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Rizan C, Rotchell JM, Eng PC, Robaire B, Ciocan C, Kapoor N, Kalra S, Sherman JD. Mitigating the environmental effects of healthcare: the role of the endocrinologist. Nat Rev Endocrinol 2025:10.1038/s41574-025-01098-9. [PMID: 40082727 DOI: 10.1038/s41574-025-01098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2025] [Indexed: 03/16/2025]
Abstract
Human health depends on planetary health, and yet healthcare provision can have unintended consequences for the health of the planet. Emissions from the healthcare sector include greenhouse gases, air pollution and plastic pollution, alongside chemical contamination. Chemical pollution resulting in endocrine disruption has been associated with plastics, which are a source of concerning additives such as phthalates, bisphenols, perfluoroalkyl and polyfluoroalkyl substances, and flame retardants (all routinely found in healthcare products). Many endocrine-disrupting chemicals are persistent and ubiquitous in the environment (including water and food sources), with potential secondary harms for human health, including disrupting reproductive, metabolic and thyroid function. Here we review evidence-based strategies for mitigating environmental effects of healthcare delivery. We focus on what endocrinologists can do, including reducing demand for healthcare services through better preventative health, focusing on high-value care and improving sustainability of medical equipment and pharmaceuticals through adopting circular economy principles (including reduce, reuse and, as a last resort, recycle). The specific issue of endocrine-disrupting chemicals might be mitigated through responsible disposal and processing, alongside advocating for the use of alternative materials and replacing additive chemicals with those that have lower toxicity profiles, as well as tighter regulations. We must work to urgently transition to sustainable models of care provision, minimizing negative effects on human and planetary health.
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Affiliation(s)
- Chantelle Rizan
- Centre for Sustainable Medicine, National University of Singapore, Singapore, Singapore.
- Brighton and Sussex Medical School, Brighton, UK.
| | | | - Pei Chia Eng
- Department of Endocrinology, National University Hospital, Singapore, Singapore
- Department of Medicine, National University of Singapore, Singapore, Singapore
| | - Bernard Robaire
- Faculty of Medicine and Biomedical Sciences, McGill University, Montreal, Quebec, Canada
| | - Corina Ciocan
- School of Applied Sciences, University of Brighton, Brighton, UK
| | - Nitin Kapoor
- Department of Endocrinology, Christian Medical College, Vellore, India
- The Non-Communicable Disease Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
- University Centre for Research and Development, Chandigarh University, Mohali, India
| | - Jodi D Sherman
- Yale School of Medicine, Yale University, New Haven, CT, USA
- Yale School of Public Health, Yale University, New Haven, CT, USA
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Thammarakcharoen F, Srion A, Suvannapruk W, Chokevivat W, Limtrakarn W, Suwanprateeb J. Process Development for Fabricating 3D-Printed Polycaprolactone-Infiltrated Hydroxyapatite Bone Graft Granules: Effects of Infiltrated Solution Concentration and Agitating Liquid. Biomedicines 2024; 12:2161. [PMID: 39335674 PMCID: PMC11429199 DOI: 10.3390/biomedicines12092161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/12/2024] [Accepted: 09/21/2024] [Indexed: 09/30/2024] Open
Abstract
Bone grafts are commonly used in orthopedic and dental surgeries to facilitate bone repair and regeneration. A new type of bone graft, polycaprolactone-infiltrated three dimensionally printed hydroxyapatite (3DP HA/PCL), was previously developed by infiltrating polycaprolactone (PCL) into preformed three-dimensional-printed hydroxyapatite (3DP HA) that was fabricated using binder jetting technology combined with a low-temperature phase transformation process. However, when producing small granules, which are often used for bone grafting, issues of granule agglomeration emerged, complicating the application of this method. This study aimed to develop a fabrication process for 3DP HA/PCL bone graft granules using solution infiltration and liquid agitation. The effects of varying PCL solution concentrations (40% and 50% w/w) and different agitating liquids (deionized water or DI, N-Methyl-2-Pyrrolidone or NMP, and an NMP-DI mixture) on the properties of the resulting composites were investigated. XRD and FTIR analysis confirmed the coexistence of HA and PCL within the composites. The final PCL content was comparable across all conditions. The contact angles of 3DP HA/PCL were 26.3 and 69.8 degree for 40% and 50% PCL solution, respectively, when using DI, but were zero when using NMP and NMP-DI. The highest compression load resistance and diametral tensile strength were achieved using the 50% PCL solution with DI or the NMP-DI mixture. DI resulted in a dense PCL coating, while NMP and the NMP-DI mixture produced a porous and irregular surface morphology. All samples exhibited a porous internal microstructure due to PCL infiltration into the initial pores of the 3D-printed HA. Biocompatibility tests showed that all samples supported the proliferation of MC3T3-E1 cells, with the greatest OD values observed for the 50% PCL solution with DI or the NMP-DI mixture at each cultured period. Considering the microstructural, mechanical, and biological properties, the 50% PCL solution with the NMP-DI mixture demonstrated overall desirable properties.
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Affiliation(s)
- Faungchat Thammarakcharoen
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
| | - Autcharaporn Srion
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
| | - Waraporn Suvannapruk
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
| | - Watchara Chokevivat
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
| | - Wiroj Limtrakarn
- Department of Mechanical Engineering, Faculty of Engineering, Thammasat University, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
- Thammasat University Center of Excellence in Computational Mechanics and Medical Engineering, Thammasat University, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
| | - Jintamai Suwanprateeb
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
- Thammasat University Center of Excellence in Computational Mechanics and Medical Engineering, Thammasat University, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
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Ershad-Langroudi A, Babazadeh N, Alizadegan F, Mehdi Mousaei S, Moradi G. Polymers for implantable devices. J IND ENG CHEM 2024; 137:61-86. [DOI: 10.1016/j.jiec.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Wang W. Recent Advances in the Titanium-Based Catalysts for Ring-Opening Polymerization. ACS OMEGA 2024; 9:29983-29993. [PMID: 39035956 PMCID: PMC11256339 DOI: 10.1021/acsomega.4c00048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 07/23/2024]
Abstract
At present, economic development and daily life cannot be separated from organic synthetic polymers. However, a large number of nondegradable polymers have caused serious pollution to the environment. It is necessary for sustainable development to use biodegradable materials instead of traditional polymers, but it is not yet comparable in performance and cost to the competitor it will replace. Therefore, there is a long way to go to develop effective synthesis methods. Through ring-opening polymerization, some cyclic monomers, such as ε-caprolactone or lactide, can be synthesized into biodegradable polymers, which can not only replace traditional synthetic polymers in some fields but also have applications in drug delivery, surgical consumables, human implant materials, bone materials, etc. Ring-opening polymerization is a potential candidate for solving environmental pollution. For ring-opening polymerization, catalysts are very important, among which titanium catalysts have attracted much attention because of their high efficiency, economy, and nontoxicity. In this paper, the development status of organotitanium compounds as ring-opening polymerization catalysts is reviewed, including the effects of different ligand structures on polymerization behavior and polymer structure, and its development trend is prospected. We hope that this review will be helpful for developing efficient ring-opening polymerization catalysts.
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Affiliation(s)
- Wei Wang
- Sinopec (Beijing) Research Institute
of Chemical Industry Co., Ltd., Sinopec
Key Laboratory of Research and Application of Medical and Hygienic
Materials, No. 14 Beisanhuan
Donglu, Chao Yang District, Beijing 100013, China
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Singh D, Sharma Y, Dheer D, Shankar R. Stimuli responsiveness of recent biomacromolecular systems (concept to market): A review. Int J Biol Macromol 2024; 261:129901. [PMID: 38316328 DOI: 10.1016/j.ijbiomac.2024.129901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/08/2024] [Accepted: 01/30/2024] [Indexed: 02/07/2024]
Abstract
Stimuli responsive delivery systems, also known as smart/intelligent drug delivery systems, are specialized delivery vehicles designed to provide spatiotemporal control over drug release at target sites in various diseased conditions, including tumor, inflammation and many others. Recent advances in the design and development of a wide variety of stimuli-responsive (pH, redox, enzyme, temperature) materials have resulted in their widespread use in drug delivery and tissue engineering. The aim of this review is to provide an insight of recent nanoparticulate drug delivery systems including polymeric nanoparticles, dendrimers, lipid-based nanoparticles and the design of new polymer-drug conjugates (PDCs), with a major emphasis on natural along with synthetic commercial polymers used in their construction. Special focus has been placed on stimuli-responsive polymeric materials, their preparation methods, and the design of novel single and multiple stimuli-responsive materials that can provide controlled drug release in response a specific stimulus. These stimuli-sensitive drug nanoparticulate systems have exhibited varying degrees of substitution with enhanced in vitro/in vivo release. However, in an attempt to further increase drug release, new dual and multi-stimuli based natural polymeric nanocarriers have been investigated which respond to a mixture of two or more signals and are awaiting clinical trials. The translation of biopolymeric directed stimuli-sensitive drug delivery systems in clinic demands a thorough knowledge of its mechanism and drug release pattern in order to produce affordable and patient friendly products.
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Affiliation(s)
- Davinder Singh
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States.
| | - Yashika Sharma
- Natural Products and Medicinal Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Jammu 180001, India
| | - Divya Dheer
- Chitkara University School of Pharmacy, Chitkara University, Baddi 174103, Himachal Pradesh, India; Chemical Biology Unit, Institute of Nano Science and Technology, Knowledge City, Sector 81, Mohali 140306, Punjab, India.
| | - Ravi Shankar
- Natural Products and Medicinal Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Jammu 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
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Farasati Far B, Naimi-Jamal MR, Jahanbakhshi M, Rostamani H, Karimi M, Keihankhadiv S. Synthesis and characterization of chitosan/collagen/polycaprolactone hydrogel films with enhanced biocompatibility and hydrophilicity for artificial tendon applications. Int J Biol Macromol 2023; 253:127448. [PMID: 37844811 DOI: 10.1016/j.ijbiomac.2023.127448] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
Regenerative medicine confronts various obstacles, such as creating and advancing biomaterials. Besides being safe, such materials should promote cellular activity. Polycaprolactone (PCL) has numerous medical applications as an engineering material. However, these polymers lack hydrophilicity. Herein, chitosan (CS)/collagen (COL)/polycaprolactone hydrogel films (CSCPs) were synthesized with different weight ratios of PCL; specifically, CS/COL (CSC): PCL content of 1:3, 1:6, and 1:9. For this purpose, novel COL immobilization on CS was performed via covalent attachment. Following the addition of PCL to CSC hydrogel, the resulting CSCP hydrogel films were characterized using tensile measurements, TGA, XRD, FTIR, and FE-SEM. A greater PCL content increases the elongation at break from 134.8 to 369.5 % and the tensile strength of the hydrogel films from 4.8 to 18.4 MPa. The hydrophobicity of prepared specimens was assessed through water absorption and contact-angle tests. For CSCP3 to CSCP9, the water contact angle increased from 61.03° to 70.82°. After 48 days, CSCP6 and CSCP9 hydrogel films demonstrated a slow rate of degradation, losing <15 % of their weight. Moreover, all three types of hydrogel films exhibited high biocompatibility (higher than 95 % after three days), as confirmed by the MTT assay. The hemolysis rates of CSCP hydrogel films were <2 %, which could be deemed safe for contact with a blood environment. The presence of no costly and bio-based crosslinking agents and desired characteristics for tissue engineering applications suggest that CSCP hydrogel films may be promising candidates for use in artificial tendons.
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Affiliation(s)
- Bahareh Farasati Far
- Research Laboratory of Green Organic Synthesis and Polymers, Department of Chemistry, Iran University of Science and Technology, Tehran, Iran
| | - Mohammad Reza Naimi-Jamal
- Research Laboratory of Green Organic Synthesis and Polymers, Department of Chemistry, Iran University of Science and Technology, Tehran, Iran.
| | - Mehdi Jahanbakhshi
- School of Chemical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Hosein Rostamani
- Department of Biomedical Engineering-Biomaterials, Faculty of Engineering, Islamic Azad University, Mashhad, Iran
| | - Mahsa Karimi
- Mechanical Engineering and Mechanics, Drexel University, Philadelphia, USA
| | - Shadi Keihankhadiv
- Department of physical chemistry and Technology of polymers, Faculty of Chemistry, Silesian University of Technology, 44_100 Gliwice, Poland
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Hussain M, Ullah S, Raza MR, Abbas N, Ali A. Recent Developments in Zn-Based Biodegradable Materials for Biomedical Applications. J Funct Biomater 2022; 14:1. [PMID: 36662048 PMCID: PMC9865652 DOI: 10.3390/jfb14010001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Zn-based biodegradable alloys or composites have the potential to be developed to next-generation orthopedic implants as alternatives to conventional implants to avoid revision surgeries and to reduce biocompatibility issues. This review summarizes the current research status on Zn-based biodegradable materials. The biological function of Zn, design criteria for orthopedic implants, and corrosion behavior of biodegradable materials are briefly discussed. The performance of many novel zinc-based biodegradable materials is evaluated in terms of biodegradation, biocompatibility, and mechanical properties. Zn-based materials perform a significant role in bone metabolism and the growth of new cells and show medium degradation without the release of excessive hydrogen. The addition of alloying elements such as Mg, Zr, Mn, Ca, and Li into pure Zn enhances the mechanical properties of Zn alloys. Grain refinement by the application of post-processing techniques is effective for the development of many suitable Zn-based biodegradable materials.
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Affiliation(s)
- Muzamil Hussain
- Department of Mechanical Engineering, COMSATS University Islamabad, Sahiwal Campus, Punjab 57000, Pakistan
| | - Sami Ullah
- Department of Chemistry, College of Science, King Khalid University, Abha 61413, Saudi Arabia
| | - Muhammad Rafi Raza
- Department of Mechanical Engineering, COMSATS University Islamabad, Sahiwal Campus, Punjab 57000, Pakistan
| | - Naseem Abbas
- Department of Mechanical Engineering, Sejong University, Seoul 05006, Republic of Korea
| | - Ahsan Ali
- Department of Mechanical Engineering, Gachon University, Seongnam-si 13120, Republic of Korea
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