Regenerative Engineering of a Biphasic Patient-Fitted Temporomandibular Joint Condylar Prosthesis.

Regenerative medicine approaches to restore the mandibular condyle of the temporomandibular joint (TMJ) may fill an unmet patient need. In this study, a method to implant an acellular regenerative TMJ prosthesis was developed for orthotopic implantation in a pilot goat study. The scaffold incorporated a porous, polycaprolactone-hydroxyapatite (PCL-HAp, 20wt% HAp) 3D printed condyle with a cartilage-matrix-containing hydrogel. A series of material characterizations was used to determine the structure, fluid transport, and mechanical properties of 3D printed PCL-HAp. To promote marrow uptake for cell seeding, a scaffold pore size of 152 ± 68 µm resulted in a whole blood transport initial velocity of 3.7 ± 1.2 mm·s-1 transported to the full 1 cm height. The Young's modulus of PCL was increased by 67% with the addition of HAp, resulting in a stiffness of 269 ± 20 MPa for etched PCL-HAp. In addition, the bending modulus increased by 2.06-fold with the addition of HAp to 470 MPa for PCL-HAp. The prosthesis design with an integrated hydrogel was compared with unoperated contralateral control and no-hydrogel group in a goat model for 6 months. A guide was used to make the condylectomy cut, and the TMJ disc was preserved. MicroCT assessment of bone suggested variable tissue responses with some regions of bone growth and loss, although more loss may have been exhibited by the hydrogel group than the no-hydrogel group. A benchtop load transmission test suggested that the prosthesis was not shielding load to the underlying bone. Although variable, signs of neocartilage formation were exhibited by Alcian blue and collagen II staining on the anterior, functional surface of the condyle. Overall, this study demonstrated signs of functional TMJ restoration with an acellular prosthesis. There were apparent limitations to continuous, reproducible bone formation, and stratified zonal cartilage regeneration. Future work may refine the prosthesis design for a regenerative TMJ prosthesis amenable to clinical translation.

Perceptions of Visible Body Art Among Radiographers.

PURPOSE: To determine the perceptions among radiographers of visible tattoos and nontraditional body piercings (piercings other than traditional pierced earlobes) in the clinical setting. METHODS: An institutional review board-approved survey was delivered electronically to radiography clinical preceptors working at hospitals affiliated with a radiography program in the South Central part of the United States. Discussion board forum posts about the survey were created in the American Society of Radiologic Technologists Communities, targeting radiographers throughout the United States. Responses were collected for 4 weeks and compared quantitatively using linear regression, logistic regression, and chi-square analysis. Qualitative results were examined for themes, and proportions among themes were reported. RESULTS: A total of 943 valid responses were received from radiographers working in the United States. Acceptance of body art was lower among individuals without tattoos compared with those who have tattoos (P < .001). Individuals without piercings had a lower acceptance of piercings compared with those who have piercings (P < .001). Acceptance was lower for those who have tattoos but cover them at work compared with those who have visible tattoos at work (P < .001). Acceptance was not statistically significant among those who have piercings who cover them compared with those who have visible nontraditional piercings at work (P = .073). Respondents believed it was more acceptable for members of the public to display a tattoo than for radiographers to display a tattoo at work (P < .001). However, acceptability was higher (P < .001) when the radiographer's tattoo was medically related. DISCUSSION: Research links visible body art with negative perceptions of professionalism and skill set ability in other professions, but no studies have addressed radiography. This study reflects findings similar to those professions. A negative perception exists among radiographers regarding the display of body art while working, even among those who have body art. However, the subject of a tattoo might matter more than the location of a tattoo in terms of acceptability. These results have implications for the credibility and appropriateness of radiographers who display body art in the clinical setting because it might adversely affect the perceptions of co-workers and the perceptions of patient care provided during imaging services, and might affect hospital policy management. CONCLUSION: Among radiographers working in the United States, a negative perception exists regarding visible body art such as tattoos and nontraditional piercings in the health care setting. Implications include negative perceptions of radiographers displaying body art while working. Future research might influence policy implementation as hospitals work to continually improve satisfaction scores and perceptions of care received.

Effects of Continuing Education Incentives on Clinical Instructors.

PURPOSE: To research whether the ability to earn continuing education (CE) credit for time spent teaching motivates radiologic science professionals to teach students in clinic and to assess whether sonographers, who earn CE credit for time teaching, have more positive attitudes toward teaching than those in modalities who do not earn CE credit for time spent teaching. METHODS: Researchers developed a 2-track digital survey and delivered it electronically and on paper to clinical instructors working at hospitals affiliated with Department of Medical Imaging and Radiation Sciences programs at the University of Oklahoma Health Sciences Center. Responses were collected for 2 weeks and then compared quantitatively using chi-square tests and logistic regression models. Qualitative results were examined for themes, and proportions among themes were reported. RESULTS: A total of 239 people responded, with 166 responses coming from individuals working in radiography, radiation therapy, nuclear medicine, and medical dosimetry, and 73 responses from sonography. Receiving CE credit did not result in a difference in teaching attitudes (x2 5 0.0004, DF 5 1, P 5 .985). However, the non-CE credit-earning population showed a 12% increase in positive attitudes if allowed to earn CE credit in the future (95% CI; 0.08, 0.17). DISCUSSION: Student learning and performance in clinic directly are related to experiencing a positive learning environment. Factors other than CE credit appear to motivate instructors to teach students. Although the results of this study did not support the hypotheses, this study furthers the need to discuss whether offering CE credit for clinic instruction is something the profession should consider. CONCLUSION: Clinical instructors who are willing to teach are the most desirable to students. Further evaluation of CE credit as an extrinsic motivating factor for clinical instructorship is important for providing the best positive learning environment for students.