3D printing of an artificial intelligence-generated patient-specific coronary artery segmentation in a support bath.

Accurate segmentation of coronary artery tree and personalized 3D printing from medical images is essential for CAD diagnosis and treatment. The current literature on 3D printing relies solely on generic models created with different software or 3D coronary artery models manually segmented from medical images. Moreover, there are not many studies examining the bioprintability of a 3D model generated by artificial intelligence (AI) segmentation for complex and branched structures. In this study, deep learning algorithms with transfer learning have been employed for accurate segmentation of the coronary artery tree from medical images to generate printable segmentations. We propose a combination of deep learning and 3D printing, which accurately segments and prints complex vascular patterns in coronary arteries. Then, we performed the 3D printing of the AI-generated coronary artery segmentation for the fabrication of bifurcated hollow vascular structure. Our results indicate improved performance of segmentation with the aid of transfer learning with a Dice overlap score of 0.86 on a test set of 10 coronary tomography angiography images. Then, bifurcated regions from 3D models were printed into the Pluronic F-127 support bath using alginate + glucomannan hydrogel. We successfully fabricated the bifurcated coronary artery structures with high length and wall thickness accuracy, however, the outer diameters of the vessels and length of the bifurcation point differ from the 3D models. The extrusion of unnecessary material, primarily observed when the nozzle moves from left to the right vessel during 3D printing, can be mitigated by adjusting the nozzle speed. Moreover, the shape accuracy can also be improved by designing a multi-axis printhead that can change the printing angle in three dimensions. Thus, this study demonstrates the potential of the use of AI-segmented 3D models in the 3D printing of coronary artery structures and, when further improved, can be used for the fabrication of patient-specific vascular implants.

Fabrication of curcumin-loaded magnetic PEGylated-PLGA nanocarriers tagged with GRGDS peptide for improving anticancer activity.

Carrier-mediated drug delivery systems are highly promising as a treatment option for the targeted delivery of potent cytotoxic drugs with increased efficacy and safety. Considering that poly (lactic-co-glycolic acid) (PLGA) and polyethylene glycol (PEG) polymers each provide certain advantages for biological purposes, PEGylated-PLGA nanoparticles have emerged as a leading candidate among other alternatives. Furthermore, these nanoparticles can be modified with the specific short peptide sequences such as glycine-arginine-glycine-aspartic acid­serine (GRGDS), which selectively binds to integrins overexpressed in most cancer cells, allowing for targeted delivery. Here, we reported the details in fabrication and characterization of magnetic PEGylated-PLGA nanoparticles functionalized with GRGDS peptide. In addition, superparamagnetic iron oxide nanoparticles (SPIONs) and the natural pharmaceutical compound curcumin (Cur) were loaded into these polymeric nanoparticles to assess their anticancer activity potential. Overall, this study provides comprehensive methodologies, including all synthesis procedures, challenges, and useful suggestions for peptide-conjugated polymeric nanoparticles that may be used for cellular targeting and therapeutic applications.•Step by step fabrication protocol for the Cur loaded magnetic PEGylated-PLGA nanoparticles was presented.•Validation of the fabrication and the GRGDS conjugation to the nanoparticles were shown via detailed characterization studies.•The cytotoxic effect of the Cur-loaded and GRGDS-tagged magnetic nanoparticles was tested on T98G glioblastoma cell line as a preliminary in vitro study.

Frequency and economic burden of psychogenic non-epileptic seizures in patients applying for disability benefits due to epilepsy.

BACKGROUND: Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures and are often misdiagnosed as epilepsy. OBJECTIVE: To investigate the frequency of PNES and to calculate the economic burden of the patients who admitted to video-electroencephalographicmonitoring (VEM) to obtain a diagnosis of epilepsy in order to apply for disability retirement. METHODS: The present retrospective study included 134 patients who required disability reports between 2013 and 2019 and had their definite diagnoses after VEM. Following VEM, the patients were divided into three groups: epilepsy, PNES, and epilepsy + PNES. RESULTS: In total, 22.4% (n = 30) of the patients were diagnosed with PNES, 21.6% (n = 29) with PNES and epilepsy, and 56% (n = 75), with epilepsy. The frequency of PNES among all patients was of 44% (n = 59). In patients with PNES alone, the annual cost of using anti-seizure medication was of 160.67 ± 94.04 dollars; for psychostimulant drugs, it was of 148.3 ± 72.48 dollars a year; and the mean direct cost for diagnostic procedures was of 582.9 ± 330.0 (range: 103.52-1601.3) dollars. CONCLUSIONS: Although it is challenging to determine the qualitative and quantitative total cost in these patient groups, early diagnosis and sociopsychological support will reduce the additional financial burden on the health system and increase the quality of life of the patients.

ANTECEDENTES: As crises psicogênicas não epilépticas (CPNE) se assemelham a crises epilépticas, e muitas vezes são diagnosticadas erroneamente como epilepsia. OBJETIVO: Investigar a frequência de CPNE e calcular o impacto econômico dos pacientes internados para serem submetidos a monitoramento videoencefalográfico (MVE) para obter um diagnóstico de epilepsia e requerer aposentadoria por invalidez. MéTODOS: Este estudo retrospectivo incluiu 134 pacientes que solicitaram laudo médico de incapacidade entre 2013 e 2019, e obtiveram seus diagnósticos definitivos após serem submetidos a MEV. Os pacientes foram divididos em três grupos: epilepsia, CPNE, e epilepsia + CPNE. RESULTADOS: Após o MEV, 22,4% (n = 30) dos pacientes foram diagnosticados com CPNE, 21,6% (n = 29), com CPNE + epilepsia, e 56%, com epilepsia. A frequência de CPNE entre todos os pacientes foi de 44% (n = 59). Em pacientes somente com CPNE, o custo anual do uso de anticonvulsivantes foi de US$ 160,67 ± 94,04; para os psicoestimulantes, o custo anual foi de US$ 148,3 ± 72,48; e a média do custo direto de procedimentos diagnósticos foi de US$ 582,9 ± 330,0 (variação: 103,52­1601,3). CONCLUSõES: Embora seja um desafio determinar o custo total qualitativo e quantitativo nesses grupos de pacientes, o diagnóstico precoce e o apoio sociopsicológico reduzirão o impacto financeiro adicional ao sistema de saúde e aumentarão a qualidade de vida dos pacientes.

Frequency and economic burden of psychogenic non-epileptic seizures in patients applying for disability benefits due to epilepsy / Frequência e impacto econômico das crises psicogênicas não epilépticas em pacientes requerentes de aposentadoria por invalidez devido a epilepsia

Abstract Background Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures and are often misdiagnosed as epilepsy. Objective To investigate the frequency of PNES and to calculate the economic burden of the patients who admitted to video-electroencephalographicmonitoring (VEM) to obtain a diagnosis of epilepsy in order to apply for disability retirement. Methods The present retrospective study included 134 patients who required disability reports between 2013 and 2019 and had their definite diagnoses after VEM. Following VEM, the patients were divided into three groups: epilepsy, PNES, and epilepsy + PNES. Results In total, 22.4% (n = 30) of the patients were diagnosed with PNES, 21.6% (n = 29) with PNES and epilepsy, and 56% (n = 75), with epilepsy. The frequency of PNES among all patients was of 44% (n = 59). In patients with PNES alone, the annual cost of using anti-seizure medication was of 160.67 ± 94.04 dollars; for psychostimulant drugs, it was of 148.3 ± 72.48 dollars a year; and the mean direct cost for diagnostic procedures was of 582.9 ± 330.0 (range: 103.52-1601.3) dollars. Conclusions Although it is challenging to determine the qualitative and quantitative total cost in these patient groups, early diagnosis and sociopsychological support will reduce the additional financial burden on the health system and increase the quality of life of the patients.

Resumo Antecedentes As crises psicogênicas não epilépticas (CPNE) se assemelham a crises epilépticas, e muitas vezes são diagnosticadas erroneamente como epilepsia. Objetivo Investigar a frequência de CPNE e calcular o impacto econômico dos pacientes internados para serem submetidos a monitoramento videoencefalográfico (MVE) para obter um diagnóstico de epilepsia e requerer aposentadoria por invalidez. Métodos Este estudo retrospectivo incluiu 134 pacientes que solicitaram laudo médico de incapacidade entre 2013 e 2019, e obtiveram seus diagnósticos definitivos após serem submetidos a MEV. Os pacientes foram divididos em três grupos: epilepsia, CPNE, e epilepsia + CPNE. Resultados Após o MEV, 22,4% (n = 30) dos pacientes foram diagnosticados com CPNE, 21,6% (n = 29), com CPNE + epilepsia, e 56%, com epilepsia. A frequência de CPNE entre todos os pacientes foi de 44% (n = 59). Em pacientes somente com CPNE, o custo anual do uso de anticonvulsivantes foi de US$ 160,67 ± 94,04; para os psicoestimulantes, o custo anual foi de US$ 148,3 ± 72,48; e a média do custo direto de procedimentos diagnósticos foi de US$ 582,9 ± 330,0 (variação: 103,52-1601,3). Conclusões Embora seja um desafio determinar o custo total qualitativo e quantitativo nesses grupos de pacientes, o diagnóstico precoce e o apoio sociopsicológico reduzirão o impacto financeiro adicional ao sistema de saúde e aumentarão a qualidade de vida dos pacientes.

Formulation of chitosan and chitosan-nanoHAp bioinks and investigation of printability with optimized bioprinting parameters.

The development of a chitosan-based bioink that can provide a cell-friendly environment at relatively low concentration and moderate cross-linking conditions is still problematic. Here, we developed amorphous nanohydroxyapatite (nHAp) containing chitosan bioink formulations that can be gelled via the inclusion of glycerol phosphate (GP) and sodium hydrogen carbonate (SHC) into the polymer network under physiological conditions. Rheological analyses indicated that all the formulations showed shear-thinning characteristics compatible with the extrusion-based bioprinting. Also, the chitosan bioinks exhibited more gel-like structure as the weight fraction of nHAp increased from 10 % to 40 %. The printability of the chitosan-based bioinks was assessed and optimized by response surface methodology (RSM). These studies revealed that all the formulations can be successfully printed within the ranges of 50-70 kPa printing pressure and 4-11 mm/s printing speed. Multi-layered chitosan biomaterials with distinct pore structure were successfully fabricated with a high printability index. High cell viability was observed after bioprinting with pre-osteoblastic MC3T3-E1 cells. In conclusion, this study represents for the first time that chitosan biomaterials bearing suitable rheological properties and cellularity can be printed with controllable architecture for 3D bone scaffolds.

Effects of radiofrequency exposure on in vitro blood-brain barrier permeability in the presence of magnetic nanoparticles.

The blood-brain barrier (BBB) remains a major obstacle for the delivery of drugs in the treatment of many neurological diseases. In this study, we aimed to investigate the effects of radiofrequency electromagnetic fields (RF-EMFs) on the permeability of an in vitro BBB model under RF exposure alone, or in the presence of nanoparticles (NPs). For this purpose, an in vitro BBB model was established by seeding human umbilical vein endothelial cells (HUVECs) and human glioblastoma cell line (T98G) on the apical and basolateral sides of the transwell membrane, respectively. The integrity of the BBB model was confirmed by measuring transendothelial electrical resistance (TEER), and a fluorescein isothiocyanate (FITC)-dextran permeability assay was performed when the resistance reached 120 Ω cm2. After the RF-field exposure (13.56 MHz, 80 W, 10 min), we found that FITC-dextran transported across the in vitro BBB was increased 10-fold compared to FITC-dextran transported without an RF-field. This notable phenomenon, which can be called the burst permeability RF effect (BP-RF), has been proposed for the first time in the literature. Subsequently, the effect of the RF-field on BBB permeability was also investigated in the presence of superparamagnetic iron oxide nanoparticles (SPIONs) and magnetic poly(lactic-co-glycolic acid)-polyethylene glycol (PLGA-b-PEG) nanoparticles (m-PNPs). It was found that the amount of both transported NPs on the basolateral sides increased after exposure to the RF-field. As a result, the RF-field can be applied simultaneously during treatment with clinical agents or nanocarriers, improving the permeability of the BBB, which may contribute to therapeutic efficacy of many drugs that are used in neurological diseases.

Do Correlations Between Mindfulness Components and Rumination in Student Athletes Support Mindfulness Training to Reduce Rumination?

In the present study, we examined the relationship between mindfulness and rumination among student-athletes. Ninety-seven young adult student-athletes (38.1% female, 61.9% male; Mage = 22.52, SD = 3.53) completed both the Mindfulness Inventory for Sport and the Ruminative Thought Style Questionnaire. Among these participants, we observed a significant positive correlation between rumination and the awareness sub-dimension of mindfulness. We also observed significant negative correlations between rumination and two scores from the Mindfulness Inventory for Sport: non-judgment and overall mindfulness. Awareness, non-judgment, and mindfulness were all significant predictors of rumination in a linear regression analysis. While these are correlational data that do not permit causal inferences, these findings raise the possibility, in this population, that awareness triggers ruminative thoughts and overall mindfulness might represent a coping tool for rumination. Further research is needed to test this possibility.

Three dimensional nanofibrous and compressible poly(L-lactic acid) bone grafts loaded with platelet-rich plasma.

In this study, nanofibrous matrices of poly(L-lactic acid)-hydroxyapatite (PLLA-HAp) were successfully fabricated by three-dimensional (3D) electrospinning for use in the treatment of irregular bone damages. Compressibility analysis showed that 3D nanofibrous grafts occupied at least 2-fold more volume than their 2D form and they can easily take shape of the defect zone with irregular geometry. Moreover, the compression moduli of the PLLA and PLLA-HAp grafts were calculated as 8.0 ± 3.0 kPa and 11.8 ± 3.9 kPa, respectively, while the strain values of the same samples at the maximum load of 600 kPa were 164 ± 28% and 130 ± 20%, respectively. Treatment of the grafts with aqueous sodium hydroxide solution increased the surface roughness and thus the alloplastic graft materials (PLLA-HAp/M) protecting the fiber morphology were produced successfully. Then, platelet-rich plasma (PRP) was loaded into the surface modified grafts and activated with 10% calcium chloride. The efficiency of the activation was evaluated with flow cytometry and it was found that after activation the percentages of CD62 (P-selectin) and CD41/61 (glycoprotein IIb/IIIa) proteins increased approximately 4-fold. Surface hydrophilicity and biological activity of the PLLA-HAp grafts were enhanced by fibrin coating after PRP activation. Thein vitrocell culture studies which were carried out by using mouse pre-osteoblasts (MC3T3-E1) showed that graft materials supported by PRP increased cellular proliferation and osteogenic differentiation significantly. Thein vivoresults demonstrated that compared with bare PLLA-HAp/M grafts, the PRP loaded grafts (PRP-PLLA-HAp/M) induced significantly greater bone formation based on computed tomography, histological and immunohistochemical analyses. Our findings suggest that 3D PLLA nanofibrous matrices can be used as a graft material for irregular bone defects especially when combined with PRP as an osteogenic induction agent.

The Prevalence of Sarcopenia in Bipolar Disorder.

BACKGROUND: Sarcopenia (SP) is a syndrome described as generalized and progressive loss of muscle mass and strength that may cause fall, fractures, disability and death. Oxidative stress might be a probable etiologic factor in SP as well. SP is a comorbid syndrome that is seen in chronic illnesses. If these two considerations are taken together, one may also think that SP could be also seen in bipolar disorder (BD), because it is a chronic disorder and oxidative stress was related to both illnesses. In our study, we proposed to investigate the prevalence of SP in BD patients. METHODS: We recruited 111 consecutive BD patients who registered in Mood Disorders Unit of Çukurova University. Blood tests were taken from patients to exclude the possible confounding factor related to SP. Socio-demographic variable forms were filled out. Every patient underwent physical mass, strength, and performance tests for the diagnosis of SP, which was determined by the criteria of European consensus. RESULTS: The mean age of the patients was 38.00 ±11.44 years (18-68). Among the participants 69 (62.2%) were female, and 42 (37.8%) were male. Pre-SP was 6.3% (n=7), SP was 9.0% (n=10), and severe SP was 1.8% (n=2) in BD patients. The prevalence of pre-SP, SP and severe SP in BD patients was 7.1%, 16.7% and 2.4% in men and 5.8%, 4.3% and 1.4% in women, respectively. Although it was not marginally significant, a difference was observed in SP patients as they had more median psychotic features and median number of episodes per year for BD. CONCLUSION: This is the first study that investigated SP in BD patients. Sarcopenia was found more frequently in BD patients than in the general population.

The relationship between somatic sense perception levels and comorbid psychiatric diseases in chronic pain patients.

OBJECTIVES: The purpose of the study was to evaluate any comorbid psychiatric disorders in patients with chronic pain and to examine the effects of sociodemographic details and the level of somatic sense perception on the severity of these diseases. METHODS: In this study, 51 chronic pain patients were evaluated in a consultation with a psychiatrist. Sociodemographic characteristics of the patients, such as age, gender, education level, and marital status were recorded, and Structured Clinical Interview for DSM-IV results were assessed. The patients' chronic pains were classified as idiopathic or secondary to organic etiology. In addition, the Symptom Checklist-90, Somatosensory Amplification Scale (SSAS), Hamilton Depression Rating Scale, and the Hamilton Anxiety Scale (HAM-A) were used. RESULTS: The incidence of psychiatric disorders in chronic pain patients was found to be 74.5%. Somatoform disorders were the most frequently diagnosed, at 37.3%. The rate of depressive and anxiety disorders was, respectively, 29.4% and 23.5%. Comorbid anxiety scores (p=0.019) and SSAS scores (p=0.046) were significantly higher in chronic pain patients with a somatoform disorder. HAM-A scores were found to be significantly higher in patients with depression (p=0.004). A positive and linear relationship was determined between the SSAS score and depression, anxiety, and the severity of mental symptoms. CONCLUSION: Structured or semi-structured interviews can be performed in pain polyclinics or psychiatric outpatient clinics to determine the level of perception of somatic sensations. This could be beneficial in the treatment of chronic pain and comorbid psychiatric disorders.

A Case of Simultaneous Mania and Idiopathic Normal Pressure Hydrocephalus: Etiology or Comorbidity? / Es Zamanli Idiopatik Normal Basinçli Hidrosefali ve Mani Olgusu: Etiyoloji mi? Es Tani mi?

Normal pressure hydrocephalus (NPH), typically associated with the triad of gait disturbance, dementia and urinary incontinence, rarely presents with symptoms of mania, depression or psychosis and psychiatric disorders may complicate the diagnosis. Few cases of NPH and psychiatric disease comorbidity have been reported so far. In most of these cases, NPH was associated with depression and psychotic symptoms. Mania symptoms were also reported in a few cases those of which were associated with a history of bipolar disorder (BPD) or subthreshold BPD symptoms. In this paper, we present a case of late-onset mania symptoms simultaneously presenting with NPH in a healthy individual without a history of psychiatric disorder.

Enhanced osteogenic activity with boron-doped nanohydroxyapatite-loaded poly(butylene adipate-co-terephthalate) fibrous 3D matrix.

In this study, three dimensional (3D) poly(butylene adipate-co-terephthalate) (PBAT) fibrous scaffolds with more than 90% porosity were fabricated via wet electrospinning method. Amorphous hydroxyapatite (HAp) and boron (B) doped hydroxyapatite (B-HAp) nanoparticles were produced by microwave-assisted biomimetic precipitation and encapsulated into PBAT fibres with the ratio of 5% (w/w) in order to enhance osteogenic activity of the scaffolds. Cell culture studies were carried out with human bone marrow derived stem cells (hBMSCs) and they showed that alkaline phosphatase (ALP) activity and the amounts of collagen and calcium were higher on B containing PBAT (B-HAp-PBAT) scaffolds during the 28-day culture period than that of the PBAT scaffolds. Moreover, hBMSCs cultivated on B-HAp-PBAT scaffolds showed significantly higher expression levels of both early and late stage osteogenic genes e.g. ALP, collagen I (COL-I), osteocalcin (OCN) and osteopontin (OPN) at day 28 than that of the PBAT scaffolds. Scanning electron microscope (SEM) photographs and energy dispersive X-ray (EDX) analysis indicated that hBMSCs produced high amounts of mineralized extracellular matrix (ECM) mainly on the surface of the 3 D matrices. This study demonstrates that boron-containing 3 D nanofibrous PBAT scaffolds with their osteoinductive and osteoconductive properties can be used as alternative constructs for bone tissue engineering.

Photostimulation of osteogenic differentiation on silk scaffolds by plasma arc light source.

Low-level laser therapy (LLLT) has been used for more than 30 years to heal wounds. In recent years, LLLT or photostimulation has been indicated as an effective tool for regenerative and dental medicine by using monochromatic light. The aim of this study is to indicate the usability of plasma arc light source for bone regeneration. This is why we used polychromatic light source providing effective wavelengths in the range of 590-1500 nm for cellular response and investigated photostimulation effects on osteogenic differentiation of human mesenchymal stem cells (hMSCs) seeded on 3D silk scaffolds. Cellular responses were examined by using cell culture methods in terms of proliferation, differentiation, and morphological analyses. The results showed that photostimulation with a polychromatic light source (applied for 5 min from the 3rd day after seeding up to the 28th day in 2-day intervals with 92-mW/cm2 power from 10-cm distance to the cells) enhanced osteogenic differentiation of hMSCs according to higher alkaline phosphatase (ALP) activity, collagen and calcium content, osteogenic gene expressions, and matrix mineralization. In conclusion, we suggest that the plasma arc light source that was used here has a great potential for bone regeneration.

Poly(butylene adipate-co-terephthalate) scaffolds: processing, structural characteristics and cellular responses.

The aliphatic-aromatic copolyester, poly(butylene adipate-co-terephthalate) (PBAT) combines good mechanical and thermal properties with biodegradation ability. However, until now, researches in its potential medical use remain limited. Only in a few studies blends of PBAT with routinely used biocompatible polymers had been prepared and investigated regarding tissue engineering applications. Therefore, in this study, we decided to determine processability of neat PBAT as a scaffold material for bone tissue by using different fabrication methods i.e. solvent evaporation, electrospinning, solvent casting-particulate leaching (SCPL) and melt molding-particulate leaching. The results of physicochemical characterizations and cell culture studies with MC3T3-E1 preosteoblasts confirmed that neat PBAT has favorable characteristics for bone tissue engineering, however, fabrication method strongly affects the cellular responses. Regarding to the characterizations and cell cultures, PBAT scaffolds produced by SCPL and electrospinning are proposed to be used for bone tissue engineering.

A Silk Fibroin and Peptide Amphiphile-Based Co-Culture Model for Osteochondral Tissue Engineering.

New biomaterials with the properties of both bone and cartilage extracellular matrices (ECM) should be designed and used with co-culture systems to address clinically applicable osteochondral constructs. Herein, a co-culture model is described based on a trilayered silk fibroin-peptide amphiphile (PA) scaffold cultured with human articular chondrocytes (hACs) and human bone marrow mesenchymal stem cells (hBMSCs) in an osteochondral cocktail medium for the cartilage and bone sides, respectively. The presence of hACs in the co-cultures significantly increases the osteogenic differentiation potential of hBMSCs based on ALP activity, RT-PCR for osteogenic markers, calcium analyses, and histological stainings, whereas hACs produces a significant amount of glycosaminoglycans (GAGs) for the cartilage region, even in the absence of growth factor TGF-ß family in the co-culture medium. This trilayered scaffold with trophic effects offers a promising strategy for the study of osteochondral defects.

The Effects of Occupational Therapy and Psychosocial Interventions on Interpersonal Functioning and Personal and Social Performance Levels of Corresponding Patients.

INTRODUCTION: In this study, we aimed to investigate the effects of occupational therapy and psychosocial interventions on the interpersonal functioning and individual and social performance levels of corresponding patients under the heading of psychosocial treatment approaches in psychiatry clinics as well as the attitudes of the patients in regard to those interventions. METHODS: In 2013, out of psychotic (schizophrenia, bipolar disorder/mania) and nonpsychotic (depression, obsessive compulsive disorder, alcohol dependence) inpatients in our clinic, 48 patients who participated in occupational activities were included in the study group and 43 patients who did not participate in these activities were included in the control group. We prepared and implemented a 3-item questionnaire constructed by our team, which probed the patients' thoughts on these occupational activities. The Interpersonal Functioning Scale (IFS) and Personal and Social Performance Scale (PSP) were applied to both groups on hospital admission and discharge; variations in scale scores were evaluated on par with sociodemographic variables, and the study and control groups were compared. RESULTS: In total, 91% of the study group provided positive feedback regarding the aforementioned interventions. When comparing the study and control groups, the IFS variance score of the study group did not show a significant difference with respect to that of the control group. A statistically significant difference (p<0.0001) was observed in the PSP scores. Evaluation of the PSP of the occupational activities, focusing on sociodemographics and diagnostic labels, revealed a significant improvement in nonpsychotic patients (p=0.002) compared with psychotic patients, in females (p=0.001) compared with males, in unemployed patients (p=0.0001) compared with employed patients, in single patients (p=0.002) compared with married patients, in less-educated patients (p=0.004) compared with high school graduates, and in patients younger than 45 years (p=0.002) compared with those older than 45 years. CONCLUSION: The findings of our study showed coherence with the literature regarding similar studies conducted on psychotic subgroups. The results demonstrated significantly positive repercussions, specifically in the treatment of nonpsychotic patients; both groups benefited from occupational activities, as shown by improvements in all psychiatric inpatients' PSP scores in comparison with scores of the control group. We concluded that the recruitment of psychosocial treatment approaches enhanced personal and social performance in the patient groups, thereby leading to additional clinical benefits.

Synergistic effect of exogeneous and endogeneous electrostimulation on osteogenic differentiation of human mesenchymal stem cells seeded on silk scaffolds.

Bioelectrical regulation of bone fracture healing is important for many cellular events such as proliferation, migration, and differentiation. The aim of this study was to investigate the osteogenic differentiation potential of human mesenchymal stem cells (hMSCs) cultivated on silk scaffolds in response to different modes of electrostimulation (e.g., exogeneous and/or endogeneous). Endogeneous electrophysiology was altered through the use of monensin (10 nM) and glibenclamide (10 µM), along with external electrostimulation (60 kHz; 100-500 mV). Monensin enhanced the expression of early osteogenic markers such as alkaline phosphatase (ALP) and runt-related transcription factor 2 (RUNX-2). When exogeneous electrostimulation was combined with glibenclamide, more mature osteogenic marker upregulation based on bone sialoprotein expression (BSP) and mineralization was found. These results suggest the potential to exploit both exogeneous and endogeneous biophysical control of cell functions towards tissue-specific goals.

Thermosensitive PHEMA microcarriers: ATRP synthesis, characterization, and usabilities in cell cultures.

In this study, we developed a novel microcarrier to enhance the production of anchorage-dependent mammalian cells in large scale by preserving them from the effects of shear forces and to enhance their removal from the surface without using proteolytic enzymes and chelating agents. This 'thermosensitive microcarrier' was synthesized by the grafting thermoresponsive molecule, N-isopropylacrylamide (NIPAAm), to the crosslinked poly(2-hydroxyethyl methacrylate) (PHEMA) beads by surface-initiated atom transfer radical polymerization. NIPAAm was polymerized on bromine-activated beads' surfaces to prepare PHEMA-g-PNIPAAm microcarriers. Then, they were chemically characterized by attenuated total reflectance Fourier transform infrared and electron spectroscopy for chemical analysis. Surface morphologies were further investigated by scanning electron microscope and atomic force microscopy techniques. The results of characterization studies confirmed that PNIPAAm was successfully grafted onto PHEMA beads by the means of atom transfer radical polymerization reaction. The cellular activities of PHEMA-g-PNIPAAm microcarriers were evaluated at static and dynamic culture conditions by using two types of cell lines with different morphology, i.e. L929 mouse fibroblasts and HS2 epithelial human keratinocytes. The microcarriers exhibited better cell adhesion and proliferation characteristics for both cell lines. Although their thermally induced cell detachment efficiencies are lower than that of trypsinization, thermally harvested cells preserved their surface morphologies and proliferation characteristics.

RGD-bearing peptide-amphiphile-hydroxyapatite nanocomposite bone scaffold: an in vitro study.

In this study, a fibrous nanocomposite scaffold was developed by combining hydroxyapatite (HA) fibers produced by electrospinning method and arginine-glycine-aspartic acid (RGD)-bearing peptide-amphiphile (PA) gel (PA-RGD) produced by self-assembly and gelation induced by calcium ions. Scanning electron microscope, transmission electron microscope and atomic force microscopy imaging confirmed the successful production of inorganic and organic components of this nanocomposite material. Within the HA, the presence of a CaCO3 phase, improving biodegradation, was shown by x-ray diffraction analysis. The in vitro effectiveness of the PA-RGD/HA scaffold was determined on MC3T3-E1 preosteoblast cultures in comparison with HA matrix and PA-RGD gel. The highest cellular proliferation was obtained on PA-RGD gel, however, alkaline phosphatase activity results denoted that osteogenic differentiation of the cells is more favorable on HA containing matrices with respect to PA-RGD itself. Microscopic observations revealed that all three matrices support cell attachment and proliferation. Moreover, cells form bridges between the HA and PA-RGD components of the nanocomposite scaffold, indicating the integrity of the biphasic components. According to the real time-polymerase chain reaction (RT-PCR) analyses, MC3T3-E1 cells expressed significantly higher osteocalcin on all matrices. Bone sialoprotein (BSP) expression level is ten-fold higher on PA-RGD/HA nanocomposite scaffolds than that of HA and PA-RGD scaffolds and the elevated expression of BSP on PA-RGD/HA nanocomposite scaffolds suggested higher mineralized matrix on this novel scaffold. Based on the results obtained in this study, the combination of HA nanofibers and PA-RGD gel takes advantage of good structural integrity during the cell culture, besides the osteoinductive and osteoconductive properties of the nanofibrous scaffold.

PNIPAAm-grafted thermoresponsive microcarriers: surface-initiated ATRP synthesis and characterization.

In this study, we developed novel thermoresponsive microcarriers as a powerful tool for cell culture and tissue engineering applications. For this purpose, two types of commercially available spherical microparticles (approximately 100 µm in diameter), dextran-based Sephadex® and vinyl acetate-based VA-OH (Biosynth®), were used and themoresponsive poly(N-isopropylacrylamide) (PNIPAAm) was grafted to the beads' surfaces by surface-initiated atom transfer radical polymerization (SI-ATRP). Initially, hydroxyl groups of microbeads were reacted with 2-bromopropionyl bromide to form ATRP macroinitiator. Then, NIPAAm was successfully polymerized from the initiator attached microbeads by ATRP with CuBr/2,2'-dipyridyl, catalyst complex. Furthermore, grafted and ungrafted microbeads were characterized by attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, scanning electron microscope (SEM), atomic force microscopy (AFM) and electron spectroscopy for chemical analysis (ESCA). The results of characterization studies confirmed that PNIPAAm was successfully grafted onto both dextran and vinyl acetate-based beads by means of ATRP reaction and thus, grafted microbeads gained thermoresponsive characteristics which will be evaluated for cell harvesting in further studies.