[The Nocturnal Respiratory Rate in COPD Patients of Varying GOLD Severity with/without Nicotine Consumption: Calculation by Means of Breath Sound Analysis]

Respiratory rate is an important risk marker and enables early detection of critically ill and vulnerable patients in clinical routine. The aim of this pilot study with 31 patients (COPD severity levels II - IV) was to determine the mean nocturnal respiratory rate based on breath sound recordings and to investigate the dependence of respiratory rate on COPD severity level and smoker status. The mean respiratory rate of the total collective was 19/min. For the COPD-GOLD severity levels, no significant differences in mean respiratory rate could be observed. When nicotine consumption is taken into account, active smokers showed a significantly higher mean respiratory rate of 20.84 ± 4.45/min compared to non-smokers with 17.41 ± 3.14/min (p < 0.05). In addition, active smokers in the study were significantly more frequent among patients with night-time wheezing (60 % vs. 23.8 %). This might suggest that smokers need to perform increased breathing work with increased breathing rate to compensate for oxygen deficiency in bronchial obstruction. The results of the present study show that with the acoustic recording of breath sounds, a reliable representation and calculation of the breath frequency is possible.

Localisation of mineralised tissue in a complex spinner flask environment correlates with predicted wall shear stress level localisation

Spinner flask bioreactors have often been employed for bone tissue engineering. However, the reasons for their success in facilitating bone growth remain inconclusive. It was hypothesised that engineered bone tissue formation can be attributed to mechanical stimuli, which can be predicted in the tissue engineered construct. To test the hypothesis and draw conclusions as to how mechanical stimulation affects cell behaviour, a multi- disciplinary approach using cell culture experiments and computational fluid dynamics (CFD) to simulate the complex flow within the spinner flask and scaffold was employed. Micro-computed tomography and histology showed that statically cultured human bone marrow derived stromal cells on silk fibroin scaffolds did not form extracellular matrix (ECM) or deposit minerals. However, constructs cultured at 60 rpm resulted in ECM formation and mineralisation, mainly at the bottom of the scaffold (bottom: 78 ± 7 %, middle: 17 ± 5 %, top: 5 ± 2 % of total mineralised volume). Culturing at 300 rpm led to a more homogeneously distributed ECM (bottom: 40 ± 14 %, middle: 33 ± 1 %, top: 27 ± 14 % of total mineralised volume). These observations were in agreement (Pearson correlation coefficient: 97 %) with the computational simulations that predicted maximal scaffold mineralisation, based on wall shear stress stimulation, in the bottom at 60 rpm and in the main body at 300 rpm. Such combinations of CFD modelling and experimentation could advance our knowledge of the mechanical stimuli that cells experience in vitro and link them to biological responses.

Atomic layer deposited oxide films as protective interface layers for integrated graphene transfer

The transfer of chemical vapour deposited graphene from its parent growth catalyst has become a bottleneck for many of its emerging applications. The sacrificial polymer layers that are typically deposited onto graphene for mechanical support during transfer are challenging to remove completely and hence leave graphene and subsequent device interfaces contaminated. Here, we report on the use of atomic layer deposited (ALD) oxide films as protective interface and support layers during graphene transfer. The method avoids any direct contact of the graphene with polymers and through the use of thicker ALD layers (≥100 nm), polymers can be eliminated from the transfer-process altogether. The ALD film can be kept as a functional device layer, facilitating integrated device manufacturing. We demonstrate back-gated field effect devices based on single-layer graphene transferred with a protective Al₂O₃ film onto SiO₂ that show significantly reduced charge trap and residual carrier densities. We critically discuss the advantages and challenges of processing graphene/ALD bilayer structures.

Embedded nanoparticle dynamics and their influence on switching behaviour of resistive memory devices

Resistively switching Conductive Bridge Random Access Memories (CBRAMs) rely on the controlled formation and dissolution of metallic filaments within a solid insulator, and are emerging building blocks for beyond von Neumann computing architectures and neuromorphic computing. A lack of understanding of the underlying switching mechanisms currently prevents further device utilisation and optimisation. We present a study of lateral and vertical CBRAM model devices that allow us to systematically relate important switching properties and their statistics to a direct characterisation of their critical switching region by scanning and transmission electron microscopy, i.e. to the physical nature of metal filaments and inclusions on all relevant length scales. We find that filaments are composed of metallic clusters and show how filament dynamics link to migration effects of embedded nanoparticles under voltage bias stress. The formation of metal clusters is promoted by a dynamic interplay of cation mobility and redox rate during switching. These clusters are not completely removed from the switching material matrix upon RESET and appear to grow by consumption of smaller clusters. We discuss in detail the interfacial stress of the nanoparticles in the context of their interaction with the switching material and ambient atmosphere. This allows us to consistently interpret previous literature and to suggest future device improvements.

International consensus on the definition and classification of fibrosis of the knee joint

AIMS

The aim of this consensus was to develop a definition of post-operative fibrosis of the knee.

PATIENTS AND METHODS

An international panel of experts took part in a formal consensus process composed of a discussion phase and three Delphi rounds.

RESULTS

Post-operative fibrosis of the knee was defined as a limited range of movement (ROM) in flexion and/or extension, that is not attributable to an osseous or prosthetic block to movement from malaligned, malpositioned or incorrectly sized components, metal hardware, ligament reconstruction, infection (septic arthritis), pain, chronic regional pain syndrome (CRPS) or other specific causes, but due to soft-tissue fibrosis that was not present pre-operatively. Limitation of movement was graded as mild, moderate or severe according to the range of flexion (90° to 100°, 70° to 89°, < 70°) or extension deficit (5° to 10°, 11° to 20°, > 20°). Recommended investigations to support the diagnosis and a strategy for its management were also agreed.

CONCLUSION

The development of standardised, accepted criteria for the diagnosis, classification and grading of the severity of post-operative fibrosis of the knee will facilitate the identification of patients for inclusion in clinical trials, the development of clinical guidelines, and eventually help to inform the management of this difficult condition. Cite this article: Bone Joint J 2016;98-B:1479-88.

Composition dependent mechanical behaviour of S53P4 bioactive glass putty for bone defect grafting

To improve the handling properties of S53P4 bioactive glass granules for clinical applications, bioactive glass putty formulations were developed. These formulations contain both granules and a synthetic binder to form an injectable material that is easy to shape. To explore its applicability in load-bearing bone defect grafting, the relation between the putty composition and its mechanical behaviour was assessed in this study. Five putty formulations with variations in synthetic binder and granule content were mechanically tested in confined compression. The results showed that the impaction strains significantly decreased and the residual strains significantly increased with an increasing binder content. The stiffness of all tested formulations was found to be in the same range as the reported stiffness of cancellous bone. The measured creep strains were low and no significant differences between formulations were observed. The stiffness significantly increased when the samples were subjected to a second loading stage. The residual strains calculated from this second loading stage were also significantly different from the first loading stage, showing an increasing difference with an increasing binder content. Since residual strains are detrimental for graft layer stability in load-bearing defects, putty compositions with a low binder content would be most beneficial for confined, load-bearing bone defect grafting.

Study of the Interaction of Eu3+ with Microbiologically Induced Calcium Carbonate Precipitates using TRLFS

The microbial induced biomineralization of calcium carbonate using the ureolytic bacterium Sporosarcina pasteurii in the presence of trivalent europium, a substitute for trivalent actinides, was investigated by time-resolved laser-induced fluorescence spectroscopy (TRLFS) and a variety of physicochemical techniques. Results showed that the bacterial-driven hydrolysis of urea provides favorable conditions for CaCO₃ precipitation and Eu³⁺ uptake due to subsequent increases in NH₄⁺ and pH in the local environment. Precipitate morphologies were characteristic of biogenically formed CaCO₃ and consistent with the respective mineral phase compositions. The formation of vaterite with some calcite was observed after 1 day, calcite with some vaterite after 1 week, and pure calcite after 2 weeks. The presence of organic material associated with the mineral was also identified and quantified. TRLFS was used to track the interaction and speciation of Eu³⁺ as a molecular probe with the mineral as a function of time. Initially, Eu³⁺ is incorporated into the vaterite phase, while during CaCO₃ phase transformation Eu³⁺ speciation changes resulting in several species incorporated in the calcite phase either substituting at the Ca²⁺ site or in a previously unidentified, low-symmetry site. Comparison of the biogenic precipitates to an abiotic sample shows mineral origin can affect Eu³⁺ speciation within the mineral.