bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultra-thin narrow-band, complementary narrow-band, and dual-band metamaterial absorbers for applications in the THz regime
Authors: Astorino Maria Denise , Frezza Fabrizio , Tedeschi Nicola
Published: February 2017

In this paper, ultra-thin narrow-band, complementary narrow-band, and dual-band metamaterial absorbers (MMAs), exploiting the same electric ring resonator configuration, are investigated at normal and oblique incidence for both transverse electric (TE) and transverse magnetic (TM) polarizations, and with different physical properties in the THz regime. In the analysis of the ultra-thin narrow-band MMA, the limit of applicability of the transmission line model has been overcome with the introduction of a capacitance which considers the z component of the electric field. These absorbing structures have shown a wide angular response and a polarization-insensitive behavior due to the introduction of a conducting ground plane and to the four-fold rotational symmetry of the resonant elements around the propagation axis. We have adopted a retrieval procedure to extract the effective electromagnetic parameters of the proposed MMAs and we have compared the simulated and analytical results through the interference theory.
Tuning of acoustic wave dispersion in ferroelectrics—A theoretical study
Authors: Chang Wontae
Published: February 2017

Tuning of acoustic wave dispersion in ferroelectrics due to its electrostrictive effect is theoretically investigated. As the acoustic wave is excited electrically in ferroelectrics, the elastic stiffness tensor can be modified by both the linear piezoelectric and nonlinear electrostrictive electromechanical couplings depending on the wave excitation direction of the crystal, where the linear piezoelectric modification has been well characterized and extensively used for the application of piezoelectric-based acoustic wave devices over the past 50 years, but the nonlinear electrostrictive modification, determining the tuning of acoustic wave dispersion in the medium, is still too premature to use the properties in application. For the tuning application, it is essential to know how the electrostrictive strain actually tunes the propagation and displacement of the ferroelectrically active acoustic waves, and this information is currently unavailable. In this paper, the ferroelectrically active acoustic wave propagation and displacement in conjunction with the nonlinear electrostrictive modification are calculated using the plane wave expansion method, and the tunable wave properties associated with the propagation and displacement, are discussed. The electrically excited acoustic wave properties in ferroelectrics are largely modified from the electrostrictive effect, e.g., tuned, excited, vanished, coupled, decoupled, etc., and this should be taken into account in the development of ferroelectric-based acoustic wave devices.
Thermionic emission from monolayer graphene, sheath formation and its feasibility towards thermionic converters
Authors: Misra Shikha , Upadhyay Kahaly M. , Mishra S. K.
Published: February 2017

A formalism describing the thermionic emission from a single layer graphene sheet operating at a finite temperature and the consequent formation of the thermionic sheath in its proximity has been established. The formulation takes account of two dimensional densities of state configuration, Fermi-Dirac (f-d) statistics of the electron energy distribution, Fowler's treatment of electron emission, and Poisson's equation. The thermionic current estimates based on the present analysis is found to be in reasonably good agreement with experimental observations (Zhu et al., Nano Res. 07, 1 (2014)). The analysis has further been simplified for the case where f-d statistics of an electron energy distribution converges to Maxwellian distribution. By using this formulation, the steady state sheath features, viz., spatial dependence of the surface potential and electron density structure in the thermionic sheath are derived and illustrated graphically for graphene parameters; the electron density in the sheath is seen to diminish within ∼10 s of Debye lengths. By utilizing the graphene based cathode in configuring a thermionic converter (TC), an appropriate operating regime in achieving the efficient energy conversion has been identified. A TC configured with the graphene based cathode (operating at ∼1200 K/work function 4.74 V) along with the metallic anode (operating at ∼400 K/ work function 2.0 V) is predicted to display ∼56% of the input thermal flux into the electrical energy, which infers approximately ∼84% of the Carnot efficiency.
Vertical microgoblet resonator with high sensitivity fabricated by direct laser writing on a Si substrate
Authors: Gao Xiaomei , Li Jiafang , Hao Zhenzhong , Bo Fang , Hu Chenyang , Wang Jie , Liu Zhiguang , Li Zhi-Yuan , Zhang Guoquan , Xu Jingjun
Published: February 2017

We propose a high-Q microgoblet resonator with improved refractive index (RI) sensitivity compared to conventional microdisk resonator. Through simulations with a finite element method (FEM), electric field distributions of a fundamental whispering-gallery mode (WGM) show that the spatial position of the WGM can be drawn from the rim of the microdisk into the vertical wall of the microgoblet resonator under proper structural modifications. The RI sensitivity could be greatly improved due to the enhancement of light-matter interaction, which is caused by the fact that the vertical microgoblet resonator exposes the double sides of its wall to the sensing medium, while for traditional microdisks, the confined electric field is only sensible from one side. The simulation results indicate that the optimized microgoblet resonator can be more sensitive than the microdisk with the same thickness. The designed microgoblet resonator is experimentally demonstrated by utilizing a direct laser writing method on a Si substrate, with Q factor on the level of 105. Preliminary optical sensing experiments show that the RI sensitivity of the vertical microgoblet resonator is ∼24% higher than that of the microdisk with the same thickness. The studies provide a novel methodology towards designing and fabricating microcavities with enhanced optical sensibility, with potential applications in environmental, biomedical, and biochemical sensing or monitoring.
A compact terahertz free-electron laser with two gratings driven by two electron-beams
Authors: Liu Weihao , Lu Yalin , Wang Lin , Jia Qika
Published: February 2017

We proposed and investigated a novel terahertz free-electron laser, which is based on two gratings driven by two electron-beams. Two gratings are symmetrically arranged to form an open-cavity. Two electron-beams generate special Smith-Purcell radiations, respectively, from two gratings. When radiation interferes constructively, operation modes of the open-cavity are excited and then amplified by beam-wave interactions. By means of particle-in-cell simulations, we have shown that, with compact equipments and available electron-beams, this scheme can generate radiation with power and efficiency being higher than those of majority radiation sources in the vicinity region of 1 THz. It can promisingly be developed as a high-power, high-efficiency, and compact terahertz source for practice.
Role of eruption season in reconciling model and proxy responses to tropical volcanism
Authors: Stevenson Samantha , Fasullo John T. , Otto-Bliesner Bette L. , Tomas Robert A. , Gao Chaochao
Published: February 2017

Significance

The starting month of many historical tropical volcanic eruptions is unknown and often assumed constant in long model simulations. Here we use model simulations to show that the season of eruptions strongly affects both atmospheric circulation and the El Niño/Southern Oscillation within the eruption year and that this could explain some of the mismatches between model simulations and paleoclimate reconstructions. The response 1 year later depends much less on eruption season, and proxy reconstructions are also more consistent. Our results imply that models may actually be correctly representing eruption-year tropical climate responses and that the season of eruptions should be considered when evaluating the mechanisms for volcanic effects on climate.
Dynamics of genome size evolution in birds and mammals
Authors: Kapusta Aurélie , Suh Alexander , Feschotte Cédric
Published: February 2017

Significance

Deciphering the forces and mechanisms modulating genome size is central to our understanding of molecular evolution, but the subject has been understudied in mammals and birds. We took advantage of the recent availability of genome sequences for a wide range of species to investigate the mechanism underlying genome size equilibrium over the past 100 million years. Our data provide evidence for an “accordion” model of genome size evolution in birds and mammals, whereby the amount of DNA gained by transposable element expansion, which greatly varies across lineages, was counteracted by DNA loss through large segmental deletions. Paradoxically, birds and bats have more compact genomes relative to their flightless relatives but exhibit more dynamic gain and loss of DNA.
Human and rat gut microbiome composition is maintained following sleep restriction
Authors: Zhang Shirley L. , Bai Lei , Goel Namni , Bailey Aubrey , Jang Christopher J. , Bushman Frederic D. , Meerlo Peter , Dinges David F. , Sehgal Amita
Published: February 2017

Significance

It is widely presumed that there is a relationship between sleep and the gut microbiome because both sleep restriction and dysbiosis of the gut microbiome are associated with metabolic diseases such as obesity and diabetes. Here, we report sleep restriction over several consecutive days does not overtly influence the composition of the microbiome of either rats or humans, despite both species showing other changes associated with sleep loss. These analyses suggest that sleep loss and microbial dysbiosis have independent effects on the development of metabolic diseases.
Critical Notice of Beyond the Analytic-Continental Divide: Pluralist Philosophy in the Twenty-First Century. Edited by Jeffrey A. Bell, Andrew Cutrofello, and Paul M. Livingston (New York: Routledge, 2016. 334 + viii pp)
Authors: Hymers Michael
Published: February 2017

This collection maintains a dialogue between the analytic and continental traditions, while aspiring to situate itself beyond the analytic-continental divide. It divides into four parts, (1) Methodologies, (2) Truth and Meaning, (3) Metaphysics and Ontology, and (4) Values, Personhood and Agency, though there is considerable overlap among the categories. History and temporality are recurrent themes, but there is a lot of metaphysics generally, with some philosophy of language, philosophy of social science, ethics, political philosophy and epistemology. Less prominent is a pragmatic, deflationary attitude, and at a number of points I argue for the virtues of such an approach.
The Role of Pain in Quitting among Human Immunodeficiency Virus (HIV)–Positive Smokers Enrolled in a Smoking Cessation Trial
Authors: Aigner Carrie J. , Gritz Ellen R. , Tamí-Maury Irene , Baum George P. , Arduino Roberto C. , Vidrine Damon J.
Published: February 2017

Background

Smoking rates among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS; PLWHA) are at least twice as high as rates in the general population. Consistent with the reciprocal model of pain and smoking, PLWHA with pain who smoke may use smoking as a means of coping with pain, thus presenting a potential barrier to quitting. The aim of this study is to better understand how pain relates to smoking cessation among 474 HIV-positive adults enrolled in a cell phone–delivered smoking cessation trial.

Methods

Participants were randomly assigned to usual care (cessation advice and self-help materials) or 11 sessions of cell phone–delivered smoking cessation treatment. Pain, as assessed by the Medical Outcomes Study-HIV Health Survey (MOS-HIV), and point prevalence abstinence were collected at the 3-month treatment end and at 6- and 12-month follow-ups. Self-reported abstinence was biochemically verified by expired carbon monoxide (CO) level of <7 ppm.

Results

Using multilevel modeling for binary outcome data, the authors examined the relationship between pain and abstinence, from treatment end through the 12-month follow-up. Consistent with the authors’ hypothesis, less pain was associated with greater likelihood of 24-hour (β = .01, t(651) = 2.53, P = .01) and 7-day (β = .01, t(651) = 2.35, P = .02) point prevalence abstinence, controlling for age, gender, baseline pain, nicotine dependence, and treatment group. No pain × treatment group interaction was observed.

Conclusions

These results can help us to better identify PLWHA at greater risk for relapse in smoking cessation treatment. Future research may examine the effectiveness of more comprehensive smoking cessation treatment that incorporates aspects of pain management for PLWHA who smoke and have high pain and symptom burden.
The transcriptional regulator of the chaperone response HSF1 controls hepatic bioenergetics and protein homeostasis
Authors: Qiao Aijun , Jin Xiongjie , Pang Junfeng , Moskophidis Demetrius , Mivechi Nahid F.
Published: February 2017

Metabolic energy reprogramming facilitates adaptations to a variety of stress conditions and cellular dysfunction, but how the energetic demands are monitored and met in response to physiological stimuli remains elusive. Our data support a model demonstrating that heat shock factor 1 (HSF1), a master transcriptional regulator of the chaperone response, has been coopted from its role as a critical protein quality-control regulator to having a central role in systemic energy sensing and for metabolic adaptation to nutrient availability. We found that in the absence of HSF1, levels of NAD+ and ATP are not efficiently sustained in hepatic cells, largely because of transcriptional repression of nicotinamide phosphoribosyltransferase in the NAD+ salvage pathway. Mechanistically, the defect in NAD+ and ATP synthesis linked to a loss of NAD+-dependent deacetylase activity, increased protein acetylation, and impaired mitochondrial integrity. Remarkably, the drop in ATP level caused by HSF1 loss invoked an adaptive response featuring the inhibition of energetically demanding processes, including gluconeogenesis, translation, and lipid synthesis. Our work identifies HSF1 as a central regulator of cellular bioenergetics and protein homeostasis that benefits malignant cell progression and exacerbates development of metabolic diseases.
The heat shock factor HSF1 juggles protein quality control and metabolic regulation
Authors: Cantó Carles
Published: February 2017

Transcriptional regulators often act as central hubs to integrate multiple nutrient and stress signals. In this issue, Qiao et al. (2017. J. Cell Biol. https://doi.org/10.1083/jcb.201607091) demonstrate how heat shock factor 1 (HSF1) uncouples metabolic control from proteostatic regulation and unveils HSF1 as a critical transcriptional regulator of NAD+ metabolism.
Vamp-7–dependent secretion at the immune synapse regulates antigen extraction and presentation in B-lymphocytes
Authors: Obino Dorian , Diaz Jheimmy , Sáez Juan José , Ibañez-Vega Jorge , Sáez Pablo J. , Alamo Martina , Lankar Danielle , Yuseff Maria-Isabel
Published: February 2017

Recognition of surface-tethered antigens (Ags) by B-cells leads to the formation of an immune synapse that promotes Ag uptake for presentation onto MHC-II molecules. Extraction of immobilized Ags at the immune synapse of B-cells relies on the local secretion of lysosomes, which are recruited to the Ag contact site by polarization of their microtubule network. Although conserved polarity proteins have been implicated in coordinating cytoskeleton remodeling with lysosome trafficking, the cellular machinery associated with lysosomal vesicles that regulates their docking and secretion at the synaptic interface has not been defined. Here we show that the v-SNARE protein Vamp-7 is associated with Lamp-1+ lysosomal vesicles, which are recruited and docked at the center of the immune synapse of B-cells. A decrease in Vamp-7 expression does not alter lysosome transport to the synaptic interface but impairs their local secretion, a defect that compromises the ability of B-cells to extract, process, and present immobilized Ag. Thus our results reveal that B-cells rely on the SNARE protein Vamp-7 to promote the local exocytosis of lysosomes at the immune synapse, which is required for efficient Ag extraction and presentation.
Criminal Law and the Constitution
Authors: Chandra Aparna , Satish Mrinal
Published: February 2017

This chapters considers themes at the intersection of criminal and constitutional law in India. It considers two perspectives that address the tension between the competing goals of protecting individual liberty and promoting the public good. The first, the ‘liberty perspective’, that emphasises individual liberty by restricting State power, whereas the second, the ‘public order perspective’, that emphasises public order by limiting individual liberty and expanding State power. The chapter illustrates the liberty perspective by focusing on discussions in the Indian Constituent Assembly on criminal due process rights, and explores how the Indian Supreme Court’s understanding of these rights differs from that of the Constituent Assembly. It demonstrates the shift in the development of constitutional criminal procedure in India from a liberty perspective to a public order perspective.
Caring Matters Most
Authors: Lazenby Mark
Published: February 2017

Through an exploration of the ethical nature of nursing, Caring Matters Most asserts that the act of nursing itself embodies goodness. Nurses can develop this goodness, or moral character, in themselves by cultivating five habits: trustworthiness, imagination, beauty, space, and presence. Practicing these habits will sustain nurses in their everyday work. The habit of trustworthiness can help nurses to meet the demands of the workplace. The habit of imagination is a counterbalance to the threat of automation, and the habit of beauty is a way for nurses to be good to themselves amid the daily difficulties the tasks of nursing present. The habit of space is a remedy to the incivilities that arise within the nursing community. The habit of presence encourages nurses to be grateful, and in turn, gratefulness puts nurses in the presence of the good of nursing. Ultimately, Caring Matters Most offers a vision of the good society that the work of nursing seeks to create—for the community of nurses and for the world.
Group B Streptococci Colonization in Pregnant Guatemalan Women: Prevalence, Risk Factors, and Vaginal Microbiome
Authors: Rick Anne-Marie , Aguilar Angie , Cortes Rosita , Gordillo Remei , Melgar Mario , Samayoa-Reyes Gabriela , Frank Daniel N. , Asturias Edwin J.
Published: February 2017

Background

Infection causes 1 of every 5 neonatal deaths globally. Group B Streptococcus (GBS) is the most significant pathogen, although little is known about its epidemiology and risk in low-income countries.

Methods

A cross-sectional study in 2015 at a public hospital in Guatemala City enrolled women ≥35 weeks’ gestation. Vaginal and rectal swabs were processed using Lim broth and GBS CHROMagar then agglutination testing. Risk factors were assessed using multivariate analysis. Vaginal microbiota were profiled by 16S ribosomal ribonucleic acid sequencing in a subset of 94 women.

Results

Of 896 pregnant women, 155 (17.3%; 95% confidence interval [CI], 14.9–19.9) were GBS colonized. Colonization was associated with history of previous infant with poor outcome (odds ratio [OR], 1.94; 95% CI, 1.15–3.27) and increasing maternal age (OR, 1.05; 95% CI, 1.02–1.09). Multiparity was protective (OR, .39; 95% CI, .21–.72). Four (6%) GBS-exposed infants had early-onset neonatal sepsis. Vaginal microbiome composition was associated with previous antibiotic exposure (P = .003) and previous low birth weight infant (P = .03), but not GBS colonization (P = .72). Several individual taxa differed in abundance between colonized and noncolonized women.

Conclusions

Group B Streptococcus is prevalent in pregnant women from Guatemala with different risk factors than previously described. Although the vaginal microbiome was not altered significantly in GBS-colonized women, use of antibiotics had an effect on its composition.
A Novel Technique for the Bedside Reduction of the Posterior Hip Dislocation
Authors: Ayzenberg Mark , Arango Dillon , Clippinger Benjamin , Saing Minn
Published: February 2017

The dislocated hip is a common condition seen in the emergency room and requires urgent reduction, especially in the case of the native hip, which carries a high risk of a vascular necrosis with increasing time to reduction. There are several reduction techniques described in the literature, the Allis technique being the among the more common methods utilized by orthopedic surgeons. This technique requires multiple assistants, applies significant force about the knee, and places the physician at risk for back strains and even falling off the gurney during the reduction maneuver. We describe a case of a historically irreducible recurrent total hip dislocation successfully relocated in the emergency room utilizing a novel technique that offers several advantages over the standard reduction method.
Dreyfus and Dreyfus and Indicators of Behavioral Performance: A Study of Measurement Convergence
Authors: Williams Betsy W. , Byrne Phil D. , Williams Nathaniel V. , Williams Michael V.
Published: February 2017

Introduction:

Assessment of efficacy of continuous professional development is an important part of continuing professional development programing as one of its goals is to increase the performance of the clinicians that serve the community. A frequently used and researched classification system for skill mastery is the Dreyfus and Dreyfus Model of Skill Acquisition. An alternative approach is the core competency framework that informs the assessment of residents and forms the foundation of the American Board of Medical Specialties Program for Maintenance of Certification. There are a number of methods of assessment of each competence. One of the most broadly employed and researched methods is a multisource assessment (360°) methodology.

Methods:

Three hundred sixty-degree data were collected from 264 raters of physicians holding supervisory roles. Raters included the physicians' leaders, peers, and support/reports. The scale items were taken from an instrument developed for the assessment of interpersonal and communications skills, professionalism, and system-based practice. The Dreyfus scale was purposely built for this application.

Results:

The Dreyfus scale was reduced to a single dimension, and raters assigned their score on that dimension as the indicator of their assessment of the physician's level of mastery. Results of a multivariate analysis of variance indicated a significant relationship between Dreyfus mastery score and competency items (P < .0001).

Discussion:

These findings demonstrate a relationship between a measure of Dreyfus skill acquisition and measures based on the American Board of Medical Specialties/Accreditation Council for Graduate Medical Education six core competency framework. Results have implication for continuing professional development design and assessment.
Effect of Procedural-Related Variables on Melanocyte–Keratinocyte Suspension Transplantation in Nonsegmental Stable Vitiligo: A Clinical and Immunocytochemical Study
Authors: El-Zawahry Bakr Mohamed , Esmat Samia , Bassiouny Dalia , Zaki Naglaa Sameh , Sobhi Rehab , Saleh Marwah A. , Abdel-Halim Dalia , Hegazy Rehab , Gawdat Heba , Samir Nesrin , El-Hawary Marwa , El Maadawi Zeinab , Gouda Heba , Khorshied Mervat
Published: February 2017

BACKGROUND

Melanocyte–keratinocyte suspension (M–K susp) is gaining popularity for vitiligo treatment. Few studies have addressed procedure-related variables.

OBJECTIVE

To assess the effect of different M–K susp procedure-related variables on the clinical outcome in stable vitiligo.

METHODS

This prospective multicenter comparative study included 40 cases with nonsegmental stable vitiligo. Donor site was either a skin graft in noncultured epidermal cell suspension (NCECS) or hair follicle units in outer root sheath hair follicle suspension (ORSHFS). Recipient site was prepared by either cryoblebbing or CO2 laser resurfacing. Cell counts and viability were recorded in the cell suspensions. Tissue melanocytes and keratinocytes were examined by melan-A and cytokeratin, respectively. Assessment of repigmentation was performed 18 months after the procedure.

RESULTS

Thirty-seven subjects completed the study. Cell count was significantly lower in the ORSHFS compared with NCECS with no significant difference in the repigmentation outcome. On comparing techniques of recipient site preparation, homogenicity was better in the CO2 group. Elbows and knees responded better to CO2 resurfacing, whereas distal fingers responded better to combination of cryoblebbing with NCECS.

CONCLUSION

Using different techniques in M–K susp produces comparable results. However, the distal fingers showed better results using combination of donor NCECS and recipient cryoblebs.
Ultrathin Skin Grafting in Resistant Stable Vitiligo: A Follow-up Study of 8 Years in 370 Patients
Authors: Majid Imran , Imran Saher
Published: February 2017

BACKGROUND

Ultrathin skin grafting (UTSG) is a tissue grafting technique used in resistant stable vitiligo.

OBJECTIVE

To assess long-term follow-up results achieved with UTSG in vitiligo.

METHODS

Over a span of 8 years, a total of 415 patients with stable vitiligo were treated with UTSG at the authors' institute. Retrospective analysis of results achieved in these patients was performed, and primary end points assessed included the extent and quality of repigmentation achieved and adverse effects from the procedure. Results were correlated with the site, morphological type of vitiligo, duration of stability, postprocedure treatment used, and the age and sex of the patient.

RESULTS

Follow-up results were available with 554 lesions in 370 patients. Excellent response (≥90% repigmentation) was documented in 78.9% (437/554) lesions whereas 8.67% (48/554) lesions demonstrated poor results. Pigmentation was retained in >98% (112/114) cases over 4-year follow-up. The commonest adverse effect noted was “perigraft halo” in 12.3% (68/554) lesions. Site and morphological type of vitiligo as well as the postoperative use of phototherapy showed statistically significant correlation with response. Age and sex of the patient and duration of stability beyond 1 year did not influence the outcome.

CONCLUSION

Ultrathin skin grafting provides long-term beneficial results in stable resistant vitiligo.
Venous-Airway Fistula With Aspergilloma
Authors: Nilforoshan Maryam , Matus Ismael
Published: February 2017

The implanted venous access catheter is commonly used in the treatment of oncology patients. Although common long-term complications of these devices, such as infection and thrombosis, have been widely reported, venous-airway fistula due to port placement is an extremely rare and poorly understood complication. We report a case of a 56-year-old woman with pancreatic adenocarcinoma whose implanted catheter was complicated by the development of an azygo-bronchial fistula with a concomitant aspergilloma. Herein is the first reported case of successful venous-airway fistula closure obtained through silicone stenting.
A DAISY Nurse
Authors: Sweeney Cynthia Divens
Published: February 2017

What does it mean to be a “DAISY nurse”? Moral distress and end-of-life issues are difficult in any situation but, within the context of a pediatric setting, can be even more difficult. In this column, a DAISY nurse shares her thoughts on her role, her professional journey to explore moral distress and ethical decision making, and the lessons learned that led to her recognition with The DAISY Award and the joyful celebration.
Chief Nursing Officers’ Experiences With Moral Distress
Authors: Prestia Angela S. , Sherman Rose O. , Demezier Christopher
Published: February 2017

OBJECTIVE

This study explores if moral distress and its lingering residue were experienced by chief nursing officers (CNOs).

BACKGROUND

Chief nursing officers, by virtue of their position and experience, are expected to uphold their professional values and act for the benefit of others. Exploration is needed to determine if the inability to do so contributes to the moral distress of these leaders.

METHODS

Twenty CNOs were interviewed to determine the lived experience related to moral distress and moral residue. An interpretive phenomenological analysis approach was used.

RESULTS

Six themes emerged describing CNO experience of moral distress including lacking psychological safety, feeling a sense of powerlessness, seeking to maintain moral compass, drawing strength from networking, moral residue, and living with the consequences.

CONCLUSION

Moral distress is a common experience for CNOs. Although CNOs act with moral courage, they still experience moral distress. Further research and professional discussion are needed to support nurse executive leaders.
A Study of Role Expectations and Satisfaction With the Healthcare Coach Role
Authors: Kohlbry Pamela , Daugherty JoAnn S. , Gorzeman Joy , Parker Joseph
Published: February 2017

OBJECTIVE

The research objective was to determine the expectations of and satisfaction with the healthcare coach (HCC) role among hospitalists and staff RNs, as well as expectations of case managers who collaborate with them.

BACKGROUND

Care transitions occur when patients move from 1 care setting or provider to another. The Centers for Medicare & Medicaid Services developed the Community-Based Care Transitions Program to address readmission, patient safety, improved quality of care, and cost savings.

METHODS

A cross-sectional study measured level of satisfaction and explored qualitatively the expectations regarding the HCC role among hospitalists and staffs RNs. Case managers were surveyed regarding expectations of the HCC role. The HCCs were surveyed regarding their new role experiences.

RESULTS

On a Likert scale of 1 to 5, satisfaction with the HCC role by staff nurses averaged 3 (neutral), whereas hospitalists’ mean satisfaction was 4 (satisfied). From the qualitative data, 6 themes emerged among participants: personal qualities, care navigation, system perspective, collaboration/teamwork, challenges/role confusion, and future role benefits. Two additional themes were identified by the HCCs: new knowledge and helpful skill sets.

CONCLUSIONS

We recommend further evaluation of the HCC role in other organizations and across care settings.
Collaboration Between Academia and Practice
Authors: Hoying Cheryl , Farra Sharon , Mainous Rosalie , Baute Rebecca , Gneuhs Matthew
Published: February 2017

An innovative interprofessional disaster preparedness program was designed and implemented through an academic-practice partnership between a large midwestern children's hospital and a community-based state university. This course was part of a constellation of courses developed in response to Presidential Directive (HSPD) 8, a mandate to standardize disaster response training that was issued after the inefficiencies following Hurricane Katrina. A hybrid immersive and didactic approach was used to train senior leadership and frontline clinicians. Included were simulated experiences at the National Center for Medical Readiness, a workshop, and online modules. The program that focused on crisis leadership and disaster management was developed and implemented to serve patient-centered organizations.
Measuring Nurse Leaders’ and Direct Care Nurses’ Perceptions of a Healthy Work Environment in Acute Care Settings, Part 3
Authors: Huddleston Penny , Mancini Mary E. , Gray Jennifer
Published: February 2017

BACKGROUND

Survey items on the Healthy Work Environment Scales (HWES) for nurse leaders (NLs) and direct care nurses (DCNs) were developed using statements from 2 qualitative research studies conducted in a healthcare system.

PURPOSE

The purposes of 2 quantitative studies were to develop items on the HWES for NLs and DCNs, to assess the validity and reliability of these new tools, and to describe the NLs and DCNs perceptions of a healthy work environment (HWE) using nonexperimental descriptive designs.

METHODS

Each research study had 2 separate phases. In phase 1 of the studies, NLs and DCNs assigned each item to 1 of the 8 characteristics of an HWE to assess face validity. Content validity was determined by calculating the scale content validity and item content validity indices. Based on these results, the items were revised or deleted to obtain version 3 of both tools. In phase 2 of the studies, principal component analysis (PCA) assessed the validity of the tools, Cronbach’s α served as the test for reliability, and the NLs and DCNs perceptions of an HWE were measured.

RESULTS

Samples included 314 subjects for the HWES for NL study and 986 subjects for the HWES for DCN study. Principal component analysis for the HWES for NLs (version 3) revealed 40 items comprising 4 components, and PCA for the HWES for DCNs (version 3) revealed 39 items comprising 5 components. Internal consistencies of the tools were 0.974 and 0.957, respectively. Based on the findings of these studies, the tools demonstrated promising psychometric properties to measure a HWE in acute care settings.
Nurses’ and Physicians’ Perceptions of Nurse-Physician Collaboration
Authors: House Sherita , Havens Donna
Published: February 2017

The purpose of this systematic review was to explore nurses’ and physicians’ perceptions of nurse-physician collaboration and the factors that influence their perceptions. Overall, nurses and physicians held different perceptions of nurse-physician collaboration. Shared decision making, teamwork, and communication were reoccurring themes in reports of perceptions about nurse-physician collaboration. These findings have implications for more interprofessional educational courses and more intervention studies that focus on ways to improve nurse-physician collaboration.
Physical Design Factors Contributing to Patient Falls
Authors: Pati Debajyoti , Valipoor Shabboo , Cloutier Aimee , Yang James , Freier Patricia , Harvey Thomas E. , Lee Jaehoon
Published: February 2017

Objectives

The aim of this study was to identify physical design elements that contribute to potential falls in patient rooms.

Methods

An exploratory, physical simulation–based approach was adopted for the study. Twenty-seven subjects, older than 70 years (11 male and 16 female subjects), conducted scripted tasks in a mockup of a patient bathroom and clinician zone. Activities were captured using motion-capture technology and video recording. After biomechanical data processing, video clips associated with potential fall moments were extracted and then examined and coded by a group of registered nurses and health care designers. Exploratory analyses of the coded data were conducted followed by a series of multivariate analyses using regression models.

Results

In multivariate models with all personal, environmental, and postural variables, only the postural variables demonstrated statistical significance—turning, grabbing, pushing, and pulling in the bathroom and pushing and pulling in the clinician zone. The physical elements/attributes associated with the offending postures include bathroom configuration, intravenous pole, door, toilet seat height, flush, grab bars, over-bed table, and patient chair.

Conclusions

Postural changes, during interactions with the physical environment, constitute the source of most fall events. Physical design must include simultaneous examination of postural changes in day-to-day activities in patient rooms and bathrooms. Among discussed testable recommendations in the article, the followings design strategies should be considered: (a) designing bathrooms to reduce turning as much as possible and (b) designing to avoid motions that involve 2 or more of the offending postures, such as turning and grabbing or grabbing and pulling, and so on.
RAD sequencing resolves fine-scale population structure in a benthic invertebrate: implications for understanding phenotypic plasticity
Authors: Vendrami David L. J. , Telesca Luca , Weigand Hannah , Weiss Martina , Fawcett Katie , Lehman Katrin , Clark M. S. , Leese Florian , McMinn Carrie , Moore Heather , Hoffman Joseph I.
Published: February 2017

The field of molecular ecology is transitioning from the use of small panels of classical genetic markers such as microsatellites to much larger panels of single nucleotide polymorphisms (SNPs) generated by approaches like RAD sequencing. However, few empirical studies have directly compared the ability of these methods to resolve population structure. This could have implications for understanding phenotypic plasticity, as many previous studies of natural populations may have lacked the power to detect genetic differences, especially over micro-geographic scales. We therefore compared the ability of microsatellites and RAD sequencing to resolve fine-scale population structure in a commercially important benthic invertebrate by genotyping great scallops (Pecten maximus) from nine populations around Northern Ireland at 13 microsatellites and 10 539 SNPs. The shells were then subjected to morphometric and colour analysis in order to compare patterns of phenotypic and genetic variation. We found that RAD sequencing was superior at resolving population structure, yielding higherFstvalues and support for two distinct genetic clusters, whereas only one cluster could be detected in a Bayesian analysis of the microsatellite dataset. Furthermore, appreciable phenotypic variation was observed in size-independent shell shape and coloration, including among localities that could not be distinguished from one another genetically, providing support for the notion that these traits are phenotypically plastic. Taken together, our results suggest that RAD sequencing is a powerful approach for studying population structure and phenotypic plasticity in natural populations.
The sentinel behaviour of Arabian babbler floaters
Authors: Ostreiher Roni , Heifetz Aviad
Published: February 2017

The sentinel behaviour of 38 Arabian babbler adult floaters, who lived alone within a territory belonging to a foreign group, was studied and compared with their own sentinel behaviour in the past, when they were group members. All floaters acted as sentinels and uttered ‘alarm calls’. This suggests that sentinel activity is due at least, in part, to selfish motives. Floaters sentinelled less than they did as group members, with the decrease in sentinel activity sharper for ex-dominants than for ex-subordinates. One possible explanation for these differences is that sentinel activity is aimed not only at detecting predators, but also at detecting foreign conspecifics. Within a group, the latter incentive is stronger for breeding dominants than for subordinates, whereas all floaters alike may be trying to detect the owners of the territory in which they were roaming but also to avoid being detected by them. Other possible explanations are that floaters have less time and energy for sentinel activity because they are weaker or because foraging is more difficult in a foreign territory. This may be especially so for dominants who used to enjoy privileged access to food in their group. No significant difference was found in the rate of sentinels' ‘alarm calls’ between floaters and group members, suggesting that their main purpose is predator–prey communication, of which warning groupmates may be a side benefit.
Small teams of myosin Vc coordinate their stepping for efficient cargo transport on actin bundles
Authors: Krementsova Elena B. , Furuta Ken’ya , Oiwa Kazuhiro , Trybus Kathleen M. , Ali M. Yusuf
Published: February 2017

Myosin Vc (myoVc) is unique among vertebrate class V myosin isoforms in that it requires teams of motors to transport cargo. Single molecules of myoVc cannot take multiple steps on single actin filaments, in stark contrast to the well-studied myosin Va (myoVa) isoform. Consistent within vivostudies (1), only teams of myoVc motors can move continuously on actin bundles at physiologic ionic strength (2), raising the question of how motor motor interactions cause this preference. Here, using DNA nanostructures as synthetic cargos for linking defined numbers of myoVa or myoVc molecules, we compared the stepping behavior of myoVa versus myoVc teams, and myoVc stepping patterns on single actin filaments versus actin bundles. Run lengths of both myoVa and myoVc teams increased with motor number, but the run lengths of myoVc teams were longer on actin bundles than on filaments. By resolving the stepping behavior of individual myoVc motors with a Qdot bound to the motor domain, we found that coupling of two myoVc molecules significantly decreases futile back/side steps, which were frequently observed for single myoVc motors. Data showing how changes in the inter-motor distance of two coupled myoVc motors affected stepping dynamics suggested that mechanical tension coordinates the stepping behavior of two molecules for efficient directional motion. Our study thus provides a molecular basis to explain how teams of myoVc motors are suited to transport cargos such as zymogen granules on actin bundles.

Abbreviations

MyoVc

Myosin Vc

myoVa

Myosin Va

Qdots

Quantum dots

SD

Standard Deviation

SE

Standard Error

DNA

deoxyribonucleic acid
Salmonella entericagenomes recovered from victims of a major 16th century epidemic in Mexico
Authors: Vågene Åshild J. , Campana Michael G. , Robles García Nelly M. , Warinner Christina , Spyrou Maria A. , Valtueña Aida Andrades , Huson Daniel , Tuross Noreen , Herbig Alexander , Bos Kirsten I. , Krause Johannes
Published: February 2017

Indigenous populations of the Americas experienced high mortality rates during the early contact period as a result of infectious diseases, many of which were introduced by Europeans. Most of the pathogenic agents that caused these outbreaks remain unknown. Using a metagenomic tool called MALT to search for traces of ancient pathogen DNA, we were able to identifySalmonella entericain individuals buried in an early contact era epidemic cemetery at Teposcolula-Yucundaa, Oaxaca in southern Mexico. This cemetery is linked to the 1545-1550 CE epidemic locally known as “cocoliztli”, the cause of which has been debated for over a century. Here we present two reconstructed ancient genomes forSalmonella entericasubsp.entericaserovar Paratyphi C, a bacterial cause of enteric fever. We propose thatS.Paratyphi C contributed to the population decline during the 1545cocoliztlioutbreak in Mexico.

One Sentence Summary

Genomic evidence of enteric fever identified in an indigenous population from early contact period Mexico.
Validation and Implementation of CLIA-Compliant Whole Genome Sequencing (WGS) in Public Health Laboratory
Authors: Kozyreva Varvara K. , Truong Chau-Linda , Greninger Alexander L. , Crandall John , Mukhopadhyay Rituparna , Chaturvedi Vishnu
Published: February 2017

Background

Public health microbiology laboratories (PHL) are at the cusp of unprecedented improvements in pathogen identification, antibiotic resistance detection, and outbreak investigation by using whole genome sequencing (WGS). However, considerable challenges remain due to the lack of common standards.

Objectives

1) Establish the performance specifications of WGS applications used in PHL to conform with CLIA (Clinical Laboratory Improvements Act) guidelines for laboratory developed tests (LDT), 2) Develop quality assurance (QA) and quality control (QC) measures, 3) Establish reporting language for end users with or without WGS expertise, 4) Create a validation set of microorganisms to be used for future validations of WGS platforms and multi-laboratory comparisons and, 5) Create modular templates for the validation of different sequencing platforms.

Methods

MiSeq Sequencer and Illumina chemistry (Illumina, Inc.) were used to generate genomes for 34 bacterial isolates with genome sizes from 1.8 to 4.7 Mb and wide range of GC content (32.1%-66.1%). A customized CLCbio Genomics Workbench - shell script bioinformatics pipeline was used for the data analysis.

Results

We developed a validation panel comprising tenEnterobacteriaceaeisolates, five gram-positive cocci, five gram-negative non-fermenting species, nineMycobacterium tuberculosis, and five miscellaneous bacteria; the set represented typical workflow in the PHL. The accuracy of MiSeq platform for individual base calling was >99.9% with similar results shown for reproducibility/repeatability of genome-wide base calling. The accuracy of phylogenetic analysis was 100%. The specificity and sensitivity inferred from MLST and genotyping tests were 100%. A test report format was developed for the end users with and without WGS knowledge.

Conclusion

WGS was validated for routine use in PHL according to CLIA guidelines for LDTs. The validation panel, sequencing analytics, and raw sequences will be available for future multi-laboratory comparisons of WGS in PHL. Additionally, the WGS performance specifications and modular validation template are likely to be adaptable for the validation of other platforms and reagents kits.
What shapes the continuum of reproductive isolation? Lessons fromHeliconiusbutterflies
Authors: Mérot C. , Salazar C. , Merrill R. M. , Jiggins C. , Joron M.
Published: February 2017

The process by which species evolve can be illuminated by investigating barriers that limit gene flow between taxa. Recent radiations, such asHeliconiusbutterflies, offer the opportunity to compare isolation between pairs of taxa at different stages of ecological, geographic and phylogenetic divergence. We carry out a comparative analysis of existing and novel data in order to quantify the strength and direction of isolating barriers within a well-studied clade ofHeliconius. Our results highlight that increased divergence is associated with the accumulation of stronger and more numerous barriers to gene flow. Wing pattern is both under natural selection for Müllerian mimicry and involved in mate choice, and therefore underlies several isolating barriers. However, pairs which share a similar wing pattern, also display strong reproductive isolation mediated by traits other than wing pattern. This suggests that, while wing pattern is a key factor for early stages of divergence, it is not essential at a higher level. Additional factors including habitat isolation, hybrid sterility and chemically-mediated mate choice are associated with complete speciation. Therefore, although most previous work has emphasised the role of wing pattern, our comparative results highlight that speciation is a multidimensional process, whose completion is stabilized by many factors.