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  Subjects -> PHARMACY AND PHARMACOLOGY (Total: 575 journals)
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Frontiers in Medical Technology
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  This is an Open Access Journal Open Access journal
ISSN (Online) 2673-3129
Published by Frontiers Media Homepage  [96 journals]
  • Editorial: From simulation to the operating theatre: new insights in
           translational surgery

    • Authors: Naci Balak, Eleni Tsianaka, Cesare Zoia, Amitendu Sekhar, Mario Ganau
      PubDate: 2023-09-21T00:00:00Z
  • Implications of immersive technologies in healthcare sector and its built

    • Authors: Eunsil Yang
      Abstract: ObjectivesThis research focuses on how built environment experts can contribute to the MXR-enabled digital innovation as part of the multidisciplinary team effort to ensure post-pandemic resilience in healthcare built environment. The goal of this research is to help healthcare providers, built environment experts, and policy makers respectively: (1) Advocate the benefits of MXR for innovating health and social care; (2) Spark debate across networks of expertise to create health-promoting environment; and (3) Understand the overriding priorities in making effective pathways to the implementation of MXR.MethodsTo highlight the novelty of this research, the study relies on two qualitative methodologies: exploratory literature review and semi-structured interviews. Based on the evaluation of prior works and cross-national case studies, hypotheses are formulated from three arenas: (1) Cross-sectional Initiatives for Post-pandemic Resilience; (2) Interoperability and Usability of Next-gen Medicines; and (3) Metaverse and New Forms of Value in Future Healthcare Ecosystems. To verify those hypotheses, empirical findings are derived from in-depth interviews with nine key informants.ResultsThe main findings are summarized under the following three themes: (1) Synergism between Architecture and Technology; (2) Patient Empowerment and Staff Support; and (3) Scalable Health and Wellbeing in Non-hospital and Therapeutic Settings. Firstly, both built environment and healthcare sectors can benefit from the various capabilities of MXR through cross-sectional initiatives, evidence-based practices, and participatory approaches. Secondly, a confluence of knowledge and methods of HCI and HBI can increase the interoperability and usability of MXR for the patient-centered and value-based healthcare models. Thirdly, the MXR-enabled technological regime will largely affect the new forms of value in healthcare premises by fostering more decentralized, preventive, and therapeutic characteristics in the future healthcare ecosystems.ConclusionWhether it's virtual or physical, our healthcare systems have placed great emphasis on the rigor of evidence-based approach linking health outcome to a clinical environment. Henceforth, built environment experts should seek closer ties with the MXR ecosystems for the co-production of scalable health and wellbeing in non-hospital and therapeutic settings. Ultimately, this is to improve resource efficiency in the healthcare sector while considering the transition of health resources towards in silico status by increasing the implementation of MXR.
      PubDate: 2023-09-20T00:00:00Z
  • Research and development of the sOLVe Tube™ dual lumen endobronchial
           tube: from concept to construct|Introduction|Methods|Results|Conclusion

    • Authors: Patricia Nwajuaku, Igor Barjaktarevic, Nir Hoftman
      Abstract: IntroductionDual lumen endobronchial tubes (DLTs) are frequently used for lung isolation and one lung ventilation in thoracic surgery and other specialized clinical scenarios. Modern DLTs are large and rigid, and account for half of all tracheobronchial injuries. Their 70 year old design has numerous flaws which limit their safety and clinical utility. Our research team set out to design a new and improved DLT to mitigate these shortcomings, and then test the proposed device to ensure proper function.MethodsUsing published airway anatomy data and computed tomography imaging from 195 thoracic surgery patients, we designed a new DLT with a single size/configuration that would fit into adult surgery patients. This single “Universal design” was intended to replace both left and right sided 35Fr-41Fr DLTs (8 total products), while remaining small in diameter (35Fr). Other design goals included: 1) making intubation easier and safer, 2) allowing full sized therapeutic bronchoscopes to fit into this tube, 3) making the DLT more resistant to dislodgement. After design process completion the proposed dimensions were tested against 195 patients' left and right mainstem bronchi for radiographic fit. Once production prototypes were manufactured, they were tested in large adult Yorkshire pigs and fresh human cadavers for anatomic fit and performance.ResultsThe proposed design passed the radiographic fit test in all 195 patients for both left and right mainstem endobronchial placement. Intubation was successful and deemed atraumatic in all pigs and cadavers, and the device appropriately fit in both the right and left mainstem bronchi. Lung isolation was successfully achieved and the device proved resistant to axial force dislodgement.ConclusionWe propose a new design for a novel DLT meant to replace 8 currently supplied adult configurations with a single, one size/configuration fits all product that allows for large bore bronchoscopy and resists axial force dislodgement.
      PubDate: 2023-09-15T00:00:00Z
  • DeepNet model empowered cuckoo search algorithm for the effective
           identification of lung cancer nodules|Introduction|Methods|Results and

    • Authors: Grace John M, Baskar S
      Abstract: IntroductionGlobally, lung cancer is a highly harmful type of cancer. An efficient diagnosis system can enable pathologists to recognize the type and nature of lung nodules and the mode of therapy to increase the patient's chance of survival. Hence, implementing an automatic and reliable system to segment lung nodules from a computed tomography (CT) image is useful in the medical industry.MethodsThis study develops a novel fully convolutional deep neural network (hereafter called DeepNet) model for segmenting lung nodules from CT scans. This model includes an encoder/decoder network that achieves pixel-wise image segmentation. The encoder network exploits a Visual Geometry Group (VGG-19) model as a base architecture, while the decoder network exploits 16 upsampling and deconvolution modules. The encoder used in this model has a very flexible structural design that can be modified and trained for any resolution based on the size of input scans. The decoder network upsamples and maps the low-resolution attributes of the encoder. Thus, there is a considerable drop in the number of variables used for the learning process as the network recycles the pooling indices of the encoder for segmentation. The Thresholding method and the cuckoo search algorithm determines the most useful features when categorizing cancer nodules.Results and discussionThe effectiveness of the intended DeepNet model is cautiously assessed on the real-world database known as The Cancer Imaging Archive (TCIA) dataset and its effectiveness is demonstrated by comparing its representation with some other modern segmentation models in terms of selected performance measures. The empirical analysis reveals that DeepNet significantly outperforms other prevalent segmentation algorithms with 0.962 ± 0.023% of volume error, 0.968 ± 0.011 of dice similarity coefficient, 0.856 ± 0.011 of Jaccard similarity index, and 0.045 ± 0.005s average processing time.
      PubDate: 2023-09-11T00:00:00Z
  • Feasibility of the preparation of cochleate suspensions from naturally
           derived phosphatidylserines|Introduction|Methods|Results

    • Authors: Søren Kristensen, Khadeija Hassan, Nadia Skarnager Andersen, Frank Steiniger, Judith Kuntsche
      Abstract: IntroductionCochleates are cylindrical particles composed of dehydrated phospholipid bilayers. They are typically prepared by addition of calcium ions to vesicles composed of negatively charged phospholipids such as phosphatidylserines (PS). Due to their high physical and chemical stability, they provide an interesting alternative over other lipid-based drug formulations for example to improve oral bioavailability or to obtain a parenteral sustained-release formulation.MethodsIn the present study, the feasibility to prepare cochleate suspensions from soy lecithin-derived phosphatidylserines (SPS) was investigated and compared to the “gold standard” dioleoyl-phosphatidylserine (DOPS) cochleates. The SPS lipids covered a large range of purities between 53 and>96% and computer-controlled mixing was evaluated for the preparation of the cochleate suspensions. Electron microscopic investigations were combined with small-angle x-ray diffraction (SAXD) and Laurdan generalized polarization (GP) analysis to characterize particle structure and lipid organization.ResultsDespite some differences in particle morphology, cochleate suspensions with similar internal lipid structure as DOPS cochleates could be prepared from SPS with high headgroup purity (≥96%). Suspensions prepared from SPS with lower purity still revealed a remarkably high degree of lipid dehydration and well-organized lamellar structure. However, the particle shape was less defined, and the typical cochleate cylinders could only be detected in suspensions prepared with higher amount of calcium ions. Finally, the study proves the feasibility to prepare suspensions of cochleates or cochleate-like particles directly from a calcium salt of soy-PS by dialysis.
      PubDate: 2023-09-06T00:00:00Z
  • Design of a syringe extension device (Chloe SED®) for low-resource
           settings in sub-Saharan Africa: a circular economy approach

    • Authors: Karlheinz Tondo Samenjo, Aparna Ramanathan, Stephen Otieno Gwer, Robert C. Bailey, Fredrick Odhiambo Otieno, Erin Koksal, Benjamin Sprecher, Rebecca Anne Price, Conny Bakker, Jan Carel Diehl
      Abstract: Underfunded healthcare infrastructures in low-resource settings in sub-Saharan Africa have resulted in a lack of medical devices crucial to provide healthcare for all. A representative example of this scenario is medical devices to administer paracervical blocks during gynaecological procedures. Devices needed for this procedure are usually unavailable or expensive. Without these devices, providing paracervical blocks for women in need is impossible resulting in compromising the quality of care for women requiring gynaecological procedures such as loop electrosurgical excision, treatment of miscarriage, or incomplete abortion. In that perspective, interventions that can be integrated into the healthcare system in low-resource settings to provide women needing paracervical blocks remain urgent. Based on a context-specific approach while leveraging circular economy design principles, this research catalogues the development of a new medical device called Chloe SED® that can be used to support the provision of paracervical blocks. Chloe SED®, priced at US$ 1.5 per device when produced in polypropylene, US$ 10 in polyetheretherketone, and US$ 15 in aluminium, is attached to any 10-cc syringe in low-resource settings to provide paracervical blocks. The device is designed for durability, repairability, maintainability, upgradeability, and recyclability to address environmental sustainability issues in the healthcare domain. Achieving the design of Chloe SED® from a context-specific and circular economy approach revealed correlations between the material choice to manufacture the device, the device's initial cost, product durability and reuse cycle, reprocessing method and cost, and environmental impact. These correlations can be seen as interconnected conflicting or divergent trade-offs that need to be continually assessed to deliver a medical device that provides healthcare for all with limited environmental impact. The study findings are intended to be seen as efforts to make available medical devices to support women's access to reproductive health services.
      PubDate: 2023-09-01T00:00:00Z
  • Digital technologies and healthcare architects' wellbeing in the National
           Health Service Estate of England during the

    • Authors: Evangelia Chrysikou, Eleni Papadonikolaki, Eleftheria Savvopoulou, Eleni Tsiantou, Christian Alexander Klinke
      Abstract: IntroductionUK Built Environment is currently undergoing a digital transformation, as is happening in the National Health Service (NHS) of England. In this paper, the focus was on the intersection of the two sectors and specifically the potential digital transformation of the NHS Estate. The NHS has developed a strategy for its workforce, to improve staff health and wellbeing, and support equality, diversity, inclusion and the development of existing staff. Digital technologies (DTs) can relate to all Estates and Facilities Management priorities, as it cross-cuts all proposed actions. As opposed to most studies on the wellbeing of blue-collar workers, this article focuses on white-collar workers, specifically architects working in the NHS, especially since NHS at this stage is developing two important policies: the New Hospital Programme and the Workforce Action Plan. Therefore, it is important for the NHS to look at the digital transformation strategy in the prism of the other two. As architecture traditionally has low job satisfaction, it negatively impacts wellbeing. This study argues that this might have been accentuated during the pandemic for the architects working in the NHS and dealing with the added pressure from three new major tasks: adjusting the infrastructure capacity to fight Covid-19; and creating the infrastructure for the testing and vaccination programs. DTs in architecture potentially affect job satisfaction in terms of creativity, autonomy, time pressure, organisational commitment, and so on.MethodologyThe methodology comprises a literature review and a pilot of interviews with healthcare architects/designers working in the NHS or on NHS-related projects. The research context is informed by the COVID-19 crisis that brought healthcare architecture to the frontline of the pandemic, with NHS architects creating new wards and vaccination centers, while private healthcare architects designed new hospitals.ResultsIn the niche area of healthcare architecture, architects were in their busiest year. Yet, the DTs available to them then could only support limited tasks and did not link well to operational data.DiscussionTo explore how DTs transform the wellbeing of healthcare architects, understanding wellbeing in healthcare architecture in light of digital transformation is crucial for creating the necessary leadership for the sector to grow.
      PubDate: 2023-08-02T00:00:00Z
  • Human-centred health-care environments: a new framework for biophilic

    • Authors: Bekir Huseyin Tekin, Rosa Urbano Gutiérrez
      Abstract: Increasing research corroborates that the qualities of the setting in which a patient receives healthcare positively influence health outcomes. Therefore, it has become progressively important to review the concept of therapeutic environments, as places where patients are treated with the most advanced medicine and technology, but also support their users in psychological, emotional and social terms. This quest for the optimal healing environment brings to the forefront the need to include other parameters in our design briefs, where the application of biophilic design proves to be paramount, as exposure to nature is associated with multiple health benefits. However, current biophilic design frameworks fail to provide efficient guidance, as their design recommendations don’t differentiate the level of value of each design parameter for each building programme and context. Our position is that a biophilic design framework can only be efficient if it is adapted to specific building functions and is geographically and culturally contextualized. This study assessed the application of biophilic design in therapeutic environments for cancer patients in the UK, and provided a revised conceptual framework that can more efficiently guide designers and policies in future interventions. This framework was informed by synthesised analyses from healthcare environments on the user's experiences, and primary data obtained from semi-structured interviews with architects and managers, which was then benchmarked against scientific data about the impact of biophilic design on humans. This comprehensive approach helped to identify and rank those biophilic design parameters that appear the most critical for promoting and supporting health and wellbeing in cancer healthcare settings and provided an up-to-date compilation of crucial design actions to enact the necessary change in future research and design practice.
      PubDate: 2023-07-25T00:00:00Z
  • A new aerodynamic endonasal filtration technology for protection against
           pollutants and respiratory infectious agents: evaluation of the particle
           filtration efficacy

    • Authors: Padmanabhan Saravanan, Francesco Broccolo, Nurshahidah Ali, Alden Toh, Sakinah Mulyana, Goh Lay Beng, Enrico Imperi, Alfredo Picano
      Abstract: An innovative nasal filter was tested, based on aerodynamic air filtration and not on conventional air filtration by means of mesh filters. A custom testing system was designed and three sizes of the filter have been tested vs. monodispersed SiO2 particles sized 5 μm, 1 μm, and 0.5 μm under cycling flow of 6 liters per minute, provided by an artificial lung breather simulating spontaneous breathing. Accelerated testing was implemented, challenging filters with a maximum load of 200 mg per cubic meter. All three filters' sizes showed initial filtration efficiencies above 90% vs. all particles' sizes, decreased to not less than 80% after 30 min of accelerated testing, corresponding to 4.5 days of continuous use at 2 mg challenge, this value being associated with hazardous air conditions in the PSI scale. Results in this study indicate that nasal filters based on aerodynamic air filtration can provide fine and ultrafine filtration, offering protection in day-to-day life from risks associated with pollens, mites, PM, pollutants, and respiratory infectious agents, introducing acceptable respiratory resistance.
      PubDate: 2023-07-21T00:00:00Z
  • Biosynthesized nanoparticles: a novel approach for cancer therapeutics

    • Authors: Vivek K. Chaturvedi, Bhaskar Sharma, Abhay Dev Tripathi, Dawesh P. Yadav, Kshitij RB Singh, Jay Singh, Ravindra Pratap Singh
      Abstract: Nanotechnology has become one of the most rapid, innovative, and adaptable sciences in modern science and cancer therapy. Traditional chemotherapy has limits owing to its non-specific nature and adverse side effects on healthy cells, and it remains a serious worldwide health issue. Because of their capacity to specifically target cancer cells and deliver therapeutic chemicals directly to them, nanoparticles have emerged as a viable strategy for cancer therapies. Nanomaterials disclose novel properties based on size, distribution, and shape. Biosynthesized or biogenic nanoparticles are a novel technique with anti-cancer capabilities, such as triggering apoptosis in cancer cells and slowing tumour growth. They may be configured to deliver medications or other therapies to specific cancer cells or tumour markers. Despite their potential, biosynthesized nanoparticles confront development obstacles such as a lack of standardisation in their synthesis and characterization, the possibility of toxicity, and their efficiency against various forms of cancer. The effectiveness and safety of biosynthesized nanoparticles must be further investigated, as well as the types of cancer they are most successful against. This review discusses the promise of biosynthesized nanoparticles as a novel approach for cancer therapeutics, as well as their mode of action and present barriers to their development.
      PubDate: 2023-07-13T00:00:00Z
  • Comparison of MRCP and ERCP in the evaluation of common bile duct and
           pancreatic duct pathologies|Background|Aim|Material and

    • Authors: Anand Kumar, Nihar Ranjan Mohanty, Madhusmita Mohanty, Sashibhusan Dash
      Abstract: BackgroundMagnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging modality that has high diagnostic accuracy for a wide range of bile duct and pancreatic duct pathologies. Endoscopic retrograde cholangiopancreatography (ERCP) is still the gold standard for the exploration of the biliopancreatic region.AimThe aim of the study was to compare the diagnostic accuracy of MRCP with that of ERCP in the diagnosis of bile duct and pancreatic duct pathologies.Material and methodsA total of 60 patients with common bile duct (CBD) and pancreatic duct pathologies detected on MRCP were subsequently evaluated by ERCP in this observational study. A comparison of MRCP findings with ERCP was made.ResultsMRCP had a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 88.1%, 94.4%, 97.3%, 72.7%, and 90%, respectively, in diagnosing choledocholithiasis in comparison to ERCP. For CBD dilation, the sensitivity was 90.91%, specificity was 93.75% and the PPV, NPV, and accuracy were 97.56%, 78.95%, and 91.67%, respectively, for MRCP. In CBD stricture, MRCP showed a sensitivity, specificity, PPV, NPV, and accuracy of 83.33%, 97.92%, 90.91%, 95.92%, and 95%, respectively. In pancreatic duct dilatation, the sensitivity, specificity, PPV, NPV, and accuracy were all 100%. Pancreatic duct stricture showed a sensitivity, specificity, PPV, NPV, and accuracy of 80%, 98%, 88.89%, 96.08%, and 95%, respectively. For the diagnosis of periampullary carcinoma, the sensitivity, specificity, PPV, NPV, and accuracy rate of MRCP were 80%, 98%, 88.89%, 96.08%, and 95%, respectively.ConclusionNo significant difference was found between MRCP and ERCP in diagnosing those six pathologies.
      PubDate: 2023-07-12T00:00:00Z
  • Understanding a videogame home intervention for children with hemiplegia:
           a mixed methods multi-case

    • Authors: Daniela Chan-Víquez, Ajmal Khan, Sarah Munce, Darcy Fehlings, F. Virginia Wright, Elaine Biddiss
      Abstract: IntroductionAccess to rehabilitation therapies is a salient and growing issue for children with cerebral palsy (CP) and their families, motivating interest in home-based interventions. Bootle Blast is a low-cost, movement-tracking videogame that can be used at home to encourage upper limb (UL) functional exercise tailored to each child's abilities and therapy goals. The study objectives were to: 1) Establish the extent to which children achieve their self-directed play-time goal over a 12-week intervention, 2) Measure changes in UL motor outcomes, and 3) Explore participants' experiences of using Bootle Blast at home.MethodsMixed methods case series study of four children with hemiplegic cerebral palsy (HCP), each with a participating parent. Participants played Bootle Blast at home for 12 weeks. Study assessments occurred at baseline, post-intervention and four week follow up. A post-intervention interview explored participants' experiences. Game-logs provided play time and progress data.ResultsThree of four participants (8-13 yrs., Manual Ability Classification Level I-II) completed the intervention. One dropped out at week 6. Play-time goals were achieved in most weeks, with two of four children surpassing their overall intervention goals. Outcomes varied across the three participants, however consistent improvements were observed on the Canadian Occupational Performance Measure and the Box and Blocks Test. Inductive analysis generated four main themes: 1) Intrinsic motivators fostered play engagement, 2) Virtual play for real-world gains, 3) Therapy on demand (at home), and 4) Shifting the onus from the parent to the game. Integration of qualitative and quantitative data was important for interpreting play patterns/usage and clinical outcomes.DiscussionThis mixed methods study describes a novel videogaming intervention designed for home-rehabilitation for children with HCP and provides preliminary evidence to guide future study design and research.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT04009031'recrs=h&cond=Cerebral+Palsy&cntry=CA&city=Toronto&draw=2&rank=1], identifier [NCT04009031].
      PubDate: 2023-07-12T00:00:00Z
  • Adaptability in healthcare buildings: a perspective through Joseph Bracops

    • Authors: Giulia Scialpi, Joost Declercq
      Abstract: The healthcare sector has to face changes happening fast and often in an unpredictable way, such as epidemiological trends, the advancements of medical technology and processes or evolving social and economic needs. This results in a frequent need for infrastructures' retrofitting, with an increasing focus on the environmental impact of buildings, which have one of the highest embodied carbon footprints per square meter in the construction sector. As result, interest in healthcare buildings' adaptability is growing among researchers and practitioners. After an introduction on the research topic, a focus on the definition of adaptability and the existing assessment models is provided to address the following research question: to what extent are adaptability models effective to evaluate and orient the design of healthcare buildings' A quite varied use of the term adaptability has been found in the literature, as well as a new research trend aiming to establish a link with circularity. Moreover, most of the assessment models do not have a focus and have never been tested on the healthcare sector. An approach to circular and adaptable design is presented through the case study of the Joseph Bracops Hospital (Belgium), which has been submitted for evaluation by the Reversible Building Design protocol developed by Dr. Durmisevic. The evaluation highlights some of the current barriers in the design of adaptable healthcare facilities. Insights for future research are provided to encourage data-collection about the service life of healthcare buildings, so to understand if the adaptability of these infrastructures should be mainly monofuntional or transfunctional.
      PubDate: 2023-07-10T00:00:00Z
  • Editorial: Relevant technology adaptation for bio medical application and

    • Authors: Anshuman Mishra, Manish Mishra
      PubDate: 2023-07-05T00:00:00Z
  • Editorial: Image-based computational approaches for personalized
           cardiovascular medicine: improving clinical applicability and reliability
           through medical imaging and experimental data

    • Authors: Selene Pirola, Amirhossein Arzani, Claudio Chiastra, Francesco Sturla
      PubDate: 2023-06-23T00:00:00Z
  • Association of x-ray velocimetry (XV) ventilation analysis compared to

    • Authors: Jason P. Kirkness, Jonathan Dusting, Nina Eikelis, Piraveen Pirakalathanan, John DeMarco, Stephen L. Shiao, Andreas Fouras
      Abstract: IntroductionX-ray Velocimetry (XV) ventilation analysis is a 4-dimensional imaging-based method for quantifying regional ventilation, aiding in the assessment of lung function. We examined the performance characteristics of XV ventilation analysis by examining correlation to spirometry and measurement repeatability.MethodsXV analysis was assessed in 27 patients receiving thoracic radiotherapy for non-lung cancer malignancies. Measurements were obtained pre-treatment and at 4 and 12-months post-treatment. XV metrics such as ventilation defect percent (VDP) and regional ventilation heterogeneity (VH) were compared to spirometry at each time point, using correlation analysis. Repeatability was assessed between multiple runs of the analysis algorithm, as well as between multiple breaths in the same patient. Change in VH and VDP in a case series over 12 months was used to determine effect size and estimate sample sizes for future studies.ResultsVDP and VH were found to significantly correlate with FEV1 and FEV1/FVC (range: −0.36 to −0.57; p 
      PubDate: 2023-06-22T00:00:00Z
  • Toxic or not toxic' The specifications of the standard ISO 10993-5 are not
           explicit enough to yield comparable results in the cytotoxicity assessment
           of an identical medical

    • Authors: Sarah Gruber, Angela Nickel
      Abstract: BackgroundMedical device manufacturers are obliged to prove the biocompatibility of their products when they come into contact with the human body. The requirements for the biological evaluation of medical devices are specified by the international standard series ISO 10993. Part five of this series describes the performance of in vitro cytotoxicity tests. This test evaluates the effects of medical device use on cell health. The existence of the specific standard suggests that the tests will produce reliable and comparable results. However, the ISO 10993-5 offers wide latitude in the test specifications. In the past, we noticed inconsistencies of the results from different laboratories.ObjectiveTo determine if the specifications of the standard ISO 10993-5 are explicit to ensure the comparability of test results and, if not, identify potential influencing factors.MethodsAn interlaboratory comparison was conducted for the in vitro cytotoxicity test according to ISO 10993-5. Fifty-two international laboratories evaluated the cytotoxicity for two unknown samples. One was polyethylene (PE) tubing, which is expected to be non-cytotoxic and the other was polyvinyl chloride (PVC) tubing, for which a cytotoxic potential was presumed. All laboratories were asked to perform an elution test with predefined extraction specifications. The other test parameters were freely chosen by the laboratories according to the guidelines set by the standard.ResultsTo our surprise only 58 percent of the participating laboratories identified the cytotoxic potential of both materials as expected. Particularly for PVC a considerable variation of the results between the laboratories was observed [mean = 43 ± 30 (SD), min = 0, max = 100]. We showed that ten percent serum supplementation to the extraction medium, as well as longer incubation of the cells with the extract, greatly increased the test sensitivity for PVC.ConclusionThe results clearly show that the specifications set by the ISO 10993-5 are not explicit enough to obtain comparable results for an identical medical device. To set requirements that ensure reliable cytotoxicity assessments, further research will be necessary to identify the best test conditions for specific materials and/or devices and the standard needs to be revised accordingly.
      PubDate: 2023-06-14T00:00:00Z
  • Tailoring the secretome composition of mesenchymal stem cells to augment
           specific functions of epidermal regeneration: an in vitro diabetic

    • Authors: Jacob G. Hodge, Jennifer L. Robinson, Adam J. Mellott
      Abstract: IntroductionWound healing consists of a dynamic series of events that are highly dependent on paracrine factors for proper progression through the phases of wound healing. Inappropriate progression through the phases is associated with insufficient epidermal regeneration (i.e., re-epithelialization) of wounds and subsequent propagation of chronic wounds, such as diabetic ulcers, which are associated with increased patient morbidity. Recently, investigation into the dynamic secretome of Adipose-derived Mesenchymal Stem Cells (ASCs), have shown promise in augmenting the wound healing response of chronic diabetic wounds. However, currently utilized 2D culture techniques are known to drastically alter the regenerative phenotype of ASCs. In this study a novel tissue-mimetic 3D system was utilized as a means to culture ASCs.MethodsThe capacity for the ASC secretome to augment epidermal regeneration activity was then evaluated after exposure of ASCs to “wound priming stimuli” in 2D and 3D. The priming stimuli consisted of coating the 2D and 3D systems with the wound matrix proteins, collagen type I, fibronectin, and fibrin. To understand the potential benefit of the ASC secretome in the context of diabetic wounds, keratinocytes (KCs) were exposed to super-physiological glucose levels to induce a diabetic-like phenotype (idKCs).ResultsRelative to KCs, idKC exhibited a 52% and 23% decline in proliferation and migration, respectively. Subsequently, analyses of the ASC secretome were performed. ASC conditioned media (ASC-CM) from tissue-mimetic culture demonstrated a > 50% increase secretion of proteins and a 2-fold increase in secreted EVs, relative to 2D culture. Interestingly, the different priming stimuli did not alter the total amount of protein or EVs secreted within the tissue-mimetic system. However, evaluation of specific soluble proteins via ELISA revealed significant differences in key epidermal regeneration factors, such as EGF, IGF-1, FGF-2, MMP-1, TIMP-1, and TGFβ-1. Additionally, the relative effect of ASC-EVs from the 2D and 3D system on idKCs epidermal regeneration functionality varied significantly, with EVs from 3D-Collagen culture providing the most significant benefit on idKC activity.DiscussionTogether, these data support the utilization of tissue-mimetic culture system to enhance the adaptability and secretory activity of MSC-like populations in order to generate tailored biologics, via priming stimuli, for specific wound healing applications.
      PubDate: 2023-06-12T00:00:00Z
  • Editorial: Artificial intelligence: applications in clinical medicine

    • Authors: Joshua Levy, Emilio Madrigal, Louis Vaickus
      PubDate: 2023-06-09T00:00:00Z
  • Effects of helical centerline stent vs. straight stent placement on blood
           flow velocity

    • Authors: Yutaro Kohata, Makoto Ohta, Kazuyoshi Jin, Hitomi Anzai
      Abstract: As an approach to maintain patency in femoropopliteal stenting, a helical stent configuration was proposed, which showed improved patency in clinical trials. However, the effects of helical stent placement on the flow have not been quantitatively analyzed. The purpose of this study was to estimate flow velocities to quantify the influence of helical stent placement. Helical and straight stents were implanted in three healthy pigs, and the flow velocities were estimated using the time-intensity curve (TIC) in the angiography images. The angiographic images indicated thinning of the leading edge of the contrast medium through the helically deformed artery, which was not observed in the straight stent. The slower rise of the TIC peak in the helical stent indicated faster travel of this thinner edge. Arterial expansion due to stenting was observed in all cases, and the expansion rate varied according to location. All cases of helical stent implantation showed that velocity was maintained (55.0%–71.3% velocity retention), unlike for straight stent implantation (43.0%–68.0% velocity retention); however, no significant difference was observed.
      PubDate: 2023-06-02T00:00:00Z
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