In vitro cellular testing of strontium/calcium substituted phosphate glass discs and microspheres shows potential for bone regeneration.

Phosphate-based glasses (PBGs) are ideal materials for regenerative medicine strategies because their composition, degradation rates, and ion release profiles can easily be controlled. Strontium has previously been found to simultaneously affect bone resorption and deposition. Therefore, by combining the inherent properties of resorbable PBG and therapeutic activity of strontium, these glasses could be used as a delivery device of therapeutic factors for the treatment of orthopaedic diseases such as osteoporosis. This study shows the cytocompatibility and osteogenic potential of PBGs where CaO is gradually replaced by SrO in the near invert glass system 40P2 O5 ·(16-x)CaO·20Na2 O·24MgO·xSrO (x = 0, 4, 8, 12, and 16 mol%). Direct seeding of MG63 cells onto glass discs showed no significant difference in cell metabolic activity and DNA amount measurement across the different formulations studied. Cell attachment and spreading was confirmed via scanning electron microscopy (SEM) imaging at Days 3 and 14. Alkaline phosphatase (ALP) activity was similarly maintained across the glass compositions. Follow-on studies explored the effect of each glass composition in microsphere conformation (size: 63-125 µm) on human mesenchymal stem cells (hMSCs) in 3D cultures, and analysis of cell metabolic activity and ALP activity showed no significant differences at Day 14 over the compositional range investigated, in line with the observations from MG63 cell culture studies. Environmental SEM and live cell imaging at Day 14 of hMSCs seeded on the microspheres showed cell attachment and colonisation of the microsphere surfaces, confirming these formulations as promising candidates for regenerative medicine strategies addressing compromised musculoskeletal/orthopaedic diseases.

Porous calcium phosphate glass microspheres for orthobiologic applications.

Orthobiologics is a rapidly advancing field utilising cell-based therapies and biomaterials to enable the body to repair and regenerate musculoskeletal tissues. This paper reports on a cost-effective flame spheroidisation process for production of novel porous glass microspheres from calcium phosphate-based glasses to encapsulate and deliver stem cells. Careful selection of the glass and pore-forming agent, along with a manufacturing method with the required processing window enabled the production of porous glass microspheres via a single-stage manufacturing process. The morphological and physical characterisation revealed porous microspheres with tailored surface and interconnected porosity (up to 76 ±â€¯5%) with average pore size of 55 ±â€¯8 µm and surface areas ranging from 0.34 to 0.9 m2 g-1. Furthermore, simple alteration of the processing parameters produced microspheres with alternate unique morphologies, such as with solid cores and surface porosity only. The tuneable porosity enabled control over their surface area, degradation profiles and hence ion release rates. Furthermore, cytocompatibility of the microspheres was assessed using human mesenchymal stem cells via direct cell culture experiments and analysis confirmed that they had migrated to within the centre of the microspheres. The novel microspheres developed have huge potential for tissue engineering and regenerative medicine applications. STATEMENT OF SIGNIFICANCE: This manuscript highlights a simple cost-effective one-step process for manufacturing porous calcium phosphate-based glass microspheres with varying control over surface pores and fully interconnected porosity via a flame spheroidisation process. Moreover, a simple alteration of the processing parameters can produce microspheres which have a solid core with surface pores only. The tuneable porosity enabled control over their surface area, degradation profiles and hence ion release rates. The paper also shows that stem cells not only attach and proliferate but more importantly migrate to within the core of the porous microspheres, highlighting applications for bone tissue engineering and regenerative medicine.

Case Report: Mass Casualty Lightning Strike at Ranger Training Camp.

BACKGROUND: Although lightning strikes are a rare occurrence, their significance cannot be ignored given military operations in the field during all types of weather. With proper medical management, patients with lightning injuries can return to duty. METHODS: Information for this case report comes from eyewitness account at the 6th Ranger Training Battalion and from review of physician documentation from the 96th Medical Group, Eglin Air Force Base, Florida. RESULTS: A lightning strike injured 44 Ranger School participants during a training exercise on August 12, 2015, at Camp Rudder, Florida. These patients were triaged in the field and transported to emergency department of Eglin Air Force Base. Of the 44 casualties, 20 were admitted. All were returned to duty the following day. One patient had cardiac arrest. This patient, along with two others, was admitted to the intensive care unit. Seventeen other patients were admitted for observation for rhabdomyolysis and/or cardiac arrhythmias. One patient was admitted with suspected acute kidney injury indicated by an elevated creatinine. All patients, including those admitted to the intensive care unit, were released on the day following the lightning strike without restrictions and were allowed to return to duty with increased medical monitoring. DISCUSSION: This case report highlights the need for proper triage and recognition of lightning strike injury, coordination of care between field operations and emergency department personnel, and close follow-up for patients presenting with lightning injury. Symptoms, physical exam, and laboratory findings from rigorous training can be difficult to distinguish from those resulting from lightning injury. Secondary injuries resulting from blunt trauma from falls may have been prevented by the use of the lightning strike posture. Further analysis of procedures and standard operating protocols to mitigate risk during thunderstorms may be required to prevent lightning's effects on large groups of military personnel.

Porous titanium manufactured by a novel powder tapping method using spherical salt bead space holders: Characterisation and mechanical properties.

Porous Ti with open porosity in the range of 70-80% has been made using Ti powder and a particulate leaching technique using porous, spherical, NaCl beads. By incorporating the Ti powder into a pre-existing network of salt beads, by tapping followed by compaction, salt dissolution and "sintering", porous structures with uniform density, pore and strut sizes and a predictable level of connectivity have been produced, showing a significant improvement on the structures made by conventional powder mixing processes. Parts made using beads with sizes in the range of 0.5-1.0 mm show excellent promise as porous metals for medical devices, showing structures and porosities similar to those of commercial porous metals used in this sector, with inter-pore connections that are similar to trabecular bone. The elastic modulus (0.86 GPa) is lower than those for commercial porous metals and more closely matches that of trabecular bone and good compressive yield strength is retained (21 MPa). The ability to further tailor the structure, in terms of the density and the size of the pores and interconnections has also been demonstrated by immersion of the porous components in acid.

Porous poly-ether ether ketone (PEEK) manufactured by a novel powder route using near-spherical salt bead porogens: characterisation and mechanical properties.

Porous PEEK structures with approximately 85% open porosity have been made using PEEK-OPTIMA® powder and a particulate leaching technique using porous, near-spherical, sodium chloride beads. A novel manufacturing approach is presented and compared with a traditional dry mixing method. Irrespective of the method used, the use of near-spherical beads with a fairly narrow size range results in uniform pore structures. However the integration, by tapping, of fine PEEK into a pre-existing network salt beads, followed by compaction and "sintering", produces porous structures with excellent repeatability and homogeneity of density; more uniform pore and strut sizes; an improved and predictable level of connectivity via the formation of "windows" between the cells; faster salt removal rates and lower levels of residual salt. Although tapped samples show a compressive yield stress >1 MPa and stiffness >30 MPa for samples with 84% porosity, the presence of windows in the cell walls means that tapped structures show lower strengths and lower stiffnesses than equivalent structures made by mixing.