1
|
Mycroft-West CJ, Devlin AJ, Cooper LC, Guimond SE, Procter P, Miller GJ, Guerrini M, Fernig DG, Yates EA, Lima MA, Skidmore MA. A sulphated glycosaminoglycan extract from Placopecten magellanicus inhibits the Alzheimer's disease β-site amyloid precursor protein cleaving enzyme 1 (BACE-1). Carbohydr Res 2023; 525:108747. [PMID: 36773398 DOI: 10.1016/j.carres.2023.108747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 10/05/2022] [Accepted: 01/19/2023] [Indexed: 01/27/2023]
Abstract
The clinically important anticoagulant heparin, a member of the glycosaminoglycan family of carbohydrates that is extracted predominantly from porcine and bovine tissue sources, has previously been shown to inhibit the β-site amyloid precursor protein cleaving enzyme 1 (BACE-1), a key drug target in Alzheimer's Disease. In addition, heparin has been shown to exert favourable bioactivities through a number of pathophysiological pathways involved in the disease processes of Alzheimer's Disease including inflammation, oxidative stress, tau phosphorylation and amyloid peptide generation. Despite the multi-target potential of heparin as a therapeutic option for Alzheimer's disease, the repurposing of this medically important biomolecule has to-date been precluded by its high anticoagulant potential. An alternative source to mammalian-derived glycosaminoglycans are those extracted from marine environments and these have been shown to display an expanded repertoire of sequence-space and heterogeneity compared to their mammalian counterparts. Furthermore, many marine-derived glycosaminoglycans appear to retain favourable bioactivities, whilst lacking the high anticoagulant potential of their mammalian counterparts. Here we describe a sulphated, marine-derived glycosaminoglycan extract from the Atlantic Sea Scallop, Placopecten magellanicus that displays high inhibitory potential against BACE-1 (IC50 = 4.8 μg.mL-1) combined with low anticoagulant activity; 25-fold less than that of heparin. This extract possesses a more favourable therapeutic profile compared to pharmaceutical heparin of mammalian provenance and is composed of a mixture of heparan sulphate (HS), with a high content of 6-sulphated N-acetyl glucosamine (64%), and chondroitin sulphate.
Collapse
Affiliation(s)
- Courtney J Mycroft-West
- Centre for Glycoscience Research and Training, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Anthony J Devlin
- Centre for Glycoscience Research and Training, Keele University, Keele, Staffordshire, ST5 5BG, UK; Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Via G. Colombo 81, 20133, Milan, Italy.
| | - Lynsay C Cooper
- University of Gloucestershire, Francis Close Hall Campus, Swindon Rd, Cheltenham, GL50 4AZ, UK.
| | - Scott E Guimond
- Centre for Glycoscience Research and Training, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Patricia Procter
- Centre for Glycoscience Research and Training, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Gavin J Miller
- Centre for Glycoscience Research and Training, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Marco Guerrini
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Via G. Colombo 81, 20133, Milan, Italy.
| | - David G Fernig
- Department of Biochemistry and Systems Biology, ISMIB, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK.
| | - Edwin A Yates
- Department of Biochemistry and Systems Biology, ISMIB, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK.
| | - Marcelo A Lima
- Centre for Glycoscience Research and Training, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Mark A Skidmore
- Centre for Glycoscience Research and Training, Keele University, Keele, Staffordshire, ST5 5BG, UK; Department of Biochemistry and Systems Biology, ISMIB, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK.
| |
Collapse
|
2
|
Mycroft-West CJ, Devlin AJ, Cooper LC, Guimond SE, Procter P, Guerrini M, Miller GJ, Fernig DG, Yates EA, Lima MA, Skidmore MA. Glycosaminoglycans from Litopenaeus vannamei Inhibit the Alzheimer's Disease β Secretase, BACE1. Mar Drugs 2021; 19:203. [PMID: 33916819 PMCID: PMC8067017 DOI: 10.3390/md19040203] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
Only palliative therapeutic options exist for the treatment of Alzheimer's Disease; no new successful drug candidates have been developed in over 15 years. The widely used clinical anticoagulant heparin has been reported to exert beneficial effects through multiple pathophysiological pathways involved in the aetiology of Alzheimer's Disease, for example, amyloid peptide production and clearance, tau phosphorylation, inflammation and oxidative stress. Despite the therapeutic potential of heparin as a multi-target drug for Alzheimer's disease, the repurposing of pharmaceutical heparin is proscribed owing to the potent anticoagulant activity of this drug. Here, a heterogenous non-anticoagulant glycosaminoglycan extract, obtained from the shrimp Litopenaeus vannamei, was found to inhibit the key neuronal β-secretase, BACE1, displaying a more favorable therapeutic ratio compared to pharmaceutical heparin when anticoagulant activity is considered.
Collapse
Affiliation(s)
- Courtney J. Mycroft-West
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK; (C.J.M.-W.); (A.J.D.); (L.C.C.); (P.P.); (M.A.L.)
| | - Anthony J. Devlin
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK; (C.J.M.-W.); (A.J.D.); (L.C.C.); (P.P.); (M.A.L.)
| | - Lynsay C. Cooper
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK; (C.J.M.-W.); (A.J.D.); (L.C.C.); (P.P.); (M.A.L.)
| | - Scott E. Guimond
- School of Medicine, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK;
| | - Patricia Procter
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK; (C.J.M.-W.); (A.J.D.); (L.C.C.); (P.P.); (M.A.L.)
| | - Marco Guerrini
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, via G. Colombo 81, 20133 Milan, Italy;
| | - Gavin J. Miller
- School of Chemistry, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK;
| | - David G. Fernig
- Department of Biochemistry and Systems Biology, ISMIB, University of Liverpool, Crown Street, Liverpool L69 7ZB, UK; (D.G.F.); (E.A.Y.)
| | - Edwin A. Yates
- Department of Biochemistry and Systems Biology, ISMIB, University of Liverpool, Crown Street, Liverpool L69 7ZB, UK; (D.G.F.); (E.A.Y.)
| | - Marcelo A. Lima
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK; (C.J.M.-W.); (A.J.D.); (L.C.C.); (P.P.); (M.A.L.)
| | - Mark A. Skidmore
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK; (C.J.M.-W.); (A.J.D.); (L.C.C.); (P.P.); (M.A.L.)
- Department of Biochemistry and Systems Biology, ISMIB, University of Liverpool, Crown Street, Liverpool L69 7ZB, UK; (D.G.F.); (E.A.Y.)
| |
Collapse
|
3
|
Mycroft-West CJ, Su D, Pagani I, Rudd TR, Elli S, Gandhi NS, Guimond SE, Miller GJ, Meneghetti MCZ, Nader HB, Li Y, Nunes QM, Procter P, Mancini N, Clementi M, Bisio A, Forsyth NR, Ferro V, Turnbull JE, Guerrini M, Fernig DG, Vicenzi E, Yates EA, Lima MA, Skidmore MA. Heparin Inhibits Cellular Invasion by SARS-CoV-2: Structural Dependence of the Interaction of the Spike S1 Receptor-Binding Domain with Heparin. Thromb Haemost 2020; 120:1700-1715. [PMID: 33368089 PMCID: PMC7869224 DOI: 10.1055/s-0040-1721319] [Citation(s) in RCA: 181] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
The dependence of development and homeostasis in animals on the interaction of hundreds of extracellular regulatory proteins with the peri- and extracellular glycosaminoglycan heparan sulfate (HS) is exploited by many microbial pathogens as a means of adherence and invasion. Heparin, a widely used anticoagulant drug, is structurally similar to HS and is a common experimental proxy. Exogenous heparin prevents infection by a range of viruses, including S-associated coronavirus isolate HSR1. Here, we show that heparin inhibits severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) invasion of Vero cells by up to 80% at doses achievable through prophylaxis and, particularly relevant, within the range deliverable by nebulisation. Surface plasmon resonance and circular dichroism spectroscopy demonstrate that heparin and enoxaparin, a low-molecular-weight heparin which is a clinical anticoagulant, bind and induce a conformational change in the spike (S1) protein receptor-binding domain (S1 RBD) of SARS-CoV-2. A library of heparin derivatives and size-defined fragments were used to probe the structural basis of this interaction. Binding to the RBD is more strongly dependent on the presence of 2-O or 6-O sulfate groups than on N-sulfation and a hexasaccharide is the minimum size required for secondary structural changes to be induced in the RBD. It is likely that inhibition of viral infection arises from an overlap between the binding sites of heparin/HS on S1 RBD and that of the angiotensin-converting enzyme 2. The results suggest a route for the rapid development of a first-line therapeutic by repurposing heparin and its derivatives as antiviral agents against SARS-CoV-2 and other members of the Coronaviridae.
Collapse
Affiliation(s)
- Courtney J. Mycroft-West
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Dunhao Su
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Isabel Pagani
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Timothy R. Rudd
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Potters Bar, Hertfordshire, United Kingdom
| | - Stefano Elli
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - Neha S. Gandhi
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Scott E. Guimond
- School of Medicine, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Gavin J. Miller
- School of Chemical and Physical Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Maria C. Z. Meneghetti
- Biochemistry Department, Federal University of São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Helena B. Nader
- Biochemistry Department, Federal University of São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Yong Li
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Quentin M. Nunes
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Patricia Procter
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | | | | | - Antonella Bisio
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - Nicholas R. Forsyth
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Hartshill, Stoke-on-Trent, Staffordshire, United Kingdom
| | - Vito Ferro
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
| | - Jeremy E. Turnbull
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Marco Guerrini
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - David G. Fernig
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Elisa Vicenzi
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edwin A. Yates
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Marcelo A. Lima
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Mark A. Skidmore
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
4
|
Mycroft-West CJ, Su D, Pagani I, Rudd TR, Elli S, Gandhi NS, Guimond SE, Miller GJ, Meneghetti MCZ, Nader HB, Li Y, Nunes QM, Procter P, Mancini N, Clementi M, Bisio A, Forsyth NR, Ferro V, Turnbull JE, Guerrini M, Fernig DG, Vicenzi E, Yates EA, Lima MA, Skidmore MA. Heparin Inhibits Cellular Invasion by SARS-CoV-2: Structural Dependence of the Interaction of the Spike S1 Receptor-Binding Domain with Heparin. Thromb Haemost 2020; 120:1700-1715. [PMID: 33368089 DOI: 10.1101/2020.04.28.066761] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The dependence of development and homeostasis in animals on the interaction of hundreds of extracellular regulatory proteins with the peri- and extracellular glycosaminoglycan heparan sulfate (HS) is exploited by many microbial pathogens as a means of adherence and invasion. Heparin, a widely used anticoagulant drug, is structurally similar to HS and is a common experimental proxy. Exogenous heparin prevents infection by a range of viruses, including S-associated coronavirus isolate HSR1. Here, we show that heparin inhibits severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) invasion of Vero cells by up to 80% at doses achievable through prophylaxis and, particularly relevant, within the range deliverable by nebulisation. Surface plasmon resonance and circular dichroism spectroscopy demonstrate that heparin and enoxaparin, a low-molecular-weight heparin which is a clinical anticoagulant, bind and induce a conformational change in the spike (S1) protein receptor-binding domain (S1 RBD) of SARS-CoV-2. A library of heparin derivatives and size-defined fragments were used to probe the structural basis of this interaction. Binding to the RBD is more strongly dependent on the presence of 2-O or 6-O sulfate groups than on N-sulfation and a hexasaccharide is the minimum size required for secondary structural changes to be induced in the RBD. It is likely that inhibition of viral infection arises from an overlap between the binding sites of heparin/HS on S1 RBD and that of the angiotensin-converting enzyme 2. The results suggest a route for the rapid development of a first-line therapeutic by repurposing heparin and its derivatives as antiviral agents against SARS-CoV-2 and other members of the Coronaviridae.
Collapse
Affiliation(s)
- Courtney J Mycroft-West
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Dunhao Su
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Isabel Pagani
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Timothy R Rudd
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Potters Bar, Hertfordshire, United Kingdom
| | - Stefano Elli
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - Neha S Gandhi
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Scott E Guimond
- School of Medicine, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Gavin J Miller
- School of Chemical and Physical Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Maria C Z Meneghetti
- Biochemistry Department, Federal University of São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Helena B Nader
- Biochemistry Department, Federal University of São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Yong Li
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Quentin M Nunes
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Patricia Procter
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | | | | | - Antonella Bisio
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - Nicholas R Forsyth
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Hartshill, Stoke-on-Trent, Staffordshire, United Kingdom
| | - Vito Ferro
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
| | - Jeremy E Turnbull
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Marco Guerrini
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - David G Fernig
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Elisa Vicenzi
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edwin A Yates
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Marcelo A Lima
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Mark A Skidmore
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
5
|
Mycroft-West CJ, Devlin AJ, Cooper LC, Procter P, Miller GJ, Fernig DG, Guerrini M, Guimond SE, Lima MA, Yates EA, Skidmore MA. Inhibition of BACE1, the β-secretase implicated in Alzheimer's disease, by a chondroitin sulfate extract from Sardina pilchardus. Neural Regen Res 2020; 15:1546-1553. [PMID: 31997821 PMCID: PMC7059579 DOI: 10.4103/1673-5374.274341] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/23/2019] [Accepted: 10/26/2019] [Indexed: 12/24/2022] Open
Abstract
The pharmaceutical and anticoagulant agent heparin, a member of the glycosaminoglycan family of carbohydrates, has previously been identified as a potent inhibitor of a key Alzheimer's disease drug target, the primary neuronal β-secretase, β-site amyloid precursor protein cleaving enzyme 1 (BACE1). The anticoagulant activity of heparin has, however, precluded the repurposing of this widely used pharmaceutical as an Alzheimer's disease therapeutic. Here, a glycosaminoglycan extract, composed predominantly of 4-sulfated chondroitin sulfate, has been isolated from Sardina pilchardus, which possess the ability to inhibit BACE1 (IC50 [half maximal inhibitory concentration] = 4.8 μg/mL), while displaying highly attenuated anticoagulant activities (activated partial thromboplastin time EC50 [median effective concentration] = 403.8 μg/mL, prothrombin time EC50 = 1.3 mg/mL). The marine-derived, chondroitin sulfate extract destabilizes BACE1, determined via differential scanning fluorimetry (ΔTm -5°C), to a similar extent as heparin, suggesting that BACE1 inhibition by glycosaminoglycans may occur through a common mode of action, which may assist in the screening of glycan-based BACE1 inhibitors for Alzheimer's disease.
Collapse
Affiliation(s)
- Courtney J. Mycroft-West
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
| | - Anthony J. Devlin
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
| | - Lynsay C. Cooper
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
| | - Patricia Procter
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
| | - Gavin J. Miller
- Lennard-Jones Laboratory, School of Chemical and Physical Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - David G. Fernig
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK
| | - Marco Guerrini
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Via G. Colombo 81, 20133 Milan, Italy
| | - Scott E. Guimond
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK
- School of Medicine, Keele, Staffordshire, ST5 5BG, UK
| | - Marcelo A. Lima
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
| | - Edwin A. Yates
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK
| | - Mark Andrew Skidmore
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK
- School of Medicine, Keele, Staffordshire, ST5 5BG, UK
| |
Collapse
|
6
|
Devlin A, Mycroft-West C, Procter P, Cooper L, Guimond S, Lima M, Yates E, Skidmore M. Tools for the Quality Control of Pharmaceutical Heparin. Medicina (Kaunas) 2019; 55:E636. [PMID: 31557911 PMCID: PMC6843833 DOI: 10.3390/medicina55100636] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/02/2019] [Accepted: 09/04/2019] [Indexed: 11/25/2022]
Abstract
Heparin is a vital pharmaceutical anticoagulant drug and remains one of the few naturally sourced pharmaceutical agents used clinically. Heparin possesses a structural order with up to four levels of complexity. These levels are subject to change based on the animal or even tissue sources that they are extracted from, while higher levels are believed to be entirely dynamic and a product of their surrounding environments, including bound proteins and associated cations. In 2008, heparin sources were subject to a major contamination with a deadly compound-an over-sulphated chondroitin sulphate polysaccharide-that resulted in excess of 100 deaths within North America alone. In consideration of this, an arsenal of methods to screen for heparin contamination have been applied, based primarily on the detection of over-sulphated chondroitin sulphate. The targeted nature of these screening methods, for this specific contaminant, may leave contamination by other entities poorly protected against, but novel approaches, including library-based chemometric analysis in concert with a variety of spectroscopic methods, could be of great importance in combating future, potential threats.
Collapse
Affiliation(s)
- Anthony Devlin
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK.
| | - Courtney Mycroft-West
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK.
| | - Patricia Procter
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK.
| | - Lynsay Cooper
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK.
| | - Scott Guimond
- Institute for Science and Technology in Medicine, Keele University, Keele, Staffordshire ST5 5BG, UK.
- School of Biological Sciences, University of Liverpool, Crown Street, Liverpool L69 7ZB, UK.
| | - Marcelo Lima
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK.
| | - Edwin Yates
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK.
- School of Biological Sciences, University of Liverpool, Crown Street, Liverpool L69 7ZB, UK.
| | - Mark Skidmore
- Molecular & Structural Biosciences, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire ST5 5BG, UK.
- Institute for Science and Technology in Medicine, Keele University, Keele, Staffordshire ST5 5BG, UK.
- School of Biological Sciences, University of Liverpool, Crown Street, Liverpool L69 7ZB, UK.
| |
Collapse
|
7
|
Abstract
Sheffield University has recently introduced a new Health Informatics Masters degree by distance learning. This paper documents the initial experiences of setting up, managing and delivering this course. The three parts of the paper cover motivation and background, design and content, and the issues, observations and problems relating to the course respectively. The latter relate to the logistics of delivery and how best to utilize the features of WebCT, and also how to meet the aspirations of students from a wide range of backgrounds.
Collapse
Affiliation(s)
- R. Bacigalupo
- Centre for Health Information Management Research (CHIMR), Department of Information Studies, University of Sheffield, Sheffield, UK,
| | - P. Bath
- Centre for Health Information Management Research (CHIMR), Department of Information Studies, University of Sheffield, Sheffield, UK,
| | - A. Booth
- School of Health and Related Research (ScHARR), Sheffield, UK,
| | - B. Eaglestone
- Centre for Health Information Management Research (CHIMR), Department of Information Studies, University of Sheffield, Sheffield, UK,
| | - P. Procter
- School of Nursing and Midwifery, University of Sheffield, Sheffield, UK,
| |
Collapse
|
8
|
Bayon Y, Bohner M, Eglin D, Procter P, Richards RG, Weber J, Zeugolis DI. Innovating in the medical device industry - challenges & opportunities ESB 2015 translational research symposium. J Mater Sci Mater Med 2016; 27:144. [PMID: 27552808 DOI: 10.1007/s10856-016-5759-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
The European Society for Biomaterials 2015 Translational Research Symposium focused on 'Innovating in the Medical Device Industry - Challenges & Opportunities' from different perspectives, i.e., from a non-profit research organisation to a syndicate of small and medium-sized companies and large companies. Lecturers from regulatory consultants, industry and research institutions described the innovation process and regulatory processes (e.g., 510K, PMA, combination product) towards market approval. The aim of the present article is to summarise and explain the main statements made during the symposium, in terms of challenges and opportunities for medical device industries, in a constantly changing customer and regulatory environment.
Collapse
Affiliation(s)
- Y Bayon
- Medtronic - Sofradim Production, 116 Avenue du Formans, Trévoux, 01600, France.
| | - M Bohner
- Dr Robert Mathys Foundation, Bischmattstr. 12, Bettlach, CH-2544, Switzerland
| | - D Eglin
- AO Research Institute Davos, Clavadelerstrasse 8, Davos, 7270, Switzerland
| | - P Procter
- Medical Device Industry Consultant, Divonne les Bains, 01220, France
| | - R G Richards
- AO Research Institute Davos, Clavadelerstrasse 8, Davos, 7270, Switzerland
| | - J Weber
- Boston Scientific, Martinolaan 50, Maastricht, 6229GS, Netherlands
| | - D I Zeugolis
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), National University of Ireland Galway (NUI Galway), Galway, Ireland
- Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway (NUI Galway), Galway, Ireland
| |
Collapse
|
9
|
Bacigalupo R, Bath P, Booth A, Eaglestone BM, Levy P, Procter P. Studying Health Information from a Distance: The Impact of a Multimedia Case Study. Health Informatics J 2016. [DOI: 10.1177/1460458203009001001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper describes a project to enhance the learning experience of students, in which a multimedia healthcare case study and associated tasks are being developed and evaluated within the Distance Learning MSc in Health Informatics programme at the University of Sheffield. The paper provides background context and motivation for the case study, followed by a description of its content, which is based upon a general practice change management scenario. The way in which this material was researched and developed is reviewed, covering rationale, methodology and the strategy for evaluation. Early evaluation suggests that the introduction of the case study is having a positive effect on the problem of isolation experienced by students on distance learning courses. The paper also reflects on the overheads of this project. Those with substantial experience in computer-assisted learning should be involved at an early stage, and planning and sequencing of both the case study itself and between the case study and the course should be given attention. The paper concludes that benefits of the approach are significant, and include better integration of course modules, shared decision making and group problem solving.
Collapse
|
10
|
Bayon Y, Bohner M, Eglin D, Thérin M, Montali A, Procter P, Fisher J, Richards RG. Progressing innovation in biomaterials. From the bench to the bed of patients. J Mater Sci Mater Med 2015; 26:228. [PMID: 26329819 DOI: 10.1007/s10856-015-5562-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 08/25/2015] [Indexed: 06/05/2023]
Abstract
A Translational Research Symposium was organized at the 2014 annual meeting of the European society for biomaterials. This brought together leading Tier one companies in clinical biomaterials and medical device markets, small and medium enterprises and entrepreneurial academics who shared their experiences on taking biomaterials technologies to commercial endpoints, in the clinics. The symposium focused on "Progressing Innovation in Biomaterials. From the Bench to the Bed of Patients". The aim of the present document is to illustrate the content of the symposium and to highlight the key lessons from selected lectures.
Collapse
Affiliation(s)
- Y Bayon
- Covidien - Sofradim Production, 116 Avenue du Formans, 01600, Trévoux, France,
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Hughes CM, Bordush A, Robioneck B, Procter P, Brown CJ. Bone Anchors—A Preliminary Finite Element Study of Some Factors Affecting Pullout. J Med Device 2014. [DOI: 10.1115/1.4026901] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Bone anchors (or suture anchors) are used to provide attachment points for sutures to connect tissue such as tendons or ligaments to bone, and work by engaging a threaded portion—sometimes tapered—to the cancellous and/or cortical bone. Such repair is often needed after trauma, or as part of reconstructive surgery. This paper uses the finite element method to compare the pullout characteristics of one common type of bone anchor in different cancellous bone structures. Finite element models are created by using computed tomography (CT) scans of cancellous bone and building computer-aided design (CAD) models to define the cancellous bone geometry. Orthopedic surgeons will sometimes remove parts of the cortical shell and this paper also examines the mechanical effects of decortication. Furthermore, the importance of the connection between anchor and cortical layer is examined. One of the key outcomes from the model is that the coefficient of friction between bone and anchor determines potential mechanisms of pullout. The stiffness of anchors and the effect of the cortical layer are presented for different pullout angles to obtain the theoretical response. The results show the detailed modeling that includes the micro-architecture of the cancellous bone is necessary to capture the large variations that can exist.
Collapse
Affiliation(s)
- C. M. Hughes
- School of Engineering and Design, Brunel University, Uxbridge UB8 3PH, UK e-mail:
| | - A. Bordush
- Stryker Osteosynthesis, Schönkirchen 24232, Germany e-mail:
| | - B. Robioneck
- Stryker Osteosynthesis, Schönkirchen 24232, Germany e-mail:
| | - P. Procter
- Stryker Osteosynthesis, Schönkirchen 24232, Germany e-mail:
| | - C. J. Brown
- School of Engineering and Design, Brunel University, Uxbridge UB8 3PH, UK e-mail:
| |
Collapse
|
12
|
Abstract
This paper presents a finite element (FE) model to identify parameters that affect the performance of an improved cancellous bone screw fixation technique, and hence potentially improve fracture treatment. In cancellous bone of low apparent density, it can be difficult to achieve adequate screw fixation and hence provide stable fracture fixation that enables bone healing. Data from predictive FE models indicate that cements can have a significant potential to improve screw holding power in cancellous bone. These FE models are used to demonstrate the key parameters that determine pull-out strength in a variety of screw, bone and cement set-ups, and to compare the effectiveness of different configurations. The paper concludes that significant advantages, up to an order of magnitude, in screw pull-out strength in cancellous bone might be gained by the appropriate use of a currently approved calcium phosphate cement.
Collapse
Affiliation(s)
- C J Brown
- School of Engineering and Design, Brunel University, Uxbridge, UB8 3PH, UK.
| | | | | | | | | |
Collapse
|
13
|
Simpson DJ, Brown CJ, Yettram AL, Procter P, Andrew GJ. Finite element analysis of intramedullary devices: The effect of the gap between the implant and the bone. Proc Inst Mech Eng H 2008; 222:333-45. [DOI: 10.1243/09544119jeim337] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper examines the interaction interface between the implant and the bone for an intramedullary femoral nailing system using a finite element (FE) model and specifically considers the hypothesis that the local geometry at the interface is significant to the resulting localized contact stress between the medial and lateral aspect of nail and endosteum. Contact mechanics algorithms are used in the FE modelling technique that can be developed to deal with any form of intramedullary device for which contact at the bone—implant interface is important. Global stiffness data from the FE model are compared with available data from an experiment carried out on a construct of the bone and the device that uses intramedullary femoral nails. Acceptable agreement is obtained. The results demonstrate that the mechanical interface between the implant and the bone is significantly affected by the gap geometry and magnitude. In particular, larger gaps lead to greater concentrations of stress on the medial side, while the distribution of stress is more uniform at the lateral contacts. Furthermore, the results show that the gap can have a marked effect on the stresses that occur on the fracture plane.
Collapse
Affiliation(s)
- D J Simpson
- Oxford Orthopaedic Engineering Centre, Nuffield Department of Orthopaedic Surgery, University of Oxford, Oxford, UK
| | - C J Brown
- School of Engineering and Design, Brunel University, Uxbridge, UK
| | - A L Yettram
- School of Engineering and Design, Brunel University, Uxbridge, UK
| | - P Procter
- School of Engineering and Design, Brunel University, Uxbridge, UK
| | - G J Andrew
- Department of Orthopaedics, Ysbyty Gwynedd, Bangor, UK
| |
Collapse
|
14
|
Abstract
OBJECTIVE To investigate the structural integrity of intramedullary nails with two lag screws, and to give guidance to orthopaedic surgeons in the choice of appropriate devices. DESIGN Alternative designs of the construct are considered, and the use of a slotted upper lag screw insertion hole is analysed. BACKGROUND Intramedullary fixation devices with a single lag screw have been known to fail at the lag screw insertion hole. Using two lag screws is considered. It has also been proposed to use a slot in the nail for the upper lag screw to prevent the upper lag screw from sticking. METHODS Bending and torsion load cases are analysed using finite element method. Consideration of both load conditions is essential. RESULTS The results present the overall stiffness of the assembly, the load sharing between lag screws, and the possibility for cut-out to occur. CONCLUSIONS While the slot for the upper lag screw might be advantageous with regard to the stresses in the lag screws, it could be detrimental for cut-out occurring adjacent to the lag screws. RELEVANCE Comparative analyses demonstrate that two lag screws may be advantageous in patients whose cancellous bone quality is good and who impose large loads on the lag screw/nail interface. However, the use of two screws might pre-dispose to failure by cut-out of the lag screws. The addition of a slotted hole for the upper lag screw appears to do nothing significant to reduce the risk of such a failure.
Collapse
Affiliation(s)
- C J Brown
- Department of Mechanical Engineering, Brunel University, Uxbridge, UB8 3PH, UK.
| | | | | | | |
Collapse
|
15
|
|
16
|
Abstract
Intramedullary nails are used to stabilise fractures of the proximal femur. The nail acts by transferring loads from the proximal fraction to the rest of the femoral shaft. The way in which this occurs depends to a large extent on the design of the distal end of the nail. This is not dissimilar to the situation with regard to load shedding (or load transfer) from the femoral component of a total hip replacement. A finite element model of a fractured femur with either a neck or a subtrochanteric fracture is set up to investigate the effects of nail length, nail distal stiffness and material stiffness on the structural behaviour of the system. Specifically what is considered is the influence of these parameters on the stress across the fracture and the normal pressure that the nail exerts on the endosteum of the femoral diaphysis. It is found that a longer nail could produce higher contact stress between the tip of the nail and the endosteum. Also, this contact stress is reduced when the distal region of the nail is made more flexible either by incorporating longitudinal slots or by using a material with a lower modulus of elasticity.
Collapse
Affiliation(s)
- C J Wang
- Department of Mechanical Engineering, Brunel University, UB8 3PH, Uxbridge, Middlesex, UK
| | | | | | | |
Collapse
|
17
|
Kokol P, Brumec V, Habjanic A, Turk DM, Procter P, Nicklin L. Intelligent systems for nursing education. Stud Health Technol Inform 2002; 84:1047-51. [PMID: 11604891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Health care is one of the fastest growing areas in terms of care, treatment and the exploitation of new technology in Slovenia. There is a great need for new approaches ensuring that education and work of health care professionals will be built upon the state of the art in nursing. As a consequence the educational, governmental and "industrial" institutions from Slovenia, UK, Italy and Greece have determined to work on above problem. EU agreed to support the project under the Phare Tempus Framework and the aim of this paper is to present an educational approach based on intelligent systems and its application in nursing education.
Collapse
Affiliation(s)
- P Kokol
- University of Maribor, Smetanova 17, 2000 Maribor, Slovenia.
| | | | | | | | | | | |
Collapse
|
18
|
Abstract
Failures of proximal femoral nails that treat unstable femoral fractures have been reported. In this communication, a finite element model to include a proximal femoral nail within a fractured femur was used to carry out preliminary investigations into configurations of single or double lag screws. The effects of the different types of fracture were investigated. The results show that in order to share the load evenly between two lag screws, a good configuration seems to be to have a slightly larger screw above the lower screw. This also ameliorates stresses in the nail at the lag screw insertion holes. However, using two screws in this way can lead to large stresses in the cancellous bone in the femoral head, and these stresses may be significant in the initiation of cut-out.
Collapse
Affiliation(s)
- C J Wang
- Department of Mechanical Engineering, Brunel University, Uxbridge UB8 3PH, UK
| | | | | | | |
Collapse
|
19
|
Kraner M, Emery D, Cvetkovic SR, Procter P, Smythe C. Information and communication systems for the assistance of carers based on ACTION. Med Inform Internet Med 1999; 24:233-48. [PMID: 10674415 DOI: 10.1080/146392399298267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Recent advances in telecommunication technologies allow the design of information and communication systems for people who are caring for others in the home as family members or as professionals in the health or community centres. The present paper analyses and classifies the information flow and maps it to an information life cycle, which governs the design of the deployed hardware, software and the data-structure. This is based on the initial findings of ACTION (assisting carers using telematics interventions to meet older persons' needs) a European Union funded project. The proposed information architecture discusses different designs such as centralized or decentralized Web and Client server solutions. A user interface is developed reflecting the special requirements of the targeted user group, which influences the functionality and design of the software, data architecture and the integrated communication system using video-conferencing. ACTION has engineered a system using plain Web technology based on HTML, extended with JavaScript and ActiveX and a software switch enabling the integration of different types of videoconferencing and other applications providing manufacturer independence.
Collapse
Affiliation(s)
- M Kraner
- University of Sheffield, Department of Computer Science, UK.
| | | | | | | | | |
Collapse
|
20
|
Burdis C, Eaglestone B, Procter P. A unified model to support an information intensive health care environment. Stud Health Technol Inform 1999; 68:171-4. [PMID: 10724863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
The two parts of this paper respectively analyses the mismatch between current systems and practice in health care, and present an outline design for enhanced Integrated Care Pathways (ICP) knowledge and information management based upon mature ICT technologies.
Collapse
Affiliation(s)
- C Burdis
- Bassetlaw Hospital and Community Services NHS Trust, Worksop, UK
| | | | | |
Collapse
|
21
|
Abstract
Failures of Gamma nails which treat unstable femoral fractures have been reported. In this paper, a finite element model to include a Gamma nail within a fractured femur was used to investigate the stresses in the Gamma nail. The effects for different types of fracture were investigated. The results show that its use for subtrochanteric fractures will cause higher stresses at the lag screw and upper distal screw insertion holes in the nail than when used for femur neck fractures.
Collapse
Affiliation(s)
- C J Wang
- Department of Mechanical Engineering, Brunel University, Uxbridge, Middlesex, UK
| | | | | | | |
Collapse
|
22
|
Yao M, Wang C, Yettram A, Procter P. The structural integrity of a gamma nail. J Biomech 1998. [DOI: 10.1016/s0021-9290(98)80261-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
23
|
Abstract
The geometric mismatch of the femoral component of the Gamma nail to the Chinese femora resulted in intraoperative complications. To provide scientific data for modification of the implant, 28 pairs of normal Chinese femora were studied with the 3-dimensional reconstruction from the computed tomography scan data. Measurements were taken from the reconstituted drawings, and the anthropometric data were applied in the modification of the implant. This study is the first report on the application of Chinese anthropometric data on the design of a trauma implant. It is hoped that a larger scale of the study will provide a more comprehensive data base for wider application to orthopaedic implant design in the future.
Collapse
Affiliation(s)
- K S Leung
- Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin
| | | | | | | |
Collapse
|
24
|
Procter P. Computing in practice. Spreading the word. Nurs Times 1991; 87:66. [PMID: 1996294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
25
|
|
26
|
Abstract
Femoral shaft perforation at total hip arthroplasty is a complication that is being noted more frequently, and it is often associated with femoral shaft fracture below the prosthesis. This study examines the anatomic and biomechanical effects of femoral shaft perforation at arthroplasty, and the effects of supporting the perforated bone with Partridge plates and bands. Two models, pig femora and Pedilen cylinders, were employed. Testing the bone models to failure in tensile mode showed that the perforations weakened the bone and that the Partridge plates and bands decreased the weakening effects of the perforation. The strengthening effect of the Partridge plates and bands on the bone with a perforation, allied with the presence of an internal splint in the event of a fracture through the perforation, suggests the benefit of using Partridge plates and bands if a cortical perforation is found at arthroplasty and revision is not feasible.
Collapse
Affiliation(s)
- J Doyle
- Department of Orthopedics, University of South Florida, Tampa 33606
| | | | | |
Collapse
|
27
|
Procter P. Quest. At the touch of a button. Nurs Times 1989; 85:65-6. [PMID: 2648338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
28
|
Procter P. Educating the nurse educators. Health Serv J 1988; 98:suppl 11. [PMID: 10291103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
29
|
Fricker DC, Procter P. Comment on the paper 'Mechanical behaviour of femoral bones in bending loading'. J Biomech 1987; 20:553. [PMID: 3611130 DOI: 10.1016/0021-9290(87)90256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
30
|
Procter P. Comment on 'Passive and active components of the internal moment developed about the ankle joint during human ambulation'. J Biomech 1986; 19:259. [PMID: 3700438 DOI: 10.1016/0021-9290(86)90159-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
31
|
Procter P. Career series: life is an education. Nurs Mirror 1984; 159:19-20. [PMID: 6567179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
|
32
|
Marks-Maran D, Procter P. Hello tutor--goodbye? Nurs Times 1983; 79:72. [PMID: 6555739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
33
|
Abstract
A three-dimensional analysis of the human ankle joint is presented to analyse data obtained from gait laboratory tests. The ankle was treated as consisting of two joints, the talocrural (Tc.) and the talocalcaneonavicular (Tcn.), and relevant anatomical dimensions were based upon cadaveric anthropometric data. Seven adult male subjects were studied during the stance phase of normal locomotion. Data was acquired from three orthogonally placed cine cameras and a force platform. Two models were investigated based on force equilibrium; a Mark I model which excluded the posterior tibial and peroneal muscle groups and a Mark II model, which included them. The Mark II model gave the following resultant peak forces expressed as multiples of body weight; Tc. joint force = 3.9; Tcn. joint forces--anterior facet = 2.4, posterior facet = 2.8. The latter model was felt to have good potential in the analytical assessment of ankle pathologies and endoprostheses.
Collapse
|