Injectable in situ gelling methylcellulose-based hydrogels for bone tissue regeneration.

Injectable bone substitutes (IBSs) represent a compelling choice for bone tissue regeneration, as they can be exploited to optimally fill complex bone defects in a minimally invasive manner. In this context, in situ gelling methylcellulose (MC) hydrogels may be engineered to be free-flowing injectable solutions at room temperature and gels upon exposure to body temperature. Moreover, incorporating a suitable inorganic phase can further enhance the mechanical properties of MC hydrogels and promote mineralization, thus assisting early cell adhesion to the hydrogel and effectively guiding bone tissue regeneration. In this work, thermo-responsive IBSs were designed selecting MC as the organic matrix and calcium phosphate (CaP) or CaP modified with graphene oxide (CaPGO) as the inorganic component. The resulting biocomposites displayed a transition temperature around body temperature, preserved injectability even after loading with the inorganic components, and exhibited adequate retention on an ex vivo calf femoral bone defect model. The addition of CaP and CaPGO promoted the in vitro mineralization process already 14 days after immersion in simulated body fluid. Interestingly, combined X-ray diffraction and solid state nuclear magnetic resonance characterizations revealed that the formed biomimetic phase was constituted by crystalline hydroxyapatite and amorphous calcium phosphate. In vitro biological characterization revealed the beneficial impact of CaP and CaPGO, indicating their potential in promoting cell adhesion, proliferation and osteogenic differentiation. Remarkably, the addition of GO, which is very attractive for its bioactive properties, did not negatively affect the injectability of the hydrogel nor the mineralization process, but had a positive impact on cell growth and osteogenic differentiation on both pre-differentiated and undifferentiated cells. Overall, the proposed formulations represent potential candidates for use as IBSs for application in bone regeneration both under physiological and pathological conditions.

Extracellular polymeric substances as paper coating biomaterials derived from anaerobic granular sludge.

Recovering extracellular polymeric substances (EPS) from waste granular sludge offers a cost-effective and sustainable approach for transforming wastewater resources into industrially valuable products. Yet, the application potential of these EPS in real-world scenarios, particularly in paper manufacturing, remains underexplored. Here we show the feasibility of EPS-based biomaterials, derived from anaerobic granular sludges, as novel coating agents in paper production. We systematically characterised the rheological properties of various EPS-based suspensions. When applied as surface sizing agents, these EPS-based biomaterials formed a distinct, ultra-thin layer on paper, as evidenced by scanning electron microscopy. A comprehensive evaluation of water and oil penetration, along with barrier properties, revealed that EPS-enhanced coatings markedly diminished water absorption while significantly bolstering oil and grease resistance. Optimal performance was observed in EPS variants with elevated protein and hydrophobic contents, correlating with their superior rheological characteristics. The enhanced water-barrier and grease resistance of EPS-coated paper can be attributed to its non-porous, fine surface structure and the functional groups in EPS, particularly the high protein content and hydrophobic humic-like substances. This research marks the first demonstration of utilizing EPS from anaerobic granular sludge as paper-coating biomaterials, bridging a critical knowledge gap in the sustainable use of biopolymers in industrial applications.

Development of acid-free chitosan films in food coating applications: Provolone cheese as a case study.

Chitosan has been extensively explored in food coatings. Still, its practical application is largely hampered by its conventional wet processing in acetic acid, whose residuals negatively impact food quality and safety. Here, we propose a new method to formulate chitosan coatings for food applications by avoiding organic acid processing and validate them on a cheese model. The procedure entails modifying a previously reported process based on HCl chitosan treatment and neutralising the resulting gel. The obtained chitosan is solubilised in water using carbonic acid that forms in situ by dissolving carbon dioxide gas. The reversibility of water carbonation allows for easy removal of carbonic acid residues, resulting in acid-free chitosan films and coatings. The performance of the coating was tested against state-of-the-art chitosan-based and polymeric coatings. We preliminarily characterised the films' properties (water stability, barrier, and optical properties). Then, we assessed the performance of the coating on Provolone cheese as a food model (mass transfer and texture profiles over 14 days). The work demonstrated the advantage of the proposed approach in solving some main issues of food quality and safety, paving the way for an effective application of chitosan in future food contact applications.

Crosslinking strategies in modulating methylcellulose hydrogel properties.

Methylcellulose (MC) hydrogels are ideal materials for the design of thermo-responsive platforms capable of exploiting the environment temperature as a driving force to activate their smart transition. However, MC hydrogels usually show reduced stability in an aqueous environment and low mechanical properties, limiting their applications' breadth. A possible approach intended to overcome these limitations is chemical crosslinking, which represents a simple yet effective strategy to modify the MC hydrogels' properties (e.g., physicochemical, mechanical, and biological). In this regard, understanding the selected crosslinking method's role in modulating the MC hydrogels' properties is a key factor in their design. This review offers a perspective on the main MC chemical crosslinking approaches reported in the literature. Three main categories can be distinguished: (i) small molecule crosslinkers, (ii) crosslinking by high-energy radiation, and (iii) crosslinking via MC chemical modification. The advantages and limitations of each approach are elucidated, and special consideration is paid to the thermo-responsive properties after crosslinking towards the development of MC hydrogels with enhanced physical stability and mechanical performance, preserving the thermo-responsive behavior.

Mucoadhesive chitosan-methylcellulose oral patches for the treatment of local mouth bacterial infections.

Mucoadhesive buccal patches are dosage forms promising for successful drug delivery. They show the distinctive advantages of long residence time on the oral mucosa and increased in situ drug bioavailability. In this context, electrophoretic deposition (EPD) of chitosan (CS) has been demonstrated as a simple and easily tunable technique to produce mucoadhesive buccal patches. However, CS-based buccal patches may suffer from weak mucoadhesion, which can impair their therapeutic effect. In this work, methylcellulose (MC), a widely investigated biopolymer in the biomedical area, was exploited to increase the mucoadhesive characteristic of pristine CS patches. CS-MC patches were obtained in a one-pot process via EPD, and the possibility of incorporating gentamicin sulfate (GS) as a model of a broad-spectrum antibiotic in the so-obtained patches was investigated. The resulting CS-MC patches showed high stability in a water environment and superior mucoadhesive characteristic (σadh = 0.85 ± 0.26 kPa, Wadh = 1192.28 ± 602.36 Pa mm) when compared with the CS control samples (σadh = 0.42 ± 0.22 kPa, Wadh = 343.13 ± 268.89 Pa mm), due to both the control of the patch porosity and the bioadhesive nature of MC. Furthermore, GS-loaded patches showed no in vitro cytotoxic effects by challenging L929 cells with material extracts and noteworthy antibacterial activity on both Gram-positive and Gram-negative bacterial strains.

Editorial on the Special Issue "Advances in Cellulose-Based Hydrogels".

Cellulose is one of the most ubiquitous and naturally abundant biopolymers found on Earth and is primarily obtained from plants and other biomass sources [...].

Structural Effects of Metal Single-Atom Catalysts for Enhanced Photocatalytic Degradation of Gemfibrozil.

The development of efficient catalysts is a highly necessary but challenging task within the field of environmental water remediation. Single-atom catalysts are promising nanomaterials within this respect, but in-depth studies encompassing this class of catalysts remain elusive. In this work, we systematically study the degradation of gemfibrozil, a persistent pollutant, on a series of carbon nitride photocatalysts, investigating both the effect of (i) catalyst textural properties and (ii) metal single atoms on the contaminant degradation. Tests in the absence of the catalyst result in negligible degradation rates, confirming the stability of the contaminant when dispersed in water. Then, photocatalytic tests at optimal pH, solvent, and wavelength reveal a correlation between the support surface area and the degradation. This points to the role of carbon nitride surface nanostructure on gemfibrozil degradation. In particular, the use of silver on mesoporous carbon nitride single-atom catalyst (Ag@mpgC3N4) leads to an unprecedented degradation of gemfibrozil (>90% within 60 min). The possible degradation intermediates and products were identified by mass spectrometry and were inert by cytotoxicity evaluation. We anticipate that, with further refinement and customization, the carbon nitride catalysts reported herein may find broad applications for light-driven degradation of other contaminants of emerging concern.

Smart Methylcellulose Hydrogels for pH-Triggered Delivery of Silver Nanoparticles.

Infection is a severe complication in chronic wounds, often leading to morbidity or mortality. Current treatments rely on dressings, which frequently contain silver as a broad-spectrum antibacterial agent, although improper dosing can result in severe side effects. This work proposes a novel methylcellulose (MC)-based hydrogel designed for the topical release of silver nanoparticles (AgNPs) via an intelligent mechanism activated by the pH variations in infected wounds. A preliminary optimization of the physicochemical and rheological properties of MC hydrogels allowed defining the optimal processing conditions in terms of crosslinker (citric acid) concentration, crosslinking time, and temperature. MC/AgNPs nanocomposite hydrogels were obtained via an in situ synthesis process, exploiting MC both as a capping and reducing agent. AgNPs with a 12.2 ± 2.8 nm diameter were obtained. MC hydrogels showed a dependence of the swelling and degradation behavior on both pH and temperature and a noteworthy pH-triggered release of AgNPs (release ~10 times higher at pH 12 than pH 4). 1H-NMR analysis revealed the role of alkaline hydrolysis of the ester bonds (i.e., crosslinks) in governing the pH-responsive behavior. Overall, MC/AgNPs hydrogels represent an innovative platform for the pH-triggered release of AgNPs in an alkaline milieu.

Chemically Crosslinked Methylcellulose Substrates for Cell Sheet Engineering.

Methylcellulose (MC) hydrogels have been successfully proposed in the field of cell sheet engineering (CSE), allowing cell detachment from their surface by lowering the temperature below their transition temperature (Tt). Among the main limitations of pristine MC hydrogels, low physical stability and mechanical performances limit the breadth of their potential applications. In this study, a crosslinking strategy based on citric acid (CA) was used to prepare thermoresponsive MC hydrogels, with different degrees of crosslinking, to exploit their possible use as substrates in CSE. The investigated amounts of CA did not cause any cytotoxic effect while improving the mechanical performance of the hydrogels (+11-fold increase in E, compared to control MC). The possibility to obtain cell sheets (CSs) was then demonstrated using murine fibroblast cell line (L929 cells). Cells adhered on crosslinked MC hydrogels' surface in standard culture conditions and then were harvested at selected time points as single CSs. CS detachment was achieved simply by lowering the external temperature below the Tt of MC. The detached CSs displayed adhesive and proliferative activity when transferred to new plastic culture surfaces, indicating a high potential for regenerative purposes.

Compounded topographical and physicochemical cueing by micro-engineered chitosan substrates on rat dorsal root ganglion neurons and human mesenchymal stem cells.

Given the intertwined physicochemical effects exerted in vivo by both natural and synthetic (e.g., biomaterial) interfaces on adhering cells, the evaluation of structure-function relationships governing cellular response to micro-engineered surfaces for applications in neuronal tissue engineering requires the use of in vitro testing platforms which consist of a clinically translatable material with tunable physiochemical properties. In this work, we micro-engineered chitosan substrates with arrays of parallel channels with variable width (20 and 60 µm). A citric acid (CA)-based crosslinking approach was used to provide an additional level of synergistic cueing on adhering cells by regulating the chitosan substrate's stiffness. Morphological and physicochemical characterization was conducted to unveil the structure-function relationships which govern the activity of rat dorsal root ganglion neurons (DRGs) and human mesenchymal stem cells (hMSCs), ultimately singling out the key role of microtopography, roughness and substrate's stiffness. While substrate's stiffness predominantly affected hMSC spreading, the modulation of the channels' design affected the neuronal architecture's complexity and guided the morphological transition of hMSCs. Finally, the combined analysis of tubulin expression and cell morphology allowed us to cast new light on the predominant role of the microtopography over substrate's stiffness in the process of hMSCs neurogenic differentiation.

Thermo-Responsive Methylcellulose Hydrogels: From Design to Applications as Smart Biomaterials.

Methylcellulose (MC) is an attractive material used to produce thermo-responsive hydrogels. They undergo sol-gel transition when a critical temperature is reached, thus modifying their properties (e.g., physicochemical and mechanical) in response to temperature changes. This behavior is particularly attractive when the body temperature acts as a trigger to modulate the thermo-responsive behavior of MC hydrogels. In this regard, exciting advances have been achieved in the field of cell and drug delivery, tissue engineering, and regenerative medicine, making MC a very attractive and versatile biomaterial. This review aims to present MC hydrogels, examining their preparation, physical properties, and tunability of thermal response, lastly moving to a comprehensive depiction of both their conventional and innovative applications for tissue regeneration purposes. In particular, three main families of applications are introduced: (1) in situ gelling systems, which undergo sol-gel transition upon delivery into a target site (e.g., tissue or organ), assisting the regeneration of the latter both in the presence or absence of loading components (e.g., cells, biomolecules, and inorganic materials); (2) three-dimensional (3D) (bio)printing, where the sol-gel transition is induced by heating MC-based (bio)inks after printing, obtaining 3D tissue-engineered substitutes with defined geometries and high shape fidelity; (3) smart culture surfaces, where the hydrophilic/hydrophobic transition of MC is exploited to reach a selective attachment/detachment of cells, offering the possibility to obtain cell sheets and cell bodies for tissue reconstruction without the need of any proteolytic enzyme. The main limitations of MC hydrogels will be then examined, together with current solutions to overcome them. Moreover, an overview of the future directions in the field of MC smart hydrogels will be given, with particular focus on the design of multiresponsive systems capable to respond to multiple stimuli (e.g., chemical and biological stimuli), toward the development of more patient-specific treatments. Finally, an overview of the patents and clinical trials describing the use of MC will be given, retracing the abovementioned families of application.

Evaluation of the subtle trade-off between physical stability and thermo-responsiveness in crosslinked methylcellulose hydrogels.

Methylcellulose (MC) hydrogels, undergoing sol-gel reversible transition upon temperature changes, lend themselves to smart system applications. However, their reduced stability in aqueous environment and unsatisfactory mechanical properties limit the breadth of their possible applications. Here, a crosslinking strategy based on citric acid (CA) was developed: exploiting three crosslinking parameters (CA concentration, crosslinking time, and crosslinking temperature) by a design of experiment approach, optimized crosslinked MC hydrogels (MC-L, MC-M, MC-H) were obtained and characterized. Swelling tests in water revealed the effectiveness of CA crosslinking in modulating the water uptake of MC hydrogels. Both theoretical and experimental analyses showed an increase in the crosslinking density by the rationale selection of process parameters. The extent of sol-gel transition was assessed by swelling tests, Raman spectroscopy and rheological analyses. MC-M samples demonstrated to preserve their thermo-responsive behavior around their lower critical solution temperature (LCST), while showing increased stability and enhanced mechanical properties when compared to pristine MC hydrogels.

Electrophoretic processing of chitosan based composite scaffolds with Nb-doped bioactive glass for bone tissue regeneration.

Bioactive glasses (BGs), due to their ability to influence osteogenic cell functions, have become attractive materials to improve loaded and unloaded bone regeneration. BG systems can be easily doped with several metallic ions (e.g., Ag, Sr, Cu, Nb) in order to confer antibacterial properties. In particular, Nb, when compared with other metal ions, has been reported to be less cytotoxic and possess the ability to enhance mineralization process in human osteoblast populations. In this study, we co-deposited, through one-pot electrophoretic deposition (EPD), chitosan (CS), gelatin (GE) and a modified BG containing Nb to obtain substrates with antibacterial activity for unloaded bone regeneration. Self-standing composite scaffolds, with a defined porosity (15-90 µm) and homogeneous dispersion of BGs were obtained. TGA analysis revealed a BG loading of about 10% in the obtained scaffolds. The apatite formation ability of the scaffolds was evaluated in vitro in simulated body fluid (SBF). SEM observations, XRD and FT-IR spectra showed a slow (21-28 days) yet effective nucleation of CaP species on BGs. In particular, FT-IR peak around 603 cm-1 and XRD peak at 2θ = 32°, denoted the formation of a mineral phase after SBF immersion. In vitro biological investigation revealed that the release of Nb from composite scaffolds had no cytotoxic effects. Interestingly, BG-doped Nb scaffolds displayed antibacterial properties, reducing S. lutea and E. coli growth of ≈60% and ≈50%, respectively. Altogether, the obtained results disclose the produced composite scaffolds as promising materials with inherent antibacterial activity for bone tissue engineering applications.

Biopolymer-based strategies in the design of smart medical devices and artificial organs.

Advances in regenerative medicine and in modern biomedical therapies are fast evolving and set goals causing an upheaval in the field of materials science. This review discusses recent developments involving the use of biopolymers as smart materials, in terms of material properties and stimulus-responsive behavior, in the presence of environmental physico-chemical changes. An overview on the transformations that can be triggered in natural-based polymeric systems (sol-gel transition, polymer relaxation, cross-linking, and swelling) is presented, with specific focus on the benefits these materials can provide in biomedical applications.

3D Printing of Thermo-Responsive Methylcellulose Hydrogels for Cell-Sheet Engineering.

A possible strategy in regenerative medicine is cell-sheet engineering (CSE), i.e., developing smart cell culture surfaces from which to obtain intact cell sheets (CS). The main goal of this study was to develop 3D printing via extrusion-based bioprinting of methylcellulose (MC)-based hydrogels. Hydrogels were prepared by mixing MC powder in saline solutions (Na2SO4 and PBS). MC-based hydrogels were analyzed to investigate the rheological behavior and thus optimize the printing process parameters. Cells were tested in vitro on ring-shaped printed hydrogels; bulk MC hydrogels were used for comparison. In vitro tests used murine embryonic fibroblasts (NIH/3T3) and endothelial murine cells (MS1), and the resulting cell sheets were characterized analyzing cell viability and immunofluorescence. In terms of CS preparation, 3D printing proved to be an optimal approach to obtain ring-shaped CS. Cell orientation was observed for the ring-shaped CS and was confirmed by the degree of circularity of their nuclei: cell nuclei in ring-shaped CS were more elongated than those in sheets detached from bulk hydrogels. The 3D printing process appears adequate for the preparation of cell sheets of different shapes for the regeneration of complex tissues.

Externalized conductors and insulation failure in Biotronik defibrillator leads: History repeating or a false alarm?

Conductor externalization and insulation failure are frequent complications with the recalled St. Jude Medical Riata implantable cardioverter-defibrillator (ICD) leads. Conductor externalization is a "unique" failure mechanism: Cables externalize through the insulation ("inside-out" abrasion) and appear outside the lead body. Recently, single reports described a similar failure also for Biotronik leads. Moreover, some studies reported a high rate of electrical dysfunction (not only insulation failure) with Biotronik Linox leads and a reduced survival rate in comparison with the competitors. In this paper we describe the case of a patient with a Biotronik Kentrox ICD lead presenting with signs of insulation failure and conductor externalization at fluoroscopy. Due to the high risk of extraction we decided to implant a new lead, abandoning the damaged one; lead reimplant was uneventful. Subsequently, we review currently available literature about Biotronik Kentrox and Linox ICD lead failure and in particular externalized conductors. Some single-center studies and a non-prospective registry reported a survival rate between 88% and 91% at 5 years for Linox leads, significantly worse than that of other manufacturers. However, the preliminary results of two ongoing multicenter, prospective registries (GALAXY and CELESTIAL) showed 96% survival rate at 5 years after implant, well within industry standards. Ongoing data collection is needed to confirm longer-term performance of this family of ICD leads.

Riata silicone defibrillation lead with normal electrical measures at routine ambulatory check: The role of high-voltage shock testing.

AIM: To describe our experience with shock testing for the evaluation of patients with Riata™ leads. METHODS: Among 51 patients with normal baseline electrical parameters, 20 died during follow-up. Of the remaining 31 patients, 15 underwent the test: In 10 cases a defibrillation testing with ventricular fibrillation (VF) induction and in 5 cases a R-wave-synchronized shock (> 20 J, without inducing VF). The test was performed under sedation with Midazolam. RESULTS: Twelve patients (80%) had a normal behavior during shock testing: In 8 cases induced VF was correctly detected and treated; in 4 cases of R-wave-synchronized shock electrical parameters remained stable and normal. Three patients (20%) failed the test. One patient with externalized conductors showed a sudden drop of high-voltage impedance (< 10 Ohm) after a 25 J R-wave-synchronized shock. Two other patients with externalized conductors, undergoing defibrillation testing, showed a short-circuit during shock delivery and the implantable cardioverter defibrillator was unable to interrupt VF. CONCLUSION: In Riata™ leads the delivery of a low current during routine measurement of high-voltage impedance may not reveal a small short circuit, that can only be evident by attempting to deliver a true shock, either for spontaneous arrhythmias or in the context of a shock testing.

[Cardiac auscultation in children]. / L'auscultazione cardiaca nel bambino.

Cardiac auscultation permits to distinguish between the innocent heart murmurs and pathologic murmurs; characteristics of pathologic murmurs include a holosystolic or diastolic murmur, maximal murmur intensity at the upper left sternal border and increased intensity when the patient stands. Murmurs should be described by their timing in the cardiac cycle, intensity, shape, pitch, location, radiation, and response to dynamic maneuvers. When the medical history and physical examination support the diagnosis of innocent heart murmur, neither further investigation nor referal is indicated. On the contrary, echocardiography is recommended for patients with any other abnormal physical examination findings that increase the likelihood of structural heart disease. In this review we discuss the definition and classification of murmurs, how to evaluate it.