Investigating How the Properties of Electrospun Poly(lactic acid) Fibres Loaded with the Essential Oil Limonene Evolve over Time under Different Storage Conditions

Essential oils have been identified as effective natural compounds to prevent bacterial infections and thus are widely proposed as bioactive agents for biomedical applications. Across the literature, various essential oils have been incorporated into electrospun fibres to produce materials with, among others, antibacterial, anti-inflammatory and antioxidant activity. However, limited research has been conducted so far on the effect of these chemical products on the physical characteristics of the resulting composite fibres for extended periods of time. Within this work, electrospun fibres of poly(lactic acid) (PLA) were loaded with the essential oil limonene, and the impact of storage conditions and duration (up to 12 weeks) on the thermal degradation, glass transition temperature and mechanical response of the fibrous mats were investigated. It was found that the concentration of the encapsulated limonene changed over time and thus the properties of the PLA-limonene fibres evolved, particularly in the first two weeks of storage (independently from storage conditions). The amount of limonene retained within the fibres, even 4 weeks after fibre generation, was effective to successfully inhibit the growth of model microorganisms Escherichia coli, Staphylococcus aureus and Bacillus subtilis. The results of this work demonstrate the importance of evaluating physical properties during the ageing of electrospun fibres encapsulating essential oils, in order to predict performance modification when the composite fibres are used as constituents of medical devices.

Electrospinning of honey and propolis for wound care

Phytochemicals and naturally derived compounds, such as plant extracts and bee products, are regarded as complementary and alternative medicines for the treatment of skin wounds, due to their antibacterial, anti-inflammatory, and antioxidant properties. In recent years, it has been shown that dressings impregnated with honey (particularly Manuka honey) are effective for the topical treatment of wounds and burns, and some of them are currently used in clinics. This has stimulated the development of more advanced dressings based on polymeric nanofibres that can release honey and other bee products (like propolis) to promote wound healing. In this review, the current literature on the electrospinning of honey and propolis is analyzed and the effectiveness of the resulting dressings to inhibit bacterial growth and stimulate cellular proliferation and tissue repair is discussed.

Exploring the Mechanical Properties and Performance of Type-I Collagen at Various Length Scales: A Progress Report

Collagen is the basic protein of animal tissues and has a complex hierarchical structure. It plays a crucial role in maintaining the mechanical and structural stability of biological tissues. Over the years, it has become a material of interest in the biomedical industries thanks to its excellent biocompatibility and biodegradability and low antigenicity. Despite its significance, the mechanical properties and performance of pure collagen have been never reviewed. In this work, the emphasis is on the mechanics of collagen at different hierarchical levels and its long-term mechanical performance. In addition, the effect of hydration, important for various applications, was considered throughout the study because of its dramatic influence on the mechanics of collagen. Furthermore, the discrepancies in reports of the mechanical properties of collagenous tissues (basically composed of 20-30% collagen fibres) and those of pure collagen are discussed.

Fracture behaviour and toughening mechanisms of dry and wet collagen

The growing interest to the use of collagen films for biomedical applications motivates the analysis of their fracture behaviour in different environments. Studies revealed the decreased mechanical strength and stiffness as well as increased plasticity in water compared to collagen specimens tested in air. However, the fracture behaviour of pure collagen films in both air and water has not been reported so far. In this paper, the entire process of mode-I loading of single-edge notched tension (SENT) specimens was recorded and analysed. In case of in-air (dry) specimens, cracks propagated rapidly in a brittle fashion while large plastic deformations were observed in aqua prior to failure due to crack opening and a blunting mechanism in wet specimens. The fracture-toughness parameters for pure collagen in air and in aqua were estimated using linear-elastic (K_I and G_I) and elasto-plastic (J_I) fracture-mechanics approaches, respectively, following the force-displacement response and deformational behaviour. G_IC and J_I were 1365 ± 112 J/m² and 2500 ± 440 J/m², respectively. Scanning electron microscopy was used to observe the structural changes linked to collagen fibrils in the crack-tip area and the fracture surface. For in-air specimens, the former mostly exhibited extrinsic toughening (usually at micro scale) acting behind the crack-tip, while in-aqua intrinsic toughening acting ahead of a crack tip was found. Fractography of in-air specimens showed no occurrence of voids while multiple micro-voids were found for in-aqua specimens. STATEMENT OF SIGNIFICANCE: The fracture toughness and crack propagation of both mineralised (bone, dentine) and non-mineralised (skin) tissues has been extensively investigated over the past decades. Though these tissues are rich in collagen, the fracture properties of pure collagen have not been quantified yet at macroscale. Considering the applications of collagen films in tissue regeneration, it is essential to perform investigations of their fracture behaviour in both dry and wet conditions. Determining the effect of environment on the fracture behaviour of collagen and understanding its toughening mechanism are essential for prevention of failures during application. Moreover, this would give an insight for fabrication of tougher collagen-based biomaterials for biomedical uses.

Electrospinning and Additive Manufacturing: Adding Three-Dimensionality to Electrospun Scaffolds for Tissue Engineering

The final biochemical and mechanical performance of an implant or scaffold are defined by its structure, as well as the raw materials and processing conditions used during its fabrication. Electrospinning and Additive Manufacturing (AM) are two contrasting processing technologies that have gained popularity amongst the fields of medical research i.e., tissue engineering, implant design, drug delivery. Electrospinning technology is favored for its ability to produce micro- to nanometer fibers from polymer solutions and melts, of which, the dimensions, alignment, porosity, and chemical composition are easily manipulatable to the desired application. AM, on the other hand, offers unrivalled levels of geometrical freedom, allowing highly complex components (i.e., patient-specific) to be built inexpensively within 24 hours. Hence, adopting both technologies together appears to be a progressive step in pursuit of scaffolds that better match the natural architecture of human tissues. Here, we present recent insights into the advances on hybrid scaffolds produced by combining electrospinning (melt electrospinning excluded) and AM, specifically multi-layered architectures consisting of alternating fibers and AM elements, and bioinks reinforced with fibers prior to AM. We discuss how cellular behavior (attachment, migration, and differentiation) is influenced by the co-existence of these micro- and nano-features.

Development of a hollow fibre-based renal module for active transport studies

Understanding the active transport of substrates by the kidney in the renal proximal convoluted tubule is crucial for drug development and for studying kidney diseases. Currently, cell-based assays are applied for this this purpose, however, differences between assays and the body are common, indicating the importance of in vitro-in vivo discrepancies. Several studies have suggested that 3D cell cultures expose cells to a more physiological environments, thus, providing more accurate cell function results. To mimic the renal proximal tubule, we have developed a custom-made renal module (RM), containing a single polypropylene hollow fibre (Plasmaphan P1LX, 3M) that serves as a porous scaffold and compared to conventional Transwell cell-based bidirectional transport studies. In addition, a constant flow of media, exposed cells to a physiological shear stress of 0.2 dyne/cm2. MDCK-Mdr1a cells, overexpressing the rat Mdr1a (P-gp) transporter, were seeded onto the HF membrane surface coated with the basement membrane matrix Geltrex which facilitated cell adhesion and tight junction formation. Cells were then seeded into the HF lumen where attachment and tight junction formation were evaluated by fluorescence microscopy while epithelial barrier integrity under shear stress was shown to be achieved by day 7. qPCR results have shown significant changes in gene expression compared to cells grown on Transwells. Kidney injury marker such as KIM-1 and the hypoxia marker CA9 have been downregulated, while the CD133 (Prominin-1) microvilli marker has shown a fivefold upregulation. Furthermore, the renal transporter P-gp expression has been downregulated by 50%. Finally, bidirectional assays have shown that cells grown in the RM were able to reabsorb albumin with a higher efficiency compared to Transwell cell cultures while efflux of the P-gp-specific substrates Hoechst and Rhodamine 123 was decreased. These results further support the effect of the microenvironment and fluidic shear stress on cell function and gene expression. This can serve as the basis for the development of a microphysiological renal model for drug transport studies.

Resonance vibration interventions in the femur: Experimental-numerical modelling approaches

MOTIVE

External vibration excitation might be key to many novel non-surgical interventions for pathologies in the musculoskeletal system and in other parts of the human organism. Lack of understanding about vibration patterns, their controllability, and reproducibility are three limitations of ongoing research. This study establishes a bovine vibration model and animal model replacements for future research.

METHODS

We used biological samples (n=5) and one polyurethane sample of the bovine femur. Mechanical resonance was measured experimentally and analysed numerically by finite element method.

MAIN RESULTS

The experiments obtained 5 distinct mode shapes for the biological sample set, with standard deviation < 7.5%. Finite element analysis of the biological samples can replicate experimental mode shape deflection. The use of polyurethane changes resonance character but results are also good approximations of the biological samples.

CONCLUSIONS

A model of the bovine femur with consistent resonance behaviour is presented with alternatives (polyurethane and finite element analysis) that can serve in reducing the number of necessary biological samples. Future work will be to adapt results to human anatomy. Of clinical interest will be to influence bone pathologies such as post-surgical non-union, or bone functionality as part of haematopoiesis and endocrine secretion.

An In-Vitro Evaluation of the Characteristics of Zein-Based Films for the Release of Lactobionic Acid and the Effects of Oleic Acid

Lactobionic acid (LBA) is widely used in different industrial sectors owing to its biocompatibility characteristics as well as antioxidant and antimicrobial properties. In this study, mixtures of the protein zein with LBA and with the addition of oleic acid (OA) as a ternary system were investigated as drug delivery films for the release of LBA. The chosen combinations exploit the vast difference in water solubility between LBA and the other two components (zein and OA). DSC thermograms and dynamic mechanical spectra, alongside electron microscopy images, were used to describe the microstructural features of the films and were found to provide insights for the release of LBA from the two examined zein-based films immersed in an aqueous physiological solution. For both film systems, a burst release behavior was observed, followed by a rapid and total extraction of LBA. The required immersion time for the total extraction of LBA was greatly reduced when oleic acid was added to the precursor solution mixture for producing the films. The LBA released from the zein-based films was found to exhibit both the expected antioxidant properties as well as exerting bacteriostatic effects towards Escherichia coli and Staphylococcus epidermidis.

Designing responsive dressings for inflammatory skin disorders; encapsulating antioxidant nanoparticles into biocompatible electrospun fibres

Inflammatory skin disorders are highly prevalent and current treatments are marred by side-effects. Here, we have designed anti-inflammatory fibrous sheets with the potential to treat low exudate inflammatory skin disorders such as psoriasis or atopic dermatitis. Antioxidant and anti-inflammatory nanoparticles composed of crosslinked poly(propylene sulfide) (PPS) were encapsulated in poly(ethylene oxide) (PEO) fibres via electrospinning from an aqueous suspension. The loading of nanoparticles did not adversely effect the homogenous nature of the electrospun fibres; furthermore, nanoparticles retained their morphology, size and anti-inflammatory character after electrospinning. The PPS-nanoparticle-loaded nanofibres were found to be highly cytocompatible when tested on human dermal fibroblasts. These findings suggest they have significant potential to topically treat inflamed tissues that are characterized by high reactive oxygen species (ROS) levels.

Porous Optically Transparent Cellulose Acetate Scaffolds for Biomimetic Blood-Brain Barrierin vitro Models

In vitro blood-brain barrier (BBB) models represent an efficient platform to conduct high-throughput quantitative investigations on BBB crossing ability of different drugs. Such models provide a closed system where different fundamental variables can be efficaciously tuned and monitored, and issues related to scarce accessibility of animal brains and ethics can be addressed. In this work, we propose the fabrication of cellulose acetate (CA) porous bio-scaffolds by exploiting both vapor-induced phase separation (VIPS) and electrospinning methods. Parameters of fabrication have been tuned in order to obtain porous and transparent scaffolds suitable for optical/confocal microscopy, where endothelial cell monolayers are allowed to growth thus obtaining biomimetic BBB in vitro models. Concerning VIPS-based approach, CA membranes fabricated using 25% H₂O + 75% EtOH as non-solvent showed submicrometer-scale porosity and an optical transmittance comparable to that one of commercially available poly(ethylene terephthalate) membranes. CA membranes fabricated via VIPS have been exploited for obtaining multicellular BBB models through the double seeding of endothelial cells and astrocytes on the two surfaces of the membrane. Electrospun CA substrates, instead, were characterized by micrometer-sized pores, and were unsuitable for double seeding approach and long term studies. However, the potential exploitation of the electrospun CA substrates for modeling blood-brain-tumor barrier and studying cell invasiveness has been speculated. The features of the obtained models have been critically compared and discussed for future applications.

Damage in extrusion additive manufactured biomedical polymer: Effects of testing direction and environment during cyclic loading

Although biodegradable polymers were widely researched, this is the first study considering the effect of combined testing environments and cyclic loading on the most important aspect related to additive manufacturing: the interfacial bond between deposited layers. Its results give confidence in applicability of the material extrusion additive manufacturing technology for biomedical fields, by demonstrating that the interface behaves in a manner similar to that of the bulk-polymer material. To do this, especially designed tensile specimens were used to analyse the degradation of 3D-printed polymers subjected to constant-amplitude and incremental cyclic loads when tested in air at room temperature (control) and submerged at 37 °C (close to in-vivo conditions). The mechanical properties of the interface between extruded filaments were compared against the bulk material, i.e. along filaments. In both cases, cyclic loading caused only a negligible detrimental effect compared to non-cyclic loading (less than 10 % difference in ultimate tensile strength), demonstrating the suitability of using 3D-printed components in biomedical applications, usually exposed to cyclic loading. For cyclic tests with a constant loading amplitude, larger residual deformation (>100 % greater) and energy dissipation (>15 % greater) were found when testing submerged in solution at 37 °C as opposed to in laboratory conditions (air at room temperature), as used by many studies. This difference may be due to plasticisation effects of water and temperature. For cyclic tests with incrementally increasing loading amplitudes, the vast majority of energy dissipation happened in the last two cycles prior to failure, when the polymer approached the yield point. The results demonstrate the importance of using an appropriate methodology for biomedical applications; otherwise, mechanical properties may be overestimated.

On the quantification of local power densities in a new vibration bioreactor

We investigate the power densities which are obtainable locally in a vibration bioreactor. These reactor systems are of great relevance for research about oncological or antibacterial therapies. Our focus lies on the local liquid pressure caused by resonance vibration in the fluid contained by the reactor's petri dish. We use for the excitation one piezoelectric patch which offer advantages concerning controllability and reproducibility, when compared to ultrasound. The experimental work is extended by finite element analyses of bioreactor details. The peaks of the vibration response for water, sodium chloride (0.1N Standard solution), and McCoy's 5A culture medium are in good alignment. Several natural frequencies can be observed. Local power density can reach multiple times the magnitude used in ultrasound studies. Based on the observed local power densities, we are planning future work for the exposure of cell cultures to mechanical vibration.

Printability and mechanical performance of biomedical PDMS-PEEK composites developed for material extrusion

Polydimethylsiloxane (PDMS) materials are widely adopted in the manufacture of facial prostheses, lab-on-chip devices and scaffolds for soft-tissue engineering applications; however, their processing by additive manufacturing (AM) has proved challenging. Liquid silicone rubbers (LSRs) are favoured for their high shape fidelity when cast, but their low viscosity and surface tension often prevent self-support, post-extrusion. Poly(ether) ether ketone (PEEK) particle reinforcement through interfacial bonding has proven to enhance key properties of PDMS, expanding their end-use functionality. Still, the impact of such particles on the printability of LSR-PDMS is not explored. In this study, for the first time, solvent-free biocompatible PDMS-PEEK composites (up to 30 wt% PEEK) were successfully characterised for material extrusion (ME) printing. Rheological analysis confirmed shear-thinning of all PDMS-PEEK composites under applied load (within the tolerances of the printer) and dominant storage moduli at rest (i.e. prints can self-support), considered highly desirable for ME-based printing. Attained rheological datasets were used to guide initial printability studies, which revealed finer track fidelity with rising fractional content of PEEK, at comparable print speed and displacement values. Composites with higher PEEK content demonstrated significant increases in Shore A hardness and stiffness (in tension and compression) in bulk form. Last but not least, enhanced shape fidelity (thanks to PEEK reinforcement) and geometrical autonomy further expanded the manufacturing freedom of PDMS, whereby infill density could be controlled in order to increase the range of mechanical performance, previously unachievable with conventional casting fabrication. Fundamentally, this could lead to the manufacture of bespoke spatially graded multi-material structures and devices that could be used to replicate the heterogenous properties of soft human tissues and in other advanced material applications.

Dry vs. wet: Properties and performance of collagen films. Part I. Mechanical behaviour and strain-rate effect

Collagen forms one-third of the body proteome and has emerged as an important biomaterial for tissue engineering and wound healing. Collagen films are used in tissue regeneration, wound treatment, dural substitute etc. as well as in flexible electronics. Thus, the mechanical behaviour of collagen should be studied under different environmental conditions and strain rates relevant for potential applications. This study's aim is to assess the mechanical behaviour of collagen films under different environmental conditions (hydration, submersion and physiological temperature (37 °C)) and strain rates. The combination of all three environment factors (hydration, submersion and physiological temperature (37 °C)) resulted in a drop of tensile strength of the collagen film by some 90% compared to that of dry samples, while the strain at failure increased to about 145%. For the first time, collagen films were subjected to different strain rates ranging from quasi-static (0.0001 s^-1) to intermediate (0.001 s^-1, 0.01 s^-1) to dynamic (0.1 s^-1, 1 s^-1) conditions, with the strain-rate-sensitivity exponent (m) reported. It was found that collagen exhibited a strain-rate-sensitive hardening behaviour with increasing strain rate. The exponent m ranged from 0.02-0.2, with a tendency to approach zero at intermediate strain rate (0.01 s^-1), indicating that collagen may be strain-rate insensitive in this regime. From the identification of hyperelastic parameter of collagen film, it was found that the Ogden Model provides realistic results for future simulations.

Electrospinning of Essential Oils

The extensive and sometimes unregulated use of synthetic chemicals, such as drugs, preservatives, and pesticides, is posing big threats to global health, the environment, and food security. This has stimulated the research of new strategies to deal with bacterial infections in animals and humans and to eradicate pests. Plant extracts, particularly essential oils, have recently emerged as valid alternatives to synthetic drugs, due to their properties which include antibacterial, antifungal, anti-inflammatory, antioxidant, and insecticidal activity. This review discusses the current research on the use of electrospinning to encapsulate essential oils into polymeric nanofibres and achieve controlled release of these bioactive compounds, while protecting them from degradation. The works here analysed demonstrate that the electrospinning process is an effective strategy to preserve the properties of essential oils and create bioactive membranes for biomedical, pharmaceutical, and food packaging applications.

Multi-layer Scaffolds of Poly(caprolactone), Poly(glycerol sebacate) and Bioactive Glasses Manufactured by Combined 3D Printing and Electrospinning

Three-dimensional (3D) printing has been combined with electrospinning to manufacture multi-layered polymer/glass scaffolds that possess multi-scale porosity, are mechanically robust, release bioactive compounds, degrade at a controlled rate and are biocompatible. Fibrous mats of poly (caprolactone) (PCL) and poly (glycerol sebacate) (PGS) have been directly electrospun on one side of 3D-printed grids of PCL-PGS blends containing bioactive glasses (BGs). The excellent adhesion between layers has resulted in composite scaffolds with a Young's modulus of 240-310 MPa, higher than that of 3D-printed grids (125-280 MPa, without the electrospun layer). The scaffolds degraded in vitro by releasing PGS and BGs, reaching a weight loss of ~14% after 56 days of incubation. Although the hydrolysis of PGS resulted in the acidification of the buffer medium (to a pH of 5.3-5.4), the release of alkaline ions from the BGs balanced that out and brought the pH back to 6.0. Cytotoxicity tests performed on fibroblasts showed that the PCL-PGS-BGs constructs were biocompatible, with cell viability of above 125% at day 2. This study demonstrates the fabrication of systems with engineered properties by the synergy of diverse technologies and materials (organic and inorganic) for potential applications in tendon and ligament tissue engineering.

Probing the Thermal Transitions of Lactobionic Acid and Effects of Sample History by DSC Analysis

We report the results of an ad hoc evaluation of the thermal transition and physical state of lactobionic acid, carried out by differential scanning calorimetry, which was motivated by the confusion about its physical state in relation to the "melting point." This work establishes that lactobionic acid is a molecular glass characterized by a glass-liquid transition at around 125°C and 2 minor transitions, respectively, at around 70°C and 40°C. The temperature at which these latter transitions appear and the intensity of the enthalpic peaks, associated with physical aging, are sensitive to the thermal history of the sample and to the presence of small quantities of absorbed water.

Synthesis and Electrospinning of Polycaprolactone from an Aluminium-Based Catalyst: Influence of the Ancillary Ligand and Initiators on Catalytic Efficiency and Fibre Structure

In the present study, we investigated the catalytic performance of a 2,2'-methylenebis(6-tert-butyl-4-methylphenol) (MDBP)⁻aluminium complex for the ring-opening polymerisation (ROP) of ε-caprolactone in combination with various alcohols as initiators. Three different alcohols were investigated: 1-adamantanemethanol (A), 1H,1H,2H,2H-perfluoro-1-octanol (F) and isopropanol (I). Samplings of polycaprolactone (PCL) at various reaction times showed a linear increase in the polymer molecular weight with time, with very narrow polydispersity, confirming the living nature of the catalytic system. Scanning electron microscope (SEM) images of electrospun PCL fibre mats produced from 30 wt % dichloromethane/dimethyl sulfoxide solutions showed a high level of surface porosity with a reasonable homogeneity of fibre diameters. The values of the liquid absorption and water contact angle were measured for the electrospun mats, with the F-capped PCL consistently showing absorption values up to three times higher than those of PCL samples capped with the other two alcohols, as well as increased hydrophobicity. The nature of the alcohol can influence the surface hydrophobicity and absorption ability of electrospun fibres, demonstrating the possibility of tailoring material properties through controlled polymerisation.

3D Arrays of Super-Hydrophobic Microtubes from Polypore Mushrooms as Naturally-Derived Systems for Oil Absorption

Porous materials derived from natural resources, such as Luffa sponges, pomelo peel and jute fibres, have recently emerged as oil adsorbents for water purification, due to their suitability, low environmental impact, biodegradability and low cost. Here we show, for the first time, that the porosity of the fruiting body of polypore mushrooms can be used to absorb oils and organic solvents while repelling water. We engineered the surface properties of Ganoderma applanatum fungi, of which the fruiting body consists of a regular array of long capillaries embedded in a fibrous matrix, with paraffin wax, octadecyltrichlorosilane (OTS) and trichloro(1H,1H,2H,2H-perfluorooctyl)silane. Morphological and wettability analyses of the modified fungus revealed that the OTS treatment was effective in preserving the 3D porosity of the natural material, inducing super-hydrophobicity (water contact angle higher than 150°) and improving oil sorption capacity (1.8⁻3.1 g/g). The treated fungus was also inserted into fluidic networks as a filtration element, and its ability to separate water from chloroform was demonstrated.

Atomic-scale clustering inhibits the bioactivity of fluoridated phosphate glasses

Here, molecular dynamics simulations have been carried out on phosphate glasses to clarify the previously debated influence of fluoride on the bioactivity of these glasses. We developed a computationally advanced inter-atomic force field including polarisation effects of the fluorine and oxygen atoms. Structural characterisations of the simulated systems showed that fluoride ions exclusively bond to the calcium modifier cations creating clusters within the glass structure and therefore decreasing the bioactivity of fluoridated phosphate glasses, making them less suitable for biomedical applications.

What are the predictive factors leading to ureteral obstruction following endoscopic correction of VUR in the pediatric population?

BACKGROUND

It is extremely important to not only address the short-term success following endoscopic correction of vesicoureteral reflux (VUR) but also the long-term efficacy and safety of the tissue augmenting substance utilized for endoscopic correction.

OBJECTIVE

This study retrospectively evaluated all cases of ureterovesical junction (UVJ) obstruction following endoscopic treatment of VUR over the last 5 years utilizing two tissue augmenting substances, with special emphasis on the safety of Vantris^®, and performed clinical and histological review of these patients.

METHODS

The study population comprised 2495 patients who underwent endoscopic correction of VUR utilizing Deflux^® (1790) and Vantris^® (705). Tissue sections were stained with hematoxylin & eosin and trichrome, and examined under a light microscope. Nine primary obstructive megaureters after ureteral re-implantation served as controls.

RESULTS

Nine (0.5%) children (three female and six male) in the Deflux group and nine (1.3%) (five females and four males) in the Vantris group developed UVJ obstruction and required ureteral re-implantation. Obstruction developed during the period ranging 2-49 months (average 16 months) following endoscopic correction. The primary reflux grade was III in seven, IV in six, and V in six children. The mean volume of the injected material in all obstructed patients was 1.2 ± 0.6 cc (mean ± SD). Histopathological analysis revealed a pseudocapsule composed of fibrous tissue and foreign-body giant cells surrounding the Vantris implant in all patients. The distal part of the ureters demonstrated significant ureteral dilatation without ureteral fibrosis. In all patients, additional biopsies from the muscularis propria adjacent to the injection site were examined and showed no significant abnormalities. There was an increased collagen deposition in the juxtavesical segment of the obstructive ureters following Deflux and Vantris injections, and of primary obstructive megaureter. No significant difference was found in the tissue response between Deflux and Vantris patients and controls. Statistical analysis of the nonhomogeneous population demonstrated higher obstruction rates in patients from the Vantris group. However, no statistical difference was demonstrated regarding the obstruction rate in the homogenous group with relation to gender, age and reflux grade group of patients. Moreover, univariate analysis revealed that Grade V reflux, the presence of beak sign on the reviewed pretreatment, and inflamed bladder mucosa upon injection were significant independent risk factors leading to obstruction.

DISCUSSION

This study suggested that the underlining ureteral pathology lead to UVJ obstruction following Vantris injection. There was increased collagen deposition in the juxtavesical segment of the obstructive ureters following Vantris injection. Furthermore, these findings were similar to those discovered in patients who underwent endoscopic correction with Deflux, and in patients who required ureteral reimplantation due to primary obstructive megaureter. Additional biopsies from the muscularis propria adjacent to the injection site showed no significant abnormalities, ironing out the fact that Vantris did not led to adverse tissue reaction following injection. Univariate analysis further ironed out the hypothesis that underlying ureteral pathology was responsible for the increased incidence of UVJ obstruction and demonstrated that Grade V reflux, the presence of beak sign on the reviewed pretreatment VCUG, and inflamed bladder mucosa upon injection were significant independent risk factors leading to obstruction.

CONCLUSION

Data showed that Vantris injection did not lead to any different ureteral fibrosis or inflammatory changes to the tissue augmenting substances utilized in past and present clinical practice, and therefore did not seem to increase the incidence of UVJ obstruction. High reflux grade, presence of obstructive/refluxing megaureter and inflamed bladder mucosa were the only statistically significant and independent predictive factors for UVJ obstruction following endoscopic correction of VUR.

Cellular Response to Surface Morphology: Electrospinning and Computational Modeling

Surface properties of biomaterials, such as chemistry and morphology, have a major role in modulating cellular behavior and therefore impact on the development of high-performance devices for biomedical applications, such as scaffolds for tissue engineering and systems for drug delivery. Opportunely-designed micro- and nanostructures provides a unique way of controlling cell-biomaterial interaction. This mini-review discusses the current research on the use of electrospinning (extrusion of polymer nanofibers upon the application of an electric field) as effective technique to fabricate patterns of micro- and nano-scale resolution, and the corresponding biological studies. The focus is on the effect of morphological cues, including fiber alignment, porosity and surface roughness of electrospun mats, to direct cell migration and to influence cell adhesion, differentiation and proliferation. Experimental studies are combined with computational models that predict and correlate the surface composition of a biomaterial with the response of cells in contact with it. The use of predictive models can facilitate the rational design of new bio-interfaces.

Bioinspired Poly(vinylidene fluoride) Membranes with Directional Release of Therapeutic Essential Oils

Here, the morphology of polypore fungi has inspired the fabrication of poly(vinylidene fluoride) (PVDF) membranes with dual porosity by nonsolvent-induced phase separation (NIPS). The fruiting body of such microorganisms is constituted of two distinct regions, finger- and sponge-like structures, which have been successfully mimicked by controlling the coagulation bath temperature during the NIPS process. The use of water at 10 °C as coagulant resulted in membranes with the highest finger-like/sponge-like ratio (53% of the total membrane thickness), while water at 90 °C allowed the formation of macrovoid-free membranes. The microchannels and the asymmetric porosity were used to enhance the oil sorption capacity of the PVDF membranes and to achieve directional release of therapeutic essential oils. These PVDF membranes with easily tuned asymmetric channel-like porosity and controlled pore size are ideal candidates for drug delivery applications.

Effect of Antibacterial Plant Extracts on the Morphology of Electrospun Poly(Lactic Acid) Fibres

Essential oils (EOs) of clary sage and black pepper induce changes in the morphology of poly(lactic acid) (PLA) electrospun fibres. The chemical composition of the oils is analysed by gas chromatography-mass spectrometry and Fourier-transform infrared spectroscopy; while the evaporation rate of the EOs and their main chemical components is characterised by Thermogravimetric Analysis. The addition of EOs generate thermodynamic instabilities during the electrospinning process, leading to the formation of fibres with either wrinkled (for clary sage oil) or nano-textured surfaces (for black pepper oil). The morphology of the PLA-EOs fibres is investigated by Scanning Electron Microscopy. Together with a well-defined structure, the fibres produced also possess antibacterial activity, as demonstrated by viability loss tests conducted on E. coli and S. epidermidis. Bacteria inactivation efficiency of 76 and 100% is reported for the composite PLA/essential oils electrospun mats. The composite mats produced are promising in the biomedical field, where nanotopography offers physical cues to regulate cell behaviour, and the delivery of therapeutic compounds (essential oils) limits microbial growth.

Influence of topography of nanofibrous scaffolds on functionality of engineered neural tissue

Properly engineered scaffolds combined with functional neurons can be instrumental for the effective repair of the neural tissue. In particular, it is essential to investigate how three-dimensional (3D) systems and topographical features can impact on neuronal activity to obtain engineered functional neural tissues. In this study, polyphenylene sulfone (PPSu) scaffolds constituted by randomly distributed or aligned electrospun nanofibers were fabricated to evaluate the neural activity in 3D culture environments for the first time. The obtained results demonstrated that the nanofibers can successfully support the adhesion and growth of neural stem cells (NSCs) and enhance neuronal differentiation compared to 2D substrates. In addition, NSCs could spread and migrate along the aligned fibers. The percentage of active NSC-derived neurons and the overall network activity in the fibrous substrates were also remarkably enhanced. Finally, the data of neuronal activity showed not only that the neurons cultured on the nanofibers are part of a functional network, but also that their activity increases, and the direction of neural signals can be controlled in the aligned 3D scaffolds.

Repeated Programmed Hospitalizations (RPH) in the Care of French Military Suffering for War Post-traumatic Psychiatric Disorders: Interests and Limitations

Introduction

The long-term management of psychiatric wounded patients with prolonged disorders requires a rethinking of our practice of care.

Objectives

The aim is to propose an integrative model of all valid therapies in the post-traumatic-stress disorder while taking care of comorbidities and ensuring patient support in the different administrative procedures that permit reconstruction. Repeated short-term hospitalizations can meet this objective by mobilizing resources, creating group dynamics, restoring a space of safety, allowing a rupture with the environment, preventing recurrence of crises, and by encouraging the histicization of trauma by the temporal sequences of intra/extra-hospitalisation repetition.

Method

We propose, by means of a review of the literature, to discuss on a psychopathological level the interest and limits of this mode of care.

Results

This work reveals the specific therapeutic effects of repeated programmed hospitalizations, which constitute a new modality of institutional psychotherapy.

Conclusion

Rethinking the place of hospitalisation in the management of psychiatric illnesses can be useful to all psychiatrists who follow patients with chronic and co-morbid disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Electrospun Nanofibres Containing Antimicrobial Plant Extracts

Over the last 10 years great research interest has been directed toward nanofibrous architectures produced by electrospinning bioactive plant extracts. The resulting structures possess antimicrobial, anti-inflammatory, and anti-oxidant activity, which are attractive for biomedical applications and food industry. This review describes the diverse approaches that have been developed to produce electrospun nanofibres that are able to deliver naturally-derived chemical compounds in a controlled way and to prevent their degradation. The efficacy of those composite nanofibres as wound dressings, scaffolds for tissue engineering, and active food packaging systems will be discussed.

Ultra-efficient, widely tunable gold nanoparticle-based fiducial markers for X-ray imaging

We show the development of a new class of highly efficient, biocompatible fiducial markers for X-ray imaging and radiosurgery, based on polymer shells encapsulating engineered gold nanoparticle (AuNP) suspensions. Our smart fabrication strategy enables wide tunability of the fiducial size, shape, and X-ray attenuation performance, up to record values >20 000 Hounsfield units (HU), i.e. comparable to or even higher than bulk gold. We show that the NP fiducials allow for superior imaging both in vitro and in vivo (yet requiring 2 orders of magnitude less material), with strong stability over time and the absence of classical "streak artifacts" of standard bulk fiducials. NP fiducials were probed in vivo, showing exceptional contrast efficiency, even after 2 weeks post-implant in mice.

Correction: Ultra-efficient, widely tunable gold nanoparticles-based fiducial markers for X-ray imaging

Correction for 'Ultra-efficient, widely tunable gold nanoparticles-based fiducial markers for X-ray imaging' by Gabriele Maiorano, et al., Nanoscale, 2016, DOI: 10.1039/c6nr07021c.

Fumarate-loaded electrospun nanofibers with anti-inflammatory activity for fast recovery of mild skin burns

In the biomedical sector the availability of engineered scaffolds and dressings that control and reduce inflammatory states is highly desired, particularly for the management of burn wounds. In this work, we demonstrate for the first time, to the best of our knowledge, that electrospun fibrous dressings of poly(octyl cyanoacrylate) (POCA) combined with polypropylene fumarate (PPF) possess anti-inflammatory activity and promote the fast and effective healing of mild skin burns in an animal model. The fibers produced had an average diameter of (0.8  ±  0.1) µm and they were able to provide a conformal coverage of the injured tissue. The application of the fibrous mats on the burned tissue effectively reduced around 80% of the levels of pro-inflammatory cytokines in the first 48 h in comparison with un-treated animals, and enhanced skin epithelialization. From histological analysis, the skin thickness of the animals treated with POCA : PPF dressings appeared similar to that of one of the naïve animals: (13.7  ±  1.4) µm and (14.3  ±  2.5) µm for naïve and treated animals, respectively. The density of dermal cells was comparable as well: (1100  ±  112) cells mm(-2) and (1358  ±  255) cells mm(-2) for naïve and treated mice, respectively. The results demonstrate the suitability of the electrospun dressings in accelerating and effectively promoting the burn healing process.

Urological complications following kidney transplantation in pediatric age: A single-center experience

Surgical complications during kidney transplantation can seriously affect renal outcomes. We assess occurrence, risk factors, and results of all urological complications in a series of renal transplants in a single center. Children who underwent renal transplant between January 2008 and December 2014 were retrospectively evaluated. Postoperative urological complications were reviewed. Demographic details, cause of ESRD, donor type, and surgical procedures at transplant were analyzed. For statistical analysis, the chi-square test or Fisher's exact test were used as appropriate. One hundred and twenty-one kidney transplants were performed in 117 children (median age 12 yr). Sixty-two of 121 (53%) had an underlying urological malformation. At a median follow-up of three yr, 28 urological complications were recorded (23%): 12 lymphocele (10%), 10 ureteral obstruction (8%), three urinary leakage (2.5%), two symptomatic VUR (1.7%), and one hydropyonephrosis. When lymphocele was excluded, the complication incidence rate dropped to 13%. Ureteral obstruction mostly occurred late after transplant (more than six months). Presence of urological malformation was the only factor related to increased occurrence of urological complication (p = 0.007) and, in particular, ureteral obstruction (p = 0.018). Children with urological malformations presented a statistically significant risk of developing urological complications after kidney transplantation, ureteral obstruction being the most common complication.

Comparison of Native Ureteral Ligation and Open Nephrectomy for Pediatric Renal Transplantation

PURPOSE

In pediatric renal transplant recipients there are some indications for native nephrectomy, which can be performed before, during or after transplantation. Indications include massive proteinuria resistant to therapy, intractable hypertension, polyuria and chronic or recurrent kidney infections. Several scientific studies of adults have demonstrated a minimally invasive alternative to native nephrectomy, which consists of ligation of the native ureter without removing the kidney. We evaluated the safety and efficacy of this minimally invasive technique in pediatric recipients of renal transplantation.

MATERIALS AND METHODS

A total of 29 pediatric kidney transplant recipients underwent unilateral native ureteral ligation during renal transplantation between 2009 and 2013 (group A). In addition, a control group of 21 pediatric renal transplant recipients was enrolled who had undergone unilateral native nephrectomy between January 2005 and December 2008 (group B). Both groups were evaluated preoperatively by Doppler ultrasound of the native kidneys.

RESULTS

Statistical analysis of the 2 groups for the 3 main variables considered (surgical time, intraoperative blood loss and length of surgical scar) revealed a significant difference (Mann-Whitney U test, p <0.001). This finding confirmed the hypothesis that during renal transplantation ligation of the native ureter is less invasive than native nephrectomy.

CONCLUSIONS

Ligation of the native ureter without removal of the ipsilateral kidney is a feasible procedure in pediatric renal transplant recipients. This method is easy to perform and significantly less invasive than surgical nephrectomy.

Alginate-lavender nanofibers with antibacterial and anti-inflammatory activity to effectively promote burn healing

One of the current challenges in wound care is the development of multifunctional dressings that can both protect the wound from external agents and promote the regeneration of the new tissue. Here, we show the combined use of two naturally derived compounds, sodium alginate and lavender essential oil, for the production of bioactive nanofibrous dressings by electrospinning, and their efficacy for the treatment of skin burns induced by midrange ultraviolet radiation (UVB). We demonstrate that the engineered dressings reduce the risk of microbial infection of the burn, since they stop the growth of Staphylococcus aureus. Furthermore, they are able to control and reduce the inflammatory response that is induced in human foreskin fibroblasts by lipopolysaccharides, and in rodents by UVB exposure. In particular, we report a remarkable reduction of pro-inflammatory cytokines when fibroblasts or animals are treated with the alginate-based nanofibers. The down-regulation of cytokines production and the absence of erythema on the skin of the treated animals confirm that the here described dressings are promising as advanced biomedical devices for burn management.

Adult Stem Cell Therapies for Wound Healing: Biomaterials and Computational Models

The increased incidence of diabetes and tumors, associated with global demographic issues (aging and life styles), has pointed out the importance to develop new strategies for the effective management of skin wounds. Individuals affected by these diseases are in fact highly exposed to the risk of delayed healing of the injured tissue that typically leads to a pathological inflammatory state and consequently to chronic wounds. Therapies based on stem cells (SCs) have been proposed for the treatment of these wounds, thanks to the ability of SCs to self-renew and specifically differentiate in response to the target bimolecular environment. Here, we discuss how advanced biomedical devices can be developed by combining SCs with properly engineered biomaterials and computational models. Examples include composite skin substitutes and bioactive dressings with controlled porosity and surface topography for controlling the infiltration and differentiation of the cells. In this scenario, mathematical frameworks for the simulation of cell population growth can provide support for the design of bioconstructs, reducing the need of expensive, time-consuming, and ethically controversial animal experimentation.

Electrospinning of natural polymers for advanced wound care: towards responsive and adaptive dressings

Nanofibrous dressings produced by electrospinning proteins and polysaccharides are highly promising candidates in promoting wound healing and skin regeneration.

Photo-polymerisable electrospun fibres of N-methacrylate glycol chitosan for biomedical applications

Nanofibrous mats of MGC were produced and photo-crosslinked for controlling their degradation and the release of an antibacterial drug.

Fibrous wound dressings encapsulating essential oils as natural antimicrobial agents

Essential oils with high antibiotic activity were incorporated into cellulose acetate natural polymer. By using the electrospinning technique, nanofibrous matrices were prepared to be used as effective antimicrobial wound dressings.