Electrospinning of nanofibres for construction of vital organ replacements

This paper described the production of a novel biosynthetic material using the manufacturing technique of electro spinning for the construction of scaffold for organ replacement. This electrostatic technique uses an electric field to control the deposition of polymer fibres onto a specific substrate to fabricate fibrous polymer constructs composed of fibre diameters ranging from several microns down to 100 nm or less. Two areas of research, in particular, heart valve leaflets and blood vessel will be discussed. Here, a sandwich structure nanofibre mesh was used to construct materials for leaflets of heart valve and blood vessel. In the case of heart valve leaflet, the randomly oriented polyurethane nanofibres were prepared as the first layer, followed by gelatin-chitosan complex layer. Complex nanofibres were initially used to spin on the PU layer with cross orientation to mimic the fibrosa layer. A gelatin and chitosan complex was then spun onto the other side of PU nanofibre mesh to mimic the ventricularis layer. This particular sandwich structure using the PU layer was designed to simulate the mechanical properties of natural tissue. In addition, this design was aimed to provide good biocompatibility and improved cellular environment to assist in adhesion and proliferation. Smooth muscle cells adhered and flattened out onto the surface of the gelatin-chitosan complex as early as 1 day post seeding. There is great potential for this biosynthetic biocompatible nanofibrous material to be developed for various clinical applications.

Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7 : Australian orthopaedic association national joint replacement registry

Background The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia.

Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk.

Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups.

Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

Utilisation of primary total knee joint replacements across socioeconomic status in the Barwon Statistical Division, Australia 2006-7 : a cross-sectional study

Objectives There are few Australian data that examine the association between total knee joint replacement (TKR) utilisation and socioeconomic status (SES). This study examined TKR surgeries with a diagnosis of osteoarthritis (OA) performed for residents of Barwon Statistical Division (BSD) for 2006–2007.

Design Cross-sectional.

Setting BSD, South-eastern Victoria, Australia

Participants All patients who underwent a TKR for OA, 2006–2007, and whose residential postcode was identified as within the BSD of Australia, and for whom SES data were available, were eligible for inclusion.

Primary outcome measure Primary TKR data ascertained from the Australian Orthopaedic Association National Joint Replacement Registry. Residential addresses were matched with the Australian Bureau of Statistics census data, and the Index of Relative Socioeconomic Disadvantage was used to determine SES, categorised into quintiles whereby quintile 1 indicated the most disadvantaged and quintile 5 the least disadvantaged. Age-specific and sex-specific rates of TKR utilisation per 1000 person-years were reported for 10-year age bands.

Results Females accounted for 62.7% of the 691 primary TKR surgeries performed during 2006–2007. The greatest utilisation rates of TKR in males was 7.6 observed in those aged >79 years, and in 10.2 in females observed in those aged 70–79 years. An increase in TKR was observed for males in SES quintile four compared to quintile 1 in which the lowest utilisation which was observed (p=0.04). No differences were observed in females across SES quintiles.

Conclusions Further investigation is warranted on a larger scale to examine the role that SES may play in TKR utilisation, and to determine whether any social disparities in TKR utilisation reflect health system biases or geographic differences.

Associations between socioeconomic status and primary total knee joint replacements performed for osteoarthritis across Australia 2003-10: data from the Australian Orthopaedic Association National Joint Replacement Registry

Relatively little is known about the social distribution of total knee joint replacement (TKR) uptake in Australia. We examine associations between socioeconomic status (SES) and TKR performed for diagnosed osteoarthritis 2003-10 for all Australian males and females aged ≥30 yr.

An evaluation of the suitability of selected waste products in feeds for three fish species

Five types of aquatic food industry waste products (carp offal, carp roe, fish frames, trout offal and surimi processing waste) together with fish meal were evaluated for their suitability as potential fish meal replacements, partially or wholly, in diets for three species (rainbow trout, Murray cod and shortfin eel) cultured in Australia, using a number of criteria.

The proximate composition of the ingredients on a dry matter basis including protein content, lipid and ash, varied considerably. The essential amino acid (EAA) contents of the waste products and fish meal decreased in the order: carp roe > fish meal > carp offal > 'surimi' processing waste > fish frames > trout offal. The results of cluster analysis of A/E ratios of waste products and fish whole body fell within three clusters. The EAAI of whole body tissue of Murray cod, rainbow trout and Australian shortfin eel however, were closest to fish meal, followed by fish frame waste and/or 'surimi' waste. The results on A/E ratios and EAAI did not conform to the raw data on TAA and EAA. Therefore, the study emphasizes the need to have a multi-prong approach to determine the suitability of ingredients for incorporation into fish feeds.

Leontief paradox and the role of factor intensity measurement

In contrast with the prediction of the Heckscher-Ohlin (HO) theorem, Leontief (1953) found that the capital-labor ratio embodied in the US exports is smaller than the capital-labor ratio embodied in the US competitive import replacements. In Leontief's analysis, the measured factor content of US imports is computed based on the assumption that all countries are using the US factor intensity techniques. This paper relaxes all assumption of identical factor intensity techniques. It uses an inferring method to infer the factor intensity techniques of different countries based on international relative factor price differences. With the inferred differentiated factor intensity techniques , the Leontief paradox is re-investigated and is found to be either disappeared or eased.

Continuity of care and general wellbeing of patients with comorbidities requiring joint replacement

Aim. The aim of this paper is to examine the continuity of care and general wellbeing of patients with comorbidities undergoing elective total hip or knee joint replacement.
Background. Advances in medical science and improved lifestyles have reduced mortality rates in most Western countries. As a result, there is an ageing population with a concomitant growth in the number of people who are living with multiple chronic illnesses, commonly referred to as comorbidities. These patients often require acute care services, creating a blend of acute and chronic illness needs. For example, joint replacement surgery is frequently performed to improve impaired mobility associated with osteoarthritis.
Method. A purposive sample of twenty participants with multiple comorbidities who required joint replacement surgery was recruited to obtain survey, interview and medical record audit data. Data were collected during 2004 and 2005.
Findings. Comorbidity care was poorly co-ordinated prior to having surgery, during the acute care stay and following surgery and primarily entailed prescribed medicines. The main focus in acute care was patient throughput following joint replacement surgery according to a prescribed clinical pathway. General wellbeing was less than optimal: participants reported pain, fatigue, insomnia and alterations in urinary elimination as the chief sources of discomfort during the course of the study.
Conclusion. Continuity of care of comorbidities was lacking. Comorbidities affected patient general wellbeing and delayed recovery from surgery. Acute care, clinical pathways and the specialisation of medicine and nursing subordinated the general problem of patients with comorbidities. Systems designed to integrate and co-ordinate chronic illness care had limited application in the acute care setting. A multidisciplinary, holistic approach is required. Recommendations for further research conclude this paper.

The interface of acute and aged care: the role of the nurse in provincial area

Objective: This study was to investigate issues that arose from pre-admission to post-discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.

Method: The study involved a multi-site, multi-agency and multi-method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.

Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post-acute discharge.

Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.

Current developments and future challenges for the creation of aortic heart valve

The concept of tissue-engineered heart valves offers an alternative to current heart valve replacements that is capable of addressing shortcomings such as life-long administration of anticoagulants, inadequate durability, and inability to grow. Since tissue engineering is a multifaceted area, studies conducted have focused on different aspects such as hemodynamics, cellular interactions and mechanisms, scaffold designs, and mechanical characteristics in the form of both in vitro and in vivo investigations. This review concentrates on the advancements of scaffold materials and manufacturing processes, and on cell–scaffold interactions. Aside from the commonly used materials, polyglycolic acid and polylactic acid, novel polymers such as hydrogels and trimethylene carbonate-based polymers are being developed to simulate the natural mechanical characteristics of heart valves. Electrospinning has been examined as a new manufacturing technique that has the potential to facilitate tissue formation via increased surface area. The type of cells utilized for seeding onto the scaffolds is another factor to take into consideration; currently, stem cells are of great interest because of their potential to differentiate into various types of cells. Although extensive studies have been conducted, the creation of a fully functional heart valve that is clinically applicable still requires further investigation due to the complexity and intricacies of the heart valve.

Toward a broader appreciation of human motion in education

Motion is a fundamental activity for the healthy functioning human organism. Its importance, however, is increasingly de-valued in Western cultures as they speed toward adopting technologies and virtual experiences as adjuncts to, and even replacements for7 traditional educational structures and processes that involve physical activity. Organised and reflective experience of human motion is becoming increasingly marginalised in teaching methodologies and learning programs in educational institutions at all levels around the globe. This inquiry sets out to gain a greater understanding of why people and human motion become disconnected, particularly during periods of formal education. A central question and two sub-questions form the basis of the inquiry. The central question asks why human motion is not valued and more utilised in education. In particular, why do learning areas that directly represent involvement with human motion, such as physical education, continually struggle in education programs. It directs the investigation to focus on the causes rather than the symptoms of the disuse and devaluation of human motion in Australian education. The two sub-questions split the praxis of the study. The first seeks to understand how the causes of devaluation work in the educational context lo affect the lack of acknowledgement; and the second considers ways to counter the disuse of human movement in education programs. To address these questions, the research focuses on rebutting the notion of a mind-body dualism. Rather, it seeks to better understand how humans learn and function as monists - integrated beings, acquiring self-knowledge in their 'world of being' in which bodily and emotional experiences, and reasoning are inextricably intertwined. I have approached this qualitative research as an ethnographic sociologist examining the issues from a critical high modernist perspective in order to demonstrate the pervading influence in Australian education of strong beliefs and values from the era of Enlightenment. Narrative analysis of 'memoir' in the form of self-defining memories was selected to gain a sensibility of the connectedness between human emotion, motion and reasoning in the lived experiences of students in three primary and three secondary schools across Years 2-12. An opportunity for human movement to be more valued and utilised in emerging educational frameworks that have life knowledge, dispositions and capabilities at their core is identified. The inquiry proposes a conceptualisation of human motion in education for new times characterised by the need for people to develop personal resources and strong positive identities in order to cope with a world of rapid change and uncertainty.

Endothelialisation and cell retention on gelation-chitosan coated electrospun polyurethane, poly (lactide-co-glycolide) and collagen-coated pericardium

Arterial bypass and heart valve replacements are two of the most common surgical treatments in cardiovascular surgery today. Currently, artificial materials are used as substitute for these cardiac tissues. However, these foreign materials do not have the ability to grow, repair or remodel and are thrombogenic, leading to stenosis. With the aid of tissue engineering, it is possible to develop functional identical copies of healthy heart valves and arteries, which are biocompatible. Although much effort has been made into this area, there are still inconsistencies with respect to
endothelialisation and cell retention on synthetic biological grafts. These variations may be attributed to differences in factors such as cell seeding density, incubation periods and effects of shear stress. In this study, we have compared the endothelialisation and cell retention between gelain chitosan-coated electrospun polyurethane (PU), poly (lactide co-glycolide) (PGA/PLA) and collagen-coated pericardium. Endothelial cells adhered to all of the materials as early as 1–day post seeding. After 7-day of seeding, the coverage on PU was almost 45% and that on PGA/PLA was about 25% and the least was on collagen-coated pericardium of approximately 15%. It was observed that the PU showed superior cell coverage and cell retention in comparison to the PGA/PLA and collagen-coated pericardium.

Multi-point and multi-level solar integration into a conventional coal-fired power plant

Solar-aided power generation (SAPG) is capable of integrating solar thermal energy into a conventional thermal power plant, at multi-points and multi-levels, to replace parts of steam extractions in the regenerative Rankine cycle. The integration assists the power plant to reduce coal (gas) consumption and pollution emission or to increase power output. The overall efficiencies of the SAPG plants with different solar replacements of extraction steam have been studied in this paper. The results indicate that the solar thermal to electricity conversion efficiencies of the SAPG system are higher than those of a solar-alone power plant with the same temperature level of solar input. The efficiency with solar input at 330 °C can be as high as 45% theoretically in a SAPG plant. Even the low-temperature solar heat at about 85 °C can be used in the SAPG system to heat the lower temperature feedwater, and the solar to electricity efficiency is nearly 10%. However, the low-temperature heat resource is very hard to be used for power generation in other types of solar power plants. Therefore, the SAPG plant is one of the most efficient ways for solar thermal power generation.

n-3 Polyunsaturated fatty acid-rich vegetable oils and blends

α-Linseed, camelina. perilla, and echium oils are n-3 C₁₈ polyunsaturated fatty acid (PUFA)-rich vegetable oil sources viewed as favorable replacements to fish oil in aquaculture feed (aquafeed) production in consideration of their high (α-linolenic acid (ALA, 18:3n-3) and/or stearidonic acid (SDA, 18:4n-3) contents and potential for subsequent bioconversion to n-3 long-chain polyunsaturated fatty acids (LC-PUFA) in farmed aquatic species. While the total production of these oils is currently low in comparison with that of other terrestrial oil sources, their distinct fatty acid composition and high n-3 to n-6 ratio deliver a unique substitute to fish oil in aquafeeds, presently unparalleled in other alternative terrestrial oil sources. The dietary inclusion of these oil sources has therefore attracted significant research attention, resulting in a multitude of investigations across a broad range of aquatic species (finfish and crustaceans). Generally, providing that the essential fatty acid (EFA) requirements of the species under investigation were met and an adequate level of fish meal was present in the diet, it was found possible to replace 100% and 60-70% of the dietary fish oil component for freshwater and marine species, respectively, with minimal impact on growth performance indices. However, the substitution of fish oil with n-3-rich vegetable oils and/or vegetable oil blends resulted in substantially reduced concentrations of health-promoting eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3) in the edible portion of the farmed species. This chapter provides an overview of the use of n-3 PUFA-rich vegetable oils and/or vegetable oil blends for use in aquafeeds. In particular, key aspects of oil production, processing, and refinement will be presented, and individual differences pertaining to the physical, chemical, and nutritional characteristics of the oil types will be highlighted. Following on from this, a summary of the key findings relevant to n-3 PUFA-rich vegetable oil inclusion in aquafeeds will be discussed, with particular emphasis placed on growth performance and nutritional modification.

3D fibrous structures as cardiovascular implants

Medical textiles are a highly specialised stream of technical textiles industry with a growing range of applications. A significant advancement has been achieved in surgical products or biomedical textiles (implantable/non-implantable) with the advent of 3D textile manufacturing techniques. Cardiovascular soft tissue implants (vascular grafts) have been a field of interest over decades for use of innovative 3D tubular structures in treatment of cardiovascular diseases. In the field of soft tissue implants, knitted and woven tubular structures are being used for large diameter blood vessel replacements. Advent of electrospinning and tissue engineering techniques has been able to provide promising answers to small diameter vascular grafts. The aim of this review is to outline the approaches in vascular graft development utilising different 3D tubular structure forming techniques. The emphasis is on vascular graft development techniques that can help improve treatment efficacy in future.

Audit of the Douglas Hocking Research Institute bone bank : ten years of non-irradiated bone graft

Background:  An audit performed in the use of non-irradiated femoral head bone graft at the Geelong Hospital over a 10-year period. While it is thought the non-irradiated bone graft provides a better structural construct there is theoretical increased risk of infection transmission.

Methods:  We performed a retrospective review of prospectively collected data in the use of non-irradiated bone allograft used from the Geelong Hospital Douglas Hosking Research Institute bone bank over a 10-year period. The review was performed using data collected from the bone bank and correlating it with the patient’s medical record. All complications, including infections, related to the use of the allograft were recorded.

Results:  We found that over the 10 years to 2004 that 811 femoral heads were donated, with 555 being used over 362 procedures in 316 patients. We identified a total of nine deep infections, of which seven were in joint replacements. Overall this was a 2.5% deep infection rate, which was lowered to 1.4% if the previously infected joints that were operated on were excluded.

Conclusion:  The use of non-irradiated femoral head bone graft was safe in a regional setting.