Role of hydrogen peroxide in intra-operative wound preparation based on an in vitro fibrin clot degradation model.

Three per cent hydrogen peroxide (H2O2) is widely used to irrigate acute and chronic wounds in the surgical setting and clinical experience tells us that it is more effective at removing dried-on blood than normal saline alone. We hypothesise that this is due to the effect of H2O2 on fibrin clot architecture via fibrinolysis. We investigate the mechanisms and discuss the clinical implications using an in vitro model. Coagulation assays with normal saline (NaCl), 1% and 3% concentrations of H2O2 were performed to determine the effect on fibrin clot formation. These effects were confirmed by spectrophotometry. The effects of 1%, 3% and 10% H2O2 on the macroscopic and microscopic features of fibrin clots were assessed at set time intervals and compared to a NaCl control. Quantitative analysis of fibrin networks was undertaken to determine the fibre length, diameter, branch point density and pore size. Fibrin clots immersed in 1%, 3% and 10% H2O2 demonstrated volume losses of 0.09-0.25mm3/min, whereas those immersed in the normal saline gained in volume by 0.02±0.13 mm3/min. Quantitative analysis showed that H2O2 affects the structure of the fibrin clot in a concentration-dependent manner, with the increase in fibre length, diameter and consequently pore sizes. Our results support our hypothesis that the efficacy of H2O2 in cleaning blood from wounds is enhanced by its effects on fibrin clot architecture in a concentration- and time-dependent manner. The observed changes in fibre size and branch point density suggest that H2O2 is acting on the quaternary structure of the fibrin clot, most likely via its effect on cross-linking of the fibrin monomers and may therefore be of benefit for the removal of other fibrin-dependent structures such as wound slough.

Paper Thermoelectrics by a Solvent-Free Drawing Method of All Carbon-Based Materials.

As practical interest in the flexible or wearable thermoelectric generators (TEGs) has increased, the demand for the high-performance TEGs based on ecofriendly, mechanically resilient, and economically viable TEGs as alternatives to the brittle inorganic materials is growing. Organic or hybrid thermoelectric (TE) materials have been employed in flexible TEGs; however, their fabrication is normally carried out using wet processing such as spin-coating or screen printing. These techniques require materials dissolved or dispersed in solvents; thus, they limit the substrate choice. Herein, we have rationally designed solvent-free, all carbon-based TEGs dry-drawn on a regular office paper using few-layered graphene (FLG). This technique showed very good TE parameters, yielding a power factor of 97 µW m-1 K-2 at low temperatures. The p-type only device exhibited an output power of up to ∼19.48 nW. As a proof of concept, all carbon-based p-n TEGs were created on paper with the addition of HB pencil traces. The HB pencil exhibited low Seebeck coefficients (-7 µV K-1), and the traces were highly resistive compared to FLG traces, which resulted in significantly lower output power compared to the p-type only TEG. The demonstration of all carbon-based TEGs drawn on paper highlights the potential for future low-cost, flexible, and almost instantaneously created TEGs for low-power applications.

Abnormal clot microstructure formed in blood containing HIT-like antibodies.

INTRODUCTION: Thrombosis is a severe and frequent complication of heparin-induced thrombocytopenia (HIT). However, there is currently no knowledge of the effects of HIT-like antibodies on the resulting microstructure of the formed clot, despite such information being linked to thrombotic events. We evaluate the effect of the addition of pathogenic HIT-like antibodies to blood on the resulting microstructure of the formed clot. MATERIALS AND METHODS: Pathogenic HIT-like antibodies (KKO) and control antibodies (RTO) were added to samples of whole blood containing Unfractionated Heparin and Platelet Factor 4. The formed clot microstructure was investigated by rheological measurements (fractal dimension; df) and scanning electron microscopy (SEM), and platelet activation was measured by flow cytometry. RESULTS AND CONCLUSIONS: Our results revealed striking effects of KKO on clot microstructure. A significant difference in df was found between samples containing KKO (df = 1.80) versus RTO (df = 1.74; p < 0.0001). This increase in df was often associated with an increase in activated platelets. SEM images of the clots formed with KKO showed a network consisting of a highly branched and compact arrangement of thin fibrin fibres, typically found in thrombotic disease. This is the first study to identify significant changes in clot microstructure formed in blood containing HIT-like antibodies. These observed alterations in clot microstructure can be potentially exploited as a much-needed biomarker for the detection, management and monitoring of HIT-associated thrombosis.

Lightweight and Bulk Organic Thermoelectric Generators Employing Novel P-Type Few-Layered Graphene Nanoflakes.

Graphene exhibits both high electrical conductivity and large elastic modulus, which makes it an ideal material candidate for many electronic devices. At present not much work has been conducted on using graphene to construct thermoelectric devices, particularly due to its high thermal conductivity and lack of bulk fabrication. Films of graphene-based materials, however, and their nanocomposites have been shown to be promising candidates for thermoelectric energy generation. Exploring methods to enhance the thermoelectric performance of graphene and produce bulk samples can significantly widen its application in thermoelectrics. Realization of bulk organic materials in the thermoelectric community is highly desired to develop cheap, Earth-abundant, light, and nontoxic thermoelectric generators. In this context, this work reports a new approach using pressed pellets bars of few-layered graphene (FLG) nanoflakes employed in thermoelectric generators (TEGs). First, FLG nanoflakes were produced by a novel dry physical grinding technique followed by graphene nanoflake liberation using plasma treatment. The resultant material is highly pure with very low defects, possessing 3 to 5-layer stacks as proved by Raman spectroscopy, X-ray diffraction measurement, and scanning electron microscopy. The thermal and electronic properties confirm the anisotropy of the material and hence the varied performance characteristics parallel to and perpendicular to the pressing direction of the pellets. The full thermoelectric properties were characterized both parallel and perpendicular to the pressing direction, and the proof-of-concept thermoelectric generators were fabricated with variable amounts of legs.

Author Correction: Morphological and biomechanical characterization of immature and mature nasoseptal cartilage.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Morphological and biomechanical characterization of immature and mature nasoseptal cartilage.

Nasoseptal cartilage has been assumed to be isotropic, unlike the well-defined zonal organization of articular cartilage attributed to postnatal biomechanical loading. We know from clinical experience that malrotation of surgical nasoseptal cartilage grafts can lead to increased graft absorption. Other studies have also suggested directionally dependent compressive stiffness suggesting anisotropy, but morphological investigations are lacking. This study characterizes immature and mature native bovine nasoseptal cartilage using a combination of immunohistochemistry, biomechanical testing and structural imaging. Our findings indicate that there is extensive postnatal synthesis and reorganization of the extracellular matrix in bovine nasoseptal cartilage, independent of joint loading forces responsible for articular cartilage anisotropy. Immature nasoseptal cartilage is more cellular and homogenous compared to the zonal organization of cells and extracellular matrix of mature cartilage. Mature samples also exhibited greater glycosaminoglycan content and type II collagen fibre alignment compared to immature cartilage and this correlates with greater compressive stiffness. Engineered neocartilage often consists of immature, isotropic, homogenous tissue that is unable to meet the functional and mechanical demands when implanted into the native environment. This study demonstrates the importance of anisotropy on biomechanical tissue strength to guide future cartilage tissue engineering strategies for surgical reconstruction.

Structural and mechanical characterization of crosslinked and sterilised nanocellulose-based hydrogels for cartilage tissue engineering.

Nanocellulose is a natural biopolymer derived from cellulose. Combined with sodium alginate, it is used to 3D print hydrogels for articular and nasal cartilage engineering and shows good integration, promising cartilage regeneration and mechanical stability over 60 days of implantation in mice. Yet, little is known about their structural and mechanical properties, particularly the impact of crosslinking and sterilisation methods. This study investigates the impact of different calcium chloride crosslinker concentrations and sterilization methods on the structural and mechanical properties of nanocellulose-based hydrogels containing plant-derived cellulose nanofibrils, cellulose nanocrystals or a blend of the two. Crosslinking significantly alters the overall network distribution, surface morphology, pore size and porosity of the hydrogels. Sterilisation has a striking effect on pore size and affects swelling depending on the sterilisation method. The effect of crosslinker and sterilisation on the overall properties of the hydrogels was reliant on the form of nanocellulose that comprised them.

Printability of pulp derived crystal, fibril and blend nanocellulose-alginate bioinks for extrusion 3D bioprinting.

BACKGROUND: One of the main challenges for extrusion 3D bioprinting is the identification of non-synthetic bioinks with suitable rheological properties and biocompatibility. Our aim was to optimize and compare the printability of crystal, fibril and blend formulations of novel pulp derived nanocellulose bioinks and assess biocompatibility with human nasoseptal chondrocytes. METHODS: The printability of crystalline, fibrillated and blend formulations of nanocellulose was determined by assessing resolution (grid-line assay), post-printing shape fidelity and rheology (elasticity, viscosity and shear thinning characteristics) and compared these to pure alginate bioinks. The optimized nanocellulose-alginate bioink was bioprinted with human nasoseptal chondrocytes to determine cytotoxicity, metabolic activity and bioprinted construct topography. RESULTS: All nanocellulose-alginate bioink combinations demonstrated a high degree of shear thinning with reversible stress softening behavior which contributed to post-printing shape fidelity. The unique blend of crystal and fibril nanocellulose bioink exhibited nano- as well as micro-roughness for cellular survival and differentiation, as well as maintaining the most stable construct volume in culture. Human nasoseptal chondrocytes demonstrated high metabolic activity post printing and adopted a rounded chondrogenic phenotype after prolonged culture. CONCLUSIONS: This study highlights the favorable rheological, swelling and biocompatibility properties of nanocellulose-alginate bioinks for extrusion-based bioprinting.

The evaluation of leukocytes in response to the in vitro testing of ventricular assist devices.

Infection is a clinically relevant adverse event in patients with ventricular assist device (VAD) support. The risk of infection could be linked to a reduced immune response resulting from damage to leukocytes during VAD support. The purpose of this study was to develop an understanding of leukocyte responses during the in vitro testing of VADs by analyzing the changes to their morphology and biochemistry. The VentrAssist implantable rotary blood pump (IRBP) and RotaFlow centrifugal pump (CP) were tested in vitro under constant hemodynamic conditions. Automated hematology analysis of samples collected regularly over 25-h tests was undertaken. A new flow cytometric assay was employed to measure biochemical alteration, necrosis (7-AAD) and morphological alteration (CD45 expression) of the circulating leukocytes during the pumping process. The results of hematology analysis show the total leukocyte number and subset counts decreased over the period of in vitro tests dependent on different blood pumps. The percentage of leukocytes damaged during 6-h tests was 40.8 ± 5.7% for the VentrAssist IRBP, 17.6 ± 5.4% for the RotaFlow CP, and 2.7 ± 1.8% for the static control (all n=5). Flow cytometric monitoring of CD45 expression and forward/side scatter characteristics revealed leukocytes that were fragmented into smaller pieces (microparticles). Scanning electron microscopy and imaging flow cytometry were used to confirm this. Device developers could use these robust cellular assays to gain a better understanding of leukocyte-specific VAD performance.