Hydroxyapatite/Polyurethane Scaffolds for Bone Tissue Engineering

Polyurethane (PU) and PU ceramic scaffolds are the principal materials investigated for developing synthetic bone materials due to their excellent biocompatibility and biodegradability. PU has been combined with calcium phosphate (such as hydroxyapatite [HA] and tricalcium phosphate) to prepare scaffolds with enhanced mechanical properties and biocompatibility. This article reviews the latest progress in the design, synthesis, modification, and biological attributes of HA/PU scaffolds for bone tissue engineering. Diverse HA/PU scaffolds have been proposed and discussed in terms of their osteogenic, antimicrobial, biocompatibility, and bioactivities. The application progress of HA/PU scaffolds in bone tissue engineering is predominantly introduced, including bone repair, bone defect filling, drug delivery, and long-term implants.

Assessment of Hydrothermal Treatment Effects on Coir Fibers for Incorporation into Polyurethane Matrix Biocomposites Derived from Castor Oil

The incorporation of natural lignocellulosic fibers as reinforcements in polymer composites has witnessed significant growth due to their biodegradability, cost-effectiveness, and mechanical properties. This study aims to evaluate castor-oil-based polyurethane (COPU), incorporating different contents of coconut coir fibers, 5, 10, and 15 wt%. The investigation includes analysis of the physical, mechanical, and microstructural properties of these composites. Additionally, this study evaluates the influence of hydrothermal treatment on the fibers, conducted at 120 °C and 98 kPa for 30 min, on the biocomposites' properties. Both coir fibers (CFs) and hydrothermal-treated coir fibers (HTCFs) were subjected to comprehensive characterization, including lignocellulosic composition analysis, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and thermogravimetric analysis (TGA). The biocomposites were subjected to water absorption analysis, bending tests, XRD, SEM, FTIR, and TGA. The results indicate that the 30 min hydrothermal treatment reduces the extractive content, enhancing the interfacial adhesion between the fiber and the matrix, as evidenced by SEM. Notably, the composite containing 5 wt% CF exhibits a reduced water absorption, approaching the level observed in pure COPU. The inclusion of 15 wt% HTCF results in a remarkable improvement in the composite's flexural strength (100%), elastic modulus (98%), and toughness (280%) compared to neat COPU. TGA highlights that incorporating CFs into the COPU matrix enhances the material's thermal stability, allowing it to withstand temperatures of up to 500 °C. These findings underscore the potential of CFs as a ductile, lightweight, and cost-effective reinforcement in COPU matrix biocomposites, particularly for engineering applications.

Influence of natural exposure on castor oil based polyurethane reinforced with waste tire rubber

Waste tire rubber (WTR) has been extensively generated worldwide due to mobility needs growth. About 1.5 billion units are generated annually, constantly discharged in the environment with a few reusability alternatives. Therefore, rubber recovery methods and these residues' transformation into a cost-effective product have gained attention. Aiming to minimize the usage of fossil resources and contributes to a circular economy, it was analyzed the usage of WTR particles (5-20% by weight) in castor oil-based polyurethane foams under natural aging to promote a holistic view of all factors involved in the performance of the foams. Morphological, thermal, chemical, and mechanical properties were determined before and after exposure to open air to observe the impact of photo-oxidation and hydrolysis. The increase in viscosity of pre-polymer during the rubber loading produced greater density foams with smaller cell sizes than neat PU, in which the average cell size increased after the weathering. The rubber contributes to enhancing the compressive behavior in the non-exposed samples. After exposure, the results suggest that degradation may act to increase the crosslinking density even with the presented structural changes such as yellowing and voids. Regarding thermal stability, the rubber promotes a slight decay in the ability to resist a heat flow before and after weathering. Still, the char yield increased, showing a possibility of better fire retardancy for composites. FTIR and UV-vis showed chemical structure changes as Photo-Fries network rearrangement, Norrish I random chain scission, and Norrish II β-scission. Besides, UV-vis revealed the maximum absorbance in the UVB region, showing that the PU reinforced by WTR can be a promising material for civil coatings.

Polyurethane/Liquid Crystal Microfibers with pDNA Polyplex Loadings for the Optimal Release and Promotion of HUVEC Proliferation

Fiber structures with connected pores resemble the natural extracellular matrix (ECM) in tissues, and show high potential for promoting the formation of natural functional tissue. The geometry of composite fibers produced by electrospinning is similar to that of the living-tissue ECM, in terms of structural complexity. The introduction of liquid crystals does not affect the morphology of fibers. The composite mat shows better hydrophilicity, with higher content of liquid crystal. At the same time, the higher the content of liquid crystal, the lower the modulus and tensile strength, and the higher the breaking energy and the elongation at break. Additionally, the factors affecting fibers are also investigated in this study. The addition of liquid crystals to the fibers' matrix can slow down the release of pDNA, which is the most common vehicle for genetic engineering, and the encapsulation of pDNA polymer into the fiber matrix can maintain biological activity. The continued release of the pDNA complex was achieved in this study through liquid crystals, and the effective release is controllable. In addition, the integration of liquid crystals into fibers with pDNA polymers can cause a faster transfection rate and promote HUVEC (Human Umbilical Vein Endothelial Cells) growth. It is possible to combine electrospun fibers containing LC (liquid crystal) with pDNA condensation technology to achieve the goal of a sustained release. The production of inductable tissue-building equipment can manipulate the required signals at an effective level in the local tissue microenvironment.

Pressure ulcer prevention-Results of a multicentre cross-sectional survey on hospital infrastructures and processes in acute hospitals and accident and emergency departments

AIMS AND OBJECTIVES

Pressure ulcers (PUs) are a serious health problem. They can be considered as an indicator of the quality of health care and are associated with considerable cost increases for the health care system. The prevention of PUs is a major concern in hospital care. The aim of the study was to reveal the current PU prevention-related processes and structures with a specific focus on the Accident and Emergency (A&E) Department.

METHOD

In late 2018/early 2019, all German hospitals were invited to participate in a nationwide cross-sectional survey. One standardized questionnaire was assigned to a representative of each hospital. The representative was asked to state what PU-related structures and processes are implemented in their hospital, in general and specific to the A&E department. Besides mostly descriptive analysis, PU-related processes were analysed on PU incidence in a multivariate linear regression model.

RESULTS

Two hundred seventy-six hospitals participated in the survey. 63.4% (n = 175) of the participating hospitals had at least one PU manager. Skin inspection was the most frequently performed procedure. Although not recommended, 1.3% (2.1%) of the facilities still use sheepskins quite often (very often). In the regression model on PU incidence, only the process 'mobilization in bed' was statistically significantly associated. Although the risk of developing a PU in the emergency department is high, more than half of the facilities had no PU guidelines.

CONCLUSION

Even if recommended procedures (skin inspection, 30° positioning) have been used frequently, regular training could help to bring new scientific findings such as the use of local skin protection dressings into clinical practice. Prevention guidelines should be established in all areas of care even for A&E as well as when patients are transferred inside or out of the hospital, where the risk of PU development was considered low.

Preparation of Bamboo-Like Carbon Nanotube Loaded Piezoresistive Polyurethane-Silicone Rubber Composite

In this study, a novel technology is reported to prepare a piezoresistive polyurethane-silicone rubber nanocomposite. Polyurethane (PU) foam was loaded with a nitrogen-doped bamboo-shaped carbon nanotube (N-BCNT) by using dip-coating, and then, impregnated with silicone rubber. PU was used as a supporting substrate for N-BCNT, while silicone rubber was applied to fill the pores of the foam to improve recoverability, compressive strength, and durability. The composite displays good electrical conductivity, short response time, and excellent repeatability. The resistance was reduced when the amount of N-BCNT (0.43 wt %) was increased due to the expanded conductive path for electron transport. The piezoresistive composite has been successfully tested in many applications, such as human monitoring and finger touch detection.

Matching Rheology, Conductivity and Joule Effect in PU/CNT Nanocomposites

We investigated polyurethane (PU)–carbon nanotube (CNT) nanocomposites (PU/CNT) in a range of concentrations from 1 to 8 wt% CNT as hot melt adhesives. We studied the thermal properties of the nanocomposites, which is relevant from an applied point of view. The phase angle plots versus complex modulus results revealed the existence of a maximum above a given CNT concentration. The intensity of the peak and associated relaxation time was analyzed with percolation theory, leading to a new method to determine the rheological percolation threshold. A lower threshold value was obtained from the electrical conductivity data, which was justified recalling that the hopping/tunnelling effect takes place in the nanocomposite, as stated by previous studies in the literature. Joule effect studies indicated that the heating effect was very significant, reaching temperature increases, ΔT, of 60 °C for low voltages. For the first time, the percolation equation was applied to the ΔT to obtain the corresponding threshold. Stimulus-responsive systems were conceived considering the correlation between the ΔT and the conductivity. The case of PU/CNT nanocomposites acting as hot melt adhesives that are welded/unglued by applying/removing an electrical voltage is presented.

Polyurethane/poly(d,l-lactic acid) scaffolds based on supercritical fluid technology for biomedical applications: Studies with L929 cells

Biomaterials can be applied in tissue engineering as scaffolds that resemble the extracellular matrix functioning as a temporary structure for cell proliferation and reconstruction of new organs and tissues. To evaluate the potential use of scaffolds as a biomaterial, this work proposes the development and characterization of polyurethane (PU), poly(D,L-lactic acid) (PDLLA) and polyurethane/poly(d,l-lactic acid) (PU/PDLLA) scaffolds produced by gas foaming technique. The neat polymers and the blends were characterized, in film form, by gel permeation chromatography (GPC), thermogravimetry (TG), differential scanning calorimetry (DSC) and field emission gun scanning electron microscopy (FEG-SEM). After supercritical fluid technology, in scaffolds form, the samples were characterized by FEG-SEM, pore size, density, cytotoxicity and cell adhesion. For film characterization the PU/PDLLA sample presented intermediate characteristics compared to the neat polymers, exhibiting the behavior of both polymers in the sample without phase separation in the FEG-SEM micrograph and bimodal molar weight distribution by GPC. The scaffolds showed interconnectivity and pore size of 141 μm ± 108 μm for PUsc and 52 μm ± 32 μm for PDLLAsc. The PU/PDLLAsc exhibited a bimodal structure in which the PU in the mixture revealed pores of 75 μm ± 57 μm, while for PDLLA, the pore size was 19 μm ± 12 μm. In vitro tests confirmed the adhesion of L929 cells to PUsc, PDLLAsc and PU/PDLLAsc, showing no cytotoxic effect. Finally, it can be concluded that it is possible to produce PU, PDLLA and PU/PDLLA scaffolds by supercritical fluid, which may be applied as biomaterials.

Compliance Study of Endovascular Stent Grafts Incorporated with Polyester and Polyurethane Graft Materials in both Stented and Unstented Zones

Compliance mismatch between stent graft and host artery may induce complications and blood flow disorders. However, few studies have been reported on stent graft compliance. This study aims to explore the deformation and compliance of stent graft in stented and unstented zones under three pressure ranges. Compliance of two stent grafts incorporated with polyurethane graft (nitinol-PU) and polyester graft (nitinol-PET) materials respectively were tested; the stents used in the two stent grafts were identical. For the circumferential deformation of the stent grafts under each pressure range, the nitinol-PET stent graft was uniform in both zones. The nitinol-PU stent graft was circumferentially uniform in the stented zone, however, it was nonuniform in the unstented zone. The compliance of the PU graft material was 15 times higher than that of the PET graft. No significant difference in compliance was observed between stented and unstented zones of the nitinol-PET stent graft regardless of the applied pressure range. However, for the nitinol-PU stent graft, compliance of the unstented PU region was approximately twice that of the stented region; thus, compliance along the length of the nitinol-PU stent graft was not constant and different from that of the nitinol-PET stent graft.

Conductive Elastomers for Stretchable Electronics, Sensors and Energy Harvesters

There have been a wide variety of efforts to develop conductive elastomers that satisfy both mechanical stretchability and electrical conductivity, as a response to growing demands on stretchable and wearable devices. This article reviews the important progress in conductive elastomers made in three application fields of stretchable technology: stretchable electronics, stretchable sensors, and stretchable energy harvesters. Diverse combinations of insulating elastomers and non-stretchable conductive materials have been studied to realize optimal conductive elastomers. It is noted that similar material combinations and similar structures have often been employed in different fields of application. In terms of stretchability, cyclic operation, and overall performance, fields such as stretchable conductors and stretchable strain/pressure sensors have achieved great advancement, whereas other fields like stretchable memories and stretchable thermoelectric energy harvesting are in their infancy. It is worth mentioning that there are still obstacles to overcome for the further progress of stretchable technology in the respective fields, which include the simplification of material combination and device structure, securement of reproducibility and reliability, and the establishment of easy fabrication techniques. Through this review article, both the progress and obstacles associated with the respective stretchable technologies will be understood more clearly.

A comprehensive patient safety program can significantly reduce preventable harm, associated costs, and hospital mortality

OBJECTIVE

To evaluate the effectiveness of a hospital-wide initiative to improve patient safety by implementing high-reliability practices as part of a quality improvement (QI) program aimed at reducing all preventable harm.

STUDY DESIGN

A hospital wide quasi-experimental time series QI initiative using high-reliability concepts, microsystem-based multidisciplinary teams, and QI science tools to reduce hospital acquired harm was implemented. Extensive error prevention training was provided for all employees. Change concepts were enacted using the Institute for Healthcare Improvement's Model for Improvement. Compliance with change packages was measured.

RESULTS

Between 2010 and 2012, the serious safety event rate decreased from 1.15 events to 0.19 event per 10 000 adjusted hospital-days, an 83.3% reduction (P < .001). Preventable harm events decreased by 53%, from a quarterly peak of 150 in the first quarter of 2010 to 71 in the fourth quarter of 2012 (P < .01). Observed hospital mortality decreased from 1.0% to 0.75% (P < .001), although severity-adjusted expected mortality actually increased slightly, and estimated harm-related hospital costs decreased by 22.0%. Hospital-wide safety climate scores increased significantly.

CONCLUSION

Substantial reductions in serious safety event rate, preventable harm, hospital mortality, and cost were seen after implementation of our multifaceted approach. Measurable improvements in the safety culture were noted as well.

A biomimetic approach for designing stent-graft structures: Caterpillar cuticle as design model

Stent-graft (SG) induced biomechanical mismatch at the aortic repair site forms the major reason behind postoperative hemodynamic complications. These complications arise from mismatched radial compliance and stiffness property of repair device relative to native aortic mechanics. The inability of an exoskeleton SG design (an externally stented rigid polyester graft) to achieve optimum balance between structural robustness and flexibility constrains its biomechanical performance limits. Therefore, a new SG design capable of dynamically controlling its stiffness and flexibility has been proposed in this study. The new design is adopted from the segmented hydroskeleton structure of a caterpillar cuticle and comprises of high performance polymeric filaments constructed in a segmented knit architecture. Initially, conceptual design models of caterpillar and SG were developed and later translated into an experimental SG prototype. The in-vitro biomechanical evaluation (compliance, bending moment, migration intensity, and viscoelasticity) revealed significantly better performance of hydroskeleton structure than a commercial SG device (Zenith(™) Flex SG) and woven Dacron(®) graft-prosthesis. Structural segmentation improved the biomechanical behaviour of new SG by inducing a three dimensional volumetric expansion property when the SG was subjected to hoop stresses. Interestingly, this behaviour matches the orthotropic elastic property of native aorta and hence proposes segmented hydroskeleton structures as promising design approach for future aortic repair devices.

Progress in microRNA delivery. J Control Release. 2013;172:962-974. [PMID: 24075926 DOI: 10.1016/j.jconrel.2013.09.015]

MicroRNAs (miRNAs) are non-coding endogenous RNAs that direct post-transcriptional regulation of gene expression by several mechanisms. Activity is primarily through binding to the 3' untranslated regions (UTRs) of messenger RNAs (mRNA) resulting in degradation and translation repression. Unlike other small-RNAs, miRNAs do not require perfect base pairing, and thus, can regulate a network of broad, yet specific, genes. Although we have only just begun to gain insights into the full range of biologic functions of miRNA, their involvement in the onset and progression of disease has generated significant interest for therapeutic development. Mounting evidence suggests that miRNA-based therapies, either restoring or repressing miRNAs expression and activity, hold great promise. However, despite the early promise and exciting potential, critical hurdles often involving delivery of miRNA-targeting agents remain to be overcome before transition to clinical applications. Limitations that may be overcome by delivery include, but are not limited to, poor in vivo stability, inappropriate biodistribution, disruption and saturation of endogenous RNA machinery, and untoward side effects. Both viral vectors and nonviral delivery systems can be developed to circumvent these challenges. Viral vectors are efficient delivery agents but toxicity and immunogenicity limit their clinical usage. Herein, we review the recent advances in the mechanisms and strategies of nonviral miRNA delivery systems and provide a perspective on the future of miRNA-based therapeutics.

Retrieval analysis of motion preserving spinal devices and periprosthetic tissues

This article reviews certain practical aspects of retrieval analysis for motion preserving spinal implants and periprosthetic tissues as an essential component of the overall revision strategy for these implants. At our institution, we established an international repository for motion-preserving spine implants in 2004. Our repository is currently open to all spine surgeons, and is intended to be inclusive of all cervical and lumbar implant designs such as artificial discs and posterior dynamic stabilization devices. Although a wide range of alternative materials is being investigated for nonfusion spine implants, many of the examples in this review are drawn from our existing repository of metal-on-polyethylene, metal-on-metal lumbar total disc replacements (TDRs), and polyurethane-based dynamic motion preservation devices. These devices are already approved or nearing approval for use in the United States, and hence are the most clinically relevant at the present time. This article summarizes the current literature on the retrieval analysis of these implants and concludes with recommendations for the development of new test methods that are based on the current state of knowledge of in vivo wear and damage mechanisms. Furthermore, the relevance and need to evaluate the surrounding tissue to obtain a complete understanding of the biological reaction to implant component corrosion and wear is reviewed.