Clinical strategies for the alleviation of contractures from a predictive mathematical model of dermal repair

Hypertrophic scars arise when there is an overproduction of collagen during wound healing. These are often associated with poor regulation of the rate of programmed cell death(apoptosis) of the cells synthesizing the collagen or by an exuberant inflammatory response that prolongs collagen production and increases wound contraction. Severe contractures that occur, for example, after a deep burn can cause loss of function especially if the wound is over a joint such as the elbow or knee. Recently, we have developed a morphoelastic mathematical model for dermal repair that incorporates the chemical, cellular and mechanical aspects of dermal wound healing. Using this model, we examine pathological scarring in dermal repair by first assuming a smaller than usual apoptotic rate for myofibroblasts, and then considering a prolonged inflammatory response, in an attempt to determine a possible optimal intervention strategy to promote normal repair, or terminate the fibrotic scarring response. Our model predicts that in both cases it is best to apply the intervention strategy early in the wound healing response. Further, the earlier an intervention is made, the less aggressive the intervention required. Finally, if intervention is conducted at a late time during healing, a significant intervention is required; however, there is a threshold concentration of the drug or therapy applied, above which minimal further improvement to wound repair is obtained.

Evaluation of modal analysis techniques using physical models to detect osseointegration of implants in transfemoral amputees

Non-invasive vibration analysis has been used extensively to monitor the progression of dental implant healing and stabilization. It is now being considered as a method to monitor femoral implants in transfemoral amputees. This paper evaluates two modal analysis excitation methods and investigates their capabilities in detecting changes at the interface between the implant and the bone that occur during osseointegration. Excitation of bone-implant physical models with the electromagnetic shaker provided higher coherence values and a greater number of modes over the same frequency range when compared to the impact hammer. Differences were detected in the natural frequencies and fundamental mode shape of the model when the fit of the implant was altered in the bone. The ability to detect changes in the model dynamic properties demonstrates the potential of modal analysis in this application and warrants further investigation.

Raman spectroscopic study of the mineral shattuckite Cu5(SiO3)4(OH)2

Shattuckite Cu5(SiO3)4(OH)2 is a copper hydroxy silicate and is commonly known as a ‘healing’ mineral. Three shattuckite mineral samples from three different origins were analysed by Raman spectroscopy. Some Raman bands are common in the spectra of the minerals. Raman bands at around 890, 1058 and 1102 are described as the ν3 –SiO3 antisymmetric stretching vibrations. The Raman band at 670 cm-1 is assigned to the ν4 bending modes of the -SiO3 units and the band at around 785 cm-1is due to Si-O-Si chain stretching mode. Raman (and infrared) spectroscopy proves that water is in the molecular structure of shattuckite; thus the formula is better written as Cu5(SiO3)4(OH)2•xH2O.

Pre-clinical evaluation of amphiphilic silicone oligomers for scar remediation

The formation of hypertrophic scars is a frequent outcome of wound repair and often requires further therapy with treatments such as silicone gel sheets (SGS; Perkins et al., 1983). Although widely used, knowledge regarding SGS and their mechanism of action on hypertrophic scars is limited. Furthermore, SGS require consistent application for at least twelve hours a day for up to twelve consecutive months, beginning as soon as wound reepithelialisation has occurred. Preliminary research at QUT has shown that some species of silicone present in SGS have the ability to permeate into collagen gel skin mimetics upon exposure. An analogue of these species, GP226, was found to decrease both collagen synthesis and the total amount of collagen present following exposure to cultures of cells derived from hypertrophic scars. This silicone of interest was a crude mixture of silicone species, which resolved into five fractions of different molecular weight. These five fractions were found to have differing effects on collagen synthesis and cell viability following exposure to fibroblasts derived from hypertrophic scars (HSF), keloid scars (KF) and normal skin (nHSF and nKF). The research performed herein continues to further assess the potential of GP226 and its fractions for scar remediation by determining in more detail its effects on HSF, KF, nHSF, nKF and human keratinocytes (HK) in terms of cell viability and proliferation at various time points. Through these studies it was revealed that Fraction IV was the most active fraction as it induced a reduction in cell viability and proliferation most similar to that observed with GP226. Cells undergoing apoptosis were also detected in HSF cultures exposed to GP226 and Fraction IV using the Tunel assay (Roche). These investigations were difficult to pursue further as the fractionation process used for GP226 was labour-intensive and time inefficient. Therefore a number of silicones with similar structure to Fraction IV were synthesised and screened for their effect following application to HSF and nHSF. PDMS7-g-PEG7, a silicone-PEG copolymer of low molecular weight and low hydrophilic-lipophilic balance factor, was found to be the most effective at reducing cell proliferation and inducing apoptosis in cultures of HSF, nHSF and HK. Further studies investigated gene expression through microarray and superarray techniques and demonstrated that many genes are differentially expressed in HSF following treatment with GP226, Fraction IV and PDMS7-g-PEG7. In brief, it was demonstrated that genes for TGFβ1 and TNF are not differentially regulated while genes for AIFM2, IL8, NSMAF, SMAD7, TRAF3 and IGF2R show increased expression (>1.8 fold change) following treatment with PDMS7-g-PEG7. In addition, genes for αSMA, TRAF2, COL1A1 and COL3A1 have decreased expression (>-1.8 fold change) following treatment with GP226, Fraction IV and PDMS7-g-PEG7. The data obtained suggest that many different pathways related to apoptosis and collagen synthesis are affected in HSF following exposure to PDMS7-g-PEG7. The significance is that silicone-PEG copolymers, such as GP226, Fraction IV and PDMS7-g-PEG7, could potentially be a non-invasive substitute to apoptosis-inducing chemical agents that are currently used as scar treatments. It is anticipated that these findings will ultimately contribute to the development of a novel scar therapy with faster action and improved outcomes for patients suffering from hypertrophic scars.

Vibrational spectroscopic study of the copper silicate mineral kinoite Ca2Cu2Si3O10(OH)4

Kinoite Ca2Cu2Si3O10(OH)4 is a mineral named after a Jesuit missionary. Raman and infrared spectroscopy have been used to characterise the structure of the mineral. The Raman spectrum is characterised by an intense sharp band at 847 cm-1 assigned to the ν1 (A1g) symmetric stretching vibration. Intense sharp bands at 951, 994 and 1000 cm-1 are assigned to the ν3 (Eu, A2u, B1g) SiO4 antisymmetric stretching vibrations. Multiple ν2 SiO4 vibrational modes indicate strong distortion of the SiO4 tetrahedra. Multiple CaO and CuO stretching bands are observed. Raman spectroscopy confirmed by infrared spectroscopy clearly shows that hydroxyl units are involved in the kinoite structure. Based upon the infrared spectra, it is proposed that water is also involved in the kinoite structure. Based upon vibrational spectroscopy, the formula of kinoite is defined as Ca2Cu2Si3O10(OH)4•xH2O.

Vibrational spectroscopy and solubility study of the mineral stringhamite CaCuSiO4•H2O

Stringhamite CaCuSiO4·H2O is a hydrated calcium copper silicate and is commonly known as a significant ‘healing’ mineral and is potentially a semi-precious jewel. Stringhamite is a neosilicate with Cu2+ in square planar coordination. Vibrational spectroscopy has been used to characterise the molecular structure of stringhamite. The intense sharp Raman band at 956 cm−1 is assigned to the ν1 (A1g) symmetric stretching vibration. Raman bands at 980, 997, 1061 cm−1 are assigned to the ν3 (A2u, B1g) antisymmetric stretching vibrations. Splitting of the ν3 vibrational mode supports the concept that the stringhamite SiO4 tetrahedron is strongly distorted. The intense bands at 505 and 519 cm−1 and at 570 cm−1 are assigned to the ν2 and ν4 vibrational modes. The question arises as to whether the mineral stringhamite can actually function as a healing mineral. An estimation of the solubility product at pH < 5 shows that the cupric ion can be released. The copper ion is a very powerful antibiological agent and thus the mineral stringhamite may well function as a healing mineral.

Whelanite Ca5Cu2(OH)2CO3,Si6O17•4H2O – A vibrational spectroscopic study

Whelanite Ca5Cu2(OH)2CO3,Si6O17•4H2O is a hydrated hydroxy mixed anion compound with both silicate and carbonate anions in the formula. The structural characterisation of the mineral whelanite remains incomplete. Whelanite is probably a neosilicate with Cu2+ in square planar coordination. Two Raman bands at 1070 and 1094 cm-1 are assigned to the ν1 symmetric stretching modes of the CO32- units. The observation of two symmetric stretching modes supports the concept of two non-equivalent CO32- units in the whelanite structure. The intense sharp Raman band at 1006 cm-1 is assigned to the ν1 (A1g) symmetric stretching vibration of the Si6O17 units. The splitting of the ν3 vibrational mode offers support to the concept that the SiO4 tetrahedron in whelanite is strongly distorted. A very intense Raman band observed at 666 cm-1 with a shoulder at 697 cm-1 is assigned to the ν4 vibrational modes. Intense Raman bands at 3534, 3556, 3550 and 3595 cm-1 are assigned to the stretching vibrations of the OH units. Low intensity Raman bands at 2910, 3187 and 3453 cm-1 are assigned to water stretching modes. Thus, vibrational spectroscopy has been used to characterise the molecular structure of whelanite. Whelanite is a mineral that could be conceived as a healing mineral

A vibrational spectroscopic study of planchéite Cu8Si8O22(OH)4•H2O

Planchéite Cu8Si8O22(OH)4•H2O is a hydrated copper hydroxy silicate. The objective of this work is to use Raman and infrared spectroscopy to determine the molecular structure of planchéite. Raman bands of planchéite at around 1048, 1081 and 1127 are described as the ν1 –SiO3 symmetric stretching vibrations; Raman bands at 828, 906 are attributed to the ν3 –SiO3 antisymmetric stretching vibrations. The Raman band at 699 cm-1 is assigned to the ν4 bending modes of the -SiO3 units. The intense Raman band at 3479 cm-1 is ascribed to the stretching vibration of the OH units. The Raman band at 3250 cm-1 is evidence for water in the structure. A comparison of the spectra of planchéite with that of shattuckite and chrysocolla.

The duplicitous nature of inflammation in wound repair

Skin plays a key role in protecting the body from the onslaught of pathogens and toxins we meet during our lifetime; thus, out of necessity, we have developed a rapid repair mechanism that quickly plugs any holes in this vital organ. Upon injury, a series of highly coordinated overlapping events, that include inflammatory, proliferation and maturation phases, result in the hasty closure of the wound and restoration of skin integrity. Over the past decade it has become clear that a number of immune cells that regulate the inflammatory phase, whilst important for removal of invading pathogens, are not necessary for repair and in fact may be responsible for the subsequent scar formation that seems to have resulted from having such a rapid repair process. The magnitude and length of inflammation in the wound not only appears to dictate the extent of scar formation but also in some cases may even prevent wound closure. In this review we will explore the two sides of inflammation in wound healing and review current and future drug therapies that target inflammation to modulate the healing outcome.

Vibrational spectroscopic study of the copper silicate mineral ajoite (K,Na)Cu7AlSi9O24(OH)6•3H2O

Ajoite (K,Na)Cu7AlSi9O24(OH)6•3H2O is a mineral named after the Ajo district of Arizona. Raman and infrared spectroscopy were used to characterise the molecular structure of ajoite. The structure of the mineral shows disorder which is reflected in the difficulty of obtaining quality Raman spectra. The Raman spectrum is characterised by a broad spectral profile with a band at 1048 cm-1 assigned to the ν1 (A1g) symmetric stretching vibration. Strong bands at 962, 1015 and 1139 cm-1 are assigned to the ν3 SiO4 antisymmetric stretching vibrations. Multiple ν4 SiO4 vibrational modes indicate strong distortion of the SiO4 tetrahedra. Multiple AlO and CuO stretching bands are observed. Raman spectroscopy and confirmed by infrared spectroscopy clearly shows that hydroxyl units are involved in the ajoite structure. Based upon the infrared spectra, water is involved in the ajoite structure, probably as zeolitic water.

Flightless, secreted through a late endosome/lysosome pathway, binds LPS and dampens cytokine secretion.

Flightless (Flii) is upregulated in response to wounding and has been shown to function in wound closure and scarring. In macrophages intracellular Flii negatively modulates TLR signalling and dampens cytokine production. We now show that Flii is constitutively secreted from macrophages and fibroblasts and is present in human plasma. Secretion from fibroblasts is upregulated in response to scratch wounding and LPS-activated macrophages also temporally upregulate their secretion of Flii. Using siRNA, wild-type and mutant proteins we show that Flii is secreted via a late endosomal/lysosomal pathway that is regulated by Rab7 and Stx11. Flii contains 11 leucine rich repeat (LRR) domains in its N-terminus that have nearly 50% similarity to those in the extracellular pathogen binding portion of Toll-like receptor 4 (TLR4). We show secreted Flii can also bind LPS and has the ability to alter macrophage activation. LPS activation of macrophages in Flii depleted conditioned media leads to enhanced macrophage activation and increased TNF secretion compared to cells activated in the presence of Flii. These results show secreted Flii binds to LPS and in doing so alters macrophage activation and cytokine secretion, suggesting that like the intracellular pool of Flii, secreted Flii also has the ability to alter inflammation.

Porous scaffold architecture guides tissue formation

Critical-sized bone defect regeneration is a remaining clinical concern. Numerous scaffold-based strategies are currently being investigated to enable in vivo bone defect healing. However, a deeper understanding of how a scaffold influences the tissue formation process and how this compares to endogenous bone formation or to regular fracture healing is missing. It is hypothesized that the porous scaffold architecture can serve as a guiding substrate to enable the formation of a structured fibrous network as a prerequirement for later bone formation. An ovine, tibial, 30-mm critical-sized defect is used as a model system to better understand the effect of the scaffold architecture on cell organization, fibrous tissue, and mineralized tissue formation mechanisms in vivo. Tissue regeneration patterns within two geometrically distinct macroscopic regions of a specific scaffold design, the scaffold wall and the endosteal cavity, are compared with tissue formation in an empty defect (negative control) and with cortical bone (positive control). Histology, backscattered electron imaging, scanning small-angle X-ray scattering, and nanoindentation are used to assess the morphology of fibrous and mineralized tissue, to measure the average mineral particle thickness and the degree of alignment, and to map the local elastic indentation modulus. The scaffold proves to function as a guiding substrate to the tissue formation process. It enables the arrangement of a structured fibrous tissue across the entire defect, which acts as a secondary supporting network for cells. Mineralization can then initiate along the fibrous network, resulting in bone ingrowth into a critical-sized defect, although not in complete bridging of the defect. The fibrous network morphology, which in turn is guided by the scaffold architecture, influences the microstructure of the newly formed bone. These results allow a deeper understanding of the mode of mineral tissue formation and the way this is influenced by the scaffold architecture. Copyright © 2012 American Society for Bone and Mineral Research.

Mechanical considerations in fracture fixation

Bone’s capacity to repair following trauma is both unique and astounding. However, fractures sometimes fail to heal. Hence, the goal of fracture treatment is the restoration of bone’s structure, composition and function. Fracture fixation devices should provide a favourable mechanical and biological environment for healing to occur. The use of internal fixation is increasing as these devices may be applied with less invasive techniques. Recent studies suggest however that, internal fixation devices may be overly stiff and suppresses callus formation. The degree of mechanical stability influences the healing outcome. This is determined by the stiffness of the fixation device and the degree of limb loading. This project aims to characterise the fixation stability of an internal plate fixation device and the influence of modifications to its configuration on implant stability. As there are no standardised methods for the determination of fixation stiffness, the first part of this project aims to compares different methodologies and determines the most appropriate method to characterise the stiffness of internal plate fixators. The stiffness of a fixation device also influences the physiological loads experienced by the healing bone. Since bone adapts to this applied load by undergoing changes through a remodelling process, undesirable changes could occur during the period of treatment with an implant. The second part of this project aims to develop a methodology to quantify remodelling changes. This quantification is expected to aid our understanding of the changes in pattern due to implant related remodelling and on the factors driving the remodelling process. Knowledge gained in this project is useful to understand how the configuration of internal fixation devices can promote timely healing and prevent undesirable bone loss.

3D-printing of highly uniform CaSiO3 ceramic scaffolds : preparation, characterization and in vivo osteogenesis

Calcium silicate (CaSiO3, CS) ceramics have received significant attention for application in bone regeneration due to their excellent in vitro apatite-mineralization ability; however, how to prepare porous CS scaffolds with a controllable pore structure for bone tissue engineering still remains a challenge. Conventional methods could not efficiently control the pore structure and mechanical strength of CS scaffolds, resulting in unstable in vivo osteogenesis. The aim of this study is to set out to solve these problems by applying a modified 3D-printing method to prepare highly uniform CS scaffolds with controllable pore structure and improved mechanical strength. The in vivo osteogenesis of the prepared 3D-printed CS scaffolds was further investigated by implanting them in the femur defects of rats. The results show that the CS scaffolds prepared by the modified 3D-printing method have uniform scaffold morphology. The pore size and pore structure of CS scaffolds can be efficiently adjusted. The compressive strength of 3D-printed CS scaffolds is around 120 times that of conventional polyurethane templated CS scaffolds. 3D-Printed CS scaffolds possess excellent apatite-mineralization ability in simulated body fluids. Micro-CT analysis has shown that 3D-printed CS scaffolds play an important role in assisting the regeneration of bone defects in vivo. The healing level of bone defects implanted by 3D-printed CS scaffolds is obviously higher than that of 3D-printed b-tricalcium phosphate (b-TCP) scaffolds at both 4 and 8 weeks. Hematoxylin and eosin (H&E) staining shows that 3D-printed CS scaffolds induce higher quality of the newly formed bone than 3D-printed b-TCP scaffolds. Immunohistochemical analyses have further shown that stronger expression of human type I collagen (COL1) and alkaline phosphate (ALP) in the bone matrix occurs in the 3D-printed CS scaffolds than in the 3D-printed b-TCP scaffolds. Considering these important advantages, such as controllable structure architecture, significant improvement in mechanical strength, excellent in vivo osteogenesis and since there is no need for second-time sintering, it is indicated that the prepared 3D-printed CS scaffolds are a promising material for application in bone regeneration.

The pomegranate cycle : reconfiguring opera through performance, technology & composition

The Pomegranate Cycle is a practice-led enquiry consisting of a creative work and an exegesis. This project investigates the potential of self-directed, technologically mediated composition as a means of reconfiguring gender stereotypes within the operatic tradition. This practice confronts two primary stereotypes: the positioning of female performing bodies within narratives of violence and the absence of women from authorial roles that construct and regulate the operatic tradition. The Pomegranate Cycle redresses these stereotypes by presenting a new narrative trajectory of healing for its central character, and by placing the singer inside the role of composer and producer. During the twentieth and early twenty-first century, operatic and classical music institutions have resisted incorporating works of living composers into their repertory. Consequently, the canon’s historic representations of gender remain unchallenged. Historically and contemporarily, men have almost exclusively occupied the roles of composer, conductor, director and critic, and therefore men have regulated the pedagogy, performance practices, repertoire and organisations that sustain classical music. In this landscape, women are singers, and few have the means to challenge the constructions of gender they are asked to reproduce. The Pomegranate Cycle uses recording technologies as the means of driving change because these technologies have already challenged the regulation of the classical tradition by changing people’s modes of accessing, creating and interacting with music. Building on the work of artists including Phillips and van Veen, Robert Ashley and Diamanda Galas, The Pomegranate Cycle seeks to broaden the definition of what opera can be. This work examines the ways in which the operatic tradition can be hybridised with contemporary musical forms such as ambient electronica, glitch, spoken word and concrete sounds as a way of bringing the form into dialogue with contemporary music cultures. The ultilisation of other sound cultures within the context of opera enables women’s voices and stories to be presented in new ways, while also providing a point of friction with opera’s traditional storytelling devices. The Pomegranate Cycle simulates aesthetics associated with Western art music genres by drawing on contemporary recording techniques, virtual instruments and sound-processing plug-ins. Through such simulations, the work disrupts the way virtuosic human craft has been used to generate authenticity and regulate access to the institutions that protect and produce Western art music. The DIY approach to production, recording, composition and performance of The Pomegranate Cycle demonstrates that an opera can be realised by a single person. Access to the broader institutions which regulate the tradition are not necessary. In short, The Pomegranate Cycle establishes that a singer can be more than a voice and a performing body. She can be her own multimedia storyteller. Her audience can be anywhere.