Should We Use Preoperative Epoetin-α in the Mildly Anemic Patient Undergoing Simultaneous Total Knee Arthroplasty?

Simultaneous knee arthroplasty is associated with significant blood loss. To prevent transfusion, three preoperative doses of epoetin-α were offered to mildly anemic simultaneous knee arthroplasty patients. A retrospective review, using ICD-9 codes, identified twenty patients from 2007-2009. Epoetin-α increased hemoglobin levels preoperatively (12.6 to 13.9,

Playing Offense: How Athletes are Impacting a Changing Administrative State

The start of the 2020s presents a broken American administrative system plagued by state ineptitude in a time of turmoil and government distrust. In their protests, marginalized citizens have seen their voices amplified by integral parts of their communities for whom they have cheered: Athletes. This Perspective draws attention to the idea of super citizens and their ability to influence policy. We argue that Black athlete activism that centers their social reality and legitimizes Black Lives Matter for broader populations is one example of a punctuated equilibrium that work to achieve administrative state change

The Use of Epoetin-α in Revision Knee Arthroplasty.

Introduction. To evaluate the efficacy of epoetin-α prior to revision total knee arthroplasty, we hypothesized that epoetin-α will reduce blood transfusion. Methods. Eighty-one patients were compared in this retrospective review; twenty-eight patients received our dosing regimen. All patients were mildly anemic. Epoetin-α to control (1 : 2) patient matching occurred so that one of two attending surgeons, gender, BMI, complexity of surgery, ASA score, and age were similar between groups. The clinical triggers for blood transfusion during or after the procedure were determined based on peri- and postoperative hemoglobin levels, ASA score, and/or clinical symptoms consistent with anemia. Blood salvage was not used. Results. Blood transfusion and length of stay were lower in the study group. None of the patients who received epoetin-α underwent transfusion. Hemoglobin increased from 11.97 to 13.8, preoperatively. Hemoglobin at day of surgery and time of discharge were higher. Gender, BMI, ASA score, total and hidden blood losses, calculated blood loss, preop PLT, PT, PTT, and INR were similar between groups. One Epogen patient had an uncomplicated DVT (3.6%). Conclusions. Epoetin-α may have a role in the mildly anemic revision knee patient. It may also decrease patient length of stay allowing for earlier readiness to resume normal activities and/or meet short-term milestones. A randomized study to evaluate the direct and indirect costs of such a treatment methodology in the mildly anemic revision patient may be warranted

Test Structures for Developing Packaging for Implantable Sensors

With their capacity for real time monitoring and spatial mapping, implantable sensors are becoming an increasingly important aspect of next generation precision healthcare. Microfabricated sensor systems are a popular choice, owing to their capacity for miniaturisation, repeatable mass manufacture, and numerous pre-existing sensor archetypes. Despite the drive for development, packaging these sensors for the environment within the body, as well as the implantation process itself, presents a significant challenge. This paper presents microelectronic test structures, which can be used to assess, compare, and optimise implantable packaging solutions in a standardised manner. The proposed structures are used to investigate: (i) the capacity of the material to be patterned, (ii) the permeability of the insulation material, (iii) adhesion of the encapsulant to the die, and (iv) the physical robustness of the package to implantation through a needle. They are used to characterise an example packaging strategy, using biocompatible epoxy-resin. In addition, a method of optimising the packaging performance using the test structures is presented

A Low Cost Patternable Packaging Technology for Biosensors

This paper demonstrates a simple and low cost technology to reliably and accurately package integrated chips. Microchannels and cavities of minimum feature size of 500 μm can be reliably reproduced. In addition, the curing depth in relation to the exposure time was investigated. A simple microfluidic device, consisting of a 500 μm channel and 2 mm ports, was manufactured to demonstrate the possibilities of this technology. Extensive electrochemical experiments showed that the packaging material is a good insulator and leaves no residue on the chip

Fluorescence-guided surgical system using holographic display: From phantom studies to canine patients

SIGNIFICANCE: Holographic display technology is a promising area of research that can lead to significant advancements in cancer surgery. We present the benefits of combining bioinspired multispectral imaging technology with holographic goggles for fluorescence-guided cancer surgery. Through a series of experiments with 43D-printed phantoms, small animal models of cancer, and surgeries on canine patients with head and neck cancer, we showcase the advantages of this holistic approach. AIM: The aim of our study is to demonstrate the feasibility and potential benefits of utilizing holographic display for fluorescence-guided surgery through a series of experiments involving 3D-printed phantoms and canine patients with head and neck cancer. APPROACH: We explore the integration of a bioinspired camera with a mixed reality headset to project fluorescent images as holograms onto a see-through display, and we demonstrate the potential benefits of this technology through benchtop and RESULTS: Our complete imaging and holographic display system showcased improved delineation of fluorescent targets in phantoms compared with the 2D monitor display approach and easy integration into the veterinarian surgical workflow. CONCLUSIONS: Based on our findings, it is evident that our comprehensive approach, which combines a bioinspired multispectral imaging sensor with holographic goggles, holds promise in enhancing the presentation of fluorescent information to surgeons during intraoperative scenarios while minimizing disruptions

Perceptions of competence: Age moderates views of healthy aging and Alzheimer’s disease

Background/Study Context: Older adults have more complex and differentiated views of aging than do younger adults, but less is known about age-related perceptions of Alzheimer’s disease. This study investigated age-related perceptions of competence of an older adult labeled as “in good health” (healthy) or “has Alzheimer’s disease” (AD), using a person-perception paradigm. It was predicted that older adults would provide more differentiated assessments of the two targets than would younger adults.Methods: Younger (n = 86; 18–36 years) and older (n = 66; 61–95 years) adults rated activities of daily living (ADL), instrumental activities of daily living (IADL), and memory abilities of a female target aged 75 years, described as healthy or with AD. Data on anxiety about aging, knowledge of and experience with aging and AD, knowledge of memory aging, and positive and negative biases toward aging and AD were also collected.Results: Older adults perceived the healthy target as more capable of cognitively effortful activities (e.g., managing finances) and as possessing better memory abilities than the AD target. As predicted, these differences were greater than differences between targets perceived by younger adults. The interaction effect remained significant after statistically controlling for relevant variables, including education and gender. Additionally, exploratory analyses revealed that older adults held less positively biased views of AD than younger adults, but negatively biased views were equivalent between age groups.Conclusion: The results demonstrate that mere labels of “healthy” and “Alzheimer’s disease” produce significant and subtle age differences in perceived competencies of older adults, and that biases towards AD vary by age group and valence. Our findings extend the person-perception paradigm to an integrative analysis of aging and AD, are consistent with models of adult development, and complement current research and theory on stereotypes of aging. Future directions for research on perceptions of aging are suggested

Comparison of Conventional and Maskless Lithographic Techniques for More than Moore Post-processing of Foundry CMOS Chips

This article details and compares the technology options for post-processing foundry produced CMOS at chip-scale to enable More than Moore functionality. In many cases there are attractions in using chip-based processing through the Multi-Project Wafer route that is frequently employed in research, early-stage development and low-volume production. This article identifies that spray-based photoresist deposition combined with optical maskless lithography demonstrates sufficient performance combined with low cost and operational convenience to offer an attractive alternative to conventional optical lithography, where spin-coated photoresist is exposed through a patterned photomask. [2020-0249

Optimization of Nafion Polymer Electrolyte Membrane Design and Microfabrication

Nafion is a solid electrolyte polymer that can be used as a sensor membrane in microfabricated electrochemical oxygen sensors. It allows ions to be transported between the sensor electrodes and removes the need for a liquid electrolyte. Here we used a series of small square Nafion test structures, fabricated on a variety of materials using standard thin-film patterning techniques, to optimize the design and processing of Nafion membranes. Measurements showed that the choice of photoresist developer is critical. Use of diluted MF-26A developer provided the most effective and manufacturable process. The underlying material also had an influence on robustness, with silicon dioxide and platinum giving the longest membrane lifetime under simulated conditions of use. Membrane size had no clear effect on lifetime, and under optimal processing conditions there were minimal failures even under continuous mechanical agitation for up to six weeks. We also developed test electrodes covered by Nafion, and showed that they were effective at supporting electrochemical oxygen detection