Complementary catalysis and analysis within solid state additively manufactured metal micro flow reactors.

Additive Manufacturing is transforming how researchers and industrialists look to design and manufacture chemical devices to meet their specific needs. In this work, we report the first example of a flow reactor formed via the solid-state metal sheet lamination technique, Ultrasonic Additive Manufacturing (UAM), with directly integrated catalytic sections and sensing elements. The UAM technology not only overcomes many of the current limitations associated with the additive manufacturing of chemical reactionware but it also significantly increases the functionality of such devices. A range of biologically important 1, 4-disubstituted 1, 2, 3-triazole compounds were successfully synthesised and optimised in-flow through a Cu mediated Huisgen 1, 3-dipolar cycloaddition using the UAM chemical device. By exploiting the unique properties of UAM and continuous flow processing, the device was able to catalyse the proceeding reactions whilst also providing real-time feedback for reaction monitoring and optimisation.

In-situ time resolved spectrographic measurement using an additively manufactured metallic micro-fluidic analysis platform.

INTRODUCTION: Microfluidic reactionware allows small volumes of reagents to be utilized for highly controlled flow chemistry applications. By integrating these microreactors with onboard analytical systems, the devices change from passive ones to active ones, increasing their functionality and usefulness. A pressing application for these active microreactors is the monitoring of reaction progress and intermediaries with respect to time, shedding light on important information about these real-time synthetic processes. OBJECTIVE: In this multi-disciplinary study the objective was to utilise advanced digital fabrication to research metallic, active microreactors with integrated fibre optics for reaction progress monitoring of solvent based liquids, incompatible with previously researched polymer devices, in combination with on-board Ultraviolet-visible spectroscopy for real-time reaction monitoring. METHOD: A solid-state, metal-based additive manufactured system (Ultrasonic Additive Manufacturing) combined with focussed ion beam milling, that permitted the accurate embedment of delicate sensory elements directly at the point of need within aluminium layers, was researched as a method to create active, metallic, flow reactors with on-board sensing. This outcome was then used to characterise and correctly identify concentrations of UV-active water-soluble B-vitamin nicotinamide and fluorescein. A dilution series was formed from 0.01-1.75 mM; which was pumped through the research device and monitored using UV-vis spectroscopy. RESULTS: The results uniquely showed the in-situ ion milling of ultrasonically embedded optical fibres resulted in a metallic microfluidic reaction and monitoring device capable of measuring solvent solutions from 18 µM to 18 mM of nicotinamide and fluorescein, in real time. This level of accuracy highlights that the researched device and methods are capable of real-time spectrographic analysis of a range of chemical reactions outside of those possible with polymer devices.

Optimization of the mean arterial pressure and timing of surgical decompression in traumatic spinal cord injury: a retrospective study.

STUDY DESIGN: A retrospective comparative study. OBJECTIVES: This study aims to investigate the extent to which early surgical decompression and maintenance of MAP ⩾85 mm Hg for 5 days postinjury affected neurological recovery utilizing internal controls for comparison of outcomes in patients with traumatic spinal cord injury. SETTING: Acute trauma center, Halifax, Nova Scotia, Canada. METHODS: We identified 94 cases of traumatic SCI. Follow-up data were available at an average of 26.7±19.5, 115.0±69.3, and 252.0±152.8 days postinjury for 61, 48, and 47 patients, respectively. Neurological recovery was assessed using the American Spinal Cord Injury Association (ASIA) Impairment Scale (AIS). RESULTS: Patients with MAP <85 mm Hg for at least 2 consecutive hours during the 5-day period postinjury were 11 times less likely to have an improvement in the AIS grade when compared with patients with MAP ⩾85 mm Hg (P=0.006). This association was independent of early surgery or the severity of SCI. At a mean of 252.0 days postinjury, a significantly greater proportion of SCI patients treated with early surgical decompression (within 24 h) improved neurologically (P=0.031). CONCLUSIONS: Our data demonstrated that there may be improved neurologic outcomes in patients with SCI who undergo early surgical decompression. Maintenance of MAP ⩾85 mm Hg for 5 consecutive days post-SCI was also associated with higher rates of AIS grade improvement at mean 26.7 days without a statistically significance difference at prolonged follow-up although a higher rate of neurological recovery persisted in patients with MAP ⩾85 mm Hg.

An analysis of ideal and actual time to surgery after traumatic spinal cord injury in Canada.

STUDY DESIGN: Retrospective analysis of a prospective registry and surgeon survey. OBJECTIVES: To identify surgeon opinion on ideal practice regarding the timing of decompression/stabilization for spinal cord injury and actual practice. Discrepancies in surgical timing and barriers to ideal timing of surgery were explored. SETTING: Canada. METHODS: Patients from the Rick Hansen Spinal Cord Registry (RHSCIR, 2004-2014) were reviewed to determine actual timing of surgical management. Following data collection, a survey was distributed to Canadian surgeons, asking for perceived to be the optimal and actual timings of surgery. Discrepancies between actual data and surgeon survey responses were then compared using χ2 tests and logistic regression. RESULTS: The majority of injury patterns identified in the registry were treated operatively. ASIA Impairment Scale (AIS) C/D injuries were treated surgically less frequently in the RHSCIR data and surgeon survey (odds ratio (OR)= 0.39 and 0.26). Significant disparities between what surgeons identified as ideal, actual current practice and RHSCIR data were demonstrated. A great majority of surgeons (93.0%) believed surgery under 24 h was ideal for cervical AIS A/B injuries and 91.0% for thoracic AIS A/B/C/D injuries. Definitive surgical management within 24 h was actually accomplished in 39.0% of cervical and 45.0% of thoracic cases. CONCLUSION: Ideal surgical timing for traumatic spinal cord injury (tSCI) within 24 h of injury was identified, but not accomplished. Discrepancies between the opinions on the optimal and actual timing of surgery in tSCI patients suggest the need for strategies for knowledge translation and reduction of administrative barriers to early surgery.

A tunable nanopore sensor for the detection of metal ions using translocation velocity and biphasic pulses.

A tunable resistive pulse sensor, utilising a polyurethane nanopore, has been used to characterise nanoparticles as they traverse the pore opening. Herein we demonstrate that the translocation speed, conductive and resistive pulse magnitude, can be used to infer the surface charge of a nanoparticle, and act as a specific transduction signal for the binding of metal ions to ligands on the particle surface. Surfaces of silica nanoparticles were modified with a ligand to demonstrate the concept, and used to extract copper(ii) ions (Cu2+) from solution. By tuning the pH and ionic strength of the solution, a biphasic pulse, a conductive followed by a resistive pulse is recorded. Biphasic pulses are becoming a powerful means to characterise materials, and provide insight into the translocation mechanism, and herein we present their first use to detect the presence of metal ions in solution. We demonstrate how combinations of translocation speed and/or biphasic pulse behaviour are used to detect Cu2+ with quantitative responses across a range of pH and ionic strengths. Using a generic ligand this assay allows a clear signal for Cu2+ as low as 1 ppm with a short 5-minute incubation time, and is capable of measuring 10 ppm Cu2+ in the presence of 5 other ions. The method has potential for monitoring heavy metals in biological and environmental samples.

Customisable 3D printed microfluidics for integrated analysis and optimisation.

The formation of smart Lab-on-a-Chip (LOC) devices featuring integrated sensing optics is currently hindered by convoluted and expensive manufacturing procedures. In this work, a series of 3D-printed LOC devices were designed and manufactured via stereolithography (SL) in a matter of hours. The spectroscopic performance of a variety of optical fibre combinations were tested, and the optimum path length for performing Ultraviolet-visible (UV-vis) spectroscopy determined. The information gained in these trials was then used in a reaction optimisation for the formation of carvone semicarbazone. The production of high resolution surface channels (100-500 µm) means that these devices were capable of handling a wide range of concentrations (9 µM-38 mM), and are ideally suited to both analyte detection and process optimisation. This ability to tailor the chip design and its integrated features as a direct result of the reaction being assessed, at such a low time and cost penalty greatly increases the user's ability to optimise both their device and reaction. As a result of the information gained in this investigation, we are able to report the first instance of a 3D-printed LOC device with fully integrated, in-line monitoring capabilities via the use of embedded optical fibres capable of performing UV-vis spectroscopy directly inside micro channels.

Cervical juxtafacet cysts: case report and literature review.

BACKGROUND: Juxtafacet cysts of the cervical and thoracic spine are rare and often present with myelopathy. Juxtafacet cysts are well recognized entities found commonly in the lumbar spine but are unusual in the cervical and thoracic spine. We present a case of a patient with gait disturbance and early myelopathy who was found to have a juxtafacet cyst at the cervico-thoracic junction. We further review the literature. PURPOSE: To describe a case of a cervico-thoracic juxtafacet cyst and review the literature. STUDY DESIGN: Case report and subject review. METHODS: One patient presenting with early myelopathy and pain underwent surgery for resection of the lesion. Pathologic analysis revealed a juxtafacet cyst. RESULTS: The patient recovered uneventfully with relief of his pain. Pubmed review revealed less than 30 similar cases in the literature. CONCLUSION: Juxtafacet cysts of the cervical spine are rare entities. These lesions comprise both synovial cysts and ganglion cysts. The benign lesions present with myelopathy and should be considered in patients with cystic lesions in the cervical spinal canal.

Neural transplantation in spinal cord injury.

Although medical advancements have significantly increased the survival of spinal cord injury patients, restoration of function has not yet been achieved. Neural transplantation has been studied over the past decade in animal models as a repair strategy for spinal cord injury. Although spinal cord neural transplantation has yet to reach the point of clinical application and much work remains to be done, reconstructive strategies offer the greatest hope for the treatment of spinal cord injury in the future. This article presents the scientific basis of neural transplantation as a repair strategy and reviews the current status of neural transplantation in spinal cord injury.

The impact of group discussion on the theory-perseverance bias.

The theory-perseverance bias was investigated in 3 related studies. In Study 1, a test of the hypothesis that group discussion attenuates this bias, male and female Canadian undergraduates examined information suggesting that either a positive or a negative relationship exists between risk preference and firefighting performance; they were then informed that this information was fictitious. They then recorded their beliefs regarding the actual relationship between these variables (a) immediately, (b) after 7 min of thought, (c) after a 7-min group discussion, or (d) after perusing a transcript of one of the discussions. Only the participants in the first condition made biased judgments. Study 2, which used Vinokur and Burnstein's (1974) procedures and which again drew a sample of Canadian students, provided support for a persuasive-arguments explanation of this group-discussion effect. The results of Study 3, which used procedures similar to those of Study 1, ruled out a social-comparison explanation for this effect. Factors that might enhance or diminish the effects of group discussion on this bias are suggested.

Culture and community in the therapeutic community: implications for the treatment of recovering substance misusers.

This paper critically discusses the conceptualization and structure of the therapeutic community employed for the treatment of substance misuse in America. The predominant American model, the concept-house model, is criticized on the grounds that the therapeutic milieu of these treatment agencies is contaminated by their subordinance to the influences of the larger American society. These influences include: the predominance of the medical model, the agency as an agent of service delivery, capitalism and inequity, implicit views of human nature, and stratification of social structure. The thesis of this paper is that treatment personnel in therapeutic communities must develop increased sensitivity to the larger cultural factors which influence the construction of the therapeutic community. It is argued that problems within the American culture play a significant role in the etiology of substance misuse. Therefore, treatment personnel must be careful to avoid constructing therapeutic communities which too closely mirror the larger culture. This cultural influence in therapeutic communities functions to maintain long-term substance misuse problems within the individual and the nation.

A mobile crisis program: collaboration between emergency psychiatric services and police.

An emergency psychiatry-mobile crisis program was established in 1987 in Charleston, South Carolina, linking professionals from the mental health center, the university, and the local police department. The program has two goals: to provide emergency psychiatric services to persons in the community and to train psychiatric residents in crisis intervention. Mental health staff act as consultants to the police in some situations, and in others the police provide security. The authors describe the development of the collaboration with police and important features of the program. Three cases illustrate how such collaboration can be of mutual benefit and can save lives.

From the benches to the trenches : training residents to provide emergency outreach services-a public/academic project.

The Charleston Area Mental Health Center and the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina have collaborated to form a comprehensive emergency service with mobile capacity. The service is staffed by an interdisciplinary team of professionals from public and academic psychiatry. Psychiatric residents are fully integrated into the service. A description of the program demonstrates how such liaisons can promote improved access to high-quality services, while enriching the training of psychiatrists through outreach experiences.