusing capacity of CO, there was no significant difference in CANO between individuals with SSc‐PAH and controls with SSc. We conclude that FENO is not useful for the diagnosis of PAH in SSc. Increased alveolar nitric oxide in SSc‐PAH likely represents impaired diffusion into pulmonary capillary blood.
Martin Luther on Marriage and the Family
Authors: Wiesner-Hanks Merry
Published: August 2016

Marriage was at the heart of Martin Luther’s break with Rome and the Reformation that followed. He preached sermons praising marriage beginning in 1519 and several years later wrote his first formal treatise attacking the value of vows of celibacy and arguing that marriage was the best Christian life. In 1525 he followed his words by deeds and married a nun who had fled her convent, Katharina von Bora. What started as a marriage of principle and mutual esteem became one of affection and deep emotional bonds. Luther continued to attack the celibate life of Catholic clergy and nuns and to celebrate marriage as a godly estate throughout his career, in sermons, formal treatises, lectures, advice manuals, letters, comments on legal cases, and casual conversation. In all of these, he both praised marriage and family life and commented on its burdensome side, moving from theoretical speculations while he was a celibate monk to reflecting on his own experiences as he became a family man, though his basic theology of marriage did not change much after the early 1520s. His words were direct and blunt, even in formal treatises. Sexual desire was inescapable for all but a handful, he argued, so should be channeled into marriage. Vows of celibacy should be rendered void, and monasteries and convents should be closed or much reduced in size. He agreed with St. Augustine on the three purposes of marriage, in the same order of importance: the procreation of children, the avoidance of sin, and mutual help and companionship. He praised spousal love but asserted that the ideal of reciprocal love in marriage was not an ideal of equality. Proper marital households were hierarchical, for the wife was and had to be the husband’s helpmeet and subordinate. Bearing children was the “precious and godly task” for which women were created, he wrote, and death in childbirth and even the deaths of children were part of God’s plan, though he himself was devastated when his twelve-year-old daughter died.

As cities and territories in Germany and then beyond became Protestant, they passed marriage ordinances and established institutions to regulate marriage, turning to Luther for advice on such issues as divorce, desertion, secret engagements, and parental consent. In making their decisions, judges slowly applied the new Protestant ideas about marriage, which people also learned about through sermons, artwork, and pamphlets. In general, however, other than clerical marriage, actual Protestant marriage patterns were not that different from Catholic ones. They fit with secular values as well, for rural and urban residents of all religious persuasions regarded appropriate marriages and stable families as essential to the social order. Recent scholarship has generally rejected earlier views that the Protestant Reformation by itself brought about dramatic change—for good or ill—in marriage and instead noted ways in which the reformers, including Luther, built on ideas and practices that were already there, especially in the middle-class urban milieus in which most of them grew up.
Primitivism in America
Authors: Bowman Matthew
Published: August 2016

Historians most often use the term primitivism to refer to the attempt to reconstruct a religious tradition’s original theology, structure, or beliefs. Primitivists believe that the earliest expressions of the faith are the most efficacious, powerful, and valid, and hence they attempt to recapture them in as complete a form as it is possible for them to imagine. Thus, they frequently dissent from established religious traditions, believing that those constructed under the primitive impulse achieve superior purity. Of course, these attempts are normally incomplete or inaccurate, reflecting the desires or needs of the group doing the restoring more than the original version of whatever faith is involved.

Primitivism has taken on a number of forms throughout American history. This essay follows a chronological approach, but uses Richard Hughes’s designations of “ethical,” “ecclesiastical,” and “experiential” primitivism to distinguish among various movements and provide some order to the narrative. These are common impulses in American religion, particularly in the years immediately following the American Revolution commonly called the Second Great Awakening. The language of primitivism has provided Americans with the weight of historical authority, often invoked to overturn established hierarchies and replace them with forms of religious practice deemed, alternately, more democratic, more biblical, more conducive to religious experience, or more ethically demanding. Whatever the case, primitivism has spoken to the American impulse toward reform, resistance to institution, and individual capacity.
Atopic dermatitis: new evidence on the role of allergic inflammation
Authors: Heratizadeh Annice
Published: August 2016

Purpose of review

Atopic dermatitis is a chronic relapsing inflammatory skin disease. In the presence of a complex genetic background, there is increasing evidence for the role of specific allergenic trigger factors in perpetuating skin inflammation in sensitized atopic dermatitis patients. In this review, clinical and in-vitro data so far published on allergen-induced adaptive immune responses in atopic dermatitis are summarized.

Recent findings

Emerging new data have been published particularly on adaptive immune responses to inhalant allergens in atopic dermatitis. In a randomized controlled study, the induction of a flare-up by grass pollen exposure in sensitized atopic dermatitis patients could be demonstrated for the first time. T cells directed to the two major allergens of house dust mite have been characterized to display a Th2, and moreover, a Th17 and Th2/Th17 phenotype in sensitized atopic dermatitis patients. With regard to microbial antigens, T cell-mediated immune responses directed to proteins of the species themselves can be observed – as has been published for Staphylococcus aureus and Malassezia spp. Beyond this, specific T-cell activation to cross-reacting human proteins might further trigger the disease in distinct patients. The role of ‘autoallergic’ phenomena in atopic dermatitis, because of human antigens without known cross-reactivity to environmental allergens, is currently under investigation as well.

Recent findings on immunological and clinical characteristics of adaptive immune responses to allergens in atopic dermatitis, but also on the identification of new, potentially relevant allergen sources might contribute to the development of effective treatment strategies ‘customized’ for allergic inflammation in atopic dermatitis in future.
A systematic review of the role of interleukin-17 and the interleukin-20 family in inflammatory allergic skin diseases
Authors: Hofmann Maja A. , Kiecker Felix , Zuberbier Torsten
Published: August 2016

Purpose of review

Allergic skin diseases include atopic dermatitis/eczema, contact dermatitis, and drug hypersensitivity. Allergic skin diseases have a high prevalence. Atopic dermatitis is one of the most common inflammatory skin diseases and similar for allergic rhinitis and allergic asthma. Over a long period, allergic diseases have been regarded as immunoglobulin E-mediated T-helper-2 (Th2)-driven. But new cytokines and T cells have been discovered within the last years. In this systematic review, the focus is laid on interleukin-17 (IL-17) and the interleukin-20 (IL-20) family which appear to be fine-tuning the Th2-driven answer.

Recent findings

IL-17 is a proinflammatory cytokine, which is produced by T cells. Primarily, IL-17 is produced by activated CD4+ cells, called Th-17 cells. IL-17 regulates keratinocyte expression of adhesion molecules and chemokines. IL-17 is involved in the pathogenesis of inflammatory diseases as psoriasis, arthritis, and inflammatory bowel diseases. In allergic diseases, the involvement of the TH17/IL17-pathway has only been recently described. Regarding the IL-20 family, IL-22 is the most interesting and the most studied cytokine in terms of allergic inflammatory disorders. IL-22 is produced by T-helper 22 cells, a new subset of CD4+ cells.

IL-17 as well as IL-22 seem to play a role in the pathogenesis of allergic skin diseases.
Substance Use as a Risk Factor for Sleep Problems Among Adolescents Presenting to the Emergency Department
Authors: Zhabenko Olena , Austic Elizabeth , Conroy Deirdre A. , Ehrlich Peter , Singh Vijay , Epstein-Ngo Quyen , Cunningham Rebecca M. , Walton Maureen A.
Published: August 2016

Objectives:

To determine correlates of sleep problems among adolescents. Specifically, to assess the relative strength of associations between sleep problems and dating victimization, reasons for emergency department (ED) visit, depression, unhealthy alcohol use, and other drug use (marijuana, nonmedical use of prescription opioids, stimulants, and tranquilizers).

Methods:

A total of 1852 adolescents aged 14 to 20 years presenting for care to the University of Michigan Emergency Department, Ann Arbor, Michigan, during 2011–2012, self-administered a computerized health survey. Sleep problems were identified if any of the 4 items on the Sleep Problems Questionnaire were rated by a patient as greater than 3 on a 0 to 5 scale. Adolescents who were too sick to be screened in the ED were eligible to participate in the study during their inpatient stay. Exclusion criteria for baseline included insufficient cognitive orientation precluding informed consent, not having parent/guardian present if younger than 18 years, medical severity precluding participation, active suicidal/homicidal ideation, non-English-speaking, deaf/visually impaired, or already participated in this study on a prior visit.

Results:

23.5% of adolescents reported clinically significant sleep problems. Female gender, depression, dating victimization, tobacco use, nonmedical use of prescription medication, and an ED visit for medical reasons were each associated with sleep problems among adolescents, even while controlling for age, other types of drug use, receiving public assistance, and dropping out of school.

Conclusions:

These exploratory findings indicate that ED-based screening and brief intervention approaches addressing substance use and/or dating victimization may need to account for previously undiagnosed sleep problems.
Racial Differences in Parental Responses to Children’s Chronic Pain
Authors: El-Behadli Ana F. , Gansert Patricia , Logan Deirdre E.
Published: August 2016

Objective:

Parental responses to children’s pain are related to how youth cope with chronic pain. However, little research has explored cultural differences in the 4 major pain response categories (ie, protect, minimize, distract, and monitor). This study compared parental responses to children’s pain between minority parents (ie, black, Hispanic, multiracial) and parents of white children.

Materials and Methods:

Participants included 234 patients, ages 8 to 17, with chronic pain (73.5% female; age M [SD]=13.91 [2.38]; 50% white, 15.39% black, 20.90% Hispanic, 13.68% multiracial). Patients’ parents completed the Adult Responses to Children’s Symptoms. Parental responses included: protect, monitor, minimize, and distrct. For between-group comparisons, white participants (N=117) were matched on age and sex with black (N=36), Hispanic (N=49), and multiracial (N=32) participants.

Results:

Paired-samples t tests revealed that protectiveness was higher for parents of black children (t
48=−3.84, P<0.001, black M [SD]=1.93 [0.69], white M [SD]=0.94 [0.77], Cohen d=1.09) and parents of Hispanic children (t
71=−7.10, P<0.001, Hispanic M [SD]=1.65 [0.76], white M [SD]=0.94 [0.77], Cohen d=1.52) compared with parents of white children. In addition, parents of black children (t
40=−2.90, P=0.006, black M [SD]=3.55 [0.49], white M [SD]=2.89 [0.93], Cohen d=0.80) and parents of Hispanic children (t
71=−3.62, P<0.001, Hispanic M [SD]=3.35 [0.69], white M [SD]=2.89 [0.93], Cohen d=0.81) were significantly more monitoring their children than were parents of white children. Parents of Hispanic children were also significantly more minimizing than parents of white children (t
71=−3.68, P<0.001, Hispanic M [SD]=0.88 [0.75], white M [SD]=0.51 [0.58], Cohen d=0.80). No other significant differences were found.

Discussion:

Results highlight the need to adapt pediatric chronic pain interventions to family culture and context. Further research is needed to understand pediatric chronic pain from a cross-cultural perspective.
Establishment of the Relationship Between Fathers and Premature Infants in Neonatal Units
Authors: Martel Marie-Josée , Milette Isabelle , Bell Linda , Tribble Denise St-Cyr , Payot Antoine
Published: August 2016

Background:

Parents and their preterm infants (born between 32-37 weeks of gestation) are often overlooked by the healthcare system. And very little attention is given to the relationship parents develop with their infants in the neonatal unit (NNU). Specifically, very few studies focused on fathers and how they establish a relationship with their infants. However, we know that the father–infant relationship is extremely important for their future social development and more.

Purpose:

This article presents the results of a qualitative study of the establishment of the father–premature infant relationship in an NNU.

Methods/Search Strategy:

The study's theoretical framework was Bell's model of the parent–infant relationship, which encompasses discovery, physical proximity, communication, involvement, and emotional attachment. Ten fathers of premature infants (gestational age: 32-37 weeks) participated in 2 semistructured interviews (1 individual and 1 “in situ,” ie, at the infant's bedside) during the first week following the premature birth.

Findings/Results:

The results confirm the emergence of different components of the relationship between fathers and their children from the first days of hospitalization in the NNU. The commitment component is the basis for the development of other components in the relationship with their children. Furthermore, involvement influences the deployment of emotional attachment, discovery, physical proximity, and communication toward premature infants. Similarly, the 5 themes of the model can be seen as forming a dynamic nexus in which each theme influences the others.

Implications for Practice:

For neonatal nurses, this model of the early father–child relationship helps the understanding of the deployment of that relationship according to 5 components. Similarly, it provides awareness of the experiences of fathers so that nurses can be better equipped to support and individualize interventions tailored to their specific needs, thus helping them develop and sustain the relationship with their children.

Implications for research:

This study allows us to better understand fathers' experience regarding the establishment of the relationship to their premature infants born between 32 and 37 weeks of gestation. However, there is little understanding about the early paternal experience and more research on this dyad is necessary in neonatology.
Social Justice as a Lens for Understanding Workplace Mistreatment
Authors: Moffa Christine , Longo Joy
Published: August 2016

Workplace mistreatment can be viewed as a social injustice that prohibits one from achieving optimal well-being. Cognitive and interpersonal skills required of nurses can be impacted by workplace mistreatment, thus extending injustices by violating the rights of patients to optimal care. The purpose of this article is to view workplace mistreatment through the lens of Powers and Faden's theory of social justice. Workplace mistreatment is explored through the 6 dimensions of well-being, including health, personal security, reasoning, respect, attachment, and self-determination, identified in the theory. The implications for practice and policy are discussed and recommendations for research made.
A Framework of Complex Adaptive Systems
Authors: D'Agata Amy L. , McGrath Jacqueline M.
Published: August 2016

Advances in neonatal care are allowing for increased infant survival; however, neurodevelopmental complications continue. Using a complex adaptive system framework, a broad analysis of the network of agents most influential to vulnerable infants in the neonatal intensive care unit (NICU) is presented: parent, nurse, and organization. By exploring these interconnected relationships and the emergent behaviors, a model of care that increases parental caregiving in the NICU is proposed. Supportive parent caregiving early in an infant's NICU stay has the potential for more sensitive caregiving and enhanced opportunities for attachment, perhaps positively impacting neurodevelopment.
Interpretation of Hospital Nurse Fatigue Using Latent Profile Analysis
Authors: Drake Diane Ash , Steege Linsey M. Barker
Published: August 2016

There has been a lack of consensus in the literature related to the conceptualization, definition, and measurement of hospital nurse fatigue. Using latent profile analysis, the Hospital Nurse Force Theory provided a conceptual format to identify 3 profiles of nurse fatigue from subjective reports of hospital patient care nurses in a survey cohort. All fatigue and adaptation variables demonstrated significant inverse relationships. Describing nurse fatigue in profiles that include measures of acute, chronic, physical, and mental fatigue dimensions provided a new and expanded view of nurse fatigue to monitor trends comprehensively and evaluate fatigue risk management strategies.
Minimally invasive techniques for pain palliation in extraspinal bone metastases: a review of conventional methods and cryoablation
Authors: Lawrenz Joshua M. , Ilaslan Hakan , Lietman Steven A. , Joyce Michael J. , Winalski Carl S. , Mesko Nathan W.
Published: August 2016

Minimally invasive techniques are an effective primary or alternative modality for pain palliation in extraspinal bone metastases. Conventional pain palliation therapies consist of chemotherapy, analgesics, and localized radiation therapy, and leave a subset of patients with refractory pain. Minimally invasive techniques include cryoablation, cementoplasty, radiofrequency ablation, selective embolization therapy, laser photocoagulation, ethanol ablation, microwave ablation, and MR-guided focused ultrasound therapy. Cryoablation’s increasing popularity with regard to patients presenting with well-defined osseous pain from lytic or mixed metastases has proven effective with regard to pain relief and narcotic usage decline. Combined with external beam radiation, these effects can be enhanced. Cryoablation is one of many minimally invasive options that may be considered for palliative methods in patients with metastatic axial and appendicular skeletal metastases. Future prospective, randomized trials are much needed to compare the efficacy of these treatments.
It is not just comfort: waterproof casting increases physical functioning in children with minimally angulated distal radius fractures
Authors: Silva Mauricio , Avoian Tigran , Warnock Robert Sean , Sadlik Gal , Ebramzadeh Edward
Published: August 2016

Waterproof casting has been reported to increase patient comfort and satisfaction, and decrease skin irritation. There are no available data on the influence of waterproof casting materials on physical function in pediatric patients. Our aim was to determine whether the use of waterproof casting would result in faster recovery of physical function while maintaining similar clinical outcomes as those obtained with nonwaterproof materials. Twenty-six children with nonangulated or minimally angulated distal radius fractures were assigned randomly to initially receive a short-arm cast made of one of two optional materials: a hybrid mesh material with a waterproof lining or fiberglass with a nonwaterproof skin protector. Two weeks later, the initial cast was removed and replaced with a short-arm cast made of the alternative option. We compared the rate of fracture displacement, physical function, pain, skin changes, itchiness, and patient satisfaction. No evidence of displacement was found in either group. The mean Activities Scale for Kids – Performance (ASK-P) (physical function) score was 10% higher during the period of time when a waterproof cast was used (P=0.04). When a waterproof cast was used during the first 2 weeks of treatment, the mean total ASK-P scores were 23% higher than that when a nonwaterproof one was used during the same period of time (P=0.003). Patients who received a waterproof cast as the initial treatment reported lower functional scores overall and in almost every domain of the ASK-P once they were in a nonwaterproof one; similarly, those who received a nonwaterproof cast as the initial treatment reported higher functional scores overall and in every domain of the ASK-P once they were in a waterproof cast. Compared with a nonwaterproof cast, the use of waterproof casting resulted in comparable levels of pain, itchiness, skin irritability, and overall patient satisfaction. The results of this randomized, cross-over trial suggest that the use of waterproof casting material for the treatment of nondisplaced or minimally displaced distal radius fractures in children can result in a faster recovery of physical function, while providing comparable stability, pain, itchiness, skin irritability, and overall patient satisfaction. Level of Evidence: II.
Clinical application of back surface topography by means of structured light in the screening of idiopathic scoliosis
Authors: Pino-Almero Laura , Mínguez-Rey Maria Fe , Rodríguez-Martínez Daniel , Cibrián-Ortiz de Anda Rosa M. , Salvador-Palmer Maria Rosario , Sentamans-Segarra Salvador
Published: August 2016

We present the results of the clinical validity in the screening of idiopathic scoliosis with a nonharming method of back surface topography by means of structured light projection. A total of 155 patients were evaluated (mean age 13.3 years). They were divided into two groups: pathologic patients (scoliosis) and nonpathologic patients (control and asymmetries). An analytical case–control study was carried out. Our topographic method obtained 92% sensitivity and 74% specificity as a screening test in identifying patients with scoliosis (P=0.05). We could quantify the vertebral deformity of scoliosis in the three spatial planes by means of three topographic variables, Horizontal Plane Deformity Index, Posterior Trunk Symmetry Index and Columnar Profile, and to elaborate a combined screening algorithm with good reliability parameters.
Bilateral femoral neck fractures associated with complex pelvic ring injuries in a pediatric patient: a case report
Authors: Scott Brandon , Taylor Brandon , Shung Joseph R. , Nimityongskul Prasit
Published: August 2016

Femoral neck and pelvic fractures are rarely encountered in the pediatric population secondary to the resilient nature of the immature skeleton. Both fracture types usually result from high-energy blunt trauma including motor vehicle collisions, motor vehicle-pedestrian accidents, and falls from height. Considerable studies have been published on the natural history, management, and complications of pediatric pelvis and femoral neck fractures. However, few case reports have documented both fracture types in the same patient. Management of concomitant injuries presents unique challenges both for operative stabilization and for clinical postoperative care. After appropriate consent was obtained, a thorough review was performed of the patient’s hospital records and imaging history. The senior author of the report also provided insight into the management of the patient’s initial injuries and subsequent complications. Our case involves a 4-year-old female who was overrun by an all-terrain vehicle. Her orthopedic injuries included a nondisplaced Delbet type 3 fracture of the right femoral neck, a completely displaced Delbet type 3 fracture of the left femoral neck, bilateral sacroiliac fracture-dislocations, severe comminution of her left pubic rami, and a free-floating right pubic rami segment spanning from the triradiate cartilage to the pubic symphysis with severe rotational deformity. Her postoperative recovery was complicated by refracture of her left femoral neck (Delbet type 1), left hip osteomyelitis, and left femoral head avascular necrosis. The salient features of her operative management, subsequent complications, and functional recovery are described in this report. Cases of bilateral femoral neck fractures and multiple pelvic fractures in pediatric patients are sparsely documented in the literature because of their infrequent occurrence. Pediatric pelvic fractures typically do well with conservative treatment secondary to the incredible remodeling ability of the immature pelvis. Femoral neck fractures, in contrast, are highly associated with complications including coxa vara, nonunion, infection, physeal closure, and avascular necrosis. This case report documents two rare fracture types in the same patient and describes the challenges encountered throughout the duration of her recovery. Level of Evidence: Level V, Case report.
Risk factors for pancreatitis after posterior spinal fusion in children with cerebral palsy
Authors: Abousamra Oussama , Nishnianidze Tristan , Rogers Kenneth J. , Er Mehmet S. , Sees Julieanne P. , Dabney Kirk W. , Miller Freeman
Published: August 2016

This study reports on the prevalence and risk factors of acute pancreatitis after posterior spinal fusion for cerebral palsy scoliosis. Pancreatitis diagnosis was based on elevated amylase or lipase above three times the upper normal limit. Perioperative data were compared between patients with and without pancreatitis. We included 300 patients; 55% developed acute pancreatitis. Gastrostomy dependence was more common in the pancreatitis group (P=0.048). Perioperative data were similar between groups. Patients with pancreatitis had longer duration of hospitalization (19 vs. 13 days, P<0.001). Acute pancreatitis is common after cerebral palsy scoliosis surgery. Gastrostomy dependence increases its risk. Although no mortality was reported, hospital stay was longer.
Neuromuscular Blocking Agents and Neuromuscular Dysfunction Acquired in Critical Illness: A Systematic Review and Meta-Analysis
Authors: Price David R. , Mikkelsen Mark E. , Umscheid Craig A. , Armstrong Ehrin J.
Published: August 2016

Objective:

The relationship between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness remains unclear. We examined the association between neuromuscular blocking agents and ICU-acquired weakness, critical illness polyneuropathy, and critical illness myopathy.

Data Sources:

PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and bibliographies of included studies were searched from database inception until September 24, 2015.

Study Selection:

Randomized controlled trials and prospective observational studies examining the association between neuromuscular blocking agents and ICU-acquired weakness, critical illness polyneuropathy, or critical illness myopathy.

Data Extraction:

One author screened titles/abstracts. Two authors independently reviewed full text and extracted data from included studies. Meta-analysis was performed using the DerSimonian-Laird random effects model (OpenMetaAnalyst 10.10 for OS.X). We assessed reporting bias with funnel plots and heterogeneity with the I
2 statistic.

Data Synthesis:

Of 2,170 titles/abstracts screened, 99 full texts were selected for review, yielding one randomized controlled trial and 18 prospective observational studies, for a total of 2,254 patients. The randomized controlled trial did not show an association between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness (odds ratio, 1.21; 95% CI, 0.67–2.19), but pooled data from all included studies suggested a modest association (odds ratio, 1.25; 95% CI, 1.06–1.48; I
2 = 16%). Funnel plots suggested reporting bias, and sensitivity analyses showed a disproportionate contribution from critical illness polyneuropathy/critical illness myopathy and severe sepsis/septic shock studies.

Conclusions:

This meta-analysis suggests a modest association between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness; limitations include studies with a high risk of bias and a disproportionate contribution from studies examining patients for critical illness polyneuropathy/critical illness myopathy and those with severe sepsis/septic shock.
Errors, Omissions, and Outliers in Hourly Vital Signs Measurements in Intensive Care
Authors: Maslove David M. , Dubin Joel A. , Shrivats Arvind , Lee Joon
Published: August 2016

Objective:

To empirically examine the prevalence of errors, omissions, and outliers in hourly vital signs recorded in the ICU.

Design:

Retrospective analysis of vital signs measurements from a large-scale clinical data warehouse (Multiparameter Intelligent Monitoring in Intensive Care III).

Setting:

Data were collected from the medical, surgical, cardiac, and cardiac surgery ICUs of a tertiary medical center in the United States.

Patients:

We analyzed data from approximately 48,000 ICU stays including approximately 28 million vital signs measurements.

Interventions:

None.

Measurements and Main Results:

We used the vital sign day as our unit of measurement, defined as all the recordings from a single patient for a specific vital sign over a single 24-hour period. Approximately 30–40% of vital sign days included at least one gap of greater than 70 minutes between measurements. Between 3% and 10% of blood pressure measurements included logical inconsistencies. With the exception of pulse oximetry vital sign days, the readings in most vital sign days were normally distributed. We found that 15–38% of vital sign days contained at least one statistical outlier, of which 6–19% occurred simultaneously with outliers in other vital signs.

Conclusions:

We found a significant number of missing, erroneous, and outlying vital signs measurements in a large ICU database. Our results provide empirical evidence of the nonrepresentativeness of hourly vital signs. Additional studies should focus on determining optimal sampling frequencies for recording vital signs in the ICU.
Increased Ratio of Visceral to Subcutaneous Adipose Tissue in Septic Patients Is Associated With Adverse Outcome*
Authors: Pisitsak Chawika , Lee Joseph G. H. , Boyd John H. , Coxson Harvey O. , Russell James A. , Walley Keith R.
Published: August 2016

Objectives:

Visceral and subcutaneous adipose tissue may contribute differentially to the septic inflammatory response. Accordingly, we tested the hypothesis that the ratio of visceral to subcutaneous adipose tissue is associated with altered sepsis outcome.

Design:

A retrospective analysis from a cohort of sepsis patients admitted between 2004 and 2009.

Setting:

A mixed medical-surgical ICU at St. Paul’s Hospital in Vancouver, Canada.

Patients:

Patients older than 16 years old who had sepsis and underwent abdominal CT scan (n = 257) for clinical reasons.

Interventions:

None.

Measurements and Main Results:

We measured the visceral adipose tissue and subcutaneous adipose tissue areas and calculated the visceral adipose tissue-to-subcutaneous adipose tissue ratio. Visceral adipose tissue/subcutaneous adipose tissue was not correlated with body mass index (r
2 = –0.015, p = NS) and therefore provides additional unique information independent of body mass index. Sepsis patients with higher visceral adipose tissue/subcutaneous adipose tissue had greater 90-day mortality than patients with lower visceral adipose tissue/subcutaneous adipose tissue (log-rank test, linear-by linear association p < 0.005). After adjustment for significant covariates using Cox regression, increased visceral adipose tissue/subcutaneous adipose tissue quartile was significantly associated with increased 90-day mortality with hazard ratios of 2.01 (95% CI, 1.01–3.99) for the third visceral adipose tissue/subcutaneous adipose tissue quartile compared with the first quartile and 2.32 (95% CI, 1.15–4.69) for the highest visceral adipose tissue/subcutaneous adipose tissue quartile when compared with the first quartile. Increased mortality for patients with higher visceral adipose tissue/subcutaneous adipose tissue was found for both patients with body mass index less than 25 kg/m2 (p = 0.004) and for body mass index greater than or equal to 25 kg/m2 (p = 0.023). Furthermore, we found significantly greater need for mechanical ventilation, renal replacement therapy, and ICU stay in patients in the highest visceral adipose tissue/subcutaneous adipose tissue quartile. The ratio of proinflammatory (interleukin-8) to anti-inflammatory (interleukin-10) plasma cytokine levels was greater in patients with higher visceral adipose tissue/subcutaneous adipose tissue than in those with lower visceral adipose tissue/subcutaneous adipose tissue (p = 0.043).

Conclusions:

Visceral obesity, defined by a high visceral adipose tissue-to-subcutaneous adipose tissue ratio, contributes to adverse outcome in sepsis patients perhaps because of a greater pro- versus anti-inflammatory response.