Advanced Hollow Cathode Discharge Plasma Treatment of Unique Bilayered Fibrous Nerve Guidance Conduits for Enhanced/Oriented Neurite Outgrowth.

Despite all recent progresses in nerve tissue engineering, critical-sized nerve defects are still extremely challenging to repair. Therefore, this study targets the bridging of critical nerve defects and promoting an oriented neuronal outgrowth by engineering innovative nerve guidance conduits (NGCs) synergistically possessing exclusive topographical, chemical, and mechanical cues. To do so, a mechanically adequate mixture of polycaprolactone (PCL) and polylactic-co-glycolic acid (PLGA) was first carefully selected as base material to electrospin nanofibrous NGCs simulating the extracellular matrix. The electrospinning process was performed using a newly designed 2-pole air gap collector that leads to a one-step deposition of seamless NGCs having a bilayered architecture with an inner wall composed of highly aligned fibers and an outer wall consisting of randomly oriented fibers. This architecture is envisaged to afford guidance cues for the extension of long neurites on the underlying inner fiber alignment and to concurrently provide a sufficient nutrient supply through the pores of the outer random fibers. The surface chemistry of the NGCs was then modified making use of a hollow cathode discharge (HCD) plasma reactor purposely designed to allow an effective penetration of the reactive species into the NGCs to eventually treat their inner wall. X-ray photoelectron spectroscopy (XPS) results have indeed revealed a successful O2 plasma modification of the inner wall that exhibited a significantly increased oxygen content (24 → 28%), which led to an enhanced surface wettability. The treatment increased the surface nanoroughness of the fibers forming the NGCs as a result of an etching effect. This effect reduced the ultimate tensile strength of the NGCs while preserving their high flexibility. Finally, pheochromocytoma (PC12) cells were cultured on the NGCs to monitor their ability to extend neurites which is the base of a good nerve regeneration. In addition to remarkably improved cell adhesion and proliferation on the plasma-treated NGCs, an outstanding neural differentiation occurred. In fact, PC12 cells seeded on the treated samples extended numerous long neurites eventually establishing a neural network-like morphology with an overall neurite direction following the alignment of the underlying fibers. Overall, PCL/PLGA NGCs electrospun using the 2-pole air gap collector and O2 plasma-treated using an HCD reactor are promising candidates toward a full repair of critical nerve damage.

A preclinical platform for assessing long-term drug efficacy exploiting mechanically tunable scaffolds colonized by a three-dimensional tumor microenvironment.

BACKGROUND: Long-term drug evaluation heavily relies upon rodent models. Drug discovery methods to reduce animal models in oncology may include three-dimensional (3D) cellular systems that take into account tumor microenvironment (TME) cell types and biomechanical properties. METHODS: In this study we reconstructed a 3D tumor using an elastic polymer (acrylate-endcapped urethane-based poly(ethylene glycol) (AUPPEG)) with clinical relevant stiffness. Single cell suspensions from low-grade serous ovarian cancer (LGSOC) patient-derived early passage cultures of cancer cells and cancer-associated fibroblasts (CAF) embedded in a collagen gel were introduced to the AUPPEG scaffold. After self-organization in to a 3D tumor, this model was evaluated by a long-term (> 40 days) exposure to a drug combination of MEK and HSP90 inhibitors. The drug-response results from this long-term in vitro model are compared with drug responses in an orthotopic LGSOC xenograft mouse model. RESULTS: The in vitro 3D scaffold LGSOC model mimics the growth ratio and spatial organization of the LGSOC. The AUPPEG scaffold approach allows to test new targeted treatments and monitor long-term drug responses. The results correlate with those of the orthotopic LGSOC xenograft mouse model. CONCLUSIONS: The mechanically-tunable scaffolds colonized by a three-dimensional LGSOC allow long-term drug evaluation and can be considered as a valid alternative to reduce, replace and refine animal models in drug discovery.

Unraveling Exclusive In-Plasma Initiated Oxidation Processes Occurring at Polymeric Surfaces upon O2 Admixtures to Medium Pressure Ar and N2 DBD Treatments.

Polymeric surfaces have been increasingly plasma-activated to adopt adequate chemistries, enabling their use in different applications. An unavoidable surface oxygen insertion upon exposure to non-oxygen-containing plasmas was always observed and mainly attributed to in-plasma oxidation stemming from O2 impurities in plasma reactors. Therefore, this work investigates exclusive in-plasma oxidation processes occurring on polyethylene surfaces by purposely admixing different O2 concentrations to medium-pressure Ar and N2 dielectric barrier discharges (base pressure: 10-7 kPa). Hence, distinctive optical emission spectroscopy and in-situ X-ray photoelectron spectroscopy (XPS) data were carefully correlated. Pure N2 discharge triggered an unprecedented surface incorporation of large nitrogen (29%) and low oxygen (3%) amounts. A steep rise in the O-content (10%) at the expense of nitrogen (15%) was detected upon the addition of 6.2 × 10-3% of O2 to the feed gas. When the added O2 exceeded 1%, the N content was completely quenched. Around 8% of surface oxygen was detected in Ar plasma due to high-energy Ar metastables creating more surface radicals that reacted with O2 impurities. When adding only 6.2 × 10-3% of O2 to Ar, the surface O content considerably increased to 12%. Overall, in-plasma oxidation caused by O2 impurities can strikingly change the surface chemistry of N2 and Ar plasma-treated polymers.

3D high-precision melt electro written polycaprolactone modified with yeast derived peptides for wound healing.

In this study melt electro written (MEW) scaffolds of poly(ε-caprolactone) PCL are decorated with anti-inflammatory yeast-derived peptide for skin wound healing. Initially, 13 different yeast-derived peptides were screened and analyzed using both in vitro and in vivo assays. The MEW scaffolds are functionalized with the selected peptide VLSTSFPPW (VW-9) with the highest activity in reducing pro-inflammatory cytokines and stimulating fibroblast proliferation, migration, and collagen production. The peptide was conjugated to the MEW scaffolds using carbodiimide (CDI) and thiol chemistry, with and without plasma treatment, as well as by directly mixing the peptide with the polymer before printing. The MEW scaffolds modified using CDI and thiol chemistry with plasma treatment showed improved fibroblast and macrophage penetration and adhesion, as well as increased cell proliferation and superior anti-inflammatory properties, compared to the other groups. When applied to full-thickness excisional wounds in rats, the peptide-modified MEW scaffold significantly enhanced the healing process compared to controls (p < 0.05). This study provides proof of concept for using yeast-derived peptides to functionalize biomaterials for skin wound healing.

Multifaceted polymeric nerve guidance conduits with distinctive double-layered architecture and plasma-induced inner chemistry gradient for the repair of critical-sized defects.

Despite tissue engineering advances, current nerve guidance conduits (NGCs) are still failing in repairing critical-sized defects. This study aims, therefore, at tackling large nerve gaps (2 cm) by designing NGCs possessing refined physicochemical properties enhancing the activity of Schwann cells (SCs) that support nerve regeneration over long distances. As such, a combinatorial strategy adopting novel plasma-induced surface chemistry and architectural heterogeneity was considered. A mechanically suitable copolymer (Polyactive®) was electrospun to produce nanofibrous NGCs mimicking the extracellular matrix. An innovative seamless double-layered architecture consisting of an inner wall comprised of bundles of aligned fibers with intercalated random fibers and an outer wall fully composed of random fibers was conceived to synergistically provide cell guidance cues and sufficient nutrient inflow. NGCs were subjected to argon plasma treatments using a dielectric barrier discharge (DBD) and a plasma jet (PJ). Surface chemical changes were examined by advanced X-ray photoelectron spectroscopy (XPS) micro-mappings. The DBD homogeneously increased the surface oxygen content from 17 % to 28 % on the inner wall. The PJ created a gradient chemistry throughout the inner wall with an oxygen content gradually increasing from 21 % to 30 %. In vitro studies revealed enhanced primary SC adhesion, elongation and proliferation on plasma-treated NGCs. A cell gradient was observed on the PJ-treated NGCs thus underlining the favorable oxygen gradient in promoting cell chemotaxis. A gradual change from circular to highly elongated SC morphologies mimicking the bands of Büngner was visualized along the gradient. Overall, plasma-treated NGCs are promising candidates paving the way towards critical nerve gap repair.

Combinatorial effects of non-thermal plasma oxidation processes and photocatalytic activity on the inactivation of bacteria and degradation of toxic compounds in wastewater.

The simultaneous presence of hazardous chemicals and pathogenic microorganisms in wastewater is tremendously endangering the environment and human health. Therefore, developing a mitigation strategy for adequately degrading toxic compounds and inactivating/killing microorganisms is urgently needed to protect ecosystems. In this paper, the synergetic effects of the photocatalytic activity of TiO2 and Cu-TiO2 nanoparticles (NPs) and the oxidation processes of non-thermal atmospheric pressure plasma (NTAPP) were comprehensively investigated for both the inactivation/killing of common water contaminating bacteria (Escherichia coli (E. coli)) and the degradation of direct textile wastewater (DTW). The photocatalytic NPs were synthesized using the hydrothermal method and further characterized employing field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), ultraviolet-visible diffuse reflection spectroscopy (UV-Vis DRS) and photoluminescence (PL). Results revealed the predominant presence of the typical anatase phase for both the flower-like TiO2 and the multipod-like Cu-TiO2 structures. UV-Vis DRS and PL analyses showed that the addition of Cu dopants reduced the bandgap and increased oxygen defect vacancies of TiO2. The inactivation of E. coli in suspension and degradation of DTW were then examined upon treating the aqueous media with various plasma alone and plasma/NPs conditions (Ar plasma, Ar + O2 plasma and Ar + N2 plasma, Ar plasma + TiO2 NPs and Ar plasma + Cu-TiO2 NPs). Primary and secondary excited species such as OH˙, O, H and N2* generated in plasma during the processes were recognized by in situ optical emission spectrometry (OES) measurements. Several other spectroscopic analyses were further employed to quantify some reactive oxygen species (ROS) such as OH, H2O2 and O3 generated during the processes. Moreover, the changes in the pH and electrical conductivity (EC) of the solutions were also assessed. The inactivation of bacteria was examined by the colony-forming unit (CFU) method after plating the treated suspensions on agar, and the degradation of organic compounds in DTW was further validated by measuring the total organic carbon (TOC) removal efficiency. All results collectively revealed that the combinatorial plasma-photocatalysis strategy involving Cu-TiO2 NPs and argon plasma jet produced higher concentrations of ROS and proved to be a promising one-step wastewater treatment effectively killing microorganisms and degrading toxic organic compounds.

Silanization of Plasma-Activated Hexamethyldisiloxane-Based Plasma Polymers for Substrate-Independent Deposition of Coatings with Controlled Surface Chemistry.

Plasma polymerization has emerged as an appealing technique for surface modification because of its advantages over a variety of conventional techniques, including ease-of-use and the possibility to modify nearly any substrate. One of the main challenges of plasma polymer-based surface modification, however, is having control over the coating chemistry, as plasma deposition generates a diversity of chemical structures. Therefore, this study presents an alternative plasma-based method for the fabrication of coatings that contain selective functionalities. In a first step, hexamethyldisiloxane (HMDSO) plasma polymerization is performed in a medium-pressure dielectric barrier discharge (DBD) to deposit polydimethylsiloxane (PDMS)-like coatings. In a second step, this coating is exposed to an air plasma in a similar DBD setup to introduce silanol groups on the surface. These groups are used in a third and final step as anchoring points for grafting of (3-aminopropyl)triethoxysilane (APTES) and (3-bromopropyl)trichlorosilane (BrPTCS) to selectively introduce amino or bromo groups, respectively. X-ray photoelectron spectroscopy (XPS) and water contact angle (WCA) measurements indicated that the first two steps were successful. Moreover, the coating could be synthesized on three different surfaces, namely, glass, ultrahigh-molecular-weight polyethylene, and polytetrafluoroethylene, indicating the wide applicability of the developed procedure. Afterward, XPS also proved that the APTES and BrPTCS grafting resulted in the formation of a coating containing primary amines and alkyl bromides, respectively, in combination with an organosilicon matrix containing silanol groups as remaining reactive groups, proving the successful synthesis of selective functional plasma-based coatings. The intermediate air-plasma-activation step was demonstrated to be necessary for successful and stable grafting of the final layer. In conclusion, this study established a general procedure for the development of coatings with selective functionality that can be applied on a wide variety of substrates for, e.g., biosensor applications, biomolecule, or polymer immobilization or for the synthesis of antibacterial coatings.

Polylactic Acid/Polyaniline Nanofibers Subjected to Pre- and Post-Electrospinning Plasma Treatments for Refined Scaffold-Based Nerve Tissue Engineering Applications.

Composite biopolymer/conducting polymer scaffolds, such as polylactic acid (PLA)/ polyaniline (PAni) nanofibers, have emerged as popular alternative scaffolds in the electrical-sensitive nerve tissue engineering (TE). Although mimicking the extracellular matrix geometry, such scaffolds are highly hydrophobic and usually present an inhomogeneous morphology with massive beads that impede nerve cell-material interactions. Therefore, the present study launches an exclusive combinatorial strategy merging successive pre- and post-electrospinning plasma treatments to cope with these issues. Firstly, an atmospheric pressure plasma jet (APPJ) treatment was applied on PLA and PLA/PAni solutions prior to electrospinning, enhancing their viscosity and conductivity. These liquid property changes largely eliminated the beaded structures on the nanofibers, leading to uniform and nicely elongated fibers having average diameters between 170 and 230 nm. After electrospinning, the conceived scaffolds were subjected to a N2 dielectric barrier discharge (DBD) treatment, which significantly increased their surface wettability as illustrated by large decreases in water contact angles for values above 125° to values below 25°. X-ray photoelectron spectroscopy (XPS) analyses revealed that 3.3% of nitrogen was implanted on the nanofibers surface in the form of C-N and N-C=O functionalities upon DBD treatment. Finally, after seeding pheochromocytoma (PC-12) cells on the scaffolds, a greatly enhanced cell adhesion and a more dispersive cell distribution were detected on the DBD-treated samples. Interestingly, when the APPJ treatment was additionally performed, the extension of a high number of long neurites was spotted leading to the formation of a neuronal network between PC-12 cell clusters. In addition, the presence of conducting PAni in the scaffolds further promoted the behavior of PC-12 cells as illustrated by more than a 40% increase in the neurite density without any external electrical stimulation. As such, this work presents a new strategy combining different plasma-assisted biofabrication techniques of conducting nanofibers to create promising scaffolds for electrical-sensitive TE applications.

Synthesis of antibacterial composite coating containing nanocapsules in an atmospheric pressure plasma.

Antibacterial coating is an important strategy preventing bacterial colonization and biofilm formation. One-step synthesis of nanocapsule-containing antibacterial coatings with controlled release of Ag+ ions was achieved in the current work by aerosol-assisted atmospheric pressure plasma deposition. The experimental parameters of deposition including the discharge power, silver nitrate concentration, aerosol flow rate, continuous and pulsed mode of operation were studied in order to analyze their effects on surface morphology and chemical composition of the coating. Formation of nanocapsules embedded in the polymeric coating was observed. A core-shell structure was found for nanocapsule with silver in the core and polymer in the shell. Antibacterial coatings on polyethylene terephthalate film were studied in terms of Ag+ ion release, antibacterial properties against Escherichia coli and Staphylococcus aureus, and cytotoxicity with murine fibroblasts. Two-phase release kinetics of Ag+ ions was observed as initially a short-term burst release followed by a long-term slow release. It was revealed that high antibacterial efficiency of the coatings deposited on polyethylene terephthalate films can be coupled with low cytotoxicity. These biocompatible antibacterial coatings are very promising in different fields including biological applications.

Combinatorial effects of coral addition and plasma treatment on the properties of chitosan/polyethylene oxide nanofibers intended for bone tissue engineering.

Given the complex calcified nature of the fibrous bone tissue, a combinatorial approach merging specific topographical/biochemical cues was adopted to design bone tissue-engineered scaffolds. Coral having a Ca-enriched structure was added to electrospun chitosan (CS)/polyethylene oxide (PEO) nanofibers that were subjected to plasma surface modifications using a medium pressure Ar, air or N2 dielectric barrier discharge. Plasma incorporated oxygen- and nitrogen-containing functionalities onto the nanofibers surface thus enhancing their wettability. Plasma treatment enhanced the performance of osteoblasts and the interplay between plasma treatment and coral was shown to boost initial cell adhesion. The fibers capacity to trigger calcium phosphate growth was predicted via immersion in simulated body fluid. Globular carbonate apatite nanocrystals were deposited on plasma-treated CS/PEO NFs while thicker layers of flake-like nanocrystals were covering plasma-treated Coral/CS/PEO fibers without blocking the interfibrous pores. Overall, the exclusive multifaceted plasma-treated Coral/CS/PEO nanofibers are believed to revolutionize the bone tissue engineering field.

Dye wastewater degradation by the synergetic effect of an atmospheric pressure plasma treatment and the photocatalytic activity of plasma-functionalized Cu‒TiO2 nanoparticles.

In this paper, the photocatalytic activity of plasma-functionalized Cu-doped TiO2 nanoparticles (NPs) and the oxidization process of atmospheric pressure plasma jet were combined for the degradation of reactive red-198 (RR-198) in aqueous solution. The first part of the study was thus devoted to subject Cu-‒TiO2 NPs synthetized by the sol-gel method to various plasma treatments operating in air, argon, oxygen and nitrogen to improve their degradation efficiency. The physicochemical properties of the NPs were then assessed by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM) measurements. XRD results indicated the predominant presence of the anatase phase which is the most photoactive form of TiO2. The XPS analysis revealed that the different plasma treatments triggered the formation of oxygen vacancies, Ti3+ oxidation state and Cu2+ oxidation state on the surface of Cu-‒TiO2 NPs. These changes, known to prevent the recombination of electron-hole pair, have led to a reduction in the bandgap that was more pronounced for the N2 plasma-treated NPs. The second part of the paper explored the actual degradation of RR-198 in aqueous solution by an Ar plasma treatment alone or combined with the plasma pre-treated Cu-‒TiO2 NPs. Optical emission spectroscopy (OES) and spectrophotometric analyses showed that the synergetic effect of Ar plasma and N2 plasma-treated NPs produced the highest concentration of OH• radicals and H2O2 species which led to the highest RR-198 degradation efficiency. This was further confirmed by pH, electrical conductivity and total organic carbon (TOC) removal measurements. The degradation of RR-198 was determined using UV-Vis spectroscopy and high-performance liquid chromatography (HPLC). Overall, it can be concluded that plasma-assisted processes illustrated by a combination of a direct plasma treatment with plasma-functionalized Cu-‒TiO2 NPs can be used in various textile and pharmaceutical industries as a highly effective treatment of their effluents before discharging.

Experience of follow-up, quality of life, and transition from pediatric to adult healthcare of patients with tuberous sclerosis complex.

INTRODUCTION: Tuberous sclerosis complex (TSC) is a multisystemic genetic disease with high clinical variability and age-related manifestations. These characteristics add to the complexity of transition to adulthood. This study aimed to explore the perception of medical follow-up and transition experience in a large group of patients with TSC who presented epilepsy in childhood. METHOD: This multicenter French study included patients with TSC aged 18 years or older who developed epilepsy before the age of 16 years. A questionnaire specifically designed for the study explored patients' opinion through 270 questions covering different aspects of their social, familial, professional, and medical courses. RESULTS: The questionnaire was sent to 72 patients, and 60 patients were included in the study (83% response rate) with a mean age of 32 years (18-55 years). Cognitive impairment was present in 80% of patients, and half of questionnaires were completed by the family. Pediatric care was coordinated by the child neurologist and was more regular and multidisciplinary than adult care. Epilepsy had the best follow-up followed by renal issues. Unmet needs were identified for psychiatric and behavioral disorders, both in children and adults. Respondents considered the help in achieving autonomy better in adult care. Only 50% of patients with a normal intellectual development had clear knowledge about their disease and the need for a regular monitoring. Two-thirds of respondents estimated that they had a transition experience between 16.5 and 21-year-old, considered as good in 60% of them. Seventy percent felt continuity between pediatric and adult care, and only 3% of respondents felt that their care would have been better if they were still followed in pediatric healthcare system. The change of care structure and/or caregivers was the most stressful factor during transition and transfer. CONCLUSION: This study highlights persistent issues in the regularity and coordination of the follow-up of patients with TSC despite established international guidelines. Although most patients had a positive transition experience, there is still an urgent need to optimize transition programs. This would be essential to maintain care continuity between pediatric and adult health systems, especially for patients with TSC with epilepsy and high rate of cognitive and psychiatric impairments.

Acrylic Acid Plasma Coated 3D Scaffolds for Cartilage tissue engineering applications.

The current generation of tissue engineered additive manufactured scaffolds for cartilage repair shows high potential for growing adult cartilage tissue. This study proposes two surface modification strategies based on non-thermal plasma technology for the modification of poly(ethylene oxide terephthalate/poly(butylene terephthalate) additive manufactured scaffolds to enhance their cell-material interactions. The first, plasma activation in a helium discharge, introduced non-specific polar functionalities. In the second approach, a carboxylic acid plasma polymer coating, using acrylic acid as precursor, was deposited throughout the scaffolds. Both surface modifications were characterized by significant changes in wettability, linked to the incorporation of new oxygen-containing functional groups. Their capacity for chondrogenesis was studied using ATDC5 chondroblasts as a model cell-line. The results demonstrate that the carboxylic acid-rich plasma coating had a positive effect on the generation of the glucoaminoglycans (GAG) matrix and stimulated the migration of cells throughout the scaffold. He plasma activation stimulated the formation of GAGs but did not stimulate the migration of chondroblasts throughout the scaffolds. Both plasma treatments spurred chondrogenesis by favoring GAG deposition. This leads to the overall conclusion that acrylic acid based plasma coatings exhibit potential as a surface modification technique for cartilage tissue engineering applications.

Heterocellular 3D scaffolds as biomimetic to recapitulate the tumor microenvironment of peritoneal metastases in vitro and in vivo.

Peritoneal metastasis is a major cause of death and preclinical models are urgently needed to enhance therapeutic progress. This study reports on a hybrid hydrogel-polylactic acid (PLA) scaffold that mimics the architecture of peritoneal metastases at the qualitative, quantitative and spatial level. Porous PLA scaffolds with controllable pore size, geometry and surface properties are functionalized by type I collagen hydrogel. Co-seeding of cancer-associated fibroblasts (CAF) increases cancer cell adhesion, recovery and exponential growth by in situ heterocellular spheroid formation. Scaffold implantation into the peritoneum allows long-term follow-up (>14 weeks) and results in a time-dependent increase in vascularization, which correlates with cancer cell colonization in vivo. CAF, endothelial cells, macrophages and cancer cells show spatial and quantitative aspects as similarly observed in patient-derived peritoneal metastases. CAF provide long-term secretion of complementary paracrine factors implicated in spheroid formation in vitro as well as in recruitment and organization of host cells in vivo. In conclusion, the multifaceted heterocellular interactions that occur within peritoneal metastases are reproduced in this tissue-engineered implantable scaffold model.

Effects of different sterilization methods on the physico-chemical and bioresponsive properties of plasma-treated polycaprolactone films.

For most tissue engineering applications, surface modification and sterilization of polymers are critical aspects determining the implant success. The first part of this study is thus dedicated to modifying polycaprolactone (PCL) surfaces via plasma treatment using a medium pressure dielectric barrier discharge, while the second part focuses on the sterilization of plasma-modified PCL. Chemical and physical surface changes are examined making use of water contact angle goniometry (WCA), x-ray photoelectron spectroscopy and atomic force microscopy. Bioresponsive properties are evaluated by performing cell culture tests. The results show that air and argon plasmas decrease the WCA significantly due to the incorporation of oxygen-containing functionalities onto the PCL surface, without modifying its morphology. Extended treatment times lead to PCL degradation, especially in the case of air plasma. In addition to surface modification, the plasma potential to sterilize PCL is studied with appropriate treatment times, but sterility has not been achieved so far. Therefore, plasma-modified films are subjected to UV, H2O2 plasma (HP) and ethylene oxide (EtO) sterilizations. UV exposure of 3 h does not alter the PCL physico-chemical properties. A decreased wettability is observed after EtO sterilization, attributable to the modification of PCL chain ends reacting with EtO molecules. HP sterilization increases the WCA of the plasma-treated samples, presumably due to the scission of the hydrophilic bonds generated during the prior plasma treatments. Moreover, HP modifies the PCL surface morphology. For all the sterilizations, an improved cell adhesion and proliferation is observed on plasma-treated films compared to untreated ones. EtO shows the lowest proliferation rate compared to HP and UV. Overall, of the three sterilizations, UV is the most effective, since the physical alterations provoked by HP might interfere with the structural integrity when it comes to 3D scaffolds, and the chemical modifications caused by EtO, in addition to its toxicity, interfere with PCL bioactivity.