The design and characterisation of sinusoidal toolpaths using sub-zero bioprinting of polyvinyl alcohol.

Sub-zero (°C) additive manufacturing (AM) systems present a promising solution for the fabrication of hydrogel structures with complex external geometry or a heterogeneous internal structure. Polyvinyl alcohol cryogels (PVA-C) are promising tissue-mimicking materials, with mechanical properties that can be designed to satisfy a wide variety of soft tissues. However, the design of more complex mechanical properties into additively manufactured PVA-C samples, which can be enabled using the toolpath, is a largely unstudied area. This research project will investigate the effect of toolpath variation on the elastic and viscoelastic properties of PVA-C samples fabricated using a sinusoidal toolpath. Samples were fabricated using parametric variation of a sinusoidal toolpath, whilst retaining the same overall cross-sectional area, using a sub-zero AM system. To mechanically characterise the samples, they were tested under tension in uniaxial ramp tests, and through dynamic mechanical analysis (DMA). The elastic and viscoelastic moduli of the samples are presented. No correlations between the parametric variation of the design and the Young's modulus were observed. Analysis of the data shows high intra-sample repeatability, demonstrated robust testing protocols, and variable inter-sample repeatability, indicating differences in the printability and consistency of fabrication between sample sets. DMA of the wavelength samples, show a frequency-dependent loss moduli. The storage modulus demonstrates frequency independence, and a large increase in magnitude as the sample increases to 3 wavelengths.

Are publicly available internet resources enabling women to make informed fertility preservation decisions before starting cancer treatment: an environmental scan?

BACKGROUND: To identify publicly available internet resources and assess their likelihood to support women making informed decisions about, and between, fertility preservation procedures before starting their cancer treatment. METHODS: A survey of publically available internet resources utilising an environmental scan method. Inclusion criteria were applied to hits from searches of three data sources (November 2015; repeated June 2017): Google (Chrome) for patient resources; repositories for clinical guidelines and projects; distribution email lists to contact patient decision aid experts. The Data Extraction Sheet applied to eligible resources elicited: resource characteristics; informed and shared decision making components; engagement health services. RESULTS: Four thousand eight hundred fifty one records were identified; 24 patient resources and 0 clinical guidelines met scan inclusion criteria. Most resources aimed to inform women with cancer about fertility preservation procedures and infertility treatment options, but not decision making between options. There was a lack of consistency about how health conditions, decision problems and treatment options were described, and resources were difficult to understand. CONCLUSIONS: Unless developed as part of a patient decision aid project, resources did not include components to support proactively women's fertility preservation decisions. Current guidelines help people deliver information relevant to treatment options within a single disease pathway; we identified five additional components for patient decision aid checklists to support more effectively people's treatment decision making across health pathways, linking current with future health problems.

Observational study of the development and evaluation of a fertility preservation patient decision aid for teenage and adult women diagnosed with cancer: the Cancer, Fertility and Me research protocol.

INTRODUCTION: Women diagnosed with cancer and facing potentially sterilising cancer treatment have to make time-pressured decisions regarding fertility preservation with specialist fertility services while undergoing treatment of their cancer with oncology services. Oncologists identify a need for resources enabling them to support women's fertility preservation decisions more effectively; women report wanting more specialist information to make these decisions. The overall aim of the 'Cancer, Fertility and Me' study is to develop and evaluate a new evidence-based patient decision aid (PtDA) for women with any cancer considering fertility preservation to address this unmet need. METHODS AND ANALYSIS: This is a prospective mixed-method observational study including women of reproductive age (16 years +) with a new diagnosis of any cancer across two regional cancer and fertility centres in Yorkshire, UK. The research involves three stages. In stage 1, the aim is to develop the PtDA using a systematic method of evidence synthesis and multidisciplinary expert review of current clinical practice and patient information. In stage 2, the aim is to assess the face validity of the PtDA. Feedback on its content and format will be ascertained using questionnaires and interviews with patients, user groups and key stakeholders. Finally, in stage 3 the acceptability of using this resource when integrated into usual cancer care pathways at the point of cancer diagnosis and treatment planning will be evaluated. This will involve a quantitative and qualitative evaluation of the PtDA in clinical practice. Measures chosen include using count data of the PtDAs administered in clinics and accessed online, decisional and patient-reported outcome measures and qualitative feedback. Quantitative data will be analysed using descriptive statistics, paired sample t-tests and CIs; interviews will be analysed using thematic analysis. ETHICS AND DISSEMINATION: Research Ethics Committee approval (Ref: 16/EM/0122) and Health Research Authority approval (Ref: 194751) has been granted. Findings will be published in open access peer-reviewed journals, presented at conferences for academic and health professional audiences, with feedback to health professionals and program managers. The Cancer, Fertility and Me patient decision aid (PtDA) will be disseminated via a diverse range of open-access media, study and charity websites, professional organisations and academic sources. External endorsement will be sought from the International Patient Decision Aid Standards (IPDAS) Collaboration inventory of PtDAs and other relevant professional organisations, for example, the British Fertility Society. TRIAL REGISTRATION NUMBER: NCT02753296; pre-results.

Novel potentiometric membrane sensor based on 6-(4-nitrophenyl)-2-phenyl-4,4-dipropyl-3,5-diaza-bicyclo[3,1,0] hex-2-ene for detection of strontium (II) ions at trace levels.

A new PVC membrane strontium ion-selective electrode has been constructed using 6-(4-nitrophenyl)-2-phenyl-4,4-dipropyl-3,5-diaza-bicyclo[3,1,0] hex-2-ene (NPDBH) as a neutral ionophore. The electrode was prepared with 7% NPDBH (as ionophore), 57% acetophenone (as plasticizer), 30% PVC and 6% oleic acid (as lipophilic additive). The electrode responds to Sr2+ ion with a sensitivity of 28.2+/-0.5 mV/decade over the range 1.0 x 10(-6)-1.0 x 10(-1) mol L(-1) and in a pH range of 3.0-10.0. The limit of detection was 2.4 x 10(-7) mol L(-1). It has a response time of <20s and can be used for at least three months without any divergence in potentials. The proposed electrode shows good discrimination of Sr2+ ion from several cations. The effect of organic solvents on electrode response was examined. The results show that this electrode can be used in ethanol media up to 15% (v/v) concentration without interference. The isothermal temperature coefficient of this electrode amounted to 0.00019 V/ degrees C. The electrode was found to work well under laboratory conditions. It was successfully applied to the determination of strontium ions in human urine and bone digests.

[Pimecrolimus (Elidel) for therapy of lichen ruber mucosae]. / Pimecrolimus (ELIDEL) zur Behandlung des Lichen planus mucosae.

Oral lichen planus (OLP) is a common chronic inflammatory disorder with criteria of auto-reactive disease. Treatment consists on topical application of corticosteroids, vitamin A derivates or cyclosporin. Calcineurin inhibitors as tacrolimus and pimecrolimus decrease the production of cytokines and inhibit T-cell proliferation. These substances have recently been introduced for local therapy of chronic inflammatory skin disorders. The aim of our study was to evaluate the effectiveness and side effects of local pimecrolimus in OLP. A group of five patients with histological proven OLP were treated with topical pimecrolimus 1% ointment twice daily to the affected area. Prior to treatment and after 7, 14, 28 and 42 days the lesions were assessed clinically and by photographs. The discomfort scores were evaluated by visual analogue scale (VAS) weekly. All five patients (median age 65.6 years) were female and showed involvement of the buccal mucosa. All lesions showed a reduction of inflammation activity during the treating period. The VAS scores decreased significantly under treatment (p=0,0014). Pimecrolimus ointment was tolerated well with no signs of itching or burning. However, 4 out of 5 patients complained about the reduced adherence properties of the cream. Although no complete remission of OLP has been observed in our series, signs of inflammatory activity of OLP as redness and burning sensations were reduced by topical pimecrolimus. Further controlled randomized studies have to be conducted to compare topical pimecrolimus with topical corticosteroid as standard therapy. The adherence properties of pimecrolimus 1% cream should be improved for intra-oral application.