Chain-Extendable Crosslinked Hydrogels Using Branching RAFT Modification.

Functional crosslinked hydrogels were prepared from 2-hydroxyethyl methacrylate (HEMA) and acrylic acid (AA). The acid monomer was incorporated both via copolymerization and chain extension of a branching, reversible addition-fragmentation chain-transfer agent incorporated into the crosslinked polymer gel. The hydrogels were intolerant to high levels of acidic copolymerization as the acrylic acid weakened the ethylene glycol dimethacrylate (EGDMA) crosslinked network. Hydrogels made from HEMA, EGDMA and a branching RAFT agent provide the network with loose-chain end functionality that can be retained for subsequent chain extension. Traditional methods of surface functionalization have the downside of potentially creating a high volume of homopolymerization in the solution. Branching RAFT comonomers act as versatile anchor sites by which additional polymerization chain extension reactions can be carried out. Acrylic acid grafted onto HEMA-EGDMA hydrogels showed higher mechanical strength than the equivalent statistical copolymer networks and was shown to have functionality as an electrostatic binder of cationic flocculants.

Constitutive Modelling of Polylactic Acid at Large Deformation Using Multiaxial Strains.

Sheet specimens of a PLLA-based polymer have been extended at a temperature near to the glass transition in both uniaxial and planar tension, with stress relaxation observed for some time after reaching the final strain. Both axial and transverse stresses were recorded in the planar experiments. In all cases during loading, yielding at small strain was followed by a drop in true stress and then strain hardening. This was followed by stress relaxation at constant strain, during which stress dropped to reach an effectively constant level. Stresses were modelled as steady state and transient components. Steady-state components were identified with the long-term stress in stress relaxation and associated with an elastic component of the model. Transient stresses were modelled using Eyring mechanisms. The greater part of the stress during strain hardening was associated with dissipative Eyring processes. The model was successful in predicting stresses in both uniaxial and planar extension over a limited range of strain rate.

Flat broadband chaos generation in a discrete-mode laser subject to optical feedback.

Chaos generation in a discrete-mode (DM) laser subject to optical feedback is experimentally explored. The results show that a DM laser with only optical feedback can produce flat broadband chaos under an optimized feedback ratio. The effect of the laser bias current on the bandwidth and flatness of chaos is also investigated. It shows that the higher bias current, the better the flatness that can be obtained at the optimal feedback ratio.

Electronic Health Record-Embedded Decision Support Platform for Morphine Precision Dosing in Neonates.

Morphine is the opioid most commonly used for neonatal pain management. In intravenous form, it is administered as continuous infusions and intermittent injections, mostly based on empirically established protocols. Inadequate pain control in neonates can cause long-term adverse consequences; however, providing appropriate individualized morphine dosing is particularly challenging due to the interplay of rapid natural physiological changes and multiple life-sustaining procedures in patients who cannot describe their symptoms. At most institutions, morphine dosing in neonates is largely carried out as an iterative process using a wide range of starting doses and then titrating to effect based on clinical response and side effects using pain scores and levels of sedation. Our background data show that neonates exhibit large variability in morphine clearance resulting in a wide range of exposures, which are poorly predicted by dose alone. Here, we describe the development and implementation of an electronic health record-integrated, model-informed decision support platform for the precision dosing of morphine in the management of neonatal pain. The platform supports pharmacokinetic model-informed dosing guidance and has functionality to incorporate real-time drug concentration information. The feedback is inserted directly into prescribers' workflows so that they can make data-informed decisions. The expected outcomes are better clinical efficacy and safety with fewer side effects in the neonatal population.

Trait-based climate vulnerability assessments in data-rich systems: An application to eastern Bering Sea fish and invertebrate stocks.

Trait-based climate vulnerability assessments based on expert evaluation have emerged as a rapid tool to assess biological vulnerability when detailed correlative or mechanistic studies are not feasible. Trait-based assessments typically view vulnerability as a combination of sensitivity and exposure to climate change. However, in some locations, a substantial amount of information may exist on system productivity and environmental conditions (both current and projected), with potential disparities in the information available for data-rich and data-poor stocks. Incorporating this level of detailed information poses challenges when conducting, and communicating uncertainty from, rapid vulnerability assessments. We applied a trait-based vulnerability assessment to 36 fish and invertebrate stocks in the eastern Bering Sea (EBS), a data-rich ecosystem. In recent years, the living marine resources of the EBS and Aleutian Islands have supported fisheries worth more than US $1 billion of annual ex-vessel value. Our vulnerability assessment uses projections (to 2039) from three downscaled climate models, and graphically characterizes the variation in climate projections between climate models and between seasons. Bootstrapping was used to characterize uncertainty in specific biological traits and environmental variables, and in the scores for sensitivity, exposure, and vulnerability. The sensitivity of EBS stocks to climate change ranged from "low" to "high," but vulnerability ranged between "low" and "moderate" due to limited exposure to climate change. Comparison with more detailed studies reveals that water temperature is an important variable for projecting climate impacts on stocks such as walleye pollock (Gadus chalcogrammus), and sensitivity analyses revealed that modifying the rule for determining vulnerability increased the vulnerability scores. This study demonstrates the importance of considering several uncertainties (e.g., climate projections, biological, and model structure) when conducting climate vulnerability assessments, and can be extended in future research to consider the vulnerability of user groups dependent on these stocks.

Modelling the Mechanical and Strain Recovery Behaviour of Partially Crystalline PLA.

This is a study of the modelling and prediction of strain recovery in a polylactide. Strain recovery near the glass transition temperature is the underlying mechanism for the shape memory in an amorphous polymer. The investigation is aimed at modelling such shape memory behaviour. A PLA-based copolymer is subjected to stress-strain, stress relaxation and strain recovery experiments at large strain at 60 °C just below its glass transition temperature. The material is 13% crystalline. Using published data on the mechanical properties of the crystals, finite element modelling was used to determine the effect of the crystal phase on the overall mechanical behaviour of the material, which was found to be significant. The finite element models were also used to relate the stress-strain results to the yield stress of the amorphous phase. This yield stress was found to possess strain rate dependence consistent with an Eyring process. Stress relaxation experiments were also interpreted in terms of the Eyring process, and a two-process Eyring-based model was defined that was capable of modelling strain recovery behaviour. This was essentially a model of the amorphous phase. It was shown to be capable of useful predictions of strain recovery.

The role of maternal age and context-dependent maternal effects in the offspring provisioning of a long-lived marine teleost.

Despite evidence of maternal age effects in a number of teleost species, there have been challenges to the assertion that maternal age intrinsically influences offspring quality. From an evolutionary perspective, maternal age effects result in young females paradoxically investing in less fit offspring despite a greater potential fitness benefit that might be gained by allocating this energy to individual somatic growth. Although a narrow range of conditions could lead to a maternal fitness benefit via the production of lower quality offspring, evolutionary theorists suggest these conditions are seldom met and that the reported maternal age effects are more likely products of the environmental context. Our goal was to determine if maternal effects operated on offspring provisioning in a long-lived rockfish (genus Sebastes), and to evaluate any such effects as an intrinsic function of maternal age or a context-dependent effect of the offspring release environment. We found that offspring provisioning is a function of both maternal age and the timing of offspring release; older females exhibit increased provisioning over younger females throughout the spawning season despite a decrease in provisioning across all maternal ages as the season progresses. These findings suggest a role for both maternal age effects and a potential context-dependent maternal effect in population productivity, carrying important implications when modelling population persistence and resilience.

Broad tunable photonic microwave generation based on period-one dynamics of optical injection vertical-cavity surface-emitting lasers.

Photonic microwave generation based on period-one dynamics of an optically injected VCSEL has been study experimentally. The results have shown that the frequency of the generated microwave signal can be broadly tunable through the adjustment of the injection power and the frequency detuning. Strong optical injection power and higher frequency detuning are favorable for obtaining a high frequency microwave signal. These results are similar to those found in systems based on distributed feedback lasers and quantum dot lasers. The variation of the microwave power at the fundamental frequency and the second-harmonic distortion have also been characterized.

A Novel Diagnostic Aid for Detection of Intra-Abdominal Adhesions to the Anterior Abdominal Wall Using Dynamic Magnetic Resonance Imaging.

Introduction. Abdominal adhesions can cause serious morbidity and complicate subsequent operations. Their diagnosis is often one of exclusion due to a lack of a reliable, non-invasive diagnostic technique. Development and testing of a candidate technique are described below. Method. During respiration, smooth visceral sliding motion occurs between the abdominal contents and the walls of the abdominal cavity. We describe a technique involving image segmentation and registration to calculate shear as an analogue for visceral slide based on the tracking of structures throughout the respiratory cycle. The presence of an adhesion is attributed to a resistance to visceral slide resulting in a discernible reduction in shear. The abdominal movement due to respiration is captured in sagittal dynamic MR images. Results. Clinical images were selected for analysis, including a patient with a surgically confirmed adhesion. Discernible reduction in shear was observed at the location of the adhesion while a consistent, gradually changing shear was observed in the healthy volunteers. Conclusion. The technique and its validation show encouraging results for adhesion detection but a larger study is now required to confirm its potential.

Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

BACKGROUND: External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. METHODS: In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. RESULTS: Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. CONCLUSIONS: The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate.

Towards radiological diagnosis of abdominal adhesions based on motion signatures derived from sequences of cine-MRI images.

This paper reports novel development and preliminary application of an image registration technique for diagnosis of abdominal adhesions imaged with cine-MRI (cMRI). Adhesions can severely compromise the movement and physiological function of the abdominal contents, and their presence is difficult to detect. The image registration approach presented here is designed to expose anomalies in movement of the abdominal organs, providing a movement signature that is indicative of underlying structural abnormalities. Validation of the technique was performed using structurally based in vitro and in silico models, supported with Receiver Operating Characteristic (ROC) methods. For the more challenging cases presented to the small cohort of 4 observers, the AUC (area under curve) improved from a mean value of 0.67 ± 0.02 (without image registration assistance) to a value of 0.87 ± 0.02 when image registration support was included. Also, in these cases, a reduction in time to diagnosis was observed, decreasing by between 20% and 50%. These results provided sufficient confidence to apply the image registration diagnostic protocol to sample magnetic resonance imaging data from healthy volunteers as well as a patient suffering from encapsulating peritoneal sclerosis (an extreme form of adhesions) where immobilization of the gut by cocooning of the small bowel is observed. The results as a whole support the hypothesis that movement analysis using image registration offers a possible method for detecting underlying structural anomalies and encourages further investigation.

Initial observations using a novel "cine" magnetic resonance imaging technique to detect changes in abdominal motion caused by encapsulating peritoneal sclerosis.

Encapsulating peritoneal sclerosis (EPS) is an uncommon complication of peritoneal dialysis (PD), with high mortality and morbidity. The peritoneum thickens, dysfunctions, and forms a cocoon that progressively "strangulates" the small intestine, causing malnutrition, ischemia, and infarction. There is as yet no reliable noninvasive means of diagnosis, but recent developments in image analysis of cine magnetic resonance imaging for the recognition of adhesions offers a way forward. We used this protocol before surgery in 3 patients with suspected EPS. Image analysis revealed patterns of abdominal movement that were markedly different from the patterns in healthy volunteers. The volunteers showed marked movement throughout the abdomen; in contrast, movement in EPS patients was restricted to just below the diaphragm. This clear difference provides early "proof of principle" of the approach that we have developed.

Thermal effects and dynamical hysteresis in the turn-on and turn-off of vertical-cavity surface-emitting lasers.

Thermal effects and dynamical hysteresis in VCSELs under dc modulation have been experimentally studied. The results show that the VCSEL turn-on and turn-off currents can display both positive hysteresis and negative hysteresis, depending on the current modulation frequency and on the substrate temperature. Numerical simulations of semiconductor laser rate equations, extended to take into account thermal effects, show a good agreement with the observations.

Combined antegrade and retrograde endoscopic retroperitoneal bypass of ureteric strictures: a modification of the 'rendezvous' procedure.

OBJECTIVE: To evaluate our experience of treating complicated iatrogenic ureteric strictures with a combined antegrade and retrograde endoscopic retroperitoneal bypass technique, a modification of the so-called 'rendezvous' procedure. PATIENTS AND METHODS: Seven patients presented to our institution between 2004 and 2008 after developing a complicated iatrogenic ureteric stricture, impassable with solitary antegrade or retrograde stenting techniques. In most cases there was a significant loss of ureteric continuity, with some strictures of up to 10-12 cm. After initial temporizing management with a percutaneous nephrostomy, each patient had a radiological 'rendezvous' procedure to insert a JJ stent and restore ureteric continuity. After 6 months, the JJ stents were removed and the patients evaluated by symptom assessment, serial measurements of serum creatinine and diuretic renography (F-15 mercaptoacetyl triglycine). RESULTS: All seven 'rendezvous' procedures were successful and a ureteric stent was inserted across or around the stricture in all cases. Five of seven patients whose follow-up was >6 months had their stent removed successfully. At a median follow-up of 21 months, all patients are alive and none has required subsequent surgery. Six of the seven patients presented with significant symptoms and they are all currently symptom-free, which we consider to be a successful clinical outcome. No patient has developed significant renal impairment (estimated glomerular filtration rate (<30 mL/min) but we could only confirm successful unequivocal renographic drainage in one patient. CONCLUSION: Combining antegrade radiological and retrograde endourological techniques, it is possible to restore ureteric continuity with a JJ stent, even in situations with extensive loss of the ureteric lumen. This reduces the need for morbid open surgical repair and offers a long-term solution to patients who might otherwise be consigned to less favourable conservative measures.

Enhanced chaos synchronization in unidirectionally coupled vertical-cavity surface-emitting semiconductor lasers with polarization-preserved injection.

We experimentally study chaos synchronization in unidirectionally coupled vertical-cavity surface-emitting semiconductor lasers (VCSELs) with polarization-preserved and polarization-selected optical injection. The measurements show, in agreement with theoretical predictions, that the maximum cross coefficient of 0.884 obtained with polarization-preserved optical injection is significantly higher than the maximum cross coefficient of 0.724 obtained with polarization-selected optical injection.

Isolation and characterisation of procyanidins from Rumex obtusifolius.

An acetone:water (7:3) extract obtained from the leaves of Rumex obtusifolius was fractionated into procyanidin oligomer and polymer fractions using a linear gradient and a simple step method on Sephadex LH-20. The chemical characteristics of the procyanidin fractions were studied by 13C-NMR spectroscopy, acid-catalysed degradation in the presence of benzyl mercaptan, matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) MS and electrospray ionisation (ESI) MS. The 13C-NMR showed that the polymer fraction consisted predominantly of procyanidin polymers, some with galloyl groups attached. The thiolysis reaction products indicated a mean degree of polymerisation (DP) of 4.3 for the step method, and a range of 2.3-8.2 mean DP for the gradient fractionation, with epicatechin as the most abundant flavan-3-ol extension unit, while the terminal units consisted of equal proportions of catechin, epicatechin and epicatechin gallate. Singly charged ions observed in MALDI-TOF/MS showed a range of oligomeric procyanidins and their polygalloyl derivatives. These species (in the range DP 2-7) were also observed by ESI/MS but the spectra were more complex due to overlapping multiply charged ions. Isolation of oligomers from the Sephadex LH-20 fraction by chromatography on polyamide and C18 yielded B1, B2, B3 and B7 dimers, an A-type trimer and a B2 3,3'-O-digallate.

A framework for the modeling of gut blood flow regulation and postprandial hyperaemia.

After a meal the activity of the gut increases markedly as digestion takes place. Associated with this increase in activity is an increase in blood flow, which has been shown to be dependent on factors such as caloric content and constitution of the meal. Much qualitative work has been carried out regarding mechanisms for the presence of food in a section of gut producing increased blood flow to that section, but there are still many aspects of this process that are not fully understood. In this paper we briefly review current knowledge on several relevant areas relating to gut blood flow, focusing on quantitative data where available and highlighting areas where further research is needed. We then present new data on the effect of feeding on flow in the superior mesenteric artery. Finally, we describe a framework for combining this data to produce a single model describing the mechanisms involved in postprandial hyperaemia. For a section of the model, where appropriate data are available, preliminary results are presented.

Ureteric embolization: an alternative treatment strategy for urinary fistulae complicating advanced pelvic malignancy.

OBJECTIVE: To report experience with a minimally invasive technique for palliation of urinary fistula/incontinence complicating advanced pelvic malignancy or its treatment. PATIENTS AND METHODS: We used ureteric embolization with permanent nephrostomy drainage in eight renal units in five patients for palliation of symptoms. All procedures were done under local anaesthesia as day-case procedures. Nephrostomy tubes were changed at regular intervals on an outpatient basis. Embolization was repeated when required. RESULTS: The follow-up was 2-84 months; four patients died from the underlying malignancy during the follow-up. All patients were continent and had effective palliation of their symptoms. Two patients required repeat embolization. There were no embolization-related complications. CONCLUSIONS: Ureteric embolization is a safe and effective minimally invasive palliative treatment option in urinary fistulae or incontinence complicating advanced pelvic malignancy.

Experimental study of polarization switching of vertical-cavity surface-emitting lasers as a dynamical bifurcation.

We study the role of the bias current sweep rate in measurements of polarization switching (PS) of vertical-cavity surface-emitting lasers (VCSELs). We show that the polarization-resolved L-I (light-intensity) curve depends on the current sweep rate. As the current sweep rate increases, the PS occurs at higher bias currents for upward scans and at lower bias currents for downward scans. We also show that the delay of the dynamical bifurcation follows a power law relationship with the frequency of the ramp, in good agreement with recent theoretical predictions.