Rotary Bend Fatigue of Nitinol to One Billion Cycles.

Nitinol implants, especially those used in cardiovascular applications, are typically expected to remain durable beyond 108 cycles, yet literature on ultra-high cycle fatigue of nitinol remains relatively scarce and its mechanisms not well understood. To investigate nitinol fatigue behavior in this domain, we conducted a multifaceted evaluation of nitinol wire subjected to rotary bend fatigue that included detailed material characterization and finite element analysis as well as post hoc analyses of the resulting fatigue life data. Below approximately 105 cycles, cyclic phase transformation, as predicted by computational simulations, was associated with fatigue failure. Between 105 and 108 cycles, fractures were relatively infrequent. Beyond 108 cycles, fatigue fractures were relatively common depending on the load level and other factors including the size of non-metallic inclusions present and the number of loading cycles. Given observations of both low cycle and ultra-high cycle fatigue fractures, a two-failure model may be more appropriate than the standard Coffin-Manson equation for characterizing nitinol fatigue life beyond 108 cycles. This work provides the first documented fatigue study of medical grade nitinol to 109 cycles, and the observations and insights described will be of value as design engineers seek to improve durability for future nitinol implants.

On the influence of test speed and environment in the fatigue life of small diameter nitinol and stainless steel wire.

To better understand the complex interplay of speed and environment on metals commonly used in implants, rotary bend fatigue tests were conducted on stainless steel and nitinol wires. A range of alternating strains was tested to create ε-N curves at two speeds (physiologic and accelerated) and in three environments (deionized water at body temperature, phosphate buffered saline at body temperature, and laboratory air at ambient room temperature). Results indicate that speed and environment can affect the observed fatigue life in nuanced ways. An electropotential monitoring technique was demonstrated to characterize fatigue crack growth which may be useful in future investigations.

Characterizing fretting damage in different test media for cardiovascular device durability testing.

In vitro durability tests of cardiovascular devices are often used to evaluate the potential for fretting damage during clinical use. Evaluation of fretting damage is important because severe fretting can concentrate stress and lead to the loss of structural integrity. Most international standards call for the use of phosphate buffered saline (PBS) for such tests although there has been little evidence to date that the use of PBS is appropriate in terms of predicting the amount of fretting damage that would occur in vivo. In order to determine an appropriate test media for in vitro durability tests where fretting damage is being evaluated, we utilized an in vitro test that is relevant to cardiovascular devices both in terms of dimensions and materials (nitinol, cobalt-chromium, and stainless steel) to characterize fretting damage in PBS, deionized water (DIW), and heparinized porcine blood. Overall, tests conducted in blood were found to have increased levels of fretting damage over tests in DIW or PBS, although the magnitude of this difference was smaller than the variability for each test media. Tests conducted in DIW and PBS led to mostly similar amounts of fretting damage with the exception of one material combination where DIW had greatly reduced damage compared to PBS and blood. Differences in fretting damage among materials were also observed with nitinol having less fretting damage than stainless steel or cobalt-chromium. In general, evaluating fretting damage in PBS or DIW may be appropriate although caution should be used when selecting test media and interpreting results given some of the differences observed across different materials.

Sodium Hypochlorite Treatment and Nitinol Performance for Medical Devices.

Processing of nitinol medical devices has evolved over the years as manufacturers have identified methods of reducing surface defects such as inclusions. One recent method proposes to soak nitinol medical devices in a 6% sodium hypochlorite (NaClO) solution as a means of identifying surface inclusions. Devices with surface inclusions could in theory then be removed from production because inclusions would interact with NaClO to form a visible black material on the nitinol surface. To understand the effects of an NaClO soak on performance, we compared as-received and NaClO-soaked nitinol wires with two different surface finishes (black oxide and electropolished). Pitting corrosion susceptibility was equivalent between the as-received and NaClO-soaked groups for both surface finishes. Nickel ion release increased in the NaClO-soaked group for black oxide nitinol, but was equivalent for electropolished nitinol. Fatigue testing revealed a lower fatigue life for NaClO-soaked black oxide nitinol at all alternating strains. With the exception of 0.83% alternating strain, NaClO-soaked and as-received electropolished nitinol had similar average fatigue life, but the NaClO-soaked group showed higher variability. NaClO-soaked electropolished nitinol had specimens with the lowest number of cycles to fracture for all alternating strains tested with the exception of the highest alternating strain 1.2%. The NaClO treatment identified only one specimen with surface inclusions and caused readily identifiable surface damage to the black oxide nitinol. Damage from the NaClO soak to electropolished nitinol surface also appears to have occurred and is likely the cause of the increased variability of the fatigue results. Overall, the NaClO soak appears to not lead to an improvement in nitinol performance and seems to be damaging to the nitinol surface in ways that may not be detectable with a simple visual inspection for black material on the nitinol surface.

Photocatalyst size controls electron and energy transfer: selectable E/Z isomer synthesis via C-F alkenylation.

Photocatalytic alkene synthesis can involve electron and energy transfer processes. The structure of the photocatalyst can be used to control the rate of the energy transfer, providing a mechanistic handle over the two processes. Jointly considering catalyst volume and emissive energy provides a highly sensitive strategy for predicting which mechanistic pathway will dominate. This model was developed en route to a photocatalytic Caryl-F alkenylation reaction of alkynes and highly-fluorinated arenes as partners. By judicious choice of photocatalyst, access to E- or Z-olefins was accomplished, even in the case of synthetically challenging trisubstituted alkenes. The generality and transferability of this model was tested by evaluating established photocatalytic reactions, resulting in shortened reaction times and access to complimentary Z-cinnamylamines in the photocatalytic [2 + 2] and C-H vinylation of amines, respectively. These results show that taking into account the size of the photocatalyst provides predictive ability and control in photochemical quenching events.

Photocatalytic C-F alkylation; facile access to multifluorinated arenes.

C-F functionalizations that provide C-C bonds are challenging synthetic transformations, due in part to the large C-F bond strength, short bond length, nonpolarizable nature, the production of fluoride, and the regioselectivity-in the case of multifluorinated substrates. However, commercially available highly fluorinated arenes possess great synthetic potential because they already possess the C-F bonds in the desired locations that would be difficult to selectively fluorinate. In order to take advantage of this potential, selective C-F functionalizations must be developed. Herein, we disclose conditions for the photocatalytic reductive alkylation of highly fluorinated arenes with ubiquitous and unactivated alkenes. The mild reaction conditions provide for a broad functional group scope, and the reaction is remarkably efficient using just 0.25 mol% catalyst. Finally, we demonstrate the utility of the strategy by converting highly fluorinated arenes to elaborate (hetero)arenes that contain 2-5 Caryl-F bonds via synergistic use of photocatalysis and SNAr chemistry.

Feasibility of localized immunosuppression: 3. Preliminary evaluation of organosilicone constructs designed for sustained drug release in a cell transplant environment using dexamethasone.

As part of our ongoing effort to develop biohybrid devices for pancreatic islet transplantation, we are interested in establishing the feasibility of a localized immune-suppressive approach to avoid or minimize the undesirable side effects of existing systemic treatments. Since biohybrid devices can also incorporate biocompatible scaffold constructs to provide a support environment for the transplanted cells that enhances their engraftment and long-term function, we are particularly interested in an approach that would use the same three-dimensional construct, or part of the same construct, to also provide sustained release of therapeutic agents to modulate the inflammatory and immune responses locally. Within this framework, here, we report preliminary results obtained during the investigation of the suitability of organosilicone constructs for providing sustained localized drug release using small, matrix-type polydimethylsiloxane (PDMS) disks and dexamethasone as a model hydrophobic drug. Following a short burst, long-term steady sustained release was observed under in vitro conditions at levels of 0.1-0.5 microg/day/disk with a profile in excellent agreement with that predicted by the Higuchi equation. To verify that therapeutic levels can be achieved, suppression of LPS-induced activation has been shown in THP-1 cells with disks that have been pre-soaked for up to 28 days. These preliminary results prove the feasibility of this approach where an integral part of the biomaterial construct used to enhance cell engraftment and long-term function also serves to provide sustained local drug release.

Incubation of European yew (Taxus baccata) with white-tailed deer (Odocoileus virginianus) rumen fluid reduces taxine A concentrations.

Yew ( Taxus baccata) foliage was co-incubated with rumen fluid (RF) taken from fistulated cattle (Bos taurus), anesthetized white-tailed deer (Odocoileus virginianus) and O. virginianus killed by bow hunters. The first trial with live deer resulted in statistically significant 59% reduction of taxine A by deer RF and no reduction by cattle RF. The second intubation trial, in which half the samples were stopped after 12 h, resulted in slightly less taxine A reduction by deer (46%) and 12% reduction by cattle RF. RF obtained by hunters eQuipped with thermos bottles and trained to collect RF immediatey upon field dressing their deer caused the most (88-96%) taxine A destruction: cattle RF reduced 68-88% the toxin. Obtaining RF from freshly killed deer was less expensive and more consistently successful than taking RF by intubation of anesthetized deer. The greater ability of white-tailed deer RF to detoxify yew taxines may not entirely explain the advantage white-tailed deer have over cattle to surviveyew ingestions without toxic effects.

Interleukin-6 and risk of cognitive decline: MacArthur studies of successful aging.

OBJECTIVE: To investigate whether plasma interleukin-6 (IL-6) is cross-sectionally related to poorer cognitive function and whether a baseline plasma IL-6 measurement can predict risk for decline in cognitive function in longitudinal follow-up of a population-based sample of nondisabled elderly people. METHODS: A prospective cohort study of 779 high-functioning men and women aged 70 to 79 from the MacArthur Study of Successful Aging was conducted. Regression modeling was used to investigate whether baseline IL-6 levels (classified by tertiles) were associated with initial cognitive function and whether IL-6 levels predicted subsequent declines in cognitive function from 1988 to 1991 (2.5-year follow-up) and from 1988 to 1995 (7-year follow-up). RESULTS: Subjects in the highest tertile for plasma IL-6 were marginally more likely to exhibit poorer baseline cognitive function (i.e., scores below the median), independent of demographic status, social status, health and health behaviors, and other physiologic variables (odds ratio [OR] = 1.46; 95% CI: 0.97, 2.20). At 2.5 years, those in both the second tertile of IL-6 (OR = 2.21; 95% CI: 1.44, 3.42) and the third tertile (OR = 2.03; 95% CI: 1.30, 3.19) were at increased risk of cognitive decline even after adjusting for all confounders. At 7 years of follow-up, only those in the highest IL-6 tertile were significantly more likely to exhibit declines in cognition (OR = 1.90; 95% CI: 1.14, 3.18) after adjustment for all confounders. CONCLUSIONS: The results suggest a relationship between elevated baseline plasma IL-6 and risk for subsequent decline in cognitive function. These findings are consistent with the hypothesized relationship between brain inflammation, as measured here by elevated plasma IL-6, and neuropathologic disorders.

Murine dendritic cells infected with adenovirus vectors show signs of activation.

Dendritic cells (DC) are highly efficient antigen presenting cells being actively evaluated as vaccine components. A number of studies have shown adenovirus-mediated gene transfer to cultured DCs is feasible and that Ad-modified DCs are effective at inducing T cell immunity in vitro and establishing antitumor immunity in experimental tumor models in vivo. The current study evaluates the biologic effects of Ad infection on murine bone marrow-derived DCs (BMDC) in primary culture. Ad infection (MOI 200) of BMDC induced significant increases in IL 12 p40 protein in culture supernatants (6 x that of uninfected BMDC and similar to that observed with addition of LPS and CD40 crosslinking antibody). Supernatants from Ad infected BMDCs induced appreciable increases in IFNgamma from naive splenocytes in culture. Consistent with DC activation, FACs analysis showed BMDC infected with Ad vectors up-regulated the surface expression of B7-2, ICAM-1 and MHC II. Additional experiments evaluated the role of virus attachment, internalization and gene expression using IL-12 p40 production as a marker of DC activation. Neither heat-inactivated Ad nor peptides containing the RGD sequence (the primary component of Ad penton base which interacts with cell surface integrins) induced significant amounts of IL12 p40. In contrast, psoralen/UV-inactivated Ad showed similar levels of IL12 p40 production compared with intact Ad. These data suggest this phenomenon is dependent on viral entry into the cell and/or translocation to the nucleus, and is independent of either viral gene or transgene expression.

The American Red Cross disaster mental health services: development of a cooperative, single function, multidisciplinary service model.

Not until 1989 did the Red Cross officially recognize a need for a systematic and organized plan for the mental health needs of disaster survivors. Over the next decade, the Red Cross Disaster Mental Health Services program has developed and evolved to assist both disaster victims and the Red Cross workers who serve them to cope with the overwhelming stresses encountered by both groups in the aftermath of disasters. The Red Cross now coordinates a large and diverse group of mental health professionals from fields of psychology, psychiatry, nursing, social work, marriage and family therapy, and counseling who work together cooperatively. Cross-disciplinary conflicts are minimized by the Red Cross' generic approach to the various mental health professional specialties as functionally interchangeable in performing Red Cross duties. This article reviews the development of this process and describes one local Red Cross chapter's early experience as part of this effort.

Marginal adaptation of castable ceramic crowns.

Tooth preparations and seating techniques of castable ceramic crowns differ from metal ceramic crowns. This study evaluated the variable effects of cementation on the marginal adaptation of Dicor, Cerestore, and porcelain-fused-to-metal crowns. The shoulder preparation was maintained for ceramic crowns, and a cavosurface bevel was designed for metal ceramic crowns. Crowns were made with a replication size of 10, placed on master dies, and the marginal openings measured with a Nikon Measurescope 20 instrument. Thirty crowns were cemented with zinc phosphate cement and the recommended clinical force. Marginal adaptation was not improved with a gingival bevel preparation or an increased seating force. The best marginal adaptation was recorded for Cerestore crowns.

Partial trisomies in two spontaneously arising long-lived human keratinocyte lines.

During experiments concerning the introduction of oncogenes into normal human keratinocytes, we observed long-lived colonies arising spontaneously at the same low frequency in control cultures as in those transfected with Ha-rasEJ or activated c-myc or both. Two of these were karyotyped early in their life span and showed additional chromosomal material on the short arm of chromosome 9 in one case and of chromosome 18 in the other, whereas the parental cells had a normal karyotype. This indicates the presence of a partial trisomy in each line, although the origin of the extra chromosomal material is not known. A similarly long-lived human keratinocyte line containing an isochromosome of the long arm of chromosome 8 has been described elsewhere. Together these results suggest that the spontaneous occurrence of long-lived lines is more common in human keratinocytes than in fibroblasts and that a triple dose of one or more genes may be the initial event in this process.

Telescopic copings in restorative dentistry.

The complete mouth reconstruction of a periodontally compromised dentition is a tremendous challenge. Although the treatment is complex, the rewards can be satisfying. In some cases, the use of telescopic copings overcomes several of the problems associated with periodontal prosthetic treatment. This article reviews the advantages and disadvantages in the use of telescopic copings in restorative dentistry.

Consultation and education in rural mental health: core elements for the (lean) 1980's.

The consultation and educational components of local mental health centers, which flourished in the 1970's, now find themselves being cut back, either along with or instead of direct services. This article examines some core ingredients of rural mental health consultation and education which can continue even with low levels of funding.