Medical Technology Research Research Articles

The TLR4-MyD88-NF-κB Pathway Is Involved in sIgA-Mediated IgA Nephropathy

Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Previous studies have shown that secretory IgA (sIgA; an important antibody in mucosal immunity) was critically involved in IgAN immune responses. Toll-like receptors (TLRs), especially TLR4 which participates in mucosal immunity, may be involved in the pathogenesis of IgAN. However, it remains unclear whether sIgA and TLRs interact to mediate the pathogenesis of IgAN. The purpose of this study was to investigate whether sIgA and TLR4 interact to mediate kidney damage in IgAN patients. Methods: IgAN patients with positive sIgA deposition in renal tissues were screened by immunofluorescence assay. Patient salivary sIgA (P-sIgA) was collected and purified by jacalin affinity chromatography. Salivary sIgA from healthy volunteers was used as a control (NsIgA). Immunohistochemistry was used to assess expression of TLR4, MyD88, NF-κB, tumour necrosis factor (TNF)-α, interleukin (IL-6), and monocyte chemoattractant protein (MCP)-1 in renal tissues of IgAN patients. Human renal mesangial cells (HRMCs) were cultured in vitro and binding of sIgA to HRMCs was assessed by flow cytometry. HRMCs were cultured in the presence of sIgA (400 μg/mL) for 24 h. Transcript and protein levels of TLR4, MyD88, NF-κB and cytokines in HRMCs were determined by qPCR, western blotting and ELISA, respectively. Finally, shRNA lentiviral particles were used to silence TLR4 expression and a small-molecule inhibitor (BAY 11-7082) was used to block NF-κB signalling in HRMCs and changes in cytokine production were observed. Results: Flow cytometry showed that P-sIgA bound HRMCs (85% positive) significantly better than N-sIgA (P< 0.05). Expression of TLR4, MyD88, NF-κB, TNF-α, IL-6, and MCP-1 were detected in the mesangial area of IgAN patients. Expression levels in renal tissue in patients with positive sIgA deposition were higher than that in patients with negative sIgA deposition. Compared with cells cultured with N-sIgA, HRMCs cultured in vitro with P-sIgA showed enhanced expression of TLR4, increased secretion of TNF-α, IL-6, and MCP-1, and increased expression of MyD88/NF-κB (P<0.05). TLR4 shRNA silencing and NF-κB inhibition both reduced the ability of HRMCs to synthesize TNF-α, IL-6, and MCP-1. Conclusions: Our results indicate that sIgA may induce high expression of TLR4 in HRMCs and further activate downstream signalling pathways, prompting HRMCs to secrete multiple cytokines and thereby mediating kidney damage in IgAN patients. Funding Statement: This work was supported by grants from the National Natural Science Foundation of China (No. 81570645/H0509), the Innovation Scientists and Technicians Troop Construction Projects of Henan Province (2018JR0014), the Sponsored by Program for Science & Technology Innovation Talents in Universities of Henan Province (18HASTIT043), and the Major Project of Henan Medical Science and Technology Research Program (201501018). Declaration of Interests: The authors have no conflicts or financial interests to declare. Ethics Approval Statement: The study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University, and was carried out according to the principles laid out in the World Medical Association’s Declaration of Helsinki.

IL-1β-Activated Schwann Cells and Human Hair Keratin Compound Culture to Construct Artificial Nerve Bridging for Repair of Sciatic Nerve Defects in Sprague-Dawley Rats

Human hair keratin (HHK) and interleukin (IL)-1β-Activated Schwann Cells and Human Hair Keratin Compound Culture to Construct Artificial Nerve Bridging for Repair of Sciatic Nerve Defects in Sprague-Dawley Rats-activated Schwann cells were combined to construct artificial nerves. End-to-end anastomosis of nerve defects could repair the sciatic nerve defect in Sprague-Dawley (SD) rats. In this study, a neural injury animal model was used to simulate the repair process of artificial nerves to repair peripheral nerve injury. We found that HHK can act as a biodegradable scaffold to induce Schwann cells to dedifferentiate and then activate macrophages through proliferation and secretion of macrophage migration inhibitory factor and other active substances. A large number of macrophages appeared in the nerve terminal after peripheral nerve injury, such as phagocytic and scavenging degeneration of axons and the myelin sheath. Peripheral nerve damage was also caused by secreting related factors of neurons and other non-neuronal cells, which are involved in a complex relationship. Among them, IL-1β-Activated Schwann Cells and Human Hair Keratin Compound Culture to Construct Artificial Nerve Bridging for Repair of Sciatic Nerve Defects in Sprague-Dawley Rats and other active substances can induce Schwann cells to divide, proliferate, and differentiate, showing high expression of nerve growth factor (NGF) and other active substances, which can further activate macrophages and Schwann cells and promote nerve regeneration. This study describes HHK preparation and advantages, morphological changes of Schwann cells and macrophages in the process of nerve repair, expression of main active substances, and the effect of HHK artificial nerve implantation on animal nerve defect repair. We reveal a related mechanism of nerve repair. Funding Statement: The study was supported by the Medical Technique and Research of Guangdong Province, China (grant number A2017463); China Postdoctoral Science Foundation, China (grant number 2017M613432); Military medical science and technology youth training program (grant number 19QNP005) and Guangdong medical science and technology research foundation (grant number 2016102511210492). Declaration of Interests: The authors have declared that no competing interests exists. Ethical Approval Statement: The experimental protocols were reviewed and approved by the Institutional Animal Care and Use Committee of the Southern Medical University, Guangzhou, China.

More Severe Loss-of-Function Sodium Channel Induced by Compound SCN5A R965C and R1309H Mutants Lead to Complex Familial Arrhythmia Syndrome

Objective: A complex familial arrhythmia syndrome was identified in a Chinese Han family, characterized by sick sinus syndrome, progressive conduction block, atrial fibrillation, atrial standstill and Brugada syndrome. The underlying mechanism associated with the genetic mutation was investigated. Methods: Genetic analysis was conducted for probands in the coding and splicing regions of genes susceptible to cardiac arrhythmia diseases. The stable cell lines overexpressing wild-type (WT) or mutant SCN5A gene were generated in HEK293T cells and electrophysiological recordings were performed to evaluate the functional changes of mutant NaV1.5 channels. Results: We identified a rare double R965C and R1309H mutations in NaV1.5 channel, as a heterozygous and compound pattern, locating in the same chromosome. Compared to WT, a single mutation of R965C or R1309H, the compound mutations of R965C-R1309H most dramatically reduced the peak current of NaV1.5 channel with testing potentials ranging from -35 mV to 25 mV. Notably, the maximal peak current of NaV1.5 channel carrying R1309H only and R965C-R1309H mutations displayed significant decreases by 31.5% and 73.34%, respectively, compared to WT. Additionally, compared to single mutations of R965C or R1309H, the R965C-R1309H mutations resulted in more obviously depolarization-shifted activation and hyperpolarization-shifted inactivation, also caused most significantly changed time constant, V1/2 and slope factor of activation and inactivation. Conclusions: The compound mutations of R965C-R1309H led to more dramatically reduced current density of Nav1.5 channel, as well as more depolarization-shifted activation and hyperpolarization-shifted inactivation than single mutation of R965C or R1309H, which may provide more understanding on the molecular mechanisms underlying the familial arrhythmia syndrome. Funding Statement: The study was supported by the Science and Technology Project of Zhuhai (20191210E030072), the Natural Grant from National Natural Science Foundation of China (81870869 and 81870019), the National Key R&D Program of China (2017YFA0104704), the Medical Science and Technology Research Project of Guangdong Province (A2018043), the Science and Technology Program of Guangdong Province (2014B070705005), the General Project of Natural Science Foundation of Guangdong Province (2018A030313554), the Hundred People Plan Scientific Research Launch Project of Sun Yat-sen University. Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: This study was approved by the Guangdong Medical Institutional Review Board and Medical Ethics Committees [No.GDREC2016001H (R1)]. Informed written consent was obtained from all patients.

Current status and future development of higher medical education in Chongqing, China

Great achievements have been made in higher medical education in Chongqing, China. Among the western provinces and cities, Chongqing has relatively high quantity and quality indicators of medical education institutions. Within the whole country, Chongqing has a medium level of the key indicators of medical education, and there is still a gap between Chongqing and the economically developed provinces such as Zhejiang and Guangdong. Among the four centrally administered municipalities, Beijing and Shanghai have rich medical education resources, and there is a large gap between Chongqing and Beijing/Shanghai in the level of medical education, the number of academicians, and the number of hospitals included in the top hundred hospitals in China. Recently, Chongqing University started to establish a medical school, and University of Chinese Academy of Sciences started to construct an affiliated hospital named Chongqing Hospital in cooperation with Chongqing Municipal Health Planning Commission, which provided valuable opportunities for the development of higher medical education in Chongqing. Chongqing should increase the investment in basic research and development of medical science and technology, seize the strategic opportunity of Internet + medicine , and gather the talents in medical science and technology, so as to promote the integration and development of military-civilian medical education and improve the level of higher medical education. Key words: Medical education; Chongqing; Current status analysis

Gene Mutation Profiling in Chinese Colorectal Cancers Patients and Its Association with Clinicopathological Characteristics and Prognosis

Background: Gene mutations may play an important role in the development, response to treatment and prognosis of colorectal cancer (CRC). This retrospective study aims to investigate the mutation profiling of Chinese patients with CRC, and its correlation with clinicopathological features and prognosis. Methods: This study included 1190 Chinese CRC patients who were diagnosed between May 1998 and December 2018 and received clinical genetic testing. The OncoCarta Panel was used to test a total of 238 possible mutations in 19 common oncogenes. Results: 582 (48.9%) cases were detected with gene mutations. Of the 582 cases, there were 111 cases (19.7%) with 2 concurrent mutations, and 6 cases (1.0%) with 3 concurrent mutations. KRAS was the most common gene that occurred mutation in all cases (429, 36.1%), followed by PIK3CA (121, 10.2%), NRAS (47, 3.9%), BRAF (35, 2.9%), HRAS (11, 0.9%) and EGFR (11, 0.9%). AKT1, KIT, FGFR1, FGFR3, FLT3, CDK, ERBB2, ABL1, MET, RET and PDGFRA mutations were also detected in several cases. When it came to the prognosis, we found that KRAS/NRAS/PIK3CA/BRAF mutation was not associated with prognosis. But BRAF mutation was associated with poor prognosis in patients who accepted anti-EGFR therapy. Conclusions: The molecular testing offered the clinical data of Chinese CRC patients, and supplemented the mutation profile in both the common mutated genes (like KRAS, BRAF, PIK3CA) and the less frequent ones. The information of these mutated genes may help to find out the correlation between mutated genes and the development or prognosis of CRC. Funding Statement: This work was supported by the National Natural Science Foundation of China [grant number 81602426 and 81602066]; the Natural Science Foundation of Guangdong Province, China [grant number 2016A030310198]; and the Medical Science and Technology Research Fund Project of Guangdong Province, China [grant number A2015003]; the Fundamental Research Funds for the Central Universities (Grant number. 16ykpy25); the third outstanding young talents training plan and Medical Scientist program of Sun Yat-sen University cancer center. Declaration of Interests: The authors state: None declared for any of the authors. Ethics Approval Statement: This study was performed in accordance with the Declaration of Helsinki protocols and was approved by the local Ethics Committee. All subjects gave written informed consent at their first visit.

Association on Dental Porphyromonas Concentration with Esophageal Cancer in Guangdong, China: A Case-Control Study

Objective: To investigate the relationship between Dental Porphyromonas Concentration and Esophageal Cancer in Guangdong, China. Methods: Research objects divided into two groups: disease group and health control group. There were 43 cases in the disease group and 43 cases in the control group, on a 1 to 1 ration matching. Two groups of individuals were retrieved from the Guangdong Provincial Hospital database between year 2016 June to 2018 June. Age, gender, race and region are strictly matched. Both of the Cases and the Controls are processing through: a. Specimen collection, b. DNA extraction, c. High-throughput sequencing (screening stage), d. Quantitative determination of target bacteria in the samples of the experimental group by Q-PCR, e. Statistical analysis of experimental data. Two sample t-test are using to detect whether have difference on concentration of Dental Porphyromonas between cases and control group. SAS 15 windows version is used as analytic tools. Results: We found the mean of concentration on Dental Porphyromonas in Esophageal Cancer Group (Cases) are statistically higher than Healthy Group (Controls), with a mean of 0.0157 in cases versus 0.0025 in controls, which is 6.54 times higher in Esophageal Group, compare with control group, with P<0.001. Where hot tea drinking is found not statistically different on Dental Porphyromonas Concentration, with P=0.448, also Hot Tea Drinking Habit are found not associated with Esophageal Cancer, with the Odds Ratio (OR) on 1.114, on a P value of 0.22. Age was positive linear associated with Dental Porphyromonas concentration, with P<0.001, and R square 0.19. Conclusion: The Case-control study had found significant difference in concentration of Dental Porphyromonas between Esophageal Cancer Patient and Healthy People, where this association still lacks of proof to be a causal relationship. Further Cohort studies are need to carry out to find out more casual association, as well as finding out Dental Porphyromonas relevant Social Determinant on Esophageal Cancer. Funding Statement: The study is funded by Guangdong medical science and technology research funding: A2016123. Declaration of Interests: The authors declare declare that I have no significant competing financial, professional, or personal interests that might have influenced the performance or presentation of the work described in this manuscript. Ethics Approval Statement: China-IRB approval are obtained before the study regarding having relevant procedure on patients.

The Relationship between Mean Telomere Length and Blood Pressure: Results from the National Health and Education National Surveys

Background: The relationship between telomere length and blood pressure remains unclear. The aim of this study is to examine the relationship between mean telomere length and blood pressure among US adults. Methods: Our study population was from the National Health and Education National Surveys (NHANES, 1999-2002). Mean telomere length were grouped by quartiles. The mean telomere length assay was performed by using the quantitative polymerase chain reaction method to measure leukocyte telomere length relative to standard reference DNA (also known as the telomere-to-single copy gene (T/S) ratio). Coefficients (betas) and 95% confidence intervals (CIs) for mean telomere length in association with blood pressure were estimated by using multivariate linear regression analysis, subgroup stratified and interaction tests. Results: There were total 5954 participants including 2911 men and 3043 women, mean age were 45.16 ± 17.26 years. After adjusting for potential confounders a non-linear relationship was detected between mean telomere length and systolic and diabolic blood pressure, which had an inflection point of 0.79 T/S ratio and 1.02 T/S ratio, respectively. Subgroup analysis in participants without antihypertensive drugs showed that mean telomere length had a negative correlation with SBP(β=-6.44, 95%CI:-7.80, -5.08,P<0.001), and the P value for the interaction was 0.0212. Conclusions: Our findings revealed that the relationship between mean telomere length and blood pressure is non-linear. The implications of this correlation needed further investigation. Funding: During the process of data analysis , writing and submission of the article, this work was supported by the Natural Science Foundation of Guangdong Province (No. 2015A030313660), the Science and Technology Program of Guangzhou (No. 201604020143, No.201604020018, No. 201510010254, and No. 201803040012), the Medical Science and Technology Research Fund of Guangdong Province (No. B2018023) and the National Key Research and Development Program of China (No. 2017FYC1307603, No. 2016YFC1301305, and No. 2017YFC0909303). Declaration of Interest: The other authors report no conflicts. Ethical Approval: The survey protocol was approved by the Institutional Review Board of the Centers for Disease Control and Prevention. All participants gave written informed consent.

The challenges of patient and public involvement in medical technology and in-vitro diagnostic research

Patient and public involvement (PPI) in research is defined as 'research being carried out "with" or "by" members of the public rather than "to", "about" or "for" them'. A knowledge transfer event (KTE) was planned to share the experience of organizations who carry out medical technology research. The KTE was attended by organizations with an interest in the effective application of PPI in health-care research, including organizations from academia, industry and charities. The aim was to share current PPI experience and to discuss the development of a PPI impact measurement framework to support future growth in PPI application within medical technology research.

Intelligent Assistive Technology for Alzheimer's Disease and Other Dementias: A Systematic Review.

Intelligent assistive technologies (IATs) have the potential of offering innovative solutions to mitigate the global burden of dementia and provide new tools for dementia care. While technological opportunities multiply rapidly, clinical applications are rare as the technological potential of IATs remains inadequately translated into dementia care. In this article, the authors present the results of a systematic review and the resulting comprehensive technology index of IATs with application in dementia care. Computer science, engineering, and medical databases were extensively searched and the retrieved items were systematically reviewed. For each IAT, the authors examined their technological type, application, target population, model of development, and evidence of clinical validation. The findings reveal that the IAT spectrum is expanding rapidly in volume and variety over time, and encompasses intelligent systems supporting various assistive tasks and clinical uses. At the same time, the results confirm the persistence of structural limitations to successful adoption including partial lack of clinical validation and insufficient focus on patients' needs. This index is designed to orient clinicians and relevant stakeholders involved in the implementation and management of dementia care across the current capabilities, applications, and limitations of IATs and to facilitate the translation of medical engineering research into clinical practice. In addition, a discussion of the major methodological challenges and policy implications for the successful and ethically responsible implementation of IAT into dementia care is provided.

Intelligent Assistive Technology for Alzheimer's Disease and Other Dementias: A Systematic Review.

Intelligent assistive technologies (IATs) have the potential of offering innovative solutions to mitigate the global burden of dementia and provide new tools for dementia care. While technological opportunities multiply rapidly, clinical applications are rare as the technological potential of IATs remains inadequately translated into dementia care. In this article, the authors present the results of a systematic review and the resulting comprehensive technology index of IATs with application in dementia care. Computer science, engineering, and medical databases were extensively searched and the retrieved items were systematically reviewed. For each IAT, the authors examined their technological type, application, target population, model of development, and evidence of clinical validation. The findings reveal that the IAT spectrum is expanding rapidly in volume and variety over time, and encompasses intelligent systems supporting various assistive tasks and clinical uses. At the same time, the results confirm the persistence of structural limitations to successful adoption including partial lack of clinical validation and insufficient focus on patients' needs. This index is designed to orient clinicians and relevant stakeholders involved in the implementation and management of dementia care across the current capabilities, applications, and limitations of IATs and to facilitate the translation of medical engineering research into clinical practice. In addition, a discussion of the major methodological challenges and policy implications for the successful and ethically responsible implementation of IAT into dementia care is provided.

Perception of the Professional Knowledge of and Education on the Medical Technology Products among the Pharmacists in the Baltic and Nordic Countries-A Cross-Sectional Exploratory Study.

With increased development of medical technology (MT), new challenges emerge related to education and training of pharmacists and other healthcare specialists. Currently, only a few universities in the EU promote MT education and research. Objectives: The aim of this study was to evaluate the current status, views on, and need for the education on MT for the pharmacy students and practicing pharmacists in the Baltic and Nordic countries. Methods: The representatives of higher education institutions and community/hospital pharmacists from six Baltic and Nordic countries participated in a qualitative cross-sectional exploratory internet-based study from May to October 2014. Results: Approximately two-third of the respondents considered professional knowledge about MT products important for pharmacists, but half of them had never participated in any MT courses. More practicing pharmacists than representatives of academia underlined the need for increased MT education for pharmacy students in the future. Conclusions: The pharmacists in the Baltic and Nordic countries consider the professional knowledge about MT as pertinent in their education and work. The limited number and status of MT courses available today, however, is a major concern among both pharmacy students and practicing pharmacists in these countries. In the future, increasing education combining theory and practice about MT products would be one possible solution to overcome this challenge.

(885) - GLP In-Vivo Study and Durability Testing for Miniaturized EVAHEART KAIZEN (EVA-kai) System

The EVAHEART was developed by Sun Medical Technology Research Corporation (Nagano Japan) as an implantable left ventricular assist device and it was approved in 2010 by the Japanese Pharmaceuticals and Medical Device Agency (PMDA) for bridge to heart transplantation (BTT). CE Marking was also approved in 2012 and it is under IDE clinical trial in the U.S.A. The pump features are: high pump performance (over 10L/min/100mmHg), low share stress, low hemolysis rate (NIH 0.005g/100L), and excellent anti-thrombogenicity. Unique flat PQ curve pump performance generates superior pulsatile and high peak flow even with advanced heart failure. The EVAHEART has been implanted more than 120 patients, more than 750 days median support duration in Japan with excellent long-term survival rate; 89.8% for 1 year and 83.2% for 2 years. The clinical outcome shows excellent low risk free rate; 95.2% for 3 years GI bleeding free, 98.0% for 3 years Hemolysis free, less than 1 % pump failure exchange and superior low vWF multimer degradation. Purpose of this research is to develop a miniaturized EVAHEART, so called EVA Kai, to fit small patients with identical support capacity with current EVAHEART. The core technology, such as Impeller design, Pump chamber design, Blood contact surface anticoagulation coating (MPC coating), hydro-dynamic bearing, Mechanical seal and CS system are inherited from current EVAHERT to EVA Kai. The inflow cannula and the outflow graft are compatible. A newly designed small diameter and flexible driveline is equipped. A small and high power drive motor is also developed and it is compatible with current controller. Pump displacement volume is 97.3 mL which is 26.3% smaller than current EVAHEART. Drive line diameter is 7.5mm which is 36.7% reduction. The pump was fabricated titanium, the pump weight was 262 g which is 37.6 % lighter including a newly developed brushless DC motor. Four animal studies with endpoint POD 60 were successfully conducted under GLP at NCVC. At the autopsy, there was no thrombus on the pump surface, and no major thromboemboli in organs except very few small renal infarct. System durability test is conducting for more than six months and electrical safety test and EMC test had successfully been conducted. The miniaturized EVAHEART has been successfully developed and animal studies show excellent result.

US Army blood program: 2025 and beyond.

In preparing to support the Army in 2025 and beyond, the Army Blood Program remains actively engaged with the research and advanced development of blood products and medical technology to improve blood safety and efficacy in conjunction with the US Army Medical Research and Materiel Command. National and International Blood Bank authorities have noted that the US Army research and development efforts in providing new blood products and improving blood safety operate on the cutting edge of technology and are transformational for the global blood industry. Over the past 14 years, the Army has transformed how blood support is provided and improved the survival rate of casualties. Almost every product or process developed by or for the military has found an application in treating civilian patients. Conflicts have many unwanted consequences; however, in times of conflict, one positive aspect is the identification of novel solutions to improve the safety and efficacy of the blood supply.

Research and application of medical management information technology in tobacco enterprise

Through the study of the disadvantages of the infirmary and the domestic and foreign related development level, this research proposes the technical analysis program of the medical system, and establishes the information and data management and control mechanism. Through information management, the final implementation of the fine management of employee health management and control, improve efficiency and scientific management.

Developing strontium-substituted bioglass and polycaprolactone composite scaffolds for bone repair via hybrid electrospinning in the direct writing mode

Event Abstract Back to Event Developing strontium-substituted bioglass and polycaprolactone composite scaffolds for bone repair via hybrid electrospinning in the direct writing mode Jiongyu Ren1, Molly M. Stevens2, Roland Steck3, Keith A. Blackwood1 and Maria A. Woodruff1 1 Queensland University of Technology, The Institute of Health and Biomedical Innovation, Australia 2 Imperial College London, Department of Materials, United Kingdom 3 Queensland University of Technology, The Medical Engineering Research Facility, Australia Introduction: Electrospinning is a versatile fibre-based technique for scaffold production with smaller fibre diameter, and thus larger surface area to volume ratio compared to melt extrusion. Recent developments in direct writing melt-electrospinning makes use of the stable and predictable fibre deposition to fabricate scaffolds in the layer-by-layer manner[1],[2]. Synthetic materials including polymers and bioactive glass (BG) are most common for bone scaffold fabrication[3],[4]. Among the synthetic polymers, polycaprolactone (PCL), which is a FDA-approved aliphatic polyester, has been become a promising candidate for bone scaffold material due to its favourable rheological and viscoelastic properties[5]. Bioactive glass (BG) is a synthetic material known to bind seamlessly to bone and promote osteogenesis. Strontium-substituted BG derived from the original 45S5 BG by substituting 0-100% of the calcium component of the 45S5 formulation for strontium[6], and have shown superior osteogenic capacity to 45S5 BG[7]. We hypothesize that melt-electrospun PCL/SrBG composite scaffolds will provide a promising bone graft substitute, which will be osteoinductive, osteoconductive, capable of osteointegration and bioresorbable in a controlled rate. The scaffolds can be manufactured with a tailored structure according to specific defect site, and can be replaced by the body’s own newly regenerated bone over time. Materials and Methods: The SrBG particles were ground down to < 6 μm prior to composite preparation with a micronizing mill to reduce the risk of needle blockage. The 50 wt% PCL/SrBG composites were prepared by incorporating fine SrBG particles into the PCL bulk using solvent precipitation technique. PCL/SrBG composite scaffolds were fabricated using a novel solvent assisted hybrid melt-electrospinning technique in the direct write mode. Light microscopy and scanning electron microscopy (SEM) were used to characterize surface topography and fibre diameter. Mechanical stiffness of PCL/SrBG fibres were assessed with atomic force microscopy. Cell attachment and morphology were assessed with confocal laser scanning microscopy and SEM . Cell proliferation and osteoblastic differentiation were assessed with PicoGreen and alkaline phosphatase assays. Results and Discussion: Our hybrid melt-electrospinning system overcame the difficulties of PCL/SrBG composite melt-electrospinning associated with viscoelastic properties of the composite material. These composite scaffolds were produced in a layer-by-layer manner with 90° cross-hatched deposition with the fibre spacing of 1 mm. Examination by scanning electron microscopy showed enhanced micro structure on the surface of PCL/SrBG fibres, while the surface of PCL only fibres were smooth. The submicron structures generated during the hybrid melt-electrospinning process largely increased the surface area of composite scaffolds and created roughness ideal for cell attachment. The in vitro results showed good cell adherence onto both the PCL/SrBG and PCL only scaffolds. However, PCL/SrBG composite scaffolds showed significantly higher osteoblast differentiation compared to PCL only scaffolds. Conclusion: We are the first to produce the composite PCL/SrBG (50 wt%) scaffolds via a novel hybrid melt-electrospinning technique. These composite scaffolds are promising bone graft substitutes, and may also lead to patient-specific and off-the-shelf solution for clinical treatment of critical-sized bone defects. Dr Henrietta Cathey (Electron microscope probe analysis); Dr Charlotte Allen, Dr Sunny Hu and Mr. Mitchell De Bruyn (Inductively coupled plasma analysis); Dr Marie-Luise Wille (micro-CT scanning and analysis); Dr Christina Theodoropoulos (Confocal microscopy); Dr Tong Li (Atomic force microscopy); ARC Linkage for funding

2B24 EVAHEART脱血管のMPCコーティングの有無が血栓飛散量に及ぼす影響の実験的検討

Thrombus formation at the interface between left ventricular wall and the inflow cannula of left ventricular assist device (LVAD) remains to be an unsolved problem that induces complications in clinical practice. The aim of this study is to develop an in vitro airless circuit which produces flow and pressure environments in patients with a LVAD, and to investigate an influence of MPC coating of the inflow cannula of EVAHEART^[○!R] LVAD (Sun Medical Technology Research Co., Japan) on thrombus detachment from the inflow cannula. In the thrombogenicity test, two identical circuits except for the cannula were prepared to form a comparative study. Heparinized blood from a single porcine with activated clotting time ranged within 130-210 sec was circulated for 4.5 hours. The tests were performed under the combinations of the total flow rate of 4 L/min or 5 L/min, and the pump rotational speed of 1800, 1900 or 2000 rpm, respectively. It was elucidated that higher amount of thrombus formed on the MPC non-coated cannula compared with MPC coated cannula. However, there was no difference in the amount of thrombus detached between the two cannula (Student's t-test, p=0.91). From these results, it was elucidated that the MPC non-coated cannula yielded significantly lower proportion of thrombus detachment to thrombus formation than the MPC coated cannula (Student's t-test, p<0.05).

Abstract 10766: What is an Optimal Setting of Continuous-flow Left Ventricular Assist Device for Severe Mitral Regurgitation?

Introduction: Excessive volume unloading of the left ventricle (LV) affects the right ventricular (RV) function by causing shift of the ventricular septum during left ventricular assist device (LVAD) support in patients with mitral regurgitation (MR). Optimal settings of LVAD that control MR without RV dysfunction are required. We developed a novel cardiac-cycle synchronized rotational speed (RS) modulation system for a continuous-flow LVAD and assessed the system in a goat model of MR. Methods: We implanted EVAHEART (Sun Medical Technology Research Corp.) through left thoracotomy in six adult goats weighing 66.4 ± 10.7 kg. After implantation of the device, severe MR was induced with inflation of a temporary inferior vena cava filter that was placed in the mitral valve. The severity of MR was defined by left ventriculography and echocardiography. We evaluated total flow (TF: the sum of aortic flow and pump flow), RV fractional area change (RVFAC) calculated by echocardiography, left atrial pressure (LAP), LV end-diastolic pressure (LVEDP), LV end-diastolic volume (LVEDV), and LV stroke work (LVSW) with a bypass rate (pump flow divided by TF) of 100% under four conditions: circuit-clamp, continuous mode, co-pulse mode (increase RS in systole) and counter-pulse mode (increase RS in diastole). Results: TF tended to be higher in counter-pulse mode (3.27 ± 1.09, 3.51 ± 2.14, 3.45 ± 2.58, and 3.75 ± 2.39 L/min, in circuit-clamp, continuous mode, co-pulse mode, and counter-pulse mode, respectively; p &gt; 0.05). RVFAC was significantly higher in counter-pulse mode than in co-pulse mode (0.68 ± 0.05 vs 0.51 ± 0.08 , p &lt; 0.05). LAP was significantly lower in all the driving modes than in circuit-clamp. LVEDP, LVEDV and LVSW, shown as percentages of those in circuit-clamp (= 100%), were significantly lower in counter-pulse mode than in circuit-clamp (54.43 ± 32.05, 89.6 0 ± 4.23, and 60.30 ± 28.41 %, respectively; p &lt; 0.05). Conclusions: Good control of MR in counter-pulse mode could be achieved with enough LV volume unloading during diastole not to leave blood that regurgitates during systole. Given higher TF and RVFAC in counter-pulse mode, the mode has less adverse effects on the RV function. In conclusion, the mode may offer a favorable control of MR with minimizing RV dysfunction.

Visualizing the structure and the evolving of digital medicine: a scientometrics review

This article aims to analyze and visualize the structure and the emerging trend of digital medicine, a new medical pattern of twenty-first century. Our study objectively explores the document co-citation clusters of 6060 bibliographic records to identify the origin of digital medicine and the hot research specialty of domain. Pivotal point articles, prominent authors, active disciplines and institution have been identified by network analysis theory. CiteSpace was used to visualize the perspective of digital medicine domain. As an interdiscipline which integrated computer science, information engineering with medicine, digital medicine originally and mainly on digital medical imaging technology research for accuracy and speedy clinical diagnosis and therapy. Of 6060 relevant records reviewed, 1719 (28 %) are on radiology, 902 (15 %) are on engineering, 539 (9 %) are on computer science. The largest co-citation cluster is on digital tomosynthesis. The earliest cluster is on medical imaging segmentation and registration. Post-processing imaging technology, detector, phase contrast, reversible watermarking, input, model 3D reconstruct, real-time dynamic imaging, dosimetry have been the hot research topics. The recently cluster is on internet health information. Harvard University of USA is the prominent institution. The coverage of digital medicine research is widely from clinic to laboratory. Recent year, domain research front is thematically on teleradiology, telemedicine and hospital information management system.

Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment.

ObjectivesRemote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine.MethodsThis study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT.ResultsThe proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT.ConclusionsThe proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical staff.

A Learning Approach to Introducing GPU Computing in Undergraduate Engineering Program

The graphics processing unit (GPU) learning initiative is developed within a project awarded by the Moroccan Fulbright Alumni Association (MFAA), entitled “GPU Acceleration of Human Genome Sequencing”. This project involves undergraduate students at Abdelmalek Essaadi University, and is conducted in collaboration with the High Performance Computing Lab (HPCL) at the George Washington University in U.S. The study brings together two of the most important topics and challenges for the medical field, Genomics, and information technology, parallel computing specially with Graphical Processing Units. The potential outcomes from the project will make very valuable contributions to medical and information technology research and will enrich the academic experience of the students. General Terms GPU programming, Learning-by-doing.