TISSUE ENGINEERING CELLULARIZED SILK-BASED LIGAMENT ANALOGUES

The resurgence, and eventual rise to prominence in the field of tissue engineering, that electrospinning has experienced over the last decade speaks to the simplicity and adaptability of the process. Electrospinning has been used for the fabrication of tissue engineering scaffolds intended for use in nearly every part of the human body: blood vessel, cartilage, bone, skin, nerve, connective tissue, etc. Diverse as the aforementioned tissues are in both form and function, electrospinning has found a niche in the repair of each due to its capacity to consistently create non-woven structures of fibers ranging from nano-to-micron size in diameter. These structures have had success in tissue engineering applications because of their ability to mimic the body’s natural structural framework, the extracellular matrix. In this study we examine a number of different techniques for altering scaffold properties (i.e. mechanical strength, degradation rate, permeability, and bioactivity) to create electrospun structures tailored to unique tissue specific applications; the end goal being the creation of a cellularized tissue engineering ligament analogue. To alter the mechanical properties of electrospun structures while maintaining high levels of bioactivity, synthetic polymers such as polydioxanone were blended in solution with naturally occurring proteins like elastin and fibrinogen prior to electrospinning. Cross-linking of electrospun structures, using glutaraldehyde, carbodiimide hydrochloride, and genipin, was also investigated as a means to both improve the mechanical stability and slow the rate of degradation of the structures. Fiber orientation and scaffold anisotropy were controlled through varying fabrication parameters, and proved effective in altering the mechanical properties of the structures. Finally, major changes in the structure of electrospun scaffolds were achieved through the implementation of air-gap electrospinning. Scaffolds created through air-gap electrospinning exhibited higher porosity’s than their traditionally fabricated counterparts, allowing for greater cell penetration into the scaffold. Overall, this collection of results provides insight into the diversity of electrospinning and reveals innumerous options, both pre and post fabrication, for the tissue engineer to create site-specific engineering scaffolds capable of mimicking both the form and function of native tissue

Scaffold Permeability as a Means to Determine Fiber Diameter and Pore Size of Electrospun Fibrinogen

The purpose of this study was to construct a flowmeter that could accurately measure the hydraulic permeability of electrospun fibrinogen scaffolds, providing insight into the transport properties of electrospun scaffolds while making the measurement of their topographical features (fiber and pore size) more accurate. Three different concentrations of fibrinogen were used (100, 120, and 150mg/ml) to create scaffolds with three different fiber diameters and pore sizes. The fiber diameters and pore sizes of the electrospun scaffolds were analyzed through scanning electron microscopy and image analysis software. The permeability of each scaffold was measured and used to calculate permeability-based fiber diameters and pore sizes, which were compared to values obtained through image analysis. Permeability measurement revealed scaffold permeability to increase linearly with fibrinogen concentration, much like average fiber diameter and pore size. Comparison between the two measurement methods proved the efficacy of the flowmeter as a way to measure scaffold features

THE RELATIONSHIP BETWEEN MUSCULOSKELETAL STRENGTH, PHYSIOLOGICAL CHARACTERISTICS, AND KNEE KINESTHESIA FOLLOWING FATIGUING EXERCISE

Fatiguing exercise may result in impaired functional joint stability and increased risk of unintentional injury. While there are several musculoskeletal and physiological characteristics related to fatigue onset, their relationship with proprioceptive changes following fatigue has not been examined. The purpose of this study was to establish the relationship between musculoskeletal and physiological characteristics and changes in proprioception, measured by threshold to detect passive motion (TTDPM), following fatiguing exercise. Twenty, physically active females participated (age: 28.65 ± 5.6 years, height: 165.6 ± 4.3 cm, weight: 61.8 ± 8.0 kg, BMI: 22.5± 2.3 kg/m2, BF: 23.3 ± 5.4%). During Visit 1, subjects completed an exercise history and 24-hour dietary questionnaire, and body composition, TTDPM familiarization, isokinetic knee strength, and maximal oxygen uptake/lactate threshold assessments. During Visit 2, subjects completed TTDPM and isometric knee strength testing prior to and following a fatiguing exercise protocol. Wilcoxon signed rank tests determined TTDPM and isometric knee strength changes from pre- to post- fatigue. Spearman’s rho correlation coefficients determined the relationship between strength and physiological variables with pre- to post-fatigue changes in TTDPM and with pre-fatigue and post-fatigue TTDPM in extension and flexion (α=0.05). No significant differences were demonstrated from pre-fatigue to post-fatigue TTDPM despite a significant decrease in isometric knee flexion strength (P<0.01) and flexion/extension ratio (P<0.05) following fatigue. No significant correlations were observed between strength or physiological variables and changes in TTDPM from pre- to post-fatigue in extension or flexion. Flexion/extension ratio was significantly correlated with pre-fatigue TTDPM in extension (r=-0.231, P<0.05). Peak oxygen uptake was significantly correlated with pre-fatigue (r=-0.500, P<0.01) and post-fatigue (r=-0.520, P<0.05) TTDPM in extension. No significant relationships were demonstrated between musculoskeletal and physiological characteristics and changes in TTDPM following fatigue. The results suggest that highly trained individuals may have better proprioception, and that the high fitness level of subjects in this investigation may have contributed to absence of TTDPM deficits following fatigue despite reaching a high level of perceptual and physiological fatigue. Future studies should consider various subject populations, other musculoskeletal strength characteristics, and different modalities of proprioception to determine the most important contributions to proprioceptive changes following fatigue

Accuracy of recall of musculoskeletal injuries in elite military personnel: a cross-sectional study

Background Self-reported data are often used in research studies among military populations. Objective The accuracy of self-reported musculoskeletal injury data among elite military personnel was assessed for issues with recall. Design Cross-sectional study. Setting Applied research laboratory at a military installation. Participants A total of 101 subjects participated (age 28.5±5.6 years). Study participants were active duty military personnel, with no conditions that precluded them from full duty. Primary and secondary outcome measures Self-reported and medical record reviewed injuries that occurred during a 1-year period were matched by anatomic location, injury side (for extremity injuries), and injury year and type. The accuracy of recall was estimated as the per cent of medical record reviewed injuries correctly recalled in the self-report. The effect of injury anatomic location, injury type and severity and time since injury, on recall, was also assessed. Injuries were classified as recent (≤4 years since injury) or old injuries (\u3e4 years since injury). Recall proportions were compared using Fisher’s exact tests. Results A total of 374 injuries were extracted from the subjects’ medical records. Recall was generally low (12.0%) and was not different between recent and old injuries (P=0.206). Injury location did not affect recall (P=0.418). Recall was higher for traumatic fractures as compared with less severe non-fracture injuries (P values 0.001 to \u3c0.001). Recall for non-fracture injuries was higher for recent as compared with old injuries (P=0.033). This effect of time since injury on recall was not observed for fractures (P=0.522). Conclusions The results of this study highlight the importance of weighing the advantages and disadvantages of self-reported injury data before their use in research studies in military populations and the need for future research to identify modifiable factors that influence recall

Centre-level variation in treatment and outcomes and predictors of outcomes in 5-year-old children with non-syndromic unilateral cleft lip treated within a centralized service:the Cleft Care UK study. Part 6: summary and implications

Objectives: To summarize and discuss centre-level variation across a range of treatment and outcome measures and examine individual and ecological determinants of outcome in children in Cleft Care UK (CCUK). Setting and sample population: Two hundred and sixty-eight 5-year-old British children with non-syndromic unilateral cleft lip and palate (UCLP) recruited to CCUK and treated within a centralized service. Materials and Methods: Children had a range of treatment and outcome measures collected at a 5-year audit clinic. These outcomes included dento-alveolar arch relationships from study models, measures of facial appearance from cropped photographs, hearing loss from audiological assessment, speech from speech recordings, self-confidence and strengths and difficulties from parental self-report. Data were collected on educational attainment at age 7 using record linkage. Centre variation was examined using hierarchical regression and associations between variables were examined using logistic or poisson regression. Results: There was centre-level variation for some treatments (early grommet placement, fitting of hearing aids, fluoride treatment, secondary speech surgery and treatment for cleft speech characteristics) and for some outcomes (intelligibility of speech). Hearing loss was associated with a higher risk of poor speech while speech therapy was associated with a lower risk of poor speech. Children had high levels of caries but levels of preventative treatment (fluoride varnish and tablets) were low. Conclusions: Further improvements to and monitoring of the current centralized model of care are required to ensure the best outcomes for all children with cleft lip and palate

Supercontinuum Generation in a Silica Spiral Waveguide

A low-loss silica spiral waveguide is used for demonstrating on-chip supercontinuum generation. The broadest measured spectrum spans an octave (936 – 1888 nm) at −50 dB from peak when 2.17 nJ pulses are launched

Accuracy of Recall of Musculoskeletal Injuries in Elite Military Personnel: A Cross-Sectional Study

Background Self-reported data are often used in research studies among military populations. Objective The accuracy of self-reported musculoskeletal injury data among elite military personnel was assessed for issues with recall. Design Cross-sectional study. Setting Applied research laboratory at a military installation. Participants A total of 101 subjects participated (age 28.5±5.6 years). Study participants were active duty military personnel, with no conditions that precluded them from full duty. Primary and secondary outcome measures Self-reported and medical record reviewed injuries that occurred during a 1-year period were matched by anatomic location, injury side (for extremity injuries), and injury year and type. The accuracy of recall was estimated as the per cent of medical record reviewed injuries correctly recalled in the self-report. The effect of injury anatomic location, injury type and severity and time since injury, on recall, was also assessed. Injuries were classified as recent (≤4 years since injury) or old injuries (\u3e4 years since injury). Recall proportions were compared using Fisher\u27s exact tests. ResultsA total of 374 injuries were extracted from the subjects\u27 medical records. Recall was generally low (12.0%) and was not different between recent and old injuries (P=0.206). Injury location did not affect recall (P=0.418). Recall was higher for traumatic fractures as compared with less severe non-fracture injuries (P values 0.001 to \u3c0.001). Recall for non-fracture injuries was higher for recent as compared with old injuries (P=0.033). This effect of time since injury on recall was not observed for fractures (P=0.522). Conclusions The results of this study highlight the importance of weighing the advantages and disadvantages of self-reported injury data before their use in research studies in military populations and the need for future research to identify modifiable factors that influence recall

Centre-level variation of treatment and outcome in 5-year-old children with non-syndromic unilateral cleft lip and palate:the Cleft Care UK study. Part 1: Methodology and results for dento-facial outcomes

Objectives: Outline methods used to describe centre-level variation in treatment and outcome in children in the Cleft Care UK (CCUK) study. Report centre-level variation in dento-facial outcomes. Setting and Sample Population: Two hundred and sixty-eight five-year-old British children with non-syndromic unilateral cleft lip and palate (UCLP). Materials and Methods: Between January 2011 and December 2012, data were collected on a comprehensive range of outcomes. Child facial appearance and symmetry were assessed using photographic pictures. Dental arch relationships were assessed from standardized dental study models. Hierarchical statistical models were used to predict overall means and the variance partition coefficient (VPC)—a measure of amount of variation in treatment or outcome explained by the centre. Results: Data on dento-alveolar arch relationships and facial appearance were available on 197 and 252 children, respectively. The median age of the children was 5.5 years, and 68% were boys. Variation was described across 13 centres. There was no evidence of centre-level variation in good or poor dento-alveolar arch relationships with a VPC of 4% and 3%, respectively. Similarly, there was no evidence of centre-level variation in good or poor facial appearance with a VPC of 2% and 5%, respectively. Conclusions: There was no evidence of centre-level variation for dento-facial outcomes although this study only had the power to detect large variation between sites

Electrospun Collagen: A Tissue Engineering Scaffold with Unique Functional Properties in a Wide Variety of Applications

Type I collagen and gelatin, a derivative of Type I collagen that has been denatured, can each be electrospun into tissue engineering scaffolds composed of nano- to micron-scale diameter fibers. We characterize the biological activity of these materials in a variety of tissue engineering applications, including endothelial cell-scaffold interactions, the onset of bone mineralization, dermal reconstruction, and the fabrication of skeletal muscle prosthetics. Electrospun collgen (esC) consistently exhibited unique biological properties in these functional assays. Even though gelatin can be spun into fibrillar scaffolds that resemble scaffolds of esC, our assays reveal that electrospun gelatin (esG) lacks intact α chains and is composed of proinflammatory peptide fragments. In contrast, esC retains intact α chains and is enriched in the α 2(I) subunit. The distinct fundamental properties of the constituent subunits that make up esC and esG appear to define their biological and functional properties

A Comparison of Cervical and Trunk Musculoskeletal Characteristics between Female and Male Army Helicopter Pilots

Introduction: Neck pain (NP) and low back pain (LBP) are prevalent among military helicopter pilots. Although there have been few studies on sex differences in the NP/LBP prevalence in this population, females are shown to be at a greater risk of NP/LBP in civilian studies. This disparity may be due to musculoskeletal characteristics differences that predispose females for NP/LBP. The purpose of this study was to compare cervical and trunk musculoskeletal characteristics between male and female pilots. Methods: A total of 8 female pilots (Age: 27.6 ± 4.2yrs, HT: 166.1 ± 7.7cm, WT: 67.9 ± 10.6kg) were tested, and they were matched (1:1 matching ratio) with male pilots (Age: 27.8 ± 4.2yrs, HT: 175.0 ± 6.8cm, WT: 79.5 ± 5.8kg), based on age (± three years) and flight experience (± two years). Cervical/trunk strength and flexibility were tested using the hand-held/isokinetic dynamometer and inclinometers, respectively. Strength values were normalized to body weight for analyses. Paired t-tests or Wilcoxon Signed Rank tests were used to examine sex differences across all variables (p \u3c 0.05). Results: Female pilots had significantly lower cervical flexion strength, trunk flexion strength, and trunk rotation strength (p \u3c 0.05). For flexibility measures, female pilots had significantly greater cervical rotation flexibility (p \u3c 0.05). No significant differences were observed in the lumbar spine flexibility. Discussion/Conclusion: The current preliminary study found sex differences in cervical and trunk musculoskeletal characteristics in Army helicopter pilots. Continued efforts are warranted to explore sex-specific intervention strategy and its effectiveness in reducing the NP/LBP prevalence among military helicopter pilots