Repair of segmental bone defects with fiber-reinforced composite: a study of material development and an animal model on rabbits

The Repair of segmental defects in load-bearing long bones is a challenging task because of the diversity of the load affecting the area; axial, bending, shearing and torsional forces all come together to test the stability/integrity of the bone. The natural biomechanical requirements for bone restorative materials include strength to withstand heavy loads, and adaptivity to conform into a biological environment without disturbing or damaging it. Fiber-reinforced composite (FRC) materials have shown promise, as metals and ceramics have been too rigid, and polymers alone are lacking in strength which is needed for restoration. The versatility of the fiber-reinforced composites also allows tailoring of the composite to meet the multitude of bone properties in the skeleton. The attachment and incorporation of a bone substitute to bone has been advanced by different surface modification methods. Most often this is achieved by the creation of surface texture, which allows bone growth, onto the substitute, creating a mechanical interlocking. Another method is to alter the chemical properties of the surface to create bonding with the bone – for example with a hydroxyapatite (HA) or a bioactive glass (BG) coating. A novel fiber-reinforced composite implant material with a porous surface was developed for bone substitution purposes in load-bearing applications. The material’s biomechanical properties were tailored with unidirectional fiber reinforcement to match the strength of cortical bone. To advance bone growth onto the material, an optimal surface porosity was created by a dissolution process, and an addition of bioactive glass to the material was explored. The effects of dissolution and orientation of the fiber reinforcement were also evaluated for bone-bonding purposes. The Biological response to the implant material was evaluated in a cell culture study to assure the safety of the materials combined. To test the material’s properties in a clinical setting, an animal model was used. A critical-size bone defect in a rabbit’s tibia was used to test the material in a load-bearing application, with short- and long-term follow-up, and a histological evaluation of the incorporation to the host bone. The biomechanical results of the study showed that the material is durable and the tailoring of the properties can be reproduced reliably. The Biological response - ex vivo - to the created surface structure favours the attachment and growth of bone cells, with the additional benefit of bioactive glass appearing on the surface. No toxic reactions to possible agents leaching from the material could be detected in the cell culture study when compared to a nontoxic control material. The mechanical interlocking was enhanced - as expected - with the porosity, whereas the reinforcing fibers protruding from the surface of the implant gave additional strength when tested in a bone-bonding model. Animal experiments verified that the material is capable of withstanding load-bearing conditions in prolonged use without breaking of the material or creating stress shielding effects to the host bone. A Histological examination verified the enhanced incorporation to host bone with an abundance of bone growth onto and over the material. This was achieved with minimal tissue reactions to a foreign body. An FRC implant with surface porosity displays potential in the field of reconstructive surgery, especially regarding large bone defects with high demands on strength and shape retention in load-bearing areas or flat bones such as facial / cranial bones. The benefits of modifying the strength of the material and adjusting the surface properties with fiber reinforcement and bone-bonding additives to meet the requirements of different bone qualities are still to be fully discovered.

A new climatic periodisation of the Gold and Guinea Coasts in West Africa, 1750-1798 : a reconstruction of the climate during the slave trade era, including an analysis of the climatically facilitated Trans-Atlantic slave trade

Avsikten med studien är att producera den första rekonstruktionen av det västafrikanska klimatet mellan 1750 och 1798. Kunskapen om det västafrikanska klimatet före 1800-talet är till dags dato bristfällig, vilket gör det svårare att förstå framtida klimatvariationer. Det är bristen på instrumentell meteorologisk data (temperatur, regnmängd, och lufttryck), vilket i princip bara täcker det senaste århundradet, som är orsaken till att tidigare klimat är bristfälligt kartlagda. Klimatet och miljön är även sådana att proxydata från ’naturens arkiv’ (såsom t.ex. trädringar) har begränsad användning. Således är historiska dokument, främst från gästande kulturer/nationer/intressenter, innehållande deskriptiv information om vädret och klimatet, klimatforskarens viktigaste källa. Genom att använda tidigare, för det här syftet, oanvända källor påvisade den här undersökningen att klimatet i västra Afrika och Guldkusten (Ghana) har ändrats sedan 1700-talet. Monsunregnen var svagare och kortvarigare, speciellt den sekundära regnperioden under hösten var betydligt svagare än idag. Det förekom kraftiga årliga variationer i monsunregnen, men sett ur längre tidsperspektiv utmärktes torrare och blötare perioder. Studien kunde också visa en viss korrelation mellan det globala väderfenomenet El Niño och regnperiodens intensitet längs med kusten. Flera torrperioder sammanföll med tidigare registrerade El Niño sekvenser. Speciellt slutet av 1760-talet påverkades kraftigt av El Niño och även det globala klimatet verkar ha genomgått graftiga förändringar just dessa år. På basis av den nya klimatrekonstruktionen genomfördes också en jämförelse av klimatets inverkan på den transatlantiska slavhandeln från 1750 till 1798, en fråga som historikerna gjort anspelningar på i över 30 år. Utförseln av slavar från västra Afrika var som kraftigast under 1700-talets andra hälft. Analysen visade att slavhandeln delvis tilltog i samband med klimatanomalierna.

Development of Craniofacial Bone Defect Reconstruction Implant Based on Fibre-Reinforced Composite with Photopolymerisable Resin Systems. Experimental studies in vitro and in vivo.

Reconstruction of defects in the craniomaxillofacial (CMF) area has mainly been based on bone grafts or metallic fixing plates and screws. Particularly in the case of large calvarial and/or craniofacial defects caused by trauma, tumours or congenital malformations, there is a need for reliable reconstruction biomaterials, because bone grafts or metallic fixing systems do not completely fulfill the criteria for the best possible reconstruction methods in these complicated cases. In this series of studies, the usability of fibre-reinforced composite (FRC) was studied as a biostable, nonmetallic alternative material for reconstructing artificially created bone defects in frontal and calvarial areas of rabbits. The experimental part of this work describes the different stages of the product development process from the first in vitro tests with resin-impregnated fibrereinforced composites to the in vivo animal studies, in which this FRC was tested as an implant material for reconstructing different size bone defects in rabbit frontal and calvarial areas. In the first in vitro study, the FRC was polymerised in contact with bone or blood in the laboratory. The polymerised FRC samples were then incubated in water, which was analysed for residual monomer content by using high performance liquid chromatography (HPLC). It was found that this in vitro polymerisation in contact with bone and blood did not markedly increase the residual monomer leaching from the FRC. In the second in vitro study, different adhesive systems were tested in fixing the implant to bone surface. This was done to find an alternative implant fixing system to screws and pins. On the basis of this study, it was found that the surface of the calvarial bone needed both mechanical and chemical treatments before the resinimpregnated FRC could be properly fixed onto it. In three animal studies performed with rabbit frontal bone defects and critical size calvarial bone defect models, biological responses to the FRC implants were evaluated. On the basis of theseevaluations, it can be concluded that the FRC, based on E-glass (electrical glass) fibres forming a porous fibre veil enables the ingrowth of connective tissues to the inner structures of the material, as well as the bone formation and mineralization inside the fibre veil. Bone formation could be enhanced by using bioactive glass granules fixed to the FRC implants. FRC-implanted bone defects healed partly; no total healing of defects was achieved. Biological responses during the follow-up time, at a maximum of 12 weeks, to resin-impregnated composite implant seemed to depend on the polymerization time of the resin matrix of the FRC. Both of the studied resin systems used in the FRC were photopolymerised and the heat-induced postpolymerisation was used additionally.

Reconstruction of 3D Planar Objects with Partial Occlusion

Kolmiulotteisten kappaleiden rekonstruktio on yksi konenäön haastavimmista ongelmista, koska kappaleiden kolmiulotteisia etäisyyksiä ei voida selvittää yhdestä kaksiulotteisesta kuvasta. Ongelma voidaan ratkaista stereonäön avulla, jossa näkymän kolmiulotteinen rakenne päätellään usean kuvan perusteella. Tämä lähestymistapa mahdollistaa kuitenkin vain rekonstruktion niille kappaleiden osille, jotka näkyvät vähintään kahdessa kuvassa. Piilossa olevien osien rekonstruktio ei ole mahdollista pelkästään stereonäön avulla. Tässä työssä on kehitetty uusi menetelmä osittain piilossa olevien kolmiulotteisten tasomaisten kappaleiden rekonstruktioon. Menetelmän avulla voidaan selvittää hyvällä tarkkuudella tasomaisista pinnoista koostuvan kappaleen muoto ja paikka käyttäen kahta kuvaa kappaleesta. Menetelmä perustuu epipolaarigeometriaan, jonka avulla selvitetään molemmissa kuvissa näkyvät kappaleiden osat. Osittain piilossa olevien piirteiden rekonstruointi suoritetaan käyttämäen stereonäköä sekä tietoa kappaleen rakenteesta. Esitettyä ratkaisua voitaisiin käyttää esimerkiksi kolmiulotteisten kappaleiden visualisointiin, robotin navigointiin tai esineentunnistukseen.

Rakennukset ja rakentajat Raision Ihalassa rautakauden lopulla ja varhaisella keskiajalla

Turun yliopiston arkeologian oppiaine tutki Raision Ihalan historiallisella kylätontilla, ns. Mullin eduspellolla, asuinpaikan, josta löydettiin maamme oloissa harvinaisen hyvin säilyneitä rakennusten puuosien jäännöksiä. Löytö on ainutlaatuinen Suomen oloissa ja sillä on kansainvälistäkin merkitystä, koska hyvin säilyneet myöhemmän rautakauden ja varhaisen keskiajan maaseutuasuinpaikat, joista tavataan puujäännöksiä, ovat harvinaisia erityisesti itäisen Itämeren piirissä. Rakennukset on ennallistettu käyttäen tiukkaa paikallisen analogian (’Tight Local Analogy’) metodia, erityisesti suoraa historiallista analogista lähestymistapaa. Tätä tarkoitusta varten muodostettiin aluksi arkeologinen, historiallinen ja etnografinen lähdemalli. Tämä valittiin maantieteellisesti ja ajallisesti relevantista tutkimusaineistosta pohjoisen Itämeren piiristä. Tiedot lounaisen Suomen rakennuksista ja rakennusteknologiasta katsottiin olevan tärkein osa mallia johtuen historiallisesta ja spatiaalisesta jatkuvuudesta. Lähdemalli yhdistettiin sitten Mullin arkeologiseen aineistoon ja analyysin tuloksena saatiin rakennusten ennallistukset. Mullista on voitu ennallistaa ainakin kuusi eri rakennusta neljässä eri rakennuspaikassa. Rakennusteknologia perustui kattoa kannattaviin horisontaalisiin pitkiin seinähirsiin, jotka oli nurkissa yhdistetty joko salvoksella tai varhopatsaalla. Kaikissa rakennuksissa ulkoseinän pituus oli 5 – 7 metriä. Löydettiin lisäksi savi- ja puulattioita sekä kaksi tulisijaa, savikupoliuuni ja avoin liesi. Runsaan palaneen saven perusteella on mahdollista päätellä, että katto oli mitä todennäköisimmin kaksilappeinen vuoliaiskatto, joka oli katettu puulla ja/tai turpeella. Kaikki rakennukset olivat samaa tyyppiä ja ne käsittivät isomman huoneen ja kapean eteisen. Kaikki analysoitu puu oli mäntyä. Ulkoalueelta tavattiin lisäksi tunkioita, ojia, aitoja ja erilaisia varastokuoppia. Rakennukset on ajoitettu 900-luvun lopulta 1200-luvun lopulle (cal AD). Lopuksi tutkittiin rakennuksia yhteisöllisessä ympäristössään, niiden ajallista asemaa sekä asukkaiden erilaisia spatiaalisia kokemuksia ja yhteyksiä. Raision Ihalaa analysoidaan sosiaalisen identiteetin ja sen materiaalisten ilmenemismuotojen kautta. Nämä sosiaaliset identiteetit muodostuvat kommunikaatioverkostoista eri spatiaalisilla ja yhteisöllisillä ta¬soilla. Näitä eri tasoja ovat: 1) kotitalous arjen toimintoineen, perhe ja sukulaisuussuhteet traditioineen; 2) paikallinen identiteetti, rakennus, rakennuspaikka, asuinpaikan ympäristö ja sen käyttö, (maa)talo ja kylä; 3) Raision Ihalan kylä laajemmassa alueellisessa kontekstissaan pohjoisen Itämeren piirissä: kauppiaiden ja käsityöläisten kontaktiverkostot, uskonnollinen identiteetti ja sen muutokset.

Choosing the optimal energy system for buildings and districts

The purpose of this master’s thesis was to develop a method to be used in the selection of an optimal energy system for buildings and districts. The term optimal energy system was defined as the energy system which best fulfils the requirements of the stakeholder on whose preferences the energy systems are evaluated. The most influential stakeholder in the process of selecting an energy system was considered to be the district developer. The selection method consisted of several steps: Definition of the district, calculating the energy consumption of the district and buildings within the district, defining suitable energy system alternatives for the district, definition of the comparing criteria, calculating the parameters of the comparing criteria for each energy system alternative and finally using a multi-criteria decision method to rank the alternatives. For the purposes of the selection method, the factors affecting the energy consumption of buildings and districts and technologies enabling the use of renewable energy were reviewed. The key element of the selection method was a multi-criteria decision making method, PROMETHEE II. In order to compare the energy system alternatives with the developed method, the comparing criteria were defined in the study. The criteria included costs, environmental impacts and technological and technical characteristics of the energy systems. Each criterion was given an importance, based on a questionnaire which was sent for the steering groups of two district development projects. The selection method was applied in two case study analyses. The results indicate that the selection method provides a viable and easy way to provide the decision makers alternatives and recommendations regarding the selection of an energy system. Since the comparison is carried out by changing the alternatives into numeric form, the presented selection method was found to exclude any unjustified preferences over certain energy systems alternatives which would affect the selection.

Organisational learning and knowledge acquisition. A case study of internationalising manufacturers of wood-based prefabricated buildings

The study investigates organisational learning and knowledge acquisition of wood-based prefabricated building manufacturers. This certain group of case companies was chosen, because their management and their employees generally have a strong manufacturing and engineering background, while the housing sector is characterised by national norms, regulations, as well as local building styles. Considering this setting, it was investigated, how the case companies develop organisational learning capabilities, acquire and transfer knowledge for their internationalisation. The theoretical framework of this study constitutes the knowledge-based conceptualisation of internationalisation, which combines the traditional internationalisation process, as well as the international new venture perspective based on their commonalities in the knowledge-based view of the firm. Different theories of internationalisation, including the network-perspective, were outlined and a framework on organisational learning and knowledge acquisition was established. The empirical research followed a qualitative approach, deploying a multiple-case study with five case companies from Austria, Finland and Germany. In the study, the development of the wood-based prefabricated building industry and of the case companies are described, and the motives, facilitators and challenges for foreign expansion, as well as the companies’ internationalisation approaches are compared. Different methods of how companies facilitate the knowledge-exchange or learn about new markets are also outlined. Experience, market knowledge and personal contacts are considered essential for the internationalisation process. The major finding of the study is that it is not necessary to acquire the market knowledge internally in a slow process as proposed by the Uppsala model. In four cases companies engaged knowledge in symbiotic relations with local business partners. Thereby, the building manufacturers contribute their design and production capabilities, and in return, their local partners provide them with knowledge about the market and local regulations; while they manage the sales and construction operations. Thus, the study provides strong evidence for the propositions of network perspective. One case company developed the knowledge internally in a gradual process: it entered the market sequentially with several business lines, showing an increasing level of complexity. In both of the observed strategies, single-loop and double-loop learning processes occurred.

Degenerative rotator cuff tear – Results and prognostic factors of arthroscopic repair

Factors affecting outcome after arthroscopic rotator cuff repair are unclear and there is still insufficient evidence of efficacy of any treatment modality for rotator cuff tears. The purpose of the current study was to determine in a prospective randomized multicenter trial whether there is a difference in clinical outcome between three different treatment modalities in the treatment of degenerative, atraumatic supraspinatus tendon tear in elderly patients. 180 shoulders were randomized into three treatment groups: 1) physiotherapy, 2) arthroscopic acromioplasty and physiotherapy, 3) arthroscopic rotator cuff reconstruction, acromioplasty and physiotherapy. The objective of this study was also to evaluate retrospectively the effect of trauma, the size of the rotator cuff tear, smoking habits and glenohumeral osteoarthritis on the clinical treatment outcome after arthroscopic rotator cuff repair in a consecutively prospectively collected series of patients. The patient data was gathered to the electronic database. The Constant score was used as a primary outcome measure. The follow‐up time was one year. The main finding was that operative treatment did not provide benefit over conservative regimen in elderly patients with atraumatic supraspinatus tear. Trauma did not affect on the clinical outcome and there was neither difference in the age of patients with traumatic vs. non‐traumatic rotator cuff tears. The size of the rotator cuff tear correlated significantly with the clinical results. The outcome was significantly poorer in tears with infraspinatus involvement compared to anterosuperior tears. Operatively treated rotator cuff tear patients who smoked were significantly younger than non‐smokers, and smoking was associated with poorer clinical outcome. Concomitant osteoarthritis of the glenohumeral joint was found to be a relatively common finding in supraspinatus tear patients. Osteoarthritis of the glenohumeral joint in operatively treated supraspinatus tear patients predicted poorer clinical results comparing to patients without osteoarthritis.

Reconstruction of cranial bone defects with fiber-reinforced composite–bioactive glass implants

A cranial bone defect may result after an operative treatment of trauma, infection, vascular insult, or tumor. New biomaterials for cranial bone defect reconstructions are needed for example to mimic the biomechanical properties and structure of cranial bone. A novel glass fiber-reinforced composite implant with bioactive glass particulates (FRC–BG, fiber-reinforced composite–bioactive glass) has osteointegrative potential in a preclinical setting. The aim of the first and second study was to investigate the functionality of a FRC–BG implant in the reconstruction of cranial bone defects. During the years 2007–2014, a prospective clinical trial was conducted in two tertiary level academic institutions (Turku University Hospital and Oulu University Hospital) to evaluate the treatment outcome in 35 patients that underwent a FRC–BG cranioplasty. The treatment outcome was good both in adult and pediatric patients. A number of conventional complications related to cranioplasty were observed. In the third study, a retrospective outcome evaluation of 100 cranioplasty procedures performed in Turku University Hospital between years 2002–2012 was conducted. The experimental fourth study was conducted to test the load-bearing capacity and fracture behavior of FRC–BG implants under static loading. The interconnective bars in the implant structure markedly increased the load-bearing capacity of the implant. A loading test did not demonstrate any protrusions of glass fibers or fiber cut. The fracture type was buckling and delamination. In this study, a postoperative complication requiring a reoperation or removal of the cranioplasty material was observed in one out of five cranioplasty patients. The treatment outcomes of cranioplasty performed with different synthetic materials did not show significant difference when compared with autograft. The FRC–BG implant was demonstrated to be safe and biocompatible biomaterial for large cranial bone defect reconstructions in adult and pediatric patients.