Background Infection after ACL reconstruction is uncommon but catastrophic. Prophylactic graft saturation in vancomycin reportedly reduces infection rates. Questions/purposes We characterized vancomycin elution from soaked tendons. Specifically, the effect of rinsing was studied. We also determined how vancomycin concentration in the soak solution and tendon dimension influenced this elution rate, and examined whether the vancomycin amount released was lower than osteoblast and chondroblast toxic concentrations. Methods Bovine tendons were wrapped in sterile gauze swabs presoaked with 5-, 2.5-, or 1.25-mg/mL vancomycin solutions. After 10 minutes, rinsed and unrinsed tendons were placed in 100 mL agitated 37°C phosphate-buffered saline (PBS). One-milliliter samples taken at 10 minutes and 1, 6, 12, 24, and 72 hours were analyzed by highperformance liquid chromatography. ResultsThe maximum elution rate occurred between 10 minutes and 1 hour, with no lag between experiment initiation and drug appearance in the solution. Rinsing affected the initial amount in solution but had little influence on drug release after 10 minutes. Vancomycin diffusion rates were dependent on soak solution concentration at all sampling intervals. The vancomycin amount released or eluted did not increase after the 1-hour interval. At 24 hours, concentrations were 45 ± 12, 16 ± 1, and 9 ± 3 lg/mL for the 5-, 2.5-, and 1.25-mg/mL solutions, respectively. Higher elution rates were observed in largervolume tendons. Conclusions Soaked tendon grafts can act as reservoirs for vancomycin, with the amount released and elution profile dependent on rinsing, tendon volume, and soak solution concentration. Vancomycin elution was lower than previously reported osteoblast and chondroblast toxicity concentrations and above the minimum inhibitory concentration for Staphylococcus. Clinical Relevance Presoaking ACL reconstruction autografts with vancomycin may reduce the risk of ACL reconstruction infection without the risk of local or general toxicity.

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In Australia, approximately 30% of people diagnosed with HIV are not accessing treatment and 8% of those receiving treatment fail to achieve viral suppression. Barriers limiting effective care warrant further examination. This mixed-methods systematic review accessed health and social sector research databases between November and December 2015 to identify studies that explored the perspective of people living with HIV in Australia. Articles were included for analysis if they described the experiences, knowledge, attitudes and beliefs, in relation to treatment uptake and adherence, published between January 2000 and December 2015. Quality appraisal utilised the Mixed Methods Appraisal Tool Version 2011. Seventy-two studies that met the inclusion criteria were reviewed. The interplay of lack of knowledge, fear, stigma, physical, emotional and social issues were found to negatively impact treatment uptake and adherence. Strategies targeting both the individual and the wider community are needed to address these barriers.

Students often approach biochemistry with a degree of trepidation with many considering it one of the more difficult subjects. This is, in part, due to the necessity of making visual images of submicroscopic concepts. Molecular interactions underpin most biological processes; therefore, mastering these concepts is essential. Understanding the forces and mechanisms that underpin protein–ligand interactions is a key learning goal for mastering the protein structure–function relationship. We intended to overcome such learning barriers by implementing assignment-based activities across three successive biochemistry cohorts. The activities involved 3D printed proteins and cheminformatics/molecular modeling software activities which had the advantage of targeting students’ visual–spatial ability. Learning activities, conducted in small groups, were specifically designed to enhance understanding of the protein structure–function relationship through a detailed analysis of molecular-level interactions between proteins and ligands. Here we describe the methodology for preparation of the learning tools and how they were incorporated in the learning exercises in the form of both formative and summative assessments. We compared their perceived effectiveness via student feedback surveys conducted over three consecutive cohorts. Survey results showed students were positively engaged with these technologies with a slight preference for cheminformatics. From an instructor’s perspective, we found significantly improved overall grade averages for the subjects following implementation of the assignments which may suggest these tools contributed to enhanced understanding. While print resolution could not match that of cheminformatics software, we present evidence to support their continued incorporation in the course. Feedback obtained will inform future curriculum development.

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