Direct-write formation of integrated bottom contacts to laser-induced graphene-like carbon.

We report a simple, scalable two-step method for direct-write laser fabrication of 3D, porous graphene-like carbon electrodes from polyimide films with integrated contact plugs to underlying metal layers (Au or Ni). Irradiation at high average CO2laser power (30 W) and low scan speed (∼18 mm s)-1leads to formation of 'keyhole' contact plugs through local ablation of polyimide (initial thickness 17µm) and graphitization of the plug perimeter wall. Top-surface laser-induced graphene (LIG) electrodes are then formed and connected to the plug by raster patterning at lower laser power (3.7 W) and higher scan speed (200 mm s)-1. Sheet resistance data (71 ± 15 Ω sq.)-1indicates formation of high-quality surface LIG, consistent with Raman data which yield sharp first- and second-order peaks. We have also demonstrated that high-quality LIG requires a minimum initial polyimide thickness. Capacitance data measured between surface LIG electrodes and the buried metal film indicate a polyimide layer of thickness ∼7µm remaining following laser processing. By contrast, laser graphitization of polyimide of initial thickness ∼8µm yielded devices with large sheet resistance (>1 kΩ sq.)-1. Raman data also indicated significant disorder. Plug contact resistance values were calculated from analysis of transfer line measurement data for single- and multi-plug test structures. Contacts to buried nickel layers yielded lower plug resistances (1-plug: 158 ± 7 Ω , 4-plug: 31 ± 14 Ω) compared to contacts to buried gold (1-plug: 346 ± 37 Ω , 4-plug: 52 ± 3 Ω). Further reductions are expected for multi-plug structures with increased areal density. Proof-of-concept mm-scale LIG electrochemical devices with local contact plugs yielded rapid electron transfer kinetics (rate constantk0 âˆ¼ 0.017 cm s-1), comparable to values measured for exposed Au films (k0 âˆ¼0.023 cm s)-1. Our results highlight the potential for integration of LIG-based sensor electrodes with semiconductor or roll-to-roll manufacturing.

Clinical diagnostic utility of ultrasound-guided fine needle aspiration biopsy in parotid masses.

BACKGROUND: Fine needle aspiration (FNA) is a common diagnostic tool used in the initial evaluation of parotid masses. In the literature, variable diagnostic accuracy of FNA is reported. Therefore, when considering clinical management of these patients, the utility of FNA is unclear. The aim of this study was to determine the capability of ultrasound-guided FNA to differentiate between benign and malignant neoplasms. Further, the way in which FNA results affect clinical decision-making was assessed. METHODS: Retrospective data were collected for all patients who underwent parotidectomy at a large Canadian tertiary care center between 2011 and 2016. Patient demographics, preoperative imaging reports, preoperative FNA results, and final pathological diagnosis were analyzed. RESULTS: Of the 199 patients who underwent parotidectomy, 184 had preoperative ultrasound-guided FNA. There were a total of 13 non-diagnostic FNAs. In diagnosing malignancy, FNA had a sensitivity and specificity of 71.4% and 98.7%, respectively. The positive predictive value (PPV) was 83.3%. The negative predictive value was 97.5%. Of the non-diagnostic FNAs, 2 out of 13 (15.4%) were deemed malignant neoplasms on final pathology. CONCLUSION: FNA is a useful adjunct in the work-up of parotid masses, but it should be used with caution. Due to limited sensitivity, it should not be relied upon as the sole determinant of a surgeon's management plan.

Phoenix: A Portable, Battery-Powered, and Environmentally Controlled Platform for Long-Distance Transportation of Live-Cell Cultures.

Despite the advent of advanced therapy medicinal products (ATMPs) in regenerative medicine, gene therapy, cell therapies, tissue engineering, and immunotherapy, the availability of treatment is limited to patients close to state-of-the-art facilities. The SCORPIO-V Division of HNu Photonics has developed the Phoenix-Live Cell TransportTM, a battery-operated mobile incubator designed to facilitate long-distance transportation of living cell cultures from GMP facilities to remote areas for increased patient accessibility to ATMPs. This work demonstrates that PhoenixTM (patent pending) is a superior mechanism for transporting living cells compared to the standard method of shipping frozen cells on dry ice (-80°C) or in liquid nitrogen (-150°C), which are destructive to the biology as well as a time consuming process. Thus, Phoenix will address a significant market need within the burgeoning ATMP industry. SH-SY5Y neuroblastoma cells were cultured in a stationary Phoenix for up to 5 days to assess cell viability and proliferation. The results show there is no significant difference in cell proliferation (∼5X growth on day 5) or viability (>90% viability on all days) when cultured in PhoenixTM and compared to a standard 5% CO2 incubator. Similarly, SH-SY5Y cells were evaluated following ground (1-3 days) and air (30 min) shipments to understand the impact of transit vibrations on the cell cultures. The results indicate that there is no significant difference in SH-SY5Y cell proliferation (∼2X growth on day 3) or viability (>90% viability for all samples) when the cells are subjected to the vibrations of ground and air transportation when compared to control samples in a standard, stationary 5% CO2 incubator. Furthermore, the temperature, pressure, humidity, and accelerometer sensors log data during culture shipment to ensure that the sensitive ATMPs are handled with the appropriate care during transportation. The PhoenixTM technology innovation will significantly increase the accessibility, reproducibility, and quality-controlled transport of living ATMPs to benefit the widespread commercialization of ATMPs globally. These results demonstrate that PhoenixTM can transport sensitive cell lines with the same care as traditional culture techniques in a stationary CO2 incubator with higher yield, less time and labor, and greater quality control than frozen samples.

Experiences of Head and Neck Cancer Patients in Middle Adulthood: Consequences and Coping.

The head and neck cancer (HNC) rate is rising among the middle-aged adult population. This trend has been attributed primarily to human papillomavirus exposure. An HNC diagnosis and its complex treatments may trigger life-changing physical, emotional, and social consequences. An interpretive descriptive study was conducted to describe the experiences of a purposive sample of 10 middle-aged adults who had experienced HNC. Two main themes were identified: consequences of HNC and coping with HNC. Subthemes of consequences of HNC included: voicelessness; being or looking sick; shifts in family dynamics; and sexual practices, sexual feelings, and stigma. Subthemes of coping with HNC included seeking information, discovering inner strengths, relying on a support network, establishing a sense of normalcy, and finding meaning within the experience. Supportive nursing interventions were identified by considering results from the standpoint of King's theory of goal attainment.

Head and Neck Surgical Oncology Choosing Wisely Campaign: imaging for patients with hoarseness, fine needle aspiration for neck mass, and ultrasound for odynophagia.

Choosing Wisely Canada, is a campaign designed to raise awareness regarding inappropriate or unnecessary tests and treatments. The Canadian Society of Otolaryngology - Head & Neck Surgery and the Canadian Association of Head and Neck Surgical Oncologists developed a Choosing Wisely Canada list to help promote high quality care for patients presenting with disorders of the head and neck: (1) Don't order imaging - computer tomography (CT) or magnetic resonance imaging (MRI) - as the initial investigation for patients presenting with a chief complaint of hoarseness, (2) Don't perform an open biopsy or excision of a neck mass without having first considered a fine needle aspiration (FNA) biopsy and, (3) Don't order neck ultrasound to investigate odynophagia (discomfort or pain with swallowing) or globus sensation.

Combination of submandibular salivary gland transfer and intensity-modulated radiotherapy to reduce dryness of mouth (xerostomia) in patients with head and neck cancer.

BACKGROUND: Xerostomia is a debilitating side effect of radiotherapy for head and neck cancer. Combining surgical submandibular-gland transfer (SMGT) with intensity-modulated radiotherapy (IMRT) may provide greater protection of salivary function. METHODS: This was a single-institution, prospective phase II feasibility trial. Patients with head and neck cancer or unknown primary with neck node metastases received primary surgery with SMGT and postoperative radiotherapy with tomotherapy (60 Gy in 30 fractions). Toxicity and quality of life (QOL) were assessed before surgery, before RT, and after RT. RESULTS: Forty patients received SMGT and IMRT. Only 1 patient experienced grade 3 salivary gland toxicity. At 12 months post-RT, the rate of absent or only mild xerostomia was 89%, and salivary flow rates were approximately 75% of pre-RT levels. CONCLUSIONS: The combination of IMRT with SMGT is feasible and with improved dose constraints may maximally spare the parotid and submandibular glands, leading to decreased xerostomia and improved patient QOL.

Sperm cell purification from mock forensic swabs using SOMAmer™ affinity reagents.

We have demonstrated a proof of concept with affinity-based purification of sperm cells from mock forensic samples using SOMAmer™ reagents, DNA-based affinity reagents developed by SomaLogic, Inc. SOMAmer reagents were selected in vitro using whole-cell SELEX to bind specifically with intact, detergent-treated sperm cells. Successful separation of sperm from epithelial cells and their debris was demonstrated using buccal swabs with added semen. Primarily male DNA profiles were generated from sperm cells eluted from the types of cotton swabs typically used for rape kit evidence collection. The quality of sperm DNA isolated from samples purified using SOMAmers is comparable to existing commercially available differential extraction-based methods at higher sperm concentrations. This purification method is simple, offers relatively rapid (<2hr) sperm purification, and can potentially be automated using robotic workstations. This work serves as proof of concept that demonstrates the first use of SOMAmer reagents as affinity ligands to bind sperm cells. With further development, this technique can potentially be used for high-throughput sexual assault forensic casework.

Phosphorus monolayer doping (MLD) of silicon on insulator (SOI) substrates.

This paper details the application of phosphorus monolayer doping of silicon on insulator substrates. There have been no previous publications dedicated to the topic of MLD on SOI, which allows for the impact of reduced substrate dimensions to be probed. The doping was done through functionalization of the substrates with chemically bound allyldiphenylphosphine dopant molecules. Following functionalization, the samples were capped and annealed to enable the diffusion of dopant atoms into the substrate and their activation. Electrical and material characterisation was carried out to determine the impact of MLD on surface quality and activation results produced by the process. MLD has proven to be highly applicable to SOI substrates producing doping levels in excess of 1 × 1019 cm-3 with minimal impact on surface quality. Hall effect data proved that reducing SOI dimensions from 66 to 13 nm lead to an increase in carrier concentration values due to the reduced volume available to the dopant for diffusion. Dopant trapping was found at both Si-SiO2 interfaces and will be problematic when attempting to reach doping levels achieved by rival techniques.

Asymmetric Pentagonal Metal Meshes for Flexible Transparent Electrodes and Heaters.

Metal meshes have emerged as an important class of flexible transparent electrodes. We report on the characteristics of a new class of asymmetric meshes, tiled using a recently discovered family of pentagons. Micron-scale meshes were fabricated on flexible polyethylene terephthalate substrates via optical lithography, metal evaporation (Ti 10 nm, Pt 50 nm), and lift-off. Three different designs were assessed, each with the same tessellation pattern and line width (5 µm), but with different sizes of the fundamental pentagonal unit. Good mechanical stability was observed for both tensile strain and compressive strain. After 1000 bending cycles, devices subjected to tensile strain showed fractional resistance increases in the range of 8-17%, while devices subjected to compressive strain showed fractional resistance increases in the range of 0-7%. The performance of the pentagonal metal mesh devices as visible transparent heaters via Joule heating was also assessed. Rapid response times (∼15 s) at low bias voltage (≤5 V) and good thermal resistance characteristics (213-258 °C cm2/W) were found using measured thermal imaging data. Deicing of an ice-bearing glass coupon on top of the transparent heater was also successfully demonstrated.

Recovery of a flawed hyperspectral imager calibration using optical modeling.

A reconstructed hyperspectral datacube has been successfully recovered from a badly flawed point-spread function (PSF) observation. The corrected PSF alleviated unnoticed detector saturation and misregistration artifacts in the calibration of a crucial, irreplaceable near-infrared flash hyperspectral imager dataset. This flawed PSF induced a defocus-like artifact as well as spectral distortions in the three-dimensional hyperspectral estimate of the data. The PSF artifacts, which would have caused severe misinterpretation of the spatio-spectral information, were correctable post detection using an optical model of the PSF constrained by the available flawed calibration.

A cluster randomized trial of an organizational linkage intervention for offenders with substance use disorders: study protocol.

BACKGROUND: Substance use disorders are highly prevalent in community correctional populations, yet these settings frequently are ill-equipped to identify and refer offenders to community-based treatment services. In particular, community corrections staff are often opposed to the use of medication in addiction treatment because of inadequate knowledge, resources, and organizational structures to facilitate client linkages to evidence-based services. METHODS/DESIGN: Each of the NIDA-funded Research Centers recruited 2 criminal justice agencies to participate in the study. Eligibility rules required study sites that were focused on community corrections (i.e., probation or parole), had few or no formal relationships with treatment providers for referring clients to medication-assisted treatment, and had no state or local policies prohibiting such relationships. Sites under the oversight of the same parent agency were eligible only if they were in geographically distinct catchment areas, and could be assigned to different study arms without cross-contamination at any level. The 18 clusters consisted of community corrections officers and their offender caseloads nested within agencies, each of which was partnered with at least one community-based substance abuse treatment program. Randomization was blocked by Research Center, within which one cluster was randomly assigned to a training-only condition (comparison) and the other to training followed by a strategic organizational linkage process (intervention). Line staff received a scientifically-grounded, systematically-delivered training session that addresses gaps in existing knowledge, perceptions, and information about medication-assisted treatment (MAT) and local availability of MAT services. Key decision-makers subsequently were asked to collaborate in a strategic planning process to enhance formal and informal linkages between criminal justice agencies and local MAT providers. It was hypothesized that the two implementation intervention components together would be more likely than staff training alone to improve the process of referring opioid- and alcohol-dependent adults under community supervision to appropriate addiction pharmacotherapy. Outcomes were measured at the client (referrals), line staff (attitudes), and organizational (linkage) levels. DISCUSSION: Through closer collaboration among criminal justice agencies and treatment providers, improved linkages to effective substance abuse treatment should yield significant clinical, public health and public safety benefits.

The great auricular nerve: an anatomic and surgical study.

BACKGROUND: The great auricular nerve (GAN) originates from the cervical plexus at the levels of C2 and C3, supplying sensation to the skin overlying the lower aspect of the pinna and angle of the mandible. The GAN can be injured during many procedures in the head and neck, resulting in a significant negative impact on the patient's quality of life. There are no reliable anatomic studies of GAN in the area where it is most likely to get injured. OBJECTIVE: To determine the GAN relationship to the posterior border of the platysma and the external jugular vein (EJV). METHODS: Patients undergoing neck dissections were included in the study. Measurements were taken between the posterior border of the platysma relative to the nearest edge of the EJV and the GAN. The distance between the GAN and the EJV was also noted. RESULTS: The posterior borders of the platysma and EJV are found, on average, 0.08 cm away from each other, and the free edge of the platysma was most often posterior to the EJV. The distance from the platysma to the GAN was, on average, 0.60 cm. The distance between the EJV and the GAN was 1.17 cm. CONCLUSION: We have added a safe, reliable, and surgically relevant technique to the head and neck surgeon's armamentarium for identifying the GAN and avoiding attendant injury with long-term debilitating neurologic sequelae.

Correlates of participation in peer recovery support groups as well as voluntary and mandated substance abuse treatment among rural and urban probationers.

This study explores the correlates of probationers' participation in 12-step programs, voluntary treatment, and mandated treatment, with respect to the geographic location of where the services are being provided as the primary covariate of interest. Data were derived from face-to-face interviews with rural and urban probationers (N = 1,464). Results of the three logistic regression models suggested that even when all the covariates are taken into account, urban probationers were significantly more likely to have been involved in 12-step programs, voluntary treatment, and mandated treatment over their lifespan. Despite high levels of self-reported substance use among all participants, treatment services were underused by rural probationers. These data suggest that individuals residing in rural communities may face additional barriers to receiving treatment services and that criminal involvement is associated with participation in peer recovery support groups and treatment. Future studies can investigate criminal involvement as an avenue to enhance recovery and how to overcome treatment barriers in rural areas.