Elastic Biomaterial Scaffold with Spatially Varying Adhesive Design.

In order to secure biomaterials to tissue surfaces, sutures or glues are commonly used. Of interest is the development of a biomaterial patch for applications in tissue engineering and regeneration that incorporates an adhesive component to simplify patch application and ensure sufficient adhesion. A separate region dedicated to fulfilling the specific requirements of an application such as mechanical support or tissue delivery is also desirable. Here, the design and fabrication of a unique patch are presented with distinct regions for adhesion and function, resulting in a biomaterial patch resembling the Band-Aid. The adhesive region contains a novel polymer, synthesized to incorporate a molecule capable of adhesion to tissue, dopamine. The desired polymer composition for patch development is selected based on chemical assessment and evaluation of key physical properties such as swelling and elastic modulus, which are tailored for use in soft tissue applications. The selected polymer formulation, referred to as the adhesive patch (AP) polymer, demonstrates negligible cytotoxicity and improves adhesive capability to rat cardiac tissue compared to currently used patch materials. Finally, the AP polymer is used in the patch, designed to possess distinct adhesive and nonadhesive domains, presenting a novel design for the next generation of biomaterials.

One-Pot Synthesis of Unsaturated Polyester Bioelastomer with Controllable Material Curing for Microscale Designs.

Synthetic polyester elastomeric constructs have become increasingly important for a range of healthcare applications, due to tunable soft elastic properties that mimic those of human tissues. A number of these constructs require intricate mechanical design to achieve a tunable material with controllable curing. Here, the synthesis and characterization of poly(itaconate-co-citrate-co-octanediol) (PICO) is presented, which exhibits tunable formation of elastomeric networks through radical crosslinking of itaconate in the polymer backbone of viscous polyester gels. Through variation of reaction times and monomer molar composition, materials with modulation of a wide range of elasticity (36-1476 kPa) are generated, indicating the tunability of materials to specific elastomeric constructs. This correlated with measured rapid and controllable gelation times. As a proof of principle, scaffold support for cardiac tissue patches is developed, which presents visible tissue organization and viability with appropriate elastomeric support from PICO materials. These formulations present potential application in a range of healthcare applications with requirement for elastomeric support with controllable, rapid gelation under mild conditions.

A 'degradable' poly(vinyl alcohol) iron oxide nanoparticle hydrogel.

Polymeric materials that contain magnetic nanoparticles are extremely useful in many applications including as multifunctional drug carriers, imaging contrast agents, or scaffold material. There is a need for biomaterials with appropriate chemical, mechanical, and magnetic properties that also have the ability to degrade or dissolve over time so they can be eliminated from the body following use. In this work, we explore the use of iron oxide nanoparticle (IONP) formation in poly(vinyl alcohol) (PVA) as a crosslinking method in conjunction with physical crosslinking achieved using low temperature thermal cycling (LTTC). PVA-IONP hydrogels were fabricated and characterized. IONPs contribute to the crosslinking of the PVA-IONP material, and their subsequent removal reduces crosslinking, and therefore stability, of the material, allowing dissolution to occur. Dissolution studies were performed on PVA-IONP hydrogels and dissolution was compared for films in solutions of varying pH, in the presence of iron chelating agents, and in simulated physiological and tumor conditions in cell culture media. Iron release, mass loss, and mechanical testing data was collected. This work demonstrates the ability of this biomaterial to 'degrade' over time, which may be very advantageous for applications such as drug delivery. This importance of this work extends to other areas such as the use of stimuli-responsive hydrogels. STATEMENT OF SIGNIFICANCE: This manuscript explores the stability of an iron oxide nanoparticle (IONP)-containing, physically crosslinked poly(vinyl alcohol) (PVA) hydrogel. The PVA-IONP hydrogel's stability is imparted through crosslinks created through a low temperature thermal cycling process and through the IONPs. Subsequent IONP removal reduces crosslinks so material dissolution can occur, resulting in a 'degradable' and multifunctional biomaterial. PVA-IONP films were fabricated, characterized and evaluated in terms of dissolution in solutions of varying pH and in the presence of chelating agents. Iron release, mass loss, and mechanical testing data demonstrate the ability of the PVA-IONP biomaterial to 'degrade' over time. This degradability has not yet been demonstrated for crosslinked PVA hydrogels. These results are relevant to the development of degradable multifunctional drug carriers, image contrast agents, or magnetic scaffold materials.

Visualising phase change in a brushite-based calcium phosphate ceramic.

The resorption of brushite-based bone cements has been shown to be highly unpredictable, with strong dependence on a number of conditions. One of the major factors is phase transformation, with change to more stable phases such as hydroxyapatite affecting the rate of resorption. Despite its importance, the analysis of phase transformation has been largely undertaken using methods that only detect crystalline composition and give no information on the spatial distribution of the phases. In this study confocal Raman microscopy was used to map cross-sections of brushite cylinders aged in Phosphate Buffered Saline, Foetal Bovine Serum, Dulbecco's - Minimum Essential Medium (with and without serum). Image maps showed the importance of ageing medium on the phase composition throughout the ceramic structure. When aged without serum, there was dissolution of the brushite phase concomitant to the deposition of octacalcium phosphate (OCP) around the periphery of the sample. The deposition of OCP was detectable within five days and reduced the rate of brushite dissolution from the material. The use of serum, even at a concentration of 10vol% prevented phase transformation. This paper demonstrates the value of confocal Raman microscopy in monitoring phase change in biocements; it also demonstrates the problems with assessing material degradation in non-serum containing media.

Myocardial infarction in men and women under 65 years of age: no evidence of gender bias.

We examined short and long term outcomes of MI in a consecutive series of 169 men and 50 women who were followed for an average of 3.5 years. Similar percentages of men and women were admitted to medical intensive care, received in-patient cardiac rehabilitation, quit smoking at one year, were still smoking, were taking a lipid lowering drug or had returned to work at one year, underwent coronary angiography at 3.5 years or had died by 3.5 years. The lack of gender difference in outcome may reflect an absence of gender bias in the management of men and women with MI in southwest Scotland.

Web-based education and support for patients on the cardiac surgery waiting list.

We assessed the effectiveness of two methods of patient education, a printed manual and a Website, provided to patients waiting for cardiac surgery. The four-phase study was conducted over two and a half years, and included urban and rural subjects in Vancouver and the interior of British Columbia. The Website was based on the specially developed patient education manual. A pilot evaluation study was carried out to assess the features of the Website and to ensure it was 'user-friendly', after which it was revised. The two education methods were evaluated using both qualitative and quantitative studies. Findings supported the feasibility and viability of both formats. The Web-based format demonstrated two additional benefits over the print-based format, namely increased social support and decreased anxiety. Other findings included the perception of increased support, lifestyle changes and more positive attitudes towards the impending surgery.

The Harlem regional stroke program: an overview.

The Harlem regional stroke program has been a demonstration model designed to detect, treat, and follow up stroke and hypertension patients through collaboration with a municipal teaching hospital, community practitioners, local service organizations and a major medical school. Many aspects of the stroke program appear suitable for replication at the local or regional levels in varied settings. In particular, the program has demonstrated the need to link community outreach programs, stressing early detection and preventive-care education, with sustained treatment and follow-up programs. The stroke program has also suggested ways in which specialized programs can be incorporated into long-term comprehensive health planning and care facilities at local and regional levels.