Innovations in hydrogel-based manufacturing: A comprehensive review of direct ink writing technique for biomedical applications.

Direct ink writing (DIW) stands as a pioneering additive manufacturing technique that holds transformative potential in the field of hydrogel fabrication. This innovative approach allows for the precise deposition of hydrogel inks layer by layer, creating complex three-dimensional structures with tailored shapes, sizes, and functionalities. By harnessing the versatility of hydrogels, DIW opens up possibilities for applications spanning from tissue engineering to soft robotics and wearable devices. This comprehensive review investigates DIW as applied to hydrogels and its multifaceted applications. The paper introduces a diverse range of printing techniques while providing a thorough exploration of DIW for hydrogel-based printing. The investigation aims to explain the progress made, challenges faced, and potential trajectories that lie ahead for DIW in hydrogel-based manufacturing. The fundamental principles underlying DIW are carefully examined, specifically focusing on rheological attributes and printing parameters, prompting a comprehensive survey of the wide variety of hydrogel materials. These encompass both natural and synthetic variations, all of which can be effectively harnessed for this purpose. Furthermore, the review explores the latest applications of DIW for hydrogels in biomedical areas, with a primary focus on tissue engineering, wound dressing, and drug delivery systems. The document not only consolidates the existing state of DIW within the context of hydrogel-based manufacturing but also charts potential avenues for further research and innovative breakthroughs.

Direct ink writing of biocompatible chitosan/non-isocyanate polyurethane/cellulose nanofiber hydrogels for wound-healing applications.

The demand for new biocompatible and 3D printable materials for biomedical applications is on the rise. Ideally, such materials should exhibit either biodegradability or recyclability, possess antibacterial properties, and demonstrate remarkable biocompatibility with no cytotoxic effects. In this research, we synthesized biocompatible and 3D printable hydrogels tailored for biomedical applications, such as wound healing films, by combining antibacterial double-quaternized chitosan (DQC) with cystamine-based non-isocyanate polyurethane (NIPU-Cys) - a material renowned for enhancing both the flexibility and mechanical properties of the hydrogels. To improve the rheological behavior, swelling attributes, and printability, cellulose nanofibrils were introduced into the matrix. We investigated the impact of DQC on degradability, swelling capacity, rheological behavior, printability, and cell biocompatibility. The slightly cytotoxic nature associated with quaternary chitosan was evaluated, and the optimal concentration of DQC in the hydrogel was determined to ensure biocompatibility. The resulting hydrogels were found to be suitable materials for 3D printing via a direct ink writing technique (DIW), producing porous, biocompatible hydrogels endowed with valuable attributes suitable for various wound-healing applications.

Lignin beyond the status quo: recent and emerging composite applications.

The demand for biodegradable materials across various industries has recently surged due to environmental concerns and the need for the adoption of renewable materials. In this context, lignin has emerged as a promising alternative, garnering significant attention as a biogenic resource that endows functional properties. This is primarily ascribed to its remarkable origin and structure that explains lignin's capacity to bind other molecules, reinforce composites, act as an antioxidant, and endow antimicrobial effects. This review summarizes recent advances in lignin-based composites, with particular emphasis on innovative methods for modifying lignin into micro and nanostructures and evaluating their functional contribution. Indeed, lignin-based composites can be tailored to have superior physicomechanical characteristics, biodegradability, and surface properties, thereby making them suitable for applications beyond the typical, for instance, in ecofriendly adhesives and advanced barrier technologies. Herein, we provide a comprehensive overview of the latest progress in the field of lignin utilization in emerging composite materials.

In Vitro and In Vivo Degradation of Photo-Crosslinked Poly(Trimethylene Carbonate-co-ε-Caprolactone) Networks.

Three-armed poly(trimethylene carbonate) (PTMC) and poly(trimethylene carbonate-co-Ɛ-caprolactone) (P(TMC-co-ε-CL)) macromers with molecular weights of approximately 30 kg mol-1 are synthesized by ring-opening polymerization and subsequent functionalization with methacrylic anhydride. Networks are then prepared by photo-crosslinking. To investigate the in vitro and in vivo degradation properties of these photo-crosslinked networks and assess the effect of ε-caprolactone content on the degradation properties, PTMC networks, and copolymer networks with two different TMC:ε-CL ratios are prepared. PTMC networks degraded slowly, via an enzymatic surface erosion process, both in vitro and in vivo. Networks prepared from P(TMC-co-ε-CL) macromers with a 74:26 ratio are found to degrade slowly as well, via a surface erosion process, albeit at a higher rate compared to PTMC networks. Increasing the ε-CL content to a ratio of 52:48, resulted in a faster degradation. These networks lost their mechanical properties much sooner than the other networks. Thus, PTMC and P(TMC-co-ε-CL) networks are interesting networks for tissue engineering purposes and the exact degradation properties can be tuned by varying the TMC:ε-CL ratio, providing researchers with a tool to obtain copolymer networks with the desired degradation rate depending on the intended application.

Dual functional quaternary chitosans with thermoresponsive behavior: structure-activity relationships in antibacterial activity and biocompatibility.

Cationically modified chitosan derivatives exhibit a range of appealing characteristics, with a particular emphasis on their antimicrobial potential across a broad spectrum of biomedical applications. This study aimed to delve deeper into quaternary chitosan (QC) derivatives. Through the synthesis of both homogeneously and heterogeneously dual-quaternized chitosan (DQC), utilizing AETMAC ([2-(acryloyloxy)ethyl]-trimethylammonium chloride) and GTMAC (glycidyl trimethylammonium chloride), a permanent charge was established, spanning a wide pH range. We assessed structural differences, the type of quaternary functional group, molecular weight (Mw), and charge density. Intriguingly, an upper critical solution temperature (UCST) behavior was observed in AETMAC-functionalized QC. To our knowledge, it is a novel discovery in cationically functionalized chitosan. These materials demonstrated excellent antimicrobial efficacy against model test organisms E. coli and P. syringae. Furthermore, we detected concentration-dependent cytotoxicity in NIH-3T3 fibroblasts. Striking a balance between antimicrobial activity and cytotoxicity becomes a crucial factor in application feasibility. AETMAC-functionalized chitosan emerges as the top performer in terms of overall antibacterial effectiveness, possibly owing to factors like molecular weight, charge characteristics, and variations in the quaternary linker. Quaternary chitosan derivatives, with their excellent antibacterial attributes, hold significant promise as antibacterial or sanitizing agents, as well as across a broad spectrum of biomedical and environmental contexts.

Strontium-Substituted Nanohydroxyapatite-Incorporated Poly(lactic acid) Composites for Orthopedic Applications: Bioactive, Machinable, and High-Strength Properties.

Traditional metal-alloy bone fixation devices provide structural support for bone repair but have limitations in actively promoting bone healing and often require additional surgeries for implant removal. In this study, we focused on addressing these challenges by fabricating biodegradable composites using poly(lactic acid) (PLA) and strontium-substituted nanohydroxyapatite (SrHAP) via melt compounding and injection molding. Various percentages of SrHAP (5, 10, 20, and 30% w/w) were incorporated into the PLA matrix. We systematically investigated the structural, morphological, thermal, mechanical, rheological, and dynamic mechanical properties of the prepared composites. Notably, the tensile modulus, a critical parameter for orthopedic implants, significantly improved from 2.77 GPa in pristine PLA to 3.73 GPa in the composite containing 10% w/w SrHAP. The incorporation of SrHAP (10% w/w) into the PLA matrix led to an increased storage modulus, indicating a uniform dispersion of SrHAP within the PLA and good compatibility between the polymer and nanoparticles. Moreover, we successfully fabricated screws using PLA composites with 10% (w/w) SrHAP, demonstrating their formability at room temperature and radiopacity when observed under X-ray microtomography (micro-CT). Furthermore, the water contact angle decreased from 93 ± 2° for pristine PLA to 75 ± 3° for the composite containing SrHAP, indicating better surface wettability. To assess the biological behavior of the composites, we conducted in vitro cell-material tests, which confirmed their osteoconductive and osteoinductive properties. These findings highlight the potential of our developed PLA/SrHAP10 (10% w/w) composites as machinable implant materials for orthopedic applications. In conclusion, our study presents the fabrication and comprehensive characterization of biodegradable composites comprising PLA and strontium-substituted nanohydroxyapatite (SrHAP). These composites exhibit improved mechanical properties, formability, and radiopacity while also demonstrating desirable biological behavior. Our results suggest that these PLA/SrHAP10 composites hold promise as machinable implant materials for orthopedic applications.

Heat-Induced Actuator Fibers: Starch-Containing Biopolyamide Composites for Functional Textiles.

This study introduces the development of a thermally responsive shape-morphing fabric using low-melting-point polyamide shape memory actuators. To facilitate the blending of biomaterials, we report the synthesis and characterization of a biopolyamide with a relatively low melting point. Additionally, we present a straightforward and solvent-free method for the compatibilization of starch particles with the synthesized biopolyamide, aiming to enhance the sustainability of polyamide and customize the actuation temperature. Subsequently, homogeneous dispersion of up to 70 wt % compatibilized starch particles into the matrix is achieved. The resulting composites exhibit excellent mechanical properties comparable to those reported for soft and tough materials, making them well suited for textile integration. Furthermore, cyclic thermomechanical tests were conducted to evaluate the shape memory and shape recovery of both plain polyamide and composites. The results confirmed their remarkable shape recovery properties. To demonstrate the potential application of biocomposites in textiles, a heat-responsive fabric was created using thermoresponsive shape memory polymer actuators composed of a biocomposite containing 50 wt % compatibilized starch. This fabric demonstrates the ability to repeatedly undergo significant heat-induced deformations by opening and closing pores, thereby exposing hidden functionalities through heat stimulation. This innovative approach provides a convenient pathway for designing heat-responsive textiles, adding value to state-of-the-art smart textiles.

Quaternized Chitosan Derivatives as Viable Antiviral Agents: Structure-Activity Correlations and Mechanisms of Action.

Cationic polysaccharides have demonstrated significant antimicrobial properties and have great potential in medical applications, where the antiviral activity is of great interest. As of today, alcohols and oxidizing agents are commonly used as antiviral disinfectants. However, these compounds are not environmentally safe, have short activity periods, and may cause health issues. Therefore, this study aimed to develop metal-free and environmentally friendly quaternary chitosans (QCs) with excellent long-lasting virucidal activity. To evaluate this, both single and double QCs were obtained using AETMAC ([2-(acryloyloxy)ethyl]-trimethylammonium chloride) and GTMAC (glycidyl trimethylammonium chloride) quaternary precursors. Further, this study investigated the influence of the quaternary functional group, charge density, and molecular weight (Mw) on the antiviral properties of QCs. It is proposed that the higher charge density, along with the length of alkyl linkers, and hydrophobic interactions affected the antiviral activity of QCs. The findings demonstrated that heterogeneously functionalized chitosan exhibited excellent antiviral activity against both the enveloped virus φ6 and the nonenveloped viruses φX174 and MS2. These quaternized chitosan derivatives have promising potential as viable antiviral agents, as hand/surface sanitizers, or in other biomedical applications.

Direct and Indirect Cationization of Cellulose Nanocrystals: Structure-Properties Relationship and Virus Capture Activity.

Due to increasing public concern over hygiene, there have been many studies investigating antimicrobial and antiviral agents recently. With the aim of developing biobased virucidal/virus capture agents, we report a chemical modification of the cellulose nanocrystals (CNCs) surface with poly(2-dimethylamino) ethyl acrylate) methyl chloride quaternary salt (Q-PDMAEA) to introduce the positively charged functional groups. The surface of CNCs was modified through direct and indirect graft polymerization. Subsequently, the direct and indirect cationization effect on the degree of functionalization, thermal stability, crystallinity, and antiviral activity of CNCs was investigated. Indirect cationization produced the highest degree of polymer grafting, increasing particle size and thermal stability. Further, the modified CNCs were tested for their ability to capture nonenveloped bacteriophages PhiX174 (ΦX174) and MS2. We observed a significant (>4.19 log10) reduction in total viral load by specific functionalized CNCs. However, the activity depended on the structure of functional groups, surface charge density, and the type of virus under study. Overall, the direct and indirect cationization of CNC leads to biobased agents with immobilized cationic charge, with good virus capture activity. Such agents can be used for various applications including textiles, packaging, wastewater treatment, etc.

Dataset from a mesocosm experiment on brownification in the Baltic Sea.

Climate change is projected to cause brownification of some coastal seas due to increased runoff of terrestrially derived organic matter. We carried out a mesocosm experiment over 15 days to test the effect of this on the planktonic ecosystem. The experiment was set up in 2.2 m3 plastic bags moored outside the Tvärminne Zoological Station at the SW coast of Finland. We used four treatments, each with three replicates: control (Contr) without any manipulation; addition of a commercially available organic carbon additive called HuminFeed (Hum; 2 mg L-1); addition of inorganic nutrients (Nutr; 5.7 µM NH4 and 0.65µM PO4); and a final treatment of combined Nutr and Hum (Nutr+Hum) additions. Water samples were taken daily, and measured variables included water transparency, organic and inorganic nutrient pools, chlorophyll a (Chla), primary and bacterial production and particle counts by flow cytometry.

Brownification affects phytoplankton community composition but not primary productivity in eutrophic coastal waters: A mesocosm experiment in the Baltic Sea.

Climate change is projected to cause brownification of some coastal seas due to increased runoff of terrestrially derived organic matter. We carried out a mesocosm experiment (15 d) to test the effect of this on the planktonic ecosystem expecting reduced primary production and shifts in the phytoplankton community composition. The experiment was set up in 2.2 m3 mesocosm bags using four treatments, each with three replicates: control (Contr) without any manipulation, organic carbon additive HuminFeed (Hum; 2 mg L-1), inorganic nutrients (Nutr; 5.7 µM NH4 and 0.65 µM PO4), and combined Nutr and Hum (Nutr + Hum) additions. Measured variables included organic and inorganic nutrient pools, chlorophyll a (Chla), primary and bacterial production and particle counts by flow cytometry. The bags with added inorganic nutrients developed a phytoplankton bloom that depleted inorganic N at day 6, followed by a rapid decline in Chla. Brownification did not reduce primary production at the tested concentration. Bacterial production was lowest in the Contr, but similar in the three treatments receiving additions likely due to increased carbon available for heterotrophic bacteria. Picoeukaryotes clearly benefited by brownification after inorganic N depletion, which could be due to more effective nutrient recycling, nutrient affinity, light absorption, or alternatively lower grazing pressure. In conclusion, brownification shifted the phytoplankton community composition towards smaller species with potential effects on carbon fluxes, such as sinking rates and export to the sea floor.

High-resolution 3D printing of xanthan gum/nanocellulose bio-inks.

The current study provides a comprehensive rheology study and a survey on direct ink writing of xanthan gum/cellulose nanocrystal (XG/CNC) bio-inks for developing 3D geometries that mimic soft tissue engineering scaffolds' physical and mechanical properties. The presence of CNC was found to be a critical prerequisite for the printability of XG bio-inks; accordingly, the hybrid XG/CNC bio-inks revealed the excellent viscoelastic properties that enabled precise control of hydrogel shaping and printing of lattice structures composed of up to eleven layers with high fidelity and fair resolution without any deformation after printing. The lyophilized 3D scaffolds presented a porous structure with open and interconnected pores and a porosity higher than 70%, vital features for tissue engineering scaffolds. Moreover, they showed a relatively high swelling of approximately 11 g/g, facilitating oxygen and nutrient exchange. Furthermore, the elastic and compressive moduli of the scaffolds that enhanced significantly upon increasing CNC content were in the range of a few kPa, similar to soft tissues. Finally, no significant cell cytotoxicity was observed against human liver cancer cells (HepG2), highlighting the potential of these developed 3D printed scaffolds for soft tissue engineering applications.

Patient-Specific Bioimplants and Reconstruction Plates for Mandibular Defects: Production Workflow and In Vivo Large Animal Model Study.

A major challenge with extensive craniomaxillofacial bone reconstruction is the limited donor-site availability to reconstruct defects predictably and accurately according to the anatomical shape of the patient. Here, patient-specific composite bioimplants, consisting of cross-linked poly(trimethylene carbonate) (PTMC) networks and ß-tricalcium phosphate (ß-TCP), are tested in vivo in twelve Göttingen minipigs in a large mandibular continuity defect model. The 25 mm defects are supported by patient-specific titanium reconstruction plates and receive either osteoconductive composite bioimplants (PTMC+TCP), neat polymer network bioimplants (PTMC), autologous bone segments (positive control), or are left empty (negative control). Postoperatively, defects treated with bioimplants show evident ossification at 24 weeks. Histopathologic evaluation reveals that neat PTMC bioimplant surfaces are largely covered with fibrous tissue, while in the PTMC+TCP bioimplants, bone attached directly to the implant surface shows good osteoconduction and histological signs of osteoinductivity. However, PTMC+TCP bioimplants are associated with high incidence of necrosis and infection, possibly due to rapid resorption and/or particle size of the used ß-TCP. The study highlights the importance of testing bone regeneration implants in a clinically relevant large animal model and at the in situ reconstruction site, since results on small animal models and studies in nonloadbearing areas do not translate directly.

Effects of Added Humic Substances and Nutrients on Photochemical Degradation of Dissolved Organic Matter in a Mesocosm Amendment Experiment in the Gulf of Finland, Baltic Sea.

Humic substances, a component of terrestrial dissolved organic matter (tDOM), contribute to dissolved organic matter (DOM) and chromophoric DOM (CDOM) in coastal waters, and have significant impacts on biogeochemistry. There are concerns in recent years over browning effects in surface waters due to increasing tDOM inputs, and their negative impacts on aquatic ecosystems, but relatively little work has been published on estuaries and coastal waters. Photodegradation could be a significant sink for tDOM in coastal environments, but the rates and efficiencies are poorly constrained. We conducted large-scale DOM photodegradation experiments in mesocosms amended with humic substances and nutrients in the Gulf of Finland to investigate the potential of photochemistry to remove added tDOM and the interactions of DOM photochemistry with eutrophication. The added tDOM was photodegraded rapidly, as CDOM absorption decreased and spectral slopes increased with increasing photons absorbed in laboratory experiments. The in situ DOM optical properties became similar among the control, humic- and humic+nutrients-amended mesocosm samples toward the end of the amendment experiment, indicating degradation of the excess CDOM/DOM through processes including photodegradation. Nutrient additions did not significantly influence the effects of added humic substances on CDOM optical property changes, but induced changes in DOM removal.

Injectable thiol-ene hydrogel of galactoglucomannan and cellulose nanocrystals in delivery of therapeutic inorganic ions with embedded bioactive glass nanoparticles.

We propose an injectable nanocomposite hydrogel that is photo-curable via light-induced thiol-ene addition between methacrylate modified O-acetyl-galactoglucomannan (GGMMA) and thiolated cellulose nanocrystal (CNC-SH). Compared to free-radical chain polymerization, the orthogonal step-growth of thiol-ene addition allows a less heterogeneous hydrogel network and more rapid crosslinking kinetics. CNC-SH reinforced the GGMMA hydrogel as both a nanofiller and a crosslinker to GGMMA resulting in an interpenetrating network via thiol-ene addition. Importantly, the mechanical stiffness of the GGMMA/CNC-SH hydrogel is mainly determined by the stoichiometric ratio between the thiol groups on CNC-SH and the methacrylate groups in GGMMA. Meanwhile, the bioactive glass nanoparticle (BaGNP)-laden hydrogels of GGMMA/CNC-SH showed a sustained release of therapeutic ions in simulated body fluid in vitro, which extended the bioactive function of hydrogel matrix. Furthermore, the suitability of the GGMMA/CNC-SH formulation as biomaterial resin to fabricate digitally designed hydrogel constructs via digital light processing (DLP) lithography printing was evaluated.

3D printing and properties of cellulose nanofibrils-reinforced quince seed mucilage bio-inks.

Plant-based hydrogels have attracted great attention in biomedical fields since they are biocompatible and based on natural, sustainable, cost-effective, and widely accessible sources. Here, we introduced new viscoelastic bio-inks composed of quince seed mucilage and cellulose nanofibrils (QSM/CNF) easily extruded into 3D lattice structures through direct ink writing in ambient conditions. The QSM/CNF inks enabled precise control on printing fidelity where CNF endowed objects with shape stability after freeze-drying and with suitable porosity, water uptake capacity, and mechanical strength. The compressive and elastic moduli of samples produced at the highest CNF content were both increased by ~100% (from 5.1 ± 0.2 kPa and 32 ± 1 kPa to 10.7 ± 0.5 and 64 ± 2 kPa, respectively). These values ideally matched those reported for soft tissues; accordingly, the cell compatibility of the printed samples was evaluated against HepG2 cells (human liver cancer). The results confirmed the 3D hydrogels as being non-cytotoxic and suitable to support attachment, survival, and proliferation of the cells. All in all, the newly developed inks allowed sustainable 3D bio-hydrogels fitting the requirements as scaffolds for soft tissue engineering.

Ascorbic acid-loaded polyvinyl alcohol/cellulose nanofibril hydrogels as precursors for 3D printed materials.

We proposed a simple method to process hydrogels containing polyvinyl alcohol and cellulose nanofibrils (PVA/CNF) to prepare volumetric architectures by direct ink writing (DIW). The presence of CNF in the aqueous PVA suspensions conferred rheology profiles that were suitable for extrusion and solidification in pre-designed shapes. The viscoelastic behavior of the hybrid inks enabled precise control on processability and shape retention, for instance, as demonstrated in multilayered lattice structures of high fidelity. After lyophilization, the obtained 3D-printed hydrogels presented a very high porosity, with open and interconnected pores, allowing a high-water uptake capacity (up to 1600%). The mechanical strength of the composite 3D-printed materials matched those of soft tissues, opening opportunities for skin applications. As such, drug-loaded samples revealed a controlled and efficient delivery of an antioxidant (ascorbic acid) in PBS buffer media at 23 °C (~80% for 8 h). Altogether, PVA/CNF hydrogels were introduced as suitable precursors of 3D-lattice geometries with excellent physical and mechanical characteristics.

Graphene Family Nanomaterials in Ocular Applications: Physicochemical Properties and Toxicity.

Graphene family nanomaterials (GFNs) are rapidly emerging for ocular applications due to their outstanding physicochemical properties. Since the eyes are very sensitive organs and the contact between the eyes and GFNs in eye drops, contact lenses, intraocular drug delivery systems and biosensors and even the workers handling these nanomaterials is inevitable, it is necessary to investigate their ocular toxicities and physiological interactions with cells as well as their toxicity mechanisms. The toxicity of GFNs can be extremely affected by their physicochemical properties, including composition, size, surface chemistry, and oxidation level as well as dose and the time of exposure. Up to now, there are several studies on the in vitro and in vivo toxicity of GFNs; however, a comprehensive review on ocular toxicity and applications of GFNs is missing, and a knowledge about the health risks of eye exposure to the GFNs is predominantly unspecified. This review highlights the ocular applications of GFNs and systematically covers the most recent advances of GFNs' physicochemical properties, in vitro and in vivo ocular toxicity, and the possible toxicity mechanisms as well as provides some perspectives on the potential risks of GFNs in material development and biomedical applications.

Direct ink writing of aloe vera/cellulose nanofibrils bio-hydrogels.

Direct-ink-writing (DIW) of hydrogels has become an attractive research area due to its capability to fabricate intricate, complex, and highly customizable structures at ambient conditions for various applications, including biomedical purposes. In the current study, cellulose nanofibrils reinforced aloe vera bio-hydrogels were utilized to develop 3D geometries through the DIW technique. The hydrogels revealed excellent viscoelastic properties enabled extruding thin filaments through a nozzle with a diameter of 630 µm. Accordingly, the lattice structures were printed precisely with a suitable resolution. The 3D-printed structures demonstrated significant wet stability due to the high aspect ratio of the nano- and microfibrils cellulose, reinforced the hydrogels, and protected the shape from extensive shrinkage upon drying. Furthermore, all printed samples had a porosity higher than 80% and a high-water uptake capacity of up to 46 g/g. Altogether, these fully bio-based, porous, and wet stable 3D structures might have an opportunity in biomedical fields.

Polymeric drug delivery systems by additive manufacturing.

Additive manufacturing (AM) is gaining interests in drug delivery applications, offering innovative opportunities for the design and development of systems with complex geometry and programmed controlled release profile. In addition, polymer-based drug delivery systems can improve drug safety, efficacy, patient compliance, and are the key materials in AM. Therefore, combining AM and polymers can be beneficial to overcome the existing limitations in the development of controlled release drug delivery systems. Considering these advantages, here we are focusing on the recent developments in the field of polymeric drug delivery systems prepared by AM. This review provides a comprehensive overview on a holistic polymer-AM perspective for drug delivery systems with discussion on the materials, properties, design and fabrication techniques and the mechanisms used to achieve a controlled release system. The current challenges and future perspectives for personalized medicine and clinical use of these systems are also briefly discussed.