Forced and chosen transfers for medical assistance in dying (MAiD) before and during the COVID 19 pandemic: A mixed methods study.

The purpose of this study was to describe the experience of people who transferred locations for MAiD. It used mixed methods with a chart review from one health authority and interviews with key informants across Canada. In the chart review, we found that of 444 MAiD deaths, 42 (9.5%) were forced to transfer due to the religious affiliation of the facility and 33 (7.4%) chose to transfer. In 23 interviews with 18 key informants we found that the most important theme was the suffering caused by forced transfers. COVID-19 restrictions led to fewer choices and more suffering.

Effect of Comonomers on Physical Properties and Cell Attachment to Silica-Methacrylate/Acrylate Hybrids for Bone Substitution.

Hybrids with a silica network covalently bonded to a polymer are promising materials for bone repair. Previous work on synthesizing methyl methacrylate (MMA) based copolymers by reversible addition-fragmentation chain transfer (RAFT) polymerization gives high tailorability of mechanical properties since sophisticated polymer structures can be designed. However, more flexible hybrids would be beneficial. Here, n-butyl methacrylate (BMA) and methyl acrylate (MA) based hybrids are produced. Unlike MMA, BMA and MA hybrids do not show plastic deformation, and BMA hybrid has strain to failure of 33%. Although the new hybrids are more flexible, preosteoblast cells do not adhere on their surfaces, due to higher hydrophobicity and lower stiffness. Comonomer choice is crucial for bone regenerative hybrids.

How the experience of medical assistance in dying changed during the COVID-19 pandemic in Canada: a qualitative study of providers.

BACKGROUND: In March 2020, all levels of government introduced various strategies to reduce the impact of the COVID-19 pandemic. The purpose of this study was to document how the experience of providing medical assistance in dying (MAiD) changed during the COVID-19 pandemic. METHODS: We conducted a qualitative study using semistructured interviews with key informants in Canada who provided or coordinated MAiD before and during the COVID-19 pandemic. We interviewed participants from April to June 2020 by telephone or email. We collected and analyzed data in an iterative manner and reached theme saturation. Our team reached consensus on the major themes and subthemes. RESULTS: We interviewed 1 MAiD coordinator and 15 providers, including 14 physicians and 1 nurse practitioner. We identified 4 main themes. The most important theme was the perception that the pandemic increased the suffering of patients receiving MAiD by isolating them from loved ones and reducing available services. Providers were distressed by the difficulty of establishing rapport and closeness at the end of life, given the requirements for physical distancing and personal protective equipment. They were concerned about the spread of SARS-CoV-2, and found it difficult to enforce rules about distancing and the number of people present. Logistics and access to MAiD became more difficult because of the new restrictions, but there were many adaptations to solve these problems. INTERPRETATION: Providers and coordinators had many challenges in providing MAiD during the COVID-19 pandemic, including their perception that the suffering of their patients increased. Some changes in how MAiD is provided that have occurred during the pandemic, including more telemedicine assessments and virtual witnessing, are likely to remain after the pandemic and may improve service.

3D Printed Porous Methacrylate/Silica Hybrid Scaffold for Bone Substitution.

Inorganic-organic hybrid biomaterials made with star polymer poly(methyl methacrylate-co-3-(trimethoxysilyl)propyl methacrylate) and silica, which show promising mechanical properties, are 3D printed as bone substitutes for the first time, by direct ink writing of the sol. Three different inorganic:organic ratios of poly(methyl methacrylate-co-3-(trimethoxysilyl)propyl methacrylate)-star-SiO2 hybrid inks are printed with pore channels in the range of 100-200 µm. Mechanical properties of the 3D printed scaffolds fall within the range of trabecular bone, and MC3T3 pre-osteoblast cells are able to adhere to the scaffolds in vitro, regardless of their compositions. Osteogenic and angiogenic properties of the hybrid scaffolds are shown using a rat calvarial defect model. Hybrid scaffolds with 40:60 inorganic:organic composition are able to instigate new vascularized bone formation within its pore channels and polarize macrophages toward M2 phenotype. 3D printing inorganic-organic hybrids with sophisticated polymer structure opens up possibilities to produce novel bone graft materials.

The impact of the COVID-19 pandemic on medical assistance in dying in Canada and the relationship of public health laws to private understandings of the legal order.

Drawing on interviews we conducted with 15 medical assistance in dying (MAiD) providers from across Canada, we examine how physicians and nurse practitioners reconcile respect for the new, changing rules brought upon by the coronavirus disease 2019 (COVID-19) pandemic, along with their existing legal obligations and ethical commitments as health care professionals and MAiD providers. Our respondents reported situations where they did not follow or did not insist on others following the applicable public health rules. We identify a variety of techniques that they deployed either to minimize, rationalize, justify or excuse deviations from the relevant public health rules. They implicitly invoked the exceptionality and emotionality of the MAiD context, especially in the time of COVID, when offering their accounts and explanations. What respondents relate about their experiences providing MAiD during the COVID pandemic offers occasion to reflect on the role actors themselves play in giving meaning (if not coherence) to the potentially conflicting normative expectations to which they are subject.

New Method for the Deposition of Nickel Oxide in Porous Scaffolds for Electrodes in Solid Oxide Fuel Cells and Electrolyzers.

A simple chemical bath deposition is used to coat a complex porous ceramic scaffold with a conformal Ni layer. The resulting composite is used as a solid oxide fuel cell electrode, and its electrochemical response is measured in humidified hydrogen. X-ray tomography is used to determine the microstructural characteristics of the uncoated and Ni-coated porous structure, which include the surface area to total volume, the radial pore size, and the size of the necks between the pores.

Global motion perception in children with amblyopia as a function of spatial and temporal stimulus parameters.

Global motion sensitivity in typically developing children depends on the spatial (Δx) and temporal (Δt) displacement parameters of the motion stimulus. Specifically, sensitivity for small Δx values matures at a later age, suggesting it may be the most vulnerable to damage by amblyopia. To explore this possibility, we compared motion coherence thresholds of children with amblyopia (7-14years old) to age-matched controls. Three Δx values were used with two Δt values, yielding six conditions covering a range of speeds (0.3-30deg/s). We predicted children with amblyopia would show normal coherence thresholds for the same parameters on which 5-year-olds previously demonstrated mature performance, and elevated coherence thresholds for parameters on which 5-year-olds demonstrated immaturities. Consistent with this, we found that children with amblyopia showed deficits with amblyopic eye viewing compared to controls for small and medium Δx values, regardless of Δt value. The fellow eye showed similar results at the smaller Δt. These results confirm that global motion perception in children with amblyopia is particularly deficient at the finer spatial scales that typically mature later in development. An additional implication is that carefully designed stimuli that are adequately sensitive must be used to assess global motion function in developmental disorders. Stimulus parameters for which performance matures early in life may not reveal global motion perception deficits.