Digitally enhanced recovery: Investigating the use of digital self-tracking for monitoring leisure time physical activity of cardiovascular disease (CVD) patients undergoing cardiac rehabilitation.

Research has shown that physical activity is essential in the prevention and treatment of chronic diseases like cardiovascular disease (CVD). Smart wearables (e.g., smartwatches) are increasingly used to foster and monitor human behaviour, including physical activity. However, despite this increased usage, little evidence is available on the effects of smart wearables in behaviour change. The little research which is available typically focuses on the behaviour of healthy individuals rather than patients. In this study, we investigate the effects of using smart wearables by patients undergoing cardiac rehabilitation. A field experiment involving 29 patients was designed and participants were either assigned to the study group (N = 13 patients who finished the study and used a self-tracking device) or the control group (N = 16 patients who finished the study and did not use a device). For both groups data about physiological performance during cardiac stress test was collected at the beginning (baseline), in the middle (in week 6, at the end of the rehabilitation in the organized rehabilitation setting), and at the end of the study (after 12 weeks, at the end of the rehabilitation, including the organized rehabilitation plus another 6 weeks of self-organized rehabilitation). Comparing the physiological performance of both groups, the data showed significant differences. The participants in the study group not only maintained the same performance level as during the midterm examination in week 6, they improved performance even further during the six weeks that followed. The results presented in this paper provide evidence for positive effects of digital self-tracking by patients undergoing cardiac rehabilitation on performance of the cardiovascular system. In this way, our study provides novel insight about the effects of the use of smart wearables by CVD patients. Our findings have implications for the design of self-management approaches in a patient rehabilitation setting. In essence, the use of smart wearables can prolong the success of the rehabilitation outside of the organized rehabilitation setting.

Tris(2-aminoethyl)amine-based α-branched fatty acid amides - Synthesis of lipids and comparative study of transfection efficiency of their lipid formulations.

The synthesis of a new class of cationic lipids, tris(2-aminoethyl)amine-based α-branched fatty acid amides, is described resulting in a series of lipids with specific variations in the lipophilic as well as the hydrophilic part of the lipids. In-vitro structure/transfection relationships were established by application of complexes of these lipids with plasmid DNA (pDNA) to different cell lines. The α-branched fatty acid amide bearing two tetradecyl chains and two lysine molecules (T14diLys) in mixture with the co-lipid 1,2-di-[(9Z)-octadec-9-enoyl]-sn-glycero-3-phosphoethanolamine (DOPE) (1/2, n/n) exhibits effective pDNA transfer in three different cell lines, namely Hep-G2, A549, and COS-7. The presence of 10% serum during lipoplex incubation of the cells did not affect the transfection efficiency. Based on that, detailed investigations of the complexation of pDNA with the lipid formulation T14diLys/DOPE 1/2 (n/n) were carried out with respect to particle size and charge using dynamic light scattering (DLS), ζ-potential measurements, and transmission electron microscopy (TEM). Additionally, the lipoplex uptake was investigated by confocal laser scanning microscopy (CLSM). Overall, lipoplexes prepared from T14diLys/DOPE 1/2 (n/n) offer large potential as lipid-based polynucleotide carriers and further justify advanced examinations.

Fulminant sepsis after liver biopsy: A long forgotten complication?

We report on a 74-year-old patient with recurrent cholangitis and a large juxtapapillary duodenal diverticulum. Despite drainage of the common bile duct by an endoscopically placed stent, the elevated liver enzymes normalized only partially. To rule out other possible causes of liver injury, a percutaneous liver biopsy was done. After the liver biopsy the patient developed fulminant septic shock and died within 24 h. We discuss the possible causes of the septic shock following percutaneous liver biopsy in our patient and give a concise overview of the literature.

Comparative studies on osteogenic potential of micro- and nanofibre scaffolds prepared by electrospinning of poly(ε-caprolactone).

The biocompatibility and osteogenic potential of four fibrous scaffolds prepared by electrospinning of poly(ε-caprolactone) (PCL) was studied with MG-63 osteoblast cells. Two different kinds of scaffolds were obtained by adjustment of spinning conditions, which were characterized as nano- or microfibrous. In addition of one nanofibrous, scaffold was made more hydrophilic by blending PCL with Pluronics F 68. Scaffolds were characterized by scanning electron microscopy and water contact angle measurements. Morphology and growth of MG63 cells seeded on the different scaffolds were investigated by confocal laser scanning microscopy after vital staining with fluorescein diacetate and by colorimetric assays. It was found that scaffolds composed of microfibres stipulated better growth conditions for osteoblasts probably by providing a real three-dimensional culture substratum, while nanofibre scaffolds restricted cell growth predominantly to surface regions. Osteogenic activity of cells was determined by alkaline phosphatase (ALP) and o-cresolphthalein complexone assay. It was observed that osteogenic activity of cells cultured in microfibre scaffolds was significantly higher than in nanofibre scaffolds regarding ALP activity. Overall, one can conclude that nanofibre scaffold provides better conditions for initial attachment of cells but does not provide advantages in terms of scaffold colonization and support of osteogenic activity compared to scaffolds prepared from microfibres.

Micromorphometrical analyses of five different ultrasonic osteotomy devices at the rabbit skull.

OBJECTIVES: The recently introduced ultrasonic osteotome procedure is an alternative to conventional methods of osteotomy. The aim of the present study was to establish the differences between five recently introduced ultrasonic osteotomes and to perform micromorphological and quantitative roughness analyses of osteotomized bone surfaces. MATERIALS AND METHODS: Fresh, standard-sized bony samples were taken from a rabbit skull using the following ultrasonic osteotomes: the Piezosurgery 3 with insert tip OT7, Piezosurgery Medical with insert tip MT1-10, Piezon Master Surgery with insert tip SL1, VarioSurg with inert tip SG1, and Piezotome 2 with insert tip BS1 II. The required duration of time for each osteotomy was recorded. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), and confocal laser scanning microscopy (CLSM). RESULTS: All of the investigated piezoelectric osteotomes preserved the anatomical structure of bone. The mean roughness values of the osteotomized bone edge obtained using the investigated piezoelectric osteotomes were as follows: 2.47 µm (Piezosurgery 3), 9.79 µm (Piezosurgery Medical), 4.66 µm (Piezon Master Surgery), 6.38 µm (VarioSurg), and 6.06 µm (Piezotome 2). Significantly higher roughness values were observed when using the Piezosurgery Medical in comparison with those achieved by the Piezosurgery 3 (P<0.0001) and Piezon Master Surgery (P=0.002). Different osteotomy durations were achieved using the different piezoelectric osteotomes: 144 s (Piezosurgery 3), 126 s (Piezosurgery Medical), 142 s (Piezon Master Surgery), 149 s (VarioSurg), and 137 s (Piezotome 2). CONCLUSIONS: In the present study, micromorphological differences following the use of various ultrasonic devices were clearly identified. According to this study, it can be concluded that the power and the composition of the teeth of the insert tip might impact procedure duration and cutting qualities.

Nanostructured material surfaces--preparation, effect on cellular behavior, and potential biomedical applications: a review.

Nanostructures play important roles in vivo, where nanoscaled features of extracellular matrix (ECM) components influence cell behavior and resultant tissue formation. This review summarizes some of the recent developments in fostering new concepts and approaches to nanofabrication, such as top-down and bottom-up and combinations of the two. As in vitro investigations demonstrate that man-made nanotopography can be used to control cell reactions to a material surface, its potential application in implant design and tissue engineering becomes increasingly evident. Therefore, we present recent progress in directing cell fate in the field of cell mechanics, which has grown rapidly over the last few years, and in various tissue-engineering applications. The main focus is on the initial responses of cells to nanostructured surfaces and subsequent influences on cellular functions. Specific examples are also given to illustrate the potential nanostructures may have for biomedical applications and regenerative medicine.

Characterization of PLGA nanospheres stabilized with amphiphilic polymers: hydrophobically modified hydroxyethyl starch vs pluronics.

Some Pluronics, particularly F127, are known to stabilize nanospheres and prolong their circulation time in vivo. However, these copolymers of poly(ethylene glycol) (PEG) and poly(propylene glycol) are not biodegradable, and despite the long history, there is no approved commercial product using F127 for parenteral administration until now. Meanwhile, hydroxyethyl starch (HES) is a biodegradable polymer that is currently investigated as a substitute for PEG. In order to produce a fully biodegradable amphiphilic polymer, we esterified different molar masses of HES with lauric acid to get different molar substitutions. These polymers, as well as Pluronic F68 and F127, were used to stabilize poly(lactic-co-glycolic acid) (PLGA) nanospheres prepared by nanoprecipitation. For physicochemical characterization, the particle size, zeta potential, and the thickness of the adsorbed polymer layer were measured. The ability of the polymer coating to prevent the adsorption of human serum albumin (HSA) and fibrinogen (FBG) was evaluated. Finally, the phagocytosis of the stabilized nanospheres by a monocyte macrophage cell line (J774.2) was assessed. Results show that the PLGA nanospheres had an average particle size of 110-140 nm. The thickness of the adsorbed polymer layer increases with the increase in molar mass, and is generally higher for HES laurates than the studied Pluronics. Pluronic F68, F127 as well as the HES laurates with low molar substitution prevented the adsorption of HSA. HES laurates with low molar substitution and F127, but not F68, prevented the adsorption of FBG. The phagocytosis experiments showed that the HES laurates, particularly the one with the highest molar mass, could reduce the uptake of the nanospheres better than F68 and comparable to F127. Finally, these results warrant in vivo experiments to evaluate how the HES laurates can affect the pharmacokinetics and fate of the nanospheres.

Micromorphometrical analysis of conventional osteotomy techniques and ultrasonic osteotomy at the rabbit skull.

OBJECTIVES: The ultrasonic osteotome, which was recently introduced, is an alternative to conventional methods of osteotomy. The aim of the present study was to establish the differences between three osteotomy techniques and to perform a quantitative roughness analysis of the osteotomized bone surfaces. MATERIALS AND METHODS: Fresh bony samples of standardized size were taken from the rabbit skull. The techniques used were as follows: reciprocate micro-saw, Lindemann bur, ultrasonic osteotome with the two insert tips OT6 (rough) and OT7 (fine). The prepared surfaces were examined by light microscopy, environmental surface electron microscopy (ESEM) and by confocal laser scanning microscopy (CLSM). RESULTS: It was difficult to distinguish between cortical and cancellous bone after using the conventional osteotomy technique. The ultrasonic technique preserved the original structure of the bone. The values observed for superficial roughness were as follows: 3.97 microm (micro-saw), 5.7 microm (Lindemann bur), 2.48 microm (OT7) and 3 microm (OT6). There were statistical differences between the values of the bur and insert tip OT6 (P=0.015) as well as between the bur and insert tip OT7 (P=0.003). CONCLUSIONS: In the present study micromorphological differences after using various osteotomy techniques could be clearly identified.

Surface modification of medical-grade polyurethane by cyanurchloride-activated tetraether lipid (a new approach for bacterial antiadhesion).

The surface of high-grade medical polyurethane was chemically modified and coated with tetraether lipid, employing cyanurchloride as coupling agent. The surfaces were initially grafted with hexamethylene diisocyanate and subsequently treated with water or hexamethylene diamine to generate free amino groups on the surface. This provides a convenient way for covalent coupling of tetraether lipids. These lipid-coated surfaces were investigated for bacterial adhesion using Pseudomonas aeruginosa. All lipid-coated surfaces significantly reduced bacterial adhesion. Surface topology and individual modification steps were controlled by contact angle measurements, attenuated total reflectance infrared spectroscopy, X-ray photoelectron spectroscopy, confocal laser scanning microscopy, and environmental scanning electron microscopy. This new surface modification approach may reduce the adhesion of bacteria on biomaterials.

Local recurrence of a unilateral cystic nephroma.

Cystic nephroma is an uncommon, benign renal lesion. We report the first case of local recurrence of a unilateral cystic nephroma in an adult. Only three cases of recurrence in bilateral cystic nephroma have been described in the literature before. Other renal lesions may not be differentiated preoperatively from cystic nephroma and thus require surgical exploration. Long-term follow-up is recommended to rule out local recurrence.