Transition from electron accumulation to depletion at InGaN surfaces

The composition dependence of the Fermi-level pinning at the oxidized (0001) surfaces of n-type InxGa1−xN films (0<=x<=1) is investigated using x-ray photoemission spectroscopy. The surface Fermi-level position varies from high above the conduction band minimum (CBM) at InN surfaces to significantly below the CBM at GaN surfaces, with the transition from electron accumulation to depletion occurring at approximately x=0.3. The results are consistent with the composition dependence of the band edges with respect to the charge neutrality level

Review of Current Data Exchange Practices: Providing Descriptive Data to Assist with Building Operations Decisions

Retailers who participate in the U.S. Department of Energy Commercial Building Energy Alliances (CBEA) identified the need to enhance communication standards. The means are available to collect massive numbers of buildings operational data, but CBEA members have difficulty transforming the data into usable information and energy-saving actions. Implementing algorithms for automated fault detection and diagnostics and linking building operational data to computerized maintenance management systems are important steps in the right direction, but have limited scalability for large building portfolios because the algorithms must be configured for each building

Corner Exponents in the Two-Dimensional Potts Model

The critical behavior at a corner in two-dimensional Ising and three-state Potts models is studied numerically on the square lattice using transfer operator techniques. The local critical exponents for the magnetization and the energy density for various opening angles are deduced from finite-size scaling results at the critical point for isotropic or anisotropic couplings. The scaling dimensions compare quite well with the values expected from conformal invariance, provided the opening angle is replaced by an effective one in anisotropic systems.Comment: 11 pages, 2 eps-figures, uses LaTex and eps

Implementation of a hospital-wide multidisciplinary blunt chest injury care bundle (ChIP): Fidelity of delivery evaluation

BackgroundIneffective intervention for patients with blunt chest wall injury results in high rates of morbidity and mortality. To address this, a blunt chest injury care bundle protocol (ChIP) was developed, and a multifaceted plan was implemented using the Behaviour Change Wheel.ObjectiveThe purpose of this study was to evaluate the reach, fidelity, and dose of the ChIP intervention to discern if it was activated and delivered to patients as intended at two regional Australian hospitals.MethodsThis is a pretest and post-test implementation evaluation study. The proportion of ChIP activations and adherence to ChIP components received by eligible patients were compared before and after intervention over a 4-year period. Sample medians were compared using the nonparametric median test, with 95% confidence intervals. Differences in proportions for categorical data were compared using the two-sample z-test.Results/findingsOver the 19-month postimplementation period, 97.1% (n = 440) of eligible patients received ChIP (reach). The median activation time was 134 min; there was no difference in time to activation between business hours and after-hours; time to activation was not associated with comorbidities and injury severity score. Compared with the preimplementation group, the postimplementation group were more likely to receive evidence-based treatments (dose), including high-flow nasal cannula use (odds ratio [OR] = 6.8 [95% confidence interval {CI} = 4.8-9.6]), incentive spirometry in the emergency department (OR = 7.5, [95% CI = 3.2-17.6]), regular analgesia (OR = 2.4 [95% CI = 1.5-3.8]), regional analgesia (OR = 2.8 [95% CI = 1.5-5.3]), patient-controlled analgesia (OR = 1.8 [95% CI = 1.3-2.4]), and multiple specialist team reviews, e.g., surgical review (OR = 9.9 [95% CI = 6.1-16.1]).ConclusionsHigh fidelity of delivery was achieved and sustained over 19 months for implementation of a complex intervention in the acute context through a robust implementation plan based on theoretical frameworks. There were significant and sustained improvements in care practices known to result in better patient outcomes. Findings from this evaluation can inform future implementation programs such as ChIP and other multidisciplinary interventions in an emergency or acute care context

The implementation of an emergency nursing framework (HIRAID) reduces patient deterioration: A multi-centre quasi-experimental study

Introduction Timely recognition and treatment of acutely ill patients at appropriate levels of the health system are fundamental to the quality and safety of healthcare. This study determines if the implementation of an emergency nursing framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) improves patient safety. Methods A quasi-experimental cohort study was conducted in two emergency departments in [Anonymised], Australia. HIRAID was implemented using a multi-pronged behaviour change intervention. Data of 920 patients (374 pre and 546 post) who deteriorated within 72-hours of ED departure were collected. Statistical tests were conducted as two-sided, with a 95% confidence interval to determine pre/post cohort association. Results Patients in the post group had more comorbidities, but experienced less deterioration associated with care delivered in the ED (27% to 13%). There was a reduction in treatment delays [ 28.3% to 15.1%, p = 0.041, 95% CI (1.1%–25.3%)], and delay or failure to escalate care when abnormal vital signs were identified [20.2% to6.9%, p = 0.014, 95% CI (3.5%–23.1%)]. Isolated nursing-related causal factors decreased from 20 (21%) to 6 (8%). Conclusions Implementing a standardised emergency nursing framework is associated with a reduction in clinical deterioration related to emergency care

The three species monomer-monomer model: A mean-field analysis and Monte Carlo study

We study the phase diagram and critical behavior of a one dimensional three species monomer-monomer surface reaction model. Static Monte Carlo simulations show a phase diagram consisting of a reactive steady state bordered by three equivalent unreactive phases where the surface is saturated with one monomer species. The transitions from the reactive to saturated phases are all continuous, while the transitions between poisoned phases are first-order, with bicritical points where the reactive phase meets two poisoned phases. A mean-field cluster analysis predicts all of the qualitative features of the phase diagram only when correlations up to triplets of adjacent sites are included. Dynamic Monte Carlo simulations show that the transition from the reactive to a saturated phase show critical behavior in the directed percolation universality class, while the bicritical point shows critical behavior in the even branching annihilating random walk class. The crossover from bicritical to critical behavior is also studied.Comment: 16 pages using RevTeX, plus 10 figures. Uses psfig.st

Proinsulin Secretion Is a Persistent Feature of Type 1 Diabetes

OBJECTIVE: Abnormally elevated proinsulin secretion has been reported in type 2 and early type 1 diabetes when significant C-peptide is present. We questioned whether individuals with long-standing type 1 diabetes and low or absent C-peptide secretory capacity retained the ability to make proinsulin. RESEARCH DESIGN AND METHODS: C-peptide and proinsulin were measured in fasting and stimulated sera from 319 subjects with long-standing type 1 diabetes (≥3 years) and 12 control subjects without diabetes. We considered three categories of stimulated C-peptide: 1) C-peptide positive, with high stimulated values ≥0.2 nmol/L; 2) C-peptide positive, with low stimulated values ≥0.017 but <0.2 nmol/L; and 3) C-peptide <0.017 nmol/L. Longitudinal samples were analyzed from C-peptide-positive subjects with diabetes after 1, 2, and 4 years. RESULTS: Of individuals with long-standing type 1 diabetes, 95.9% had detectable serum proinsulin (>3.1 pmol/L), while 89.9% of participants with stimulated C-peptide values below the limit of detection (<0.017 nmol/L; n = 99) had measurable proinsulin. Proinsulin levels remained stable over 4 years of follow-up, while C-peptide decreased slowly during longitudinal analysis. Correlations between proinsulin with C-peptide and mixed-meal stimulation of proinsulin were found only in subjects with high stimulated C-peptide values (≥0.2 nmol/L). Specifically, increases in proinsulin with mixed-meal stimulation were present only in the group with high stimulated C-peptide values, with no increases observed among subjects with low or undetectable (<0.017 nmol/L) residual C-peptide. CONCLUSIONS: In individuals with long-duration type 1 diabetes, the ability to secrete proinsulin persists, even in those with undetectable serum C-peptide

2019 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations : summary from the basic life support; advanced life support; pediatric life support; neonatal life support; education, implementation, and teams; and first aid task forces

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research