Theory of simultaneous control of orientation and translational motion of nanorods using positive dielectrophoretic forces

The manipulation of individual submicron-sized objects has been the focus of significant efforts over the last few years. A method to arbitrarily move and orient a set of rod-shaped conductive particles in a region defined by a set of electrodes using positive dielectrophoretic forces is presented. While the orientation of each particle is directly specified through the angle of the local electric field, its position is indirectly controlled through the applied force. Each electrode is approximated as an unknown point charge and an induced dipole. Since each induced dipole results from the combination of all other sources, a set of linear constraints are derived to enforce the self-consistency of the system. Additionally, the force and orientation of each particle also form an additional set of linear constraints. This combined set of constraints is then solved numerically to yield the sources required to induce the desired orientation and motion of each particle. It is observed that the minimum number of electrodes that can be used to control a set of N particles is 4N+1. Numerical simulations demonstrate that the control of a single nanorod (diameter of 70 nm; length of 1.4μm) in the midst of a realistic electrode array can be accomplished under practical conditions. In addition, such control of orientation and motion can be achieved over an ample region in the vicinity of each rod

Electric Tweezers: Experimental Studies of Positive Dielectrophoresis-Based Positioning and Orientation of a Nanorod

The manipulation of individual micrometer sized objects has been the focus of significant research efforts over the last few years. A previously proposed method for the arbitrary manipulation of nanoparticles is experimentally demonstrated. This method employs dielectrophoretic forces for the planar control of the motion and orientation of such nanoparticles between a set of microfabricated electrodes. Each electrode is approximated as a set of sources, namely, an unknown point charge and induced dipole. Imposing constraints on the electric field at the location of the particle and requiring self-consistency uniquely determine the sources. They can then be subsequently used to determine the set of electrode voltages that creates an electric field that will produce the prescribed orientation and force on the particle. The drag coefficients of a nanorod are experimentally determined by sequentially applying a constant force both parallel and perpendicular to its axis and observing a resulting motion.With the drag coefficients in hand, the velocity rather than force can be prescribed, and the rod is directed to move accurately at oblique angles to its orientation. The rod is in a constant state of unstable equilibrium and requires negative feedback to maintain a fixed position. The automation of such feedback is demonstrated, allowing a controlled travel of the nanostructures over complex paths

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

An examination of the ethical decision-making processes used in decisions to fund, reduce or cease funding tailored health services

Health authority administrators were interviewed for their perspectives on what makes a good health care system; on tailored population-specific services as a way to address health inequities; and on how they perceive themselves to be making good funding decisions on the public’s behalf. The qualitative descriptive research dataset includes 24 hour-and-a-half long interviews with administrators from four BC health authorities, health region documents, memos, and field notes. Participants support the continuation of a public health care system and all participants acknowledge using tailored services as a route towards reducing health inequities. However, these identified services have not been evaluated for their overall effectiveness. When it comes to decision-making, participants describe using a series of governance and bioethical principles that help them frame what and how issues can be considered. Decision situations are framed in a way that informs them whether they need to use formal or informal processes. In both cases participants collect information that allows others to understand that they have made wise decisions. The Recognition-Primed Decision Model accurately reflects the intuitive processes that participants describe using during informal decision-making and portions of formal decision-making. However, in relation to formal decision situations, there is less alignment with existing Decision-Analysis literature. Seven practice and future research recommendations are provided: 1. Increase health authority participation in intersectoral partnerships that address non-medical determinants of health. 2. Develop new strategies for addressing health inequities. 3. Evaluate the efficacy of using tailored services beyond their ability to remove barriers to access. In addition, increase focus on testing new strategies for reducing the inequities gap. 4. Enhance existing decision-making processes by including the explicit review of decision tradeoffs, value weighting, and mechanisms for requesting revisions. 5. Focus future research on developing and evaluating the usefulness of formal decision-making tools in health authority structures and their relation to decision latitude. 6. Launch a longitudinal research study that examines how health authority expert decision-makers use judgmental heuristics and how they avoid the negative effects of bias. 7. Commission public dialogue on shifting the current illness-based system to one that is wellness based.Graduate and Postdoctoral StudiesGraduat

Fractured beings : exploring theories of identity formation, while encouraging social change

This thesis explores both modernist and poststructuralist theories of the identification process as a vehicle for understanding the makeup of individuals and their relationship with social movements. It is asserted that individuals are made up of multiple lines of identity, such as sexuality and gender, which interact with societal normative discourse. This essay develops the theory of the fractured being to account for these arrangements and asserts that individuals continually rearrange their identity in order to negotiate axiomatic activities. By demonstrating that it is possible to affect change at micro and macro levels, the fractured being retains agonistic power relations. Theories that demonstrate how individuals resist norms on a daily basis are explored through an examination of daily events, popular culture, and a qualitative interview. This thesis concludes that benefits are derived within social movements when members organise around more complex relationships rather than singular issues

Atomic layer deposition of TiN for the fabrication of nanomechanical resonators

Films of titanium nitride were grown by atomic layer deposition (ALD) over a range of temperatures from 120 \ub0C to 300 \ub0C, and their deposition rates were characterized by ellipsometry and reflectometry. The stress state of the films was evaluated by interferometry using a wafer bowing technique and varied from compressive (-18 MPa) to tensile (650 MPa). The crystal structure of the films was assessed by x-ray diffraction. The grain size varied with temperature in the range of 2-9 nm. The chemical composition of the films was ascertained by high-resolution x-ray photoelectron spectroscopy and showed the presence of O, Cl, and C contaminants. A mildly tensile (250 MPa) stressed film was employed for the fabrication (by electron beam lithography and reactive ion etching) of doubly clamped nanoresonator beams. The resonance frequency of resonators was assayed using an interferometric resonance testing apparatus. The devices exhibited sharp mechanical resonance peaks in the 17-25 MHz range. The uniformity and controllable deposition rate of ALD films make them ideal candidate materials for the fabrication of ultranarrow (<50 nm) nanobeam structures. \ua9 2013 American Vacuum Society.Peer reviewed: YesNRC publication: Ye