Flow focusing through gels as a tool to generate 3D concentration profiles in hydrogel-filled microfluidic chips

Laminar flow patterning is an iconic microfluidic technology used to deliver chemicals to specific regions on a two-dimensional surface with high spatial fidelity. Here we present a novel extension of this technology using Darcy flow within a three-dimensional (3D) hydrogel. Our test device is a simple 3-inlet microfluidic channel, totally filled with collagen, a cured biological hydrogel, where the concentration profiles of solutes are manipulated via the inlet pressures. This method allows solutes to be delivered with 50 micron accuracy within the gel, as we evidence by controlling concentration profiles of 40 kDa and 1 kDa fluorescent polysaccharide dyes. Furthermore, we design and test a 3D-printed version of our device with an extra two inlets for control of the vertical position of the concentration profile, demonstrating that this method is easily extensible to control of the concentration profile in 3D

Species specific anaesthetics for fish anaesthesia and euthanasia.

There is a need to ensure that the care and welfare for fish maintained in the laboratory are to the highest standards. This extends to the use of anaesthetics for both scientific study, humane killing and euthanasia at end of life. An anaesthetic should not induce negative behaviours and fish should not seek to avoid the anaesthetic. Surprisingly little information is available to facilitate a humane choice of anaesthetic agent for fish despite over 100 years of use and the millions of fish currently held in thousands of laboratories worldwide. Using a chemotaxic choice chamber we found different species specific behavioural responses among four closely related fish species commonly held in the laboratory, exposed to three widely used anaesthetic agents. As previously found for zebrafish (Danio rerio), the use of MS-222 and benzocaine also appears to induce avoidance behaviours in medaka (Oryzias latipes); but etomidate could provide an alternative choice. Carp (Cyprinus carpio), although closely related to zebrafish showed avoidance behaviours to etomidate, but not benzocaine or MS-222; and rainbow trout (Oncorhynchus mykiss) showed no avoidance to the three agents tested. We were unable to ascertain avoidance responses in fathead minnows (Pimephales promelas) and suggest different test paradigms are required for that species

Does clinical management improve outcomes following self-Harm? Results from the multicentre study of self-harm in England

Background Evidence to guide clinical management of self-harm is sparse, trials have recruited selected samples, and psychological treatments that are suggested in guidelines may not be available in routine practice. Aims To examine how the management that patients receive in hospital relates to subsequent outcome. Methods We identified episodes of self-harm presenting to three UK centres (Derby, Manchester, Oxford) over a 10 year period (2000 to 2009). We used established data collection systems to investigate the relationship between four aspects of management (psychosocial assessment, medical admission, psychiatric admission, referral for specialist mental health follow up) and repetition of self-harm within 12 months, adjusted for differences in baseline demographic and clinical characteristics. Results 35,938 individuals presented with self-harm during the study period. In two of the three centres, receiving a psychosocial assessment was associated with a 40% lower risk of repetition, Hazard Ratios (95% CIs): Centre A 0.99 (0.90–1.09); Centre B 0.59 (0.48–0.74); Centre C 0.59 (0.52–0.68). There was little indication that the apparent protective effects were mediated through referral and follow up arrangements. The association between psychosocial assessment and a reduced risk of repetition appeared to be least evident in those from the most deprived areas. Conclusion These findings add to the growing body of evidence that thorough assessment is central to the management of self-harm, but further work is needed to elucidate the possible mechanisms and explore the effects in different clinical subgroups

Self-inflicted penetrating eye injuries using a razor blade: Case report

<p>Abstract</p> <p>Background</p> <p>A 23 year old white male with a history of social and behavioural problems attempted to blind himself chemically, with alcohol, and mechanically, with a razor blade.</p> <p>Methods</p> <p>Observational case report of a patient who self-inflicted bilateral scleral lacerations with a razor blade, after losing his job.</p> <p>Results</p> <p>The patient sustained bilateral inferior scleral perforations, with hypotony and a right traumatic cataract. He received urgent surgical repair, and prophylactic antibiotics. There were no retinal breaks or detachments. He later underwent successful cataract surgery to the right eye.</p> <p>Conclusion</p> <p>Self-inflicted ocular injury may be possible in non-psychotic patients, as a situational response to a life event. Urgent repair can completely restore vision in some cases. Referral for psychiatric counseling is mandatory.</p

Precision Dual-Aquifer Dewatering at a Low Level Radiological Cleanup in New Jersey

Cleanup of low-level radioactive wastes at the Wayne Interim Storage Site (WISS), Wayne, New Jersey during the period October, 2000 through November, 2001 required the design, installation and operation of a dual-aquifer dewatering system to support excavation of contaminated soils. Waste disposal pits from a former rare-earth processing facility at the WISS had been in contact with the water table aquifer, resulting in moderate levels of radionuclides being present in the upper aquifer groundwater. An uncontaminated artesian aquifer underlies the water table aquifer, and is a localized drinking water supply source. The lower aquifer, confined by a silty clay unit, is flowing artesian and exhibits potentiometric heads of up to 4.5 meters above grade. This high potentiometric head presented a strong possibility that unloading due to excavation would result in a ''blowout'', particularly in areas where the confining unit was &lt; 1 meter thick. Excavation of contaminated materials w as required down to the surface of the confining unit, potentially resulting in an artesian aquifer head of greater than 8 meters above the excavation surface. Consequently, it was determined that a dual-aquifer dewatering system would be required to permit excavation of contaminated material, with the water table aquifer dewatered to facilitate excavation, and the deep aquifer depressurized to prevent a ''blowout''. An additional concern was the potential for vertical migration of contamination present in the water table aquifer that could result from a vertical gradient reversal caused by excessive pumping in the confined system. With these considerations in mind, a conceptual dewatering plan was developed with three major goals: (1) dewater the water table aquifer to control radionuclide migration and allow excavation to proceed; (2) depressurize the lower, artesian aquifer to reduce the potential for a ''blowout''; and (3) develop a precise dewatering level control mechanism to insure a vertical gradient reversal did not result in cross-contamination. The plan was executed through a hydrogeologic investigation culminating with the design and implementation of a complex, multi-phased dual-aquifer dewatering system equipped with a state of the art monitoring network

Chain of care for patients who have attempted suicide: a follow-up study from Bærum, Norway

<p>Abstract</p> <p>Background</p> <p>Individuals who have attempted suicide are at increased risk of subsequent suicidal behavior. Since 1983, a community-based suicide prevention team has been operating in the municipality of Bærum, Norway. This study aimed to test the effectiveness of the team's interventions in preventing repeated suicide attempts and suicide deaths, as part of a chain of care model for all general hospital treated suicide attempters.</p> <p>Methods</p> <p>Data has been collected consecutively since 1984 and a follow-up was conducted on all individuals admitted to the general hospital after a suicide attempt. The risk of repeated suicide attempt and suicide were comparatively examined in subjects who received assistance from the suicide prevention team in addition to treatment as usual versus those who received treatment as usual only. Logistic regression and Cox regression were used to analyze the data.</p> <p>Results</p> <p>Between January 1984 and December 2007, 1,616 subjects were registered as having attempted suicide; 197 of them (12%) made another attempt within 12 months. Compared to subjects who did not receive assistance from the suicide prevention team, individuals involved in the prevention program did not have a significantly different risk of repeated attempt within 6 months (adjusted <it>OR </it>= 1.08; 95% CI = 0.66-1.74), 12 months (adjusted <it>OR </it>= 0.86; 95% CI = 0.57-1.30), or 5 years (adjusted <it>RR </it>= 0.90; 95% CI = 0.67-1.22) after their first recorded attempt. There was also no difference in risk of suicide (adjusted <it>RR </it>= 0.85; 95% CI = 0.46-1.57). Previous suicide attempts, marital status, and employment status were significantly associated with a repeated suicide attempt within 6 and 12 months (p < 0.05). Alcohol misuse, employment status, and previous suicide attempts were significantly associated with a repeated attempt within 5 years (p < 0.05) while marital status became non-significant (p > 0.05). With each year of age, the risk of suicide increased by 3% (p < 0.05).</p> <p>Conclusions</p> <p>The present study did not find any differences in the risk of fatal and non-fatal suicidal behavior between subjects who received treatment as usual combined with community assistance versus subjects who received only treatment as usual. However, assistance from the community team was mainly offered to attempters who were not receiving sufficient support from treatment as usual and was accepted by 50-60% of those deemed eligible. Thus, obtaining similar outcomes for individuals, all of whom were clinically judged to have different needs, could in itself be considered a desirable result.</p

A Szemeredi-Trotter type theorem in R4\mathbb{R}^4

We show that $m$ points and $n$ two-dimensional algebraic surfaces in $\mathbb{R}^4$ can have at most $O(m^{\frac{k}{2k-1}}n^{\frac{2k-2}{2k-1}}+m+n)$ incidences, provided that the algebraic surfaces behave like pseudoflats with $k$ degrees of freedom, and that $m\leq n^{\frac{2k+2}{3k}}$. As a special case, we obtain a Szemer\'edi-Trotter type theorem for 2--planes in $\mathbb{R}^4$, provided $m\leq n$ and the planes intersect transversely. As a further special case, we obtain a Szemer\'edi-Trotter type theorem for complex lines in $\mathbb{C}^2$ with no restrictions on $m$ and $n$ (this theorem was originally proved by T\'oth using a different method). As a third special case, we obtain a Szemer\'edi-Trotter type theorem for complex unit circles in $\mathbb{C}^2$. We obtain our results by combining several tools, including a two-level analogue of the discrete polynomial partitioning theorem and the crossing lemma.Comment: 50 pages. V3: final version. To appear in Discrete and Computational Geometr

Options for early breast cancer follow-up in primary and secondary care : a systematic review

Background Both incidence of breast cancer and survival have increased in recent years and there is a need to review follow up strategies. This study aims to assess the evidence for benefits of follow-up in different settings for women who have had treatment for early breast cancer. Method A systematic review to identify key criteria for follow up and then address research questions. Key criteria were: 1) Risk of second breast cancer over time - incidence compared to general population. 2) Incidence and method of detection of local recurrence and second ipsi and contra-lateral breast cancer. 3) Level 1–4 evidence of the benefits of hospital or alternative setting follow-up for survival and well-being. Data sources to identify criteria were MEDLINE, EMBASE, AMED, CINAHL, PSYCHINFO, ZETOC, Health Management Information Consortium, Science Direct. For the systematic review to address research questions searches were performed using MEDLINE (2011). Studies included were population studies using cancer registry data for incidence of new cancers, cohort studies with long term follow up for recurrence and detection of new primaries and RCTs not restricted to special populations for trials of alternative follow up and lifestyle interventions. Results Women who have had breast cancer have an increased risk of a second primary breast cancer for at least 20 years compared to the general population. Mammographically detected local recurrences or those detected by women themselves gave better survival than those detected by clinical examination. Follow up in alternative settings to the specialist clinic is acceptable to women but trials are underpowered for survival. Conclusions Long term support, surveillance mammography and fast access to medical treatment at point of need may be better than hospital based surveillance limited to five years but further large, randomised controlled trials are needed