The impact of nurse-led education on haemodialysis patients' phosphate binder medication adherence

Background Phosphate binder medication adherence is required to maintain optimal phosphate levels and minimise bone disease in people with end stage kidney disease.

Objectives To examine the impact of a nurse-led education intervention on bone disorder markers, adherence to phosphate binder medication and medication knowledge.

Design Descriptive study with a paired pre–post intervention survey.

Participants Adults receiving haemodialysis.

Methods Twelve-week intervention where patients self-administered their phosphate binder medication at each dialysis treatment. Nurses provided individualised education. Patients completed a pre- and post-intervention survey designed to explore their knowledge of phosphate binders.

Results There were no statistically significant changes in clinical markers but a significant improvement in the proportion of patients who took their phosphate binder correctly, increasing from 44 to 72% (p = 0.016). There were moderate to large effect size changes for improved knowledge.

Conclusions A nurse-led intervention education programme can increase patients' phosphate binder adherence. However, this does not necessarily manifest into improved serum phosphate levels.

A self-supported, flexible, binder-free pseudo-supercapacitor electrode material with high capacitance and cycling stability from hollow, capsular polypyrrole fibers

Flexible energy devices with high performance and long-term stability are highly promising for applications in portable electronics, but remain challenging to develop. As an electrode material for pseudo-supercapacitors, conducting polymers typically show higher energy storage ability over carbon materials and larger conductivity than transition-metal oxides. However, conducting polymer-based supercapacitors often have poor cycling stability, attributable to the structural rupture caused by the large volume contrast between doping and de-doping states, which has been the main obstacle to their practical applications. Herein, we report a simple method to prepare a flexible, binder-free, self-supported polypyrrole (PPy) supercapacitor electrode with high cycling stability through using novel, hollow PPy nanofibers with porous capsular walls as a film-forming material. The unique fiber structure and capsular walls provide the PPy film with enough free-space to adapt to volume variation during doping/de-doping, leading to super-high cycling stability (capacitance retention > 90% after 11000 charge-discharge cycles at a high current density of 10 A g^-1) and high rate capability (capacitance retention ∼ 82.1% at a current density in the range of 0.25-10 A g^-1).

The effects of various binders and moisture content on pellet stability of research diets for freshwater crayfish

Two experiments were conducted to assess the water stability of a practical research diet manufactured with various binders and differing levels of moisture. In the first experiment the binders – agar, gelatine, carrageenan, and carboxymethylcellulose (CMC) were included at both 3 and 5% of total ingredient weight. All binders were tested with equal ingredient weight to water volume, and additionally carrageenan was tested in a diet with double the water volume. The dry matter remaining following immersion for up to 180 min was calculated and the rate of pellet decay was modelled using the Weibull distribution. The analysis revealed that the rate of dry matter loss decreased with time, and that carrageenan and CMC binders were significantly better (P < 0.001) binders than the agar and gelatine. The 5% binder concentration slowed the decay rate by as much as 62% as compared with the 3% binder concentration. The second experiment compared the binding performance of carrageenan and sodium alginate in both 50% moisture and 10% moisture pellets. The same analysis revealed that 10% moisture alginate-bound pellets were more water stable than the others. A discussion of the use of moist diets for crayfish research is included.

Analysis of stamping production data with view towards quality management

A quality analysis trial was undertaken at Ford Geelong Stamping Plant on a press line that was fitted with standard press sensors to measure press and binder force over the stamping cycle for each panel. The quality of randomly sampled panels was measured by obtaining the panel thicknesses at five points, for 135 panels in total. These points were chosen such that they exhibited different forming modes. This paper analyses the input force data and the output quality data from the trial to determine any potential relationships. The analysis of the production data was performed using statistical correlation techniques to determine initial potential relationships between input and output variables. An Active Shape Model was used to extract features when identifying the major sources of variation within the input data. However, the initial analysis of the data elicited no direct relationship between the input variables measured and the panel thicknesses. This result is significant as the data collected is from a standard sensor configuration found in many press lines through-out the world. The reason for the lack of a direct relationship is believed to come from the lack of sensitivity in the force measurements which are not able to identify small changes in the process, whereas gross geometric variations have in previous studies shown an obvious relationship with changes in the force press profile. This means that existing force sensors require augmentation by additional sensors if a detailed automatic quality control system for the press lines based on input sensors alone.

Elastic behaviour in mechanical draw presses

This thesis explores the elastic behaviour of the mechanical double action press and draw die system commonly used to draw sheet metal components in the automotive industry. High process variability in production and excessive time spent in die try-out are significant problems in automotive stamping. It has previously been suggested that the elastic behaviour of the system may contribute to these problems. However, the mechanical principles that cause the press system to affect the forming process have not been documented in detail. Due to a poor understanding of these problems in industry, the elasticity of the press and tools is currently not considered during the die design. The aim of this work was to explore the physical principles of press system elasticity and determine the extent to which it contributes to problems in try-out and production. On the basis of this analysis methods were developed for controlling or accounting for problems during the design process. The application of frictional restraining force to the edges of the blank during forming depends on the distribution and magnitude of the clamping force between the binders surfaces of the draw die. This is an important control parameter for the deep drawing process. It has been demonstrated in this work that the elasticity of the press and draw die can affect clamping force in two ways. The response of the press system, to the forces produced in the press during forming, causes the magnitude of clamping force to change during the stroke. This was demonstrated using measured data from a production press. A simple linear elastic model of the press system was developed to illustrate a definite link between the measured force variation and the elasticity of the press and tools. The simple model was extended into a finite element model of the complete press system, which was used to control a forming simulation. It was demonstrated that stiffness variation within the system could influence the final strains in a drawn part. At the conclusion of this investigation a method is proposed for assessing the sensitivity of a part to clamping force variation in the press during die design. A means of reducing variation in the press through the addition of a simple linear spring element is also discussed. The second part of the work assessed the influence of tool structure on the distribution of frictional restraining forces to the blank. A forming simulation showed that tool stiffness affects the distribution of clamping pressure between the binders. This was also shown to affect the final strains in a drawn part. However, the most significant influence on restraining force was the tendency of the blank to increase in thickness between the binders during forming. Using a finite element approximation of the try-out process it was shown that the structure of the tool would also contribute to the problems currently experienced in try-out where uneven contact pressure distributions are addressed by manually adjusting the tool surfaces. Finally a generalised approach to designing draw die structures was developed. Simple analysis methods were combined with finite element based topology optimisation techniques to develop a set of basic design guidelines. The aim of the guidelines was to produce a structure with uniform stiffness response to a pressure applied at the binder surface. The work concludes with a recommendation for introducing the methods developed in this thesis into the standard production process.

Electrophoretic deposition of YSZ thin-film electrolyte for SOFCs utilizing electrostatic-steric stabilized suspensions obtained via high energy ball milling

This manuscript describes a facile alternative route to make thin-film yttria-stabilized zirconia (YSZ) electrolyte by liquid-phase assisted electrophoretic deposition utilizing electrostatic-steric stabilized YSZ suspension followed by sintering. Very fine YSZ particles in ball-milled suspension facilitate their sustained dispersion through electrostatic mechanism as evidenced by their higher zeta potentials. Binder addition into the ball-milled suspension is also demonstrated to contribute complementary steric hindrance effects on suspension stability. As the consequence, the film quality and sinterability improve in the sequence of film made from non ball-milled suspension, film made from ball-milled suspension and film made from ball-milled suspension with binder addition. The specific deposition mechanisms pertaining to each suspension are also postulated and discussed below. A very thin dense electrolyte layer of ∼10 μm can be achieved via electrophoretic deposition route utilizing ball-milled suspension and binder addition. This in turn, makes the electrolyte resistance a more negligible part of the overall cell resistance. Further on, we also tested the performance of SOFC utilizing as-formed 10 μm YSZ electrolyte i.e. YSZ-NiO|YSZ|LSM (La0.8Sr0.2MnO3-δ), whereby a maximum power density of ∼850 mW cm−2 at 850 °C was demonstrated.

Carbon Nanotube Biofiber Formation in a Polymer-Free Coagulation Bath

A novel solution spinning method to produce highly conducting carbon nanotube (CNT) biofibers is reported. In this process, carbon nanotubes are dispersed using biomolecules such as hyaluronic acid, chitosan, and DNA, and these dispersions are used as spinning solutions. Unlike previous reports in which a polymer binder is used in the coagulation bath, these dispersions can be converted into fibers simply by altering the nature of the coagulation bath via pH control, use of a crosslinking agent, or use of a biomolecule-precipitating solvent system. With strength comparable to most reported CNT fibers to date, these CNT biofibers demonstrate superior electrical conductivities. Cell culture experiments are performed to investigate the cytotoxicity of these fibers. This novel fiber spinning approach could simplify methodologies for creating electrically conducting and biocompatible platforms for a variety of biomedical applications, particularly in those systems where the application of an electrical field is advantageous?for example, in directed nerve and/or muscle repair.

Efficient simulations of the aqueous bio-interface of graphitic nanostructures with a polarisable model.

To fully harness the enormous potential offered by interfaces between graphitic nanostructures and biomolecules, detailed connections between adsorbed conformations and adsorption behaviour are needed. To elucidate these links, a key approach, in partnership with experimental techniques, is molecular simulation. For this, a force-field (FF) that can appropriately capture the relevant physics and chemistry of these complex bio-interfaces, while allowing extensive conformational sampling, and also supporting inter-operability with known biological FFs, is a pivotal requirement. Here, we present and apply such a force-field, GRAPPA, designed to work with the CHARMM FF. GRAPPA is an efficiently implemented polarisable force-field, informed by extensive plane-wave DFT calculations using the revPBE-vdW-DF functional. GRAPPA adequately recovers the spatial and orientational structuring of the aqueous interface of graphene and carbon nanotubes, compared with more sophisticated approaches. We apply GRAPPA to determine the free energy of adsorption for a range of amino acids, identifying Trp, Tyr and Arg to have the strongest binding affinity and Asp to be a weak binder. The GRAPPA FF can be readily incorporated into mainstream simulation packages, and will enable large-scale polarisable biointerfacial simulations at graphitic interfaces, that will aid the development of biomolecule-mediated, solution-based graphene processing and self-assembly strategies.

Binding affinities of amino acid analogues at the charged aqueous titania interface : implications for titania-binding peptides

Despite the extensive utilization of biomolecule-titania interfaces, biomolecular recognition and interactions at the aqueous titania interface remain far from being fully understood. Here, atomistic molecular dynamics simulations, in partnership with metadynamics, are used to calculate the free energy of adsorption of different amino acid side chain analogues at the negatively-charged aqueous rutile TiO2 (110) interface, under conditions corresponding with neutral pH. Our calculations predict that charged amino acid analogues have a relatively high affinity to the titania surface, with the arginine analogue predicted to be the strongest binder. Interactions between uncharged amino acid analogues and titania are found to be repulsive or weak at best. All of the residues that bound to the negatively-charged interface show a relatively stronger adsorption compared with the charge-neutral interface, including the negatively-charged analogue. Of the analogues that are found to bind to the titania surface, the rank ordering of the binding affinities is predicted to be "arginine" > "lysine" ≈ aspartic acid > "serine". This is the same ordering as was found previously for the charge-neutral aqueous titania interface. Our results show very good agreement with available experimental data and can provide a baseline for the interpretation of peptide-TiO2 adsorption data.

What makes a good graphene-binding peptide? Adsorption of amino acids and peptides at aqueous graphene interfaces

Investigation of the non-covalent interaction of biomolecules with aqueous graphene interfaces is a rapidly expanding area. However, reliable exploitation of these interfaces in many applications requires that the links between the sequence and binding of the adsorbed peptide structures be clearly established. Molecular dynamics (MD) simulations can play a key role in elucidating the conformational ensemble of peptides adsorbed at graphene interfaces, helping to elucidate these rules in partnership with experimental characterisation. We apply our recently-developed polarisable force-field for biomolecule-graphene interfaces, GRAPPA, in partnership with advanced simulation approaches, to probe the adsorption behaviour of peptides at aqueous graphene. First we determine the free energy of adsorption of all twenty naturally occurring amino acids (AAs) via metadynamics simulations, providing a benchmark for interpreting peptide-graphene adsorption studies. From these free energies, we find that strong-binding amino acids have flat and/or compact side chain groups, and we relate this behaviour to the interfacial solvent structuring. Second, we apply replica exchange with solute tempering simulations to efficiently and widely sample the conformational ensemble of two experimentally-characterised peptide sequences, P1 and its alanine mutant P1A3, in solution and adsorbed on graphene. For P1 we find a significant minority of the conformational ensemble possesses a helical structure, both in solution and when adsorbed, while P1A3 features mostly extended, random-coil conformations. In solution this helical P1 configuration is stabilised through favourable intra-peptide interactions, while the adsorbed structure is stabilised via interaction of four strongly-binding residues, identified from our metadynamics simulations, with the aqueous graphene interface. Our findings rationalise the performance of the P1 sequence as a known graphene binder.