Regional Variation on Rates of Bronchopulmonary Dysplasia and Associated Risk Factors

Background. An abnormally high incidence (44%) of bronchopulmonary dysplasia with variations in rates among cities was observed in Colombia among premature infants. Objective. To identify risk factors that could explain the observed high incidence and regional variations of bronchopulmonary dysplasia. Study Design. A case-control study was designed for testing the hypothesis that differences in the disease rates were not explained by differences in city-of-birth specific population characteristics or by differences in respiratory management practices in the first 7 days of life, among cities. Results. Multivariate analysis showed that premature rupture of membranes, exposure to mechanical ventilation after received nasal CPAP, no surfactant exposure, use of rescue surfactant (instead of early surfactant), PDA, sepsis and the median daily FIO2, were associated with a higher risk of dysplasia. Significant differences between cases and controls were found among cities. Models exploring for associations between city of birth and dysplasia showed that being born in the highest altitude city (Bogotá) was associated with a higher risk of dysplasia (OR 1.82 95% CI 1.31–2.53). Conclusions. Bronchopulmonary dysplasia was manly explained by traditional risk factors. Findings suggest that altitude may play an important role in the development of this disease. Prenatal steroids did not appear to be protective at high altitude.

Development of thresholds for surface preparation in repair systems with wet lay -up fiber reinforced polymers

Bonded repair of concrete structures with fiber reinforced polymer (FRP) systems is increasingly being accepted as a cost-efficient and structurally viable method of rapid rehabilitation of concrete structures. However, the relationships between long-term performance attributes, service-life, and details of the installation process are not easy to quantify. Accordingly, there is currently a lack of generally accepted construction specifications, making it difficult for the field engineer to certify the adequacy of the construction process. ^ The objective of the present study, as part of the National Cooperative Highway Research Program (NCHRP) Project 10-59B, was to investigate the effect of surface preparation on the behavior of wet lay-up FRP repair systems and consequently develop rational thresholds that provide sufficient performance. ^ The research program was comprised of both experimental and analytical work for wet lay-up FRP applications. The experimental work included flexure testing of sixty-seven (67) reinforced concrete beams and bond testing of ten (10) reinforced concrete blocks. Four different parameters were studied: surface roughness, surface flatness, surface voids and bug holes, and surface cracks/cuts. The findings were analyzed from various aspects and compared with the data available in the literature. As part of the analytical work, finite element models of the flexural specimens with surface flaws were developed using ANSYS. The purpose of this part was to extend the parametric study on the effects of concrete surface flaws and verify the experimental results based on nonlinear finite element analysis. ^ Test results showed that surface roughness does not appear to have a significant influence on the overall performance of the wet lay-up FRP systems with or without adequate anchorage, and whether failure was by debonding or rupture of FRP. Both experimental and analytical results for surface flatness proved that peaks on concrete surface, in the range studied, do not have a significant effect on the performance of wet lay-up FRP systems. However, valleys of particular size could reduce the strength of wet lay-up FRP systems. Test results regarding surface voids and surface cracks/cuts revealed that previously suggested thresholds for these flaws appear to be conservative, as also confirmed by analytical study. ^

Hydroxyapatite-nanotube composites and coatings for orthopedic applications

Hydroxyapatite (HA) has received wide attention in orthopedics, due to its biocompatibility and osseointegration ability. Despite these advantages, the brittle nature and low fracture toughness of HA often results in rapid wear and premature fracture of implant. Hence, there is a need to improve the fracture toughness and wear resistance of HA without compromising its biocompatibility. ^ The aim of the current research is to explore the potential of nanotubes as reinforcement to HA for orthopedic implants. HA- 4 wt.% carbon nanotube (CNT) composites and coatings are synthesized by spark plasma sintering and plasma spraying respectively, and investigated for their mechanical, tribological and biological behavior. CNT reinforcement improves the fracture toughness (>90%) and wear resistance (>66%) of HA for coating and free standing composites. CNTs have demonstrated a positive influence on the proliferation, differentiation and matrix mineralization activities of osteoblasts, during in-vitro biocompatibility studies. In-vivo exposure of HA-CNT coated titanium implant in animal model (rat) shows excellent histocompatibility and neobone integration on the implant surface. The improved osseointegration due to presence of CNTs in HA is quantified by the adhesion strength measurement of single osteoblast using nano-scratch technique. ^ Considering the ongoing debate about cytotoxicity of CNTs in the literature, the present study also suggests boron nitride nanotube (BNNT) as an alternative reinforcement. BNNT with the similar elastic modulus and strength as CNT, were added to HA. The resulting composite having 4 wt.% BNNTs improved the fracture toughness (∼85%) and wear resistance (∼75%) of HA in the similar range as HA-CNT composites. BNNTs were found to be non-cytotoxic for osteoblasts and macrophages. In-vitro evaluation shows positive role of BNNT in osteoblast proliferation and viability. Apatite formability of BNNT surface in ∼4 days establishes its osseointegration ability.^