We read with interest the recent editorial, “The Hennepin Ketamine Study,” by Dr. Samuel Stratton commenting on the research ethics, methodology, and the current public controversy surrounding this study.1 As researchers and investigators of this study, we strongly agree that prospective clinical research in the prehospital environment is necessary to advance the science of Emergency Medical Services (EMS) and emergency medicine. We also agree that accomplishing this is challenging as the prehospital environment often encounters patient populations who cannot provide meaningful informed consent due to their emergent conditions. To ensure that fellow emergency medicine researchers understand the facts of our work so they may plan future studies, and to address some of the questions and concerns in Dr. Stratton’s editorial, the lay press, and in social media,2 we would like to call attention to some inaccuracies in Dr. Stratton’s editorial, and to the lay media stories on which it appears to be based.

Ho JD, Cole JB, Klein LR, Olives TD, Driver BE, Moore JC, Nystrom PC, Arens AM, Simpson NS, Hick JL, Chavez RA, Lynch WL, Miner JR. The Hennepin Ketamine Study investigators’ reply. Prehosp Disaster Med. 2019;34(2):111–113

One method to grow artificial body tissue is to place a porous scaffold seeded with cells, known as a tissue construct, into a rotating bioreactor filled with a nutrient-rich fluid. The flow within the bioreactor is affected by the movement of the construct relative to the bioreactor which, in turn, is affected by the hydrodynamical and gravitational forces the construct experiences. The construct motion is thus coupled to the flow within the bioreactor. Over the time scale of a few hours, the construct appears to move in a periodic orbit but, over tens of hours, the construct drifts from periodicity. In the biological literature, this effect is often attributed to the change in density of the construct that occurs via tissue growth. In this paper, we show that weak inertia can cause the construct to drift from its periodic orbit over the same time scale as tissue growth. We consider the coupled flow and construct motion problem within a rotating high-aspect-ratio vessel bioreactor. Using an asymptotic analysis, we investigate the case where the Reynolds number is large but the geometry of the bioreactor yields a small reduced Reynolds number, resulting in a weak inertial effect. In particular, to accurately couple the bioreactor and porous flow regions, we extend the nested boundary layer analysis of Dalwadi et al. (J. Fluid Mech., vol. 798, 2016, pp. 88–139) to include moving walls and the thin region between the porous construct and the bioreactor wall. This allows us to derive a closed system of nonlinear ordinary differential equations for the construct trajectory, from which we show that neglecting inertia results in periodic orbits; we solve the inertia-free problem analytically, calculating the periodic orbits in terms of the system parameters. Using a multiple-scale analysis, we then systematically derive a simpler system of nonlinear ordinary differential equations that describe the long-time drift of the construct due to the effect of weak inertia. We investigate the bifurcations of the construct trajectory behaviour, and the limit cycles that appear when the construct is less dense than the surrounding fluid and the rotation rate is large enough. Thus, we are able to predict when the tissue construct will drift towards a stable limit cycle within the bioreactor and when it will drift out until it hits the bioreactor edge.

The method of matched asymptotic expansions is used to study the canonical problem of steady laminar flow through a narrow two-dimensional channel blocked by a tight-fitting finite-length highly permeable porous obstacle. We investigate the behaviour of the local flow close to the interface between the single-phase and porous regions (governed by the incompressible Navier–Stokes and Darcy flow equations, respectively). We solve for the flow in these inner regions in the limits of low and high Reynolds number, facilitating an understanding of the nature of the transition from Poiseuille to plug to Poiseuille flow in each of these limits. Significant analytical progress is made in the high Reynolds number limit, and we explore in detail the rich boundary layer structure that occurs. We derive general results for the interfacial stress and for the conditions that couple the flow in the outer regions away from the interface. We consider the three-dimensional generalization to unsteady laminar flow through and around a tight-fitting highly permeable cylindrical porous obstacle within a Hele-Shaw cell. For the high Reynolds number limit, we give the coupling conditions and interfacial stress in terms of the outer flow variables, allowing information from a nonlinear three-dimensional problem to be obtained by solving a linear two-dimensional problem. Finally, we illustrate the utility of our analysis by considering the specific example of time-dependent forced far-field flow in a Hele-Shaw cell containing a porous cylinder with a circular cross-section. We determine the internal stress within the porous obstacle, which is key for tissue engineering applications, and the interfacial stress on the boundary of the porous obstacle, which has applications to biofilm erosion. In the high Reynolds number limit, we demonstrate that the fluid inertia can result in the cylinder experiencing a time-independent net force, even when the far-field forcing is periodic with zero mean.

More than 300 coots (Fulica americana) became frozen in Spring Lake, Tazewell County, Illinois, on December 1, 1985. This catastrophic event permitted 8 weeks of taphonomic observations, which showed that ice forms a stable substrate which permits terrestrial taphonomic processes to be imprinted on lacustrine deposits. Bird and mammal scavengers attacked coot carcasses in different manners, resulting in distinct disarticulation sequences. Bird scavengers preferentially fed on the head, neck, and breast-wing complex, causing early disarticulation of bones in these areas, late loss of hindlimb joints, and minimal bone damage. In contrast, mammal scavengers concentrated their attention on the hindlimb and tail region, resulting in bone breakage and early disarticulation of these body parts, but late disarticulation of the breast-wing complex. These data demonstrate that scavenger-specific feeding behaviors significantly influence disarticulation patterns early in assemblage formation, while anatomy may exert increasingly greater influence on disarticulation patterns as carasses become less attractive to scavengers. Finally, because taphonomic processes change in intensity and type through time, bone frequency and modification patterns will vary according to the time at which the patterns are arrested by burial. Thus, bone frequency and modification patterns should provide an index to the relative importance of specific biotic agents and of anatomy in fossil disarticulation patterns as well as an estimate of the time between death and burial.

N-methyl-d-aspartate receptor (NMDA-R) autoantibodies have been reported in people with acute psychosis. We hypothesised that their presence may be implicated in the aetiology of treatment-refractory psychosis. We sought to ascertain the point prevalence of NMDA-R antibody positivity in patients referred to services for treatment-refractory psychosis. We found that 3 (7.0%) of 43 individuals had low positive NMDA-R antibody titres. This suggests that NMDA-R autoantibodies are unlikely to account for a large proportion of treatment-refractory psychosis.

The transport properties of doped and undoped, high quality, plasma-assisted molecular beam epitaxy grown tin dioxide (SnO2) thin films are reviewed. Intentional doping can vary the SnO2 resistivity over more than seven orders of magnitude from a transparent conducting oxide-like conductivity up to the semi-insulating range. A region of high unintentional n-type conductivity was identified in the substrate interface region and had to be accounted for. Sb was a well-behaved shallow donor up to the regime of conducting oxides. In and Ga were too deep acceptors to achieve p-type conductivity but were suitable to render SnO2 semi-insulating. While the surface accumulation layer strongly influenced contact properties, its conductance was negligible. The methodology used here for studying the transport can also be applied to other semiconducting oxides.