Ultrasound Mapping of Stimulated Finger Flexion During Infra-Clavicular Brachial Plexus Nerve Blockade for Elbow Arthroplasty and Its Correlation To Postoperative Analgesia

Background: Infraclavicular brachial plexus nerve blockade (ICNB) is a very common anesthetic procedure performed for upper extremity surgery at the elbow and distally, however the rate of adequate analgesia is variable among patients. Ultrasound guidance (US) has not been demonstrated to increase the success rate of ICNB when compared to nerve stimulator (NS) guidance. Combined US and NS guided ICNB have not been reported, although there is a call for more trials comparing the two techniques. This study was performed to observe if a specific anatomic region near the axillary artery of the brachial plexus identified by finger flexion with nerve stimulation results in improved postoperative analgesia. Method: Patients undergoing elective elbow arthroplasty received a postoperative ICNB. The angle of the nerve stimulator needle tip and the radial distance from the center of the arterial lumen at which an optimal finger flexion twitch response was observed were measured with ultrasound imaging. Pain scores and postoperative opioid dosages on discharge from the post anesthesia care unit and at 24 hours after surgery were recorded. Results: 11 patients enrolled in this study. Adequate finger flexion response to nerve stimulation that resulted in complete analgesia was more frequently observed when the needle was located in the postero-superior quadrant in relation to the axillary artery. Identifying a specific point near the brachial plexus in relation to the artery that consistently provides superior analgesia is desirable and would lead to improved analgesia and faster onset time of nerve blockade and would reduce the need for other approaches for brachial plexus blockade with their associated disadvantages.

Assessing the Influence of Acoustic Variation on the Acquisition of Bathymetric Surveying Data

[author abstract] The field of hydrographic surveying is inherently important to achieving a true understanding of the world that underlies the vast bodies of water that cover the earth. In this study I will determine the uncertainties of depth estimates of the seafloor that relate to the survey design and sound velocity. The survey design and collection of sound velocity were all conducted of the coast of Vancouver Island, B.C. near the entrance of the Strait of Juan de Fuca. The assessment will show how the change in sound velocity over time will influence the bathymetric reading, if not corrected for. The differences in bathymetric depth readings will show a correlation to the changes in sound velocity.

High field chemistry with scanning probes

Fabricating Ge and Si integrated structures with nanoscale accuracy is a challenging pursuit essential for novel advances in electronics and photonics. While several scanning probe-based techniques have been proposed, no current technique offers control of nanostructure size, shape, placement, and chemical composition. To this end, atomic force microscope direct write uses a high electric field (> 109 V m-1) to create nanoscale features as fast as 1 cm s-1 by reacting a liquid precursor with a biased AFM tip. In this work, I present the first results on fabricating inorganic nanostructures via AFM direct write. Using diphenylgermane (DPG) and diphenylsilane (DPS), carbon-free germanium and silicon nanostructures (SIMS, x-ray PEEM) are fabricated. For this chemistry, I propose a model that involves electron capture and precursor fragmentation under the high electric field. To verify this model, experimental data and simulations are presented. High field chemistry for DPG and DPS has also been demonstrated for both sequential deposition and the creation of nanoscale heterostuctures, in addition to microscale deposition using a flexible stamp approach. This high field chemistry approach to the deposition of organometallic precursors could offer a low-cost, high throughput alternative for future optical, electronic, and photovoltaic applications.