Development of regenerative extracellular vesicles for bone tissue engineering

There are a number of clinical strategies to promote fracture healing and treat bone defects, such as autologous or allogenic bone grafting procedures and stem cell therapies. Stem cell therapies have shown great potential in the area of regenerative medicine and tissue engineering. However, numerous considerable limitations are associated with the presented techniques, including limited supply in donor tissue, often insurmountable regulatory hurdles, ethical and economic issues. Extracellular vesicles (EVs) have gained considerable attention in tissue engineering as a new potential therapy that enables bone and tissue healing. EVs are nano-sized particles that are released into the cellular environment from all types of cells contributing to cell-to-cell communication. Naturally EVs deliver important biological cargo including nucleic acids and osteoinductive proteins. An EV approach to tissue engineering could eliminate the significant issues with grafting procedures and provide an alternative therapy to the current biological therapies. However, the separation and identification of regenerative EV populations is currently problematic due to the variability that exists in vesicles and isolation protocols. The vast part of this study concerns the isolation and characterisation of osteoblastic EVs. EVs were isolated by two different methods; sequential and differential ultracentrifugation. Their size distribution and morphologies wеrе determined via three different microscopy techniques such as dynamic light scattering (DLS), nanoparticle tracking analysis (NTA) and transmission electron microscopy (TEM). The total protein content was analysed using a protein quantification assay (BCA) and the influences of these EVs on osteoblast metabolism were assessed using an Alamar Blue assay (AB). Finally, formulation of an injectable biomaterial in an effort to facilitate localised EV delivery to a bone defect was explored. The biomaterial of interest in this study was a natural hydrogel called Gellan Gum (GG). Gellan Gum (GG) is commonly usеd in the food and pharmaceutical industries as a thickening agent. In this study, different cross-linker solutions were prepared and evaluated as a potential injectable system that may be used to controllably deliver therapeutic doses of isolated vesicles. In order to produce an injectable gel, toothpaste was considered as a baseline material with desirable rheological characteristics. The rheological behavior of GG sample was tested and compared to that of a toothpaste. EVs were successfully isolated using both protocols. The highest centrifugal forces; 75,000 x g and 120,000 x g gave the highest concentration of EVs that were capable to enhance cell proliferation in culture. Also, at these two centrifugal forces in both protocols, EVs with similar average sizes appeared. Future work would focus on the incorporation of EVs into optimised GG hydrogels and in-vitro testing of mineralisation

Staying put: the impact of the ‘bedroom tax’ on tenants in North Staffordshire

Much has been written and said about the introduction of size criteria in the social rented sector (the ‘bedroom tax’). Indeed, few other changes to the benefits system have provoked so much comment from politicians, journalists, charities, landlords, advice providers and church leaders. Here, Richard Machin, Anna Tsaroucha and Liz Boath describe new research from Staffordshire University examining the impact of the bedroom tax on a group of local housing association tenants

Using a modified Delphi Method to develop a new advanced accreditation award (‘Triple A’) in money advice practice

Staffordshire University has delivered the Certificate of Credit in Money Advice Practice (CMAP) in partnership with the Institute of Money Advisers (IMA) and since 2010 and over 1000 money advisers across the United Kingdom have achieved the qualification (Wright et al., 2014). CMAP graduates and employers expressed a need for an advanced specialist accreditation module for experienced money advisers to build on the CMAP. A Delphi study, a consensus method for curriculum design, was carried out to support the new course development. Participants were 13 experts in Money Advice Practice, including CMAP graduates. Three rounds of the Delphi process were carried out and consensus was obtained on course structure and content of modules, assessment, communication & support, professional competencies & skills, fees & duration, entry criteria, induction and materials and benefits of the advanced accreditation. The Delphi technique proved successful in involving experts in the design of a new course. A Feedback/ Feed forward event was also carried out to aid the process and the course is currently being developed

Involving students in curriculum design: a research and statistics course designed by students for students

The following study relates to the development of a research and statistic training course for staff members and postgraduate students within the Faculty of Health Sciences, Staffordshire University. As part of the research and advanced scholarship university agenda, the demand for increase in research and advanced scholarly outputs, a need was identified by numerous staff and postgraduate students for additional research and statistics methods training. University funding was obtained to further investigate staff and students' specific needs for such training. As a result, a basic research and statistics course was developed and delivered as a pilot to a small group of staff and postgraduate students. Written evaluation of the course was obtained by all attendees and analysed with the aim of improving the training course. Staff and student involvement was a vital part of the study throughout all stages, from course design to delivery and evaluation. The paper presents and discusses the key study findings as well as recommendations for practice

Anesthetic Considerations in Hepatectomies under Hepatic Vascular Control

Background. Hazards of liver surgery have been attenuated by the evolution in methods of hepatic vascular control and the anesthetic management. In this paper, the anesthetic considerations during hepatic vascular occlusion techniques were reviewed. Methods. A Medline literature search using the terms “anesthetic,” “anesthesia,” “liver,” “hepatectomy,” “inflow,” “outflow occlusion,” “Pringle,” “hemodynamic,” “air embolism,” “blood loss,” “transfusion,” “ischemia-reperfusion,” “preconditioning,” was performed. Results. Task-orientated anesthetic management, according to the performed method of hepatic vascular occlusion, ameliorates the surgical outcome and improves the morbidity and mortality rates, following liver surgery. Conclusions. Hepatic vascular occlusion techniques share common anesthetic considerations in terms of preoperative assessment, monitoring, induction, and maintenance of anesthesia. On the other hand, the hemodynamic management, the prevention of vascular air embolism, blood transfusion, and liver injury are plausible when the anesthetic plan is scheduled according to the method of hepatic vascular occlusion performed

Safety and effectiveness of outpatient laparoscopic cholecystectomy in a teaching hospital: a prospective study of 110 consecutive patients

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to evaluate the safety and efficacy of outpatient laparoscopic cholecystectomy (OLC) in a day surgery unit in a teaching hospital. OLC was offered to patients with symptomatic cholelithiasis who met the following established inclusion criteria: ASA (American Society of Anesthesiology) physical status classification class I and II; age: 18 - 70 years; body mass index (BMI) < 30 kg/m²; patient acceptance and cooperation (informed consent); presence of a responsible adult to accompany the patient to his residency; patient residency in Athens. The primary study end-point was to evaluate success rates (patient discharge on the day of surgery), postoperative outcome (complications, re-admissions, morbidity and mortality) and patient satisfaction. A secondary endpoint was to evaluate its safe performance under appropriate supervision by higher surgical trainees (HSTs).</p> <p>Findings</p> <p>110 consecutive patients, predominantly female (71%) and ASA I (89%) with a mean age 40.6 ± 8.1 years underwent an OLC. Surgery was performed by a HST in 90 patients (81.8%). A mean postoperative pain score 3.3 (range 0-6) occurred in the majority of patients and no patient presented postoperative nausea or vomiting. Discharge on the day of surgery occurred in 95 cases (86%), while an overnight admission was required for 15 patients (14%). Re-admission following hospital discharge was necessary for 2 patients (1.8%) on day 2, due to persistent pain in the umbilical trocar site. The overall rate of major (trocar site bleeding) and minor morbidity was 15.5% (17 patients). At 1 week follow-up, 94 patients (85%) were satisfied with their experience undergoing OLC, with no difference between grades of operating surgeons.</p> <p>Conclusions</p> <p>This study confirmed that OLC is clinical effective and can be performed safely in a teaching hospital by supervised HSTs.</p

Staying put: the impact of the ‘bedroom tax’ on tenants in North Staffordshire

Much has been written and said about the introduction of size criteria in the social rented sector (the ‘bedroom tax’). Indeed, few other changes to the benefits system have provoked so much comment from politicians, journalists, charities, landlords, advice providers and church leaders. Here, Richard Machin, Anna Tsaroucha and Liz Boath describe new research from Staffordshire University examining the impact of the bedroom tax on a group of local housing association tenants