Patient decision making in recovering from surgery

Patient work in surgery recovery is fraught with complex judgments and decisions. These decisions are not unlike ones that professionals make that we traditionally study with the Naturalistic Decision Making (NDM) theoretical lens and methods. Similarly, patients are making decisions in naturalistic settings and doing so with the objective of minimizing risk and maximizing safety. What is different is that patients are put in a position to perform complex, high level, high consequence work in the absence of any training, education, or decision support. Using a lived experience, I illustrate that the burden of judgement and decision making in surgery recovery work (e.g., caring for surgical sites, managing drains, managing medications, supporting activities of daily living) can be understood through a macrocognitive paradigm. Thus, the NDM theoretical lens and the associated methods is appropriate to study this problem space

Microchannel fluid behavior using micropolar fluid theory

Journal ArticleIn this paper, we describe microchannel fluid behavior using a numerical model based on micropolar fluid theory and experimentally verify the model using micromachined channels. The micropolar fluid theory augments the laws of classical continuum mechanics by incorporating the effects of fluid molecules on the continuum. The behavior of fluids was studied using surface micromachined rectangular metallic pipette arrays. A downstream port for static pressure measurement was used to eliminate entrance effects. The numerical model of the micropolar fluid theory compares favorably with the experimental data

Dean Flow Dynamics in Low-Aspect Ratio Spiral Microchannels

A wide range of microfluidic cell-sorting devices has emerged in recent years, based on both passive and active methods of separation. Curvilinear channel geometries are often used in these systems due to presence of secondary flows, which can provide high throughput and sorting efficiency. Most of these devices are designed on the assumption of two counter rotating Dean vortices present in the curved rectangular channels and existing in the state of steady rotation and amplitude. In this work, we investigate these secondary flows in low aspect ratio spiral rectangular microchannels and define their development with respect to the channel aspect ratio and Dean number. This work is the first to experimentally and numerically investigate Dean flows in microchannels for Re > 100, and show presence of secondary Dean vortices beyond a critical Dean number. We further demonstrate the impact of these multiple vortices on particle and cell focusing. Ultimately, this work offers new insights into secondary flow instabilities for low-aspect ratio, spiral microchannels, with improved flow models for design of more precise and efficient microfluidic devices for applications such as cell sorting and micromixing

Manganese in residential drinking water from a community-initiated case study in Massachusetts

Background: Manganese (Mn) is a metal commonly found in drinking water, but the level that is safe for consumption is unknown. In the United States (U.S.), Mn is not regulated in drinking water and data on water Mn concentrations are temporally and spatially sparse. Objective: Examine temporal and spatial variability of Mn concentrations in repeated tap water samples in a case study of Holliston, Massachusetts (MA), U.S., where drinking water is pumped from shallow aquifers that are vulnerable to Mn contamination. Methods: We collected 79 residential tap water samples from 21 households between September 2018 and December 2019. Mn concentrations were measured using inductively coupled plasma mass spectrometry. We calculated descriptive statistics and percent of samples exceeding aesthetic (secondary maximum containment level; SMCL) and lifetime health advisory (LHA) guidelines of 50 µg/L and 300 µg/L, respectively. We compared these concentrations to concurrent and historic water Mn concentrations from publicly available data across MA. Results: The median Mn concentration in Holliston residential tap water was 2.3 µg/L and levels were highly variable (range: 0.03–5,301.8 µg/L). Mn concentrations exceeded the SMCL and LHA in 14% and 12% of samples, respectively. Based on publicly available data across MA from 1994–2022, median Mn concentration was 17.0 µg/L (N = 37,210; range: 1–159,000 µg/L). On average 40% of samples each year exceeded the SMCL and 9% exceeded the LHA. Samples from publicly available data were not evenly distributed between MA towns or across sampling years. Impact statement: This study is one of the first to examine Mn concentrations in drinking water both spatially and temporally in the U.S. Findings suggest that concentrations of Mn in drinking water frequently exceed current guidelines and occur at concentrations shown to be associated with adverse health outcomes, especially for vulnerable and susceptible subpopulations like children. Future studies that comprehensively examine exposure to Mn in drinking water and its associations with children’s health are needed to protect public health. © 2023, The Author(s)

The Patient in Patient Safety: Clinicians’ Experiences Engaging Patients as Partners in Safety

Patients and families play a role in the safety of care provided across clinical settings, highlighting the need to understand clinician perspectives and experiences related to their engagement. Through a panel discussion entitled, The Patient in Patient Safety: Clinicians’ Experiences Engaging Patients as Partners in Safety, we elicited clinician perspectives that have implications for human factors relevance in both, research and solution development/evaluation. We provide an overview of the panel including participants, format and content, and the resulting discussion

Electroosmotic flow of biorheological micropolar fluids through microfluidic channels

An analysis is presented in this work to assess the influence of micropolar nature of fluids in fully developed flow induced by electrokinetically driven peristaltic pumping through a parallel plate microchannel. The walls of the channel are assumed as sinusoidal wavy to analyze the peristaltic flow nature. We consider that the wavelength of the wall motion is much larger as compared to the channel width to validate the lubrication theory. To simplify the Poisson Boltzmann equation, we also use the Debye-Hückel linearization (i.e. wall zeta potential ≤ 25mV). We consider governing equation for micropolar fluid in absence of body force and couple effects however external electric field is employed. The solutions for axial velocity, spin velocity, flow rate, pressure rise and stream functions subjected to given physical boundary conditions are computed. The effects of pertinent parameters like Debye length and Helmholtz-Smoluchowski velocity which characterize the EDL phenomenon and external electric field, coupling number and micropolar parameter which characterize the micropolar fluid behavior, on peristaltic pumping are discussed through the illustrations. The results show that peristaltic pumping may alter by applying external electric fields. This model can be used to design and engineer the peristalsis-lab-on-chip and micro peristaltic syringe pumps for biomedical applications

Debye-Hueckel solution for steady electro-osmotic flow of a micropolar fluid in a cylindrical microcapillary

Analytic expressions for the speed, flux, microrotation, stress, and couple stress in a micropolar fluid exhibiting steady, symmetric and one-dimensional electro-osmotic flow in a uniform cylindrical microcapillary were derived under the constraint of the Debye-Hueckel approximation, which is applicable when the cross-sectional radius of the microcapillary exceeds the Debye length, provided that the zeta potential is sufficiently small in magnitude. As the aciculate particles in a micropolar fluid can rotate without translation, micropolarity influences fluid speed, fluid flux, and one of the two non-zero components of the stress tensor. The axial speed in a micropolar fluid intensifies as the radius increases. The stress tensor is confined to the region near the wall of the microcapillary but the couple stress tensor is uniform across the cross-section.Comment: 19 page

A pressure drop correlation for low Reynolds number Newtonian flows through a rectangular orifice in a similarly shaped micro-channel

Current microfabrication methods mean that rectangular orifices in similarly shaped micro-channels are often found in microfluidic devices. The power required to overcome the pressure drop across such orifices is often of importance. In the contribution reported here, numerical results for low Reynolds number incompressible Newtonian fluid flow through rectangular orifice in similarly shaped micro-channel have been used to develop a correlation for pressure drop arising from the orifice. The correlation, which was motivated by theoretical developments, indicates that the pressure drop is proportional to the average velocity through the orifice, and a function of the orifice contraction ratio, length-to-width ratio and, most particularly, aspect ratio.V. Zivkovic, P. Zerna, Z.T. Alwahabi, M.J. Bigg

Heterogeneous Immunoassay Using Channels and Droplets in a Digital Microfluidic Platform

This work presents a heterogeneous immunoassay using the integrated functionalities of a channel and droplets in a digital microfluidic (DMF) platform. Droplet functionality in DMF allows for the programmable manipulation of discrete sample and reagent droplets in the range of nanoliters. Pressure-driven channels become advantageous over droplets when sample must be washed, as the supernatant can be thoroughly removed in a convenient and rapid manner while the sample is immobilized. Herein, we demonstrate a magnetic bead-based, enzyme-linked immunosorbent assay (ELISA) using ~60 nL of human interleukin-6 (IL-6) sample. The wash buffer was introduced in the form of a wall-less virtual electrowetting channel by a syringe pump at the flow rate of 10 μL/min with ~100% bead retention rate. Critical parameters such as sample wash flow rate and bead retention rate were optimized for reliable assay results. A colorimetric readout was analyzed in the International Commission on Illumination (CIE) color space without the need for costly equipment. The concepts presented in this work are potentially applicable in rapid neonatal disease screening using a finger prick blood sample in a DMF platform