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Purpose: The aim of our prospective randomised trial was to demonstrate the efficacy and improvement in surgical skills of inexperienced surgeons in the balloon kyphoplasty procedures trained with virtual reality (VR) compared to untrained inexperienced surgeons., Methods: Six orthopaedic residents were randomized to group VR1 (trained) and group VR0 (untrained, control group). At the beginning, all participants, after a theoretical lesson, performed a virtual kyphoplasty. Each resident of the Group VR1 did four training sessions in 1 month (2 h per week) and at the end of training was re-evaluated performing a virtual kyphoplasty. Residents were evaluated with global task completion time and rates subtask ability according to Global Rating Scale of Operative Performance adaptation (both in VR simulation and during the surgery). A percutaneous vertebral augmentation with balloon kyphoplasty was performed by all residents. Intraoperative parameters, complications and cumulative transfer effectiveness ratio (CTER) were analysed., Results: Intraoperative scores revealed an improvement in the group VR1 between the first VR trial and the intraoperative phase (2.85 ± 0.65 vs. 4.09 ± 0.62, P < 0.05), which was not seen in the group VR0 (2.71 ± 0.71 vs. 2.85 ± 0.75). Statistical analyses indicated significant differences in intraoperative scores between the two groups. The CTER was 0.85 and suggests that 10 training sessions could reduce the procedure time by approximately 8 min in a 15 min of surgery., Conclusion: Our study about the balloon kyphoplasy reaffirms the potential of VR as an effective and cost-efficient training tool, bridging the gap between theoretical knowledge and practical execution., Competing Interests: Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Ethical approval: This study was performed according to the standards EN ISO 14155:1, EN ISO 14155:2, Declaration of Helsinki and Good Clinical Practices (GCP). Informed consent: All study participants or their legal guardian provided informed written consent prior to study enrolment., (© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Abstract: Helical plating for humeral shaft fractures has gained popularity in recent years as it avoids iatrogenic nerve damage. A total of 16 patients with humeral shaft fracture involving the metaphyseal proximal part were treated between Dicembrer 2016 and January 2023. Complications such as pseudarthrosis, infections and nerve lesions were investigated during the postoperative period. Functional outcome was quantified using the Italian version of the DASH 30 quality of life assessment item. Healing of the fracture was achie-ved at the last follow-up with good clinical recovery and no pain. The self-contoured Philos-Helix plate for humeral shaft fractures with proximal extension in combination with an anterior window approach is a safe procedure with good functional results at a follow-up of at least one year.

We propose an approach to 4D print solvent-triggered, gradient-based bilayers made of semi-crystalline crosslinked polymer networks. Out-of-plane bending is obtained after immersion in the solvent, exploiting the different swelling degrees of the layers resulting from crosslinking gradients. Lastly, a beam model of the shape transformation is applied and experimentally validated.

Grape seeds (GS), wine lees (WL), and grape pomace (GP) are common winery by-products, used as bio-fillers in this research with two distinct biopolymer matrices-poly(butylene adipate- co -terephthalate) (PBAT) and polybutylene succinate (PBS)-to create fully bio-based composite materials. Each composite included at least 30 v% bio-filler, with a sample reaching 40 v%, as we sought to determine a composition that could be economically and environmentally effective as a substitute for a pure biopolymer matrix. The compounding process employed a twin-screw extruder followed by an injection molding procedure to fabricate the specimens. An acetylation treatment assessed the specimen's efficacy in enhancing matrix-bio-filler affinity, particularly for WL and GS. The fabricated bio-composites underwent an accurate characterization, revealing no alteration in thermal properties after compounding with bio-fillers. Moreover, hygroscopic measurements indicated increased water-affinity in bio-composites compared to neat biopolymer, most significantly with GP, which exhibited a 7-fold increase. Both tensile and dynamic mechanical tests demonstrated that bio-fillers not only preserved, but significantly enhanced, the stiffness of the neat biopolymer across all samples. In this regard, the most promising results were achieved with the PBAT and acetylated GS sample, showing a 162% relative increase in Young's modulus, and the PBS and WL sample, which exhibited the highest absolute values of Young's modulus and storage modulus, even at high temperatures. These findings underscore the scientific importance of exploring the interaction between bio-fillers derived from winery by-products and three different biopolymer matrices, showcasing their potential for sustainable material development, and advancing polymer science and bio-sourced material processing. From a practical standpoint, the study highlighted the tangible benefits of using by-product bio-fillers, including cost savings, waste reduction, and environmental advantages, thus paving the way for greener and more economically viable material production practices.

The present work aimed to prepare novel bio-based composites by adding fillers coming from agro-wastes to an acrylate epoxidized soybean oil (AESO) resin, using liquid crystal display (LCD) 3D printing. Different photocurable formulations were prepared by varying the reactive diluents, iso-bornyl methacrylate (IBOMA) and tetrahydrofurfuryl acrylate (THFA). Then, two fillers derived from different industrial wastes, corn (GTF) and wine (WPL-CF) by-products, were added to the AESO-based formulations to develop polymer composites with improved properties. The printability by LCD of the photocurable formulations was widely studied. Bio-based objects with different geometries were realized, showing printing accuracy, layer adhesion, and accurate details. The thermo-mechanical and mechanical properties of the 3D-printed composites were tested by TGA, DMA, and tensile tests. The results revealed that the agro-wastes' addition led to a remarkable increase in the elastic modulus, tensile strength, and glass transition temperature in the glassy state for the systems containing IBOMA and for flexible structures in the rubbery region for systems containing THFA. AESO-based polymers demonstrated tunable properties, varying from rigid to flexible, in the presence of different diluents and biofillers. This finding paves the way for the use of this kind of composite in applications, such as biomedical for the realization of prostheses.

Introduction: Aim of our study was to evaluate the influence of working length and screw density on callus formation in distal tibial fractures fixed with a medial bridge plate., Materials and Methods: 42 distal tibia fractures treated with a bridge plate were analyzed. Minimum follow-up was 12 months. mRUST score (modified Radiographic Union Scale for Tibial fractures) was used to assess callus formation. Working length and screw density were  measured from post-operative radiographs., Results: 39 (92.9%) fractures healed uneventfully. 32 (76.19%) patients showed signs of early callus formation 3 months post-surgery. In these patients a lower screw density was used compared to patients who didn't show early callus (33.4 vs. 26.6; p = 0.04). No differences was noticed in working length., Conclusion: Bridge plate osteosynthesis is a good treatment option in distal tibia fractures. In our series increasing the working length was not associated with a faster callus formation in distal tibia fractures. Conversely, a lower screw density proximally to the fracture site was associated to a faster callus growth., (© 2023. The Author(s).)

Introduction: Open fractures of the distal tibia can be functionally devastating, and they remain one of the most challenging injuries treated by trauma surgeons usually burdened with a high rate of complications, including surgical site infections (SSI). Our aim is to analyze the most significant risk factors of SSI and propose a new scoring system-called the DANGER scale-potentially able to predict reliably and quantify the infection risk in distal tibia open fractures., Methods: We identified six variables summarized in the acronym DANGER where D stands for Diabetes, A for Antibiotic, N for Nature of trauma (high- or low-energy trauma), G represents Grade of fracture following the AO/OTA classification, E indicates Exposure of the fracture according to the Gustilo-Anderson classification, and R represents Relative risk of patient, including use of tobacco, alcoholism, and psychiatric disorders. Therefore, total score ranged from 1 to 14, with a lower score indicating less risk to develop SSI., Results: A total of 103 patients with open distal tibial fractures were enrolled, 12 patients (11.6%) developed SSI. Regarding DANGER score, a rating of 8.2 was calculated in SSI group and 4.8 in non-SSI group. Based on Fisher's test, diabetes (odds = 31.8 p < 0.05), grade of articular involvement (p < 0.05), severity of open fracture (p < 0.05), and dangerous behavior such as use of tobacco, alcoholism, and psychiatric disorders (p < 0.05) were significantly correlated with infection. Significant difference between total DANGER scores in SSI and non-SSI groups was found (p < 0.001). ROC curve was calculated founding a potential threshold of 7.5 (p < 0.001)., Conclusion: Based on the above well-accepted risk factors, DANGER scale represents an advantageous and practical tool in order to readily estimate the risk of surgical site infection of open distal tibial fractures., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

While biomaterials have become indispensable for a wide range of tissue repair strategies, second removal procedures oftentimes needed in the case of non-bio-based and non-bioresorbable scaffolds are associated with significant drawbacks not only for the patient, including the risk of infection, impaired healing, or tissue damage, but also for the healthcare system in terms of cost and resources. New biopolymers are increasingly being investigated in the field of tissue regeneration, but their widespread use is still hampered by limitations regarding mechanical, biological, and functional performance when compared to traditional materials. Therefore, a common strategy to tune and broaden the final properties of biopolymers is through the effect of different reinforcing agents. This research work focused on the fabrication and characterization of a bio-based and bioresorbable composite material obtained by compounding a poly(3-hydroxybutyrate- co -3-hydroxyhexanoate) (PHBH) matrix with acetylated cellulose nanocrystals (CNCs). The developed biocomposite was further processed to obtain three-dimensional scaffolds by additive manufacturing (AM). The 3D printability of the PHBH-CNC biocomposites was demonstrated by realizing different scaffold geometries, and the results of in vitro cell viability studies provided a clear indication of the cytocompatibility of the biocomposites. Moreover, the CNC content proved to be an important parameter in tuning the different functional properties of the scaffolds. It was demonstrated that the water affinity, surface roughness, and in vitro degradability rate of biocomposites increase with increasing CNC content. Therefore, this tailoring effect of CNC can expand the potential field of use of the PHBH biopolymer, making it an attractive candidate for a variety of tissue engineering applications.

The surface properties of drug containers should reduce the adsorption of the drug and avoid packaging surface/drug interactions, especially in the case of biologically-derived products. Here, we developed a multi-technique approach that combined Differential Scanning Calorimetry (DSC), Atomic Force Microscopy (AFM), Contact Angle (CA), Quartz Crystal Microbalance with Dissipation monitoring (QCM-D), and X-ray Photoemission Spectroscopy (XPS) to investigate the interactions of rhNGF on different pharma grade polymeric materials. Polypropylene (PP)/polyethylene (PE) copolymers and PP homopolymers, both as spin-coated films and injected molded samples, were evaluated for their degree of crystallinity and adsorption of protein. Our analyses showed that copolymers are characterized by a lower degree of crystallinity and lower roughness compared to PP homopolymers. In line with this, PP/PE copolymers also show higher contact angle values, indicating a lower surface wettability for the rhNGF solution on copolymers than PP homopolymers. Thus, we demonstrated that the chemical composition of the polymeric material and, in turn, its surface roughness determine the interaction with the protein and identified that copolymers may offer an advantage in terms of protein interaction/adsorption. The combined QCM-D and XPS data indicated that protein adsorption is a self-limiting process that passivates the surface after the deposition of roughly one molecular layer, preventing any further protein adsorption in the long term.

Introduction: In this retrospective case-series study we discuss the clinical and radiographic outcomes obtained following the "tibia-first concept" in the treatment of distal tibia fractures, both in patients with fibular comminution and in cases with a simple fibula fracture., Materials and Methods: We analysed a consecutive series of 64 patients who presented at our emergency department with a distal articular tibial and fibular fracture from January 2015 to September 2020. A total of 22 patients met the inclusion and exclusion criteria and were included in the study. Clinical and radiographic examination were performed at each follow-up. To quantify pain and functional disability, the Foot and Ankle Outcome Score (FAOS) and the American Orthopaedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS) were applied., Results: The overall mean age was 52.8 years, and the mean follow-up was 13.18 months. Multiple scales data from the FAOS were as follows: pain score 80.70; symptoms score 81.69; activities of daily living score 87.22; quality of life 76.05. The mean AOFAS ankle-hindfoot score was 74.36., Conclusions: Even though the principles of Rüedi and Allgöwer are still valid, in specific circumstances, the tibia-first concept could be considered as a valid option for the treatment of these demanding fractures. If a good reduction is obtained intra-operatively by ligamentotaxis, we recommend fixing the tibia first, avoiding surgical stress on tissues derived from a previous fibular fixation., Competing Interests: All authors confirm that they have no financial and personal relationships with any commercial party. No financial relationships with any organisations that might have an interest in the submitted work in the previous five years., (© 2023 Malaysian Orthopaedic Association (MOA). All Rights Reserved.)

Study Design: Biomechanical finite-element study., Objective: To directly compare the biomechanical effects of two different techniques for sagittal plane correction of adult spine deformity based on the anterior longitudinal ligament (ALL) resection and use of hyperlordotic cages, namely, the anterior column realignment (ACR) in L3-4, and ALIF in L5-S1 in terms of primary stability and rod stresses using finite-element models., Methods: A finite-element model of the thoracolumbar spine was used to perform the analysis. Starting from this "intact" model, three further models were constructed through the insertion of spinal instrumentation, i.e., pedicle screws, rods and cages: 1) posterior instrumentation between T9 and S1 (referred to as "T9-S1"); 2) posterior instrumentation T9-S1 + Hyperlordotic (26°) ALIF cage in L5-S1 ("ALIF"); 3) posterior instrumentation T9-S1 + Hyperlordotic (30°) ACR cage in L3-4 ("ACR"). These models were studied by simulations applying, alternately, a pure moment of 7.5 Nm between the three planes of motion (flexion, extension, lateral bending, and bilateral axial rotation), uniformly distributed over the upper surface of the T9 thoracic vertebra. A total of 24 simulations were performed (6 per models)., Results: All models presented a significant reduced ROM when compared to the intact model; the ROM reduction was higher both at L3-4 in the ACR model and at L5-S1 in the ALIF model. At L3-4, the ACR model had, in all cases, the lowest maximum values of Von Mises stresses on the rods, especially in flexion-extension. At L4-5, the ALIF model had the lowest stresses during flexion-extension and axial rotation, while the ACR model had the lowest stresses during lateral bending. At L5-S1, the ALIF model had, in all cases, the lowest stresses on the rods., Conclusions: This finite-element study showed how both ACR at L3-4 and ALIF-ACR at L5-S1 are effective in restoring lumbar lordosis (LL), stabilizing the spine and reducing stress on posterior rods at the index level when compared to a simple fixation model. Interestingly, ALIF-ACR reduces rod stress even at L4-5 in flexion-extension and axial rotation, possibly due to a better distribution of LL, especially on the lower arch, while ACR reduces the stress at L4-5 in lateral bending, possibly thanks to the larger footprint of the cage that increases the area of contact with the lateral side of the endplates., (© 2022. The Author(s), under exclusive licence to Scoliosis Research Society.)

By definition, anteroposterior (AP) compression type 1 (APC-1) injury is a type of pelvic ring injury, which is widely acknowledged as 'stable'. Unstable forms of this injury are very rare and present a challenge for diagnosis and clinical management. Detailed herein is a man in his early 30s, referred to our institution with a 2-year history of pubic symphysis pain following a road traffic accident. Radiological investigation revealed an unstable APC-1 injury. This was subsequently managed with surgical reconstruction leading to the successful return of the patient to former function and recreational activities., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Distal metaphyseal-diaphyseal fractures of the hume-rus can be challenging. The success lies in achieving a stable fixation that could allow early functional recovery. Our aim is to combine dif-ferent approaches already reported, to obtain an ideal surgical strategy for treating these fracture patterns., Methods: In this retrospective study, we present the clinical outco-me of a 12-patient cohort in which we used a combined paratricipital and triceps-splitting approach to the distal humerus. The mean age of the group was 50 years (range 17 - 88). Clinical and radiographic evaluation was performed at 1, 3, 6, and 12 months after surgery and thereafter, depending on the necessity of a further control. Patients' range of motion (ROM) of the elbow was reported, and functional outcome was assessed using the Mayo Elbow Performance Index (MEPI).The minimum follow-up was fixed at 12 months., Results: Union was achieved in all fractures. After a median follow-up of 15.7 months (range 12-21), none of the patients complained of any limitation in daily activities. The ROM at the last follow-up was complete in eight patients. Instead, three patients had ROM limitations, but none of them mentioned limitations in the activities of daily living. We observed a single iatrogenic radial nerve palsy undergoing a full functional recovery at the final follow-up. No further complications occurred., Conclusion: We believe that the here presented modified approach could represent a solution that meets the modern demands for both ro-bust fixation and early mobilization, with minimal soft tissues damage around distal humeral fractures.

Background: Tibial plateau fractures pose multiple challenges to the surgeon given their frequent intra-articular involvement and the tendency to displace under axial load. The aim of this study is to de-scribe the clinical outcomes of a retrospective case series in which tibial plateau fractures were not treated with PL fragment osteosynthesis., Methods: In the present retrospective study, we included patients treated for tibial plateau fracture with PL fragment in our department from January 2016 to January 2020. All patients were seen at the outpa-tient clinic 2 and 5 weeks after surgery, and at 3, 6 and 12 months, and thereafter at regular intervals, depending on the overall clinical status. Every patient included in this study was then contacted by phone to assess self-reported clinical outcomes. The Oxford Knee Score (OKS) questionnaire was used to assess functional outcomes. Patients were divided in six groups depending on the three-column classification by Lou (groups A1-A6). Patients were also divided in four groups based on the whole area of the PL column and on the depression of the PL fragment (group B1-B4). One-way ANOVA was used to compare groups of patients., Results: OKS scores, extension and step-off of the PL fragment were analyzed in groups A1 - A6. No significant differences between OKS scores and step-off were found, while statistical difference was found between surfaces of PL fragment. No significant difference was found between OKS scores in groups B1-B4., Conclusion: Our findings suggest that the treatment outcome is influenced not only by the superficial involvement or collapse of PL fragments, but also by other variables, including BMI, pre-injury physi-cal health, and age.

Background: This work evaluated the performances of protein-based bioplastics obtained from black soldier fly (Hermetia illucens) prepupae. Protein films were synthesized by film casting, using both the whole proteins and their soluble fraction at pH = 10. The effects of glycerol as a plasticizer and of citric acid as a mild crosslinker on film properties were also evaluated., Results: Films obtained using the soluble protein fraction were the strongest, as well as the most homogeneous and transparent ones. Protein mild crosslinking improved film tensile properties, especially in films obtained with the whole protein fraction. Non-crosslinked samples had a high affinity with water while crosslinking almost eliminated the ability of films to absorb water. All protein-based films proved to be effective barriers to red light (transmittance less than 2%)., Conclusions: Bioplastics derived from black soldier fly prepupae may find applications in the agricultural sector (biodegradable pots, mulching films, utensils) and deserve to be tested for food and non-food packaging. © 2021 Society of Chemical Industry., (© 2021 Society of Chemical Industry.)

The present work investigated the possibility to use wet blue (WB) leather wastes as natural reinforcing fibers within different polymer matrices. After their preparation and characterization, WB fibers were melt-mixed at 10 wt.% with poly(lactic acid) (PLA), polyamide 12 (PA12), thermoplastic elastomer (TPE), and thermoplastic polyurethane (TPU), and the obtained samples were subjected to rheological, thermal, thermo-mechanical, and viscoelastic analyses. In parallel, morphological properties such as fiber distribution and dispersion, fiber-matrix adhesion, and fiber exfoliation phenomena were analyzed through a scanning electron microscope (SEM) and energy-dispersive spectroscopy (EDS) to evaluate the relationship between the compounding process, mechanical responses, and morphological parameters. The PLA-based composite exhibited the best results since the Young modulus (+18%), tensile strength (+1.5%), impact (+10%), and creep (+5%) resistance were simultaneously enhanced by the addition of WB fibers, which were well dispersed and distributed in and significantly branched and interlocked with the polymer matrix. PA12- and TPU-based formulations showed a positive behavior (around +47% of the Young modulus and +40% of creep resistance) even if the not-optimal fiber-matrix adhesion and/or the poor de-fibration of WB slightly lowered the tensile strength and elongation at break. Finally, the TPE-based sample exhibited the worst performance because of the poor affinity between hydrophilic WB fibers and the hydrophobic polymer matrix.

Grape stalks are a lignocellulosic biomass, which is a very complex material, whose easy and profitable fractionation to obtain its basic components is still not available. Therefore, alternative ways to try and make use of grape stalks are currently being explored. In the present study, the possible use of dried and milled grape stalks as filler in bio-composites was assessed using polybutylene succinate as a basic polymer. The tensile specimens produced using 10% grape stalk powder as it is and functionalized through pre-extrusion acetylation and silylation, and silylation in situ were characterized for their structural, mechanical, thermal, morphological, and color properties. The bio-composites showed to be stiffer than the control polymer, with an increase of Young's modulus from 616 MPa to 732 MPa in the specimens obtained with acetylated grape stalk powder. This led to a potentially new method to valorize by-products of the wine industry such as grape stalks in order to recover raw materials which could prove useful in the biomaterials and bio-composites sector., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

In recent years, biopolymers have been attracting the attention of researchers and specialists from different fields, including biotechnology, material science, engineering, and medicine. The reason is the possibility of combining sustainability with scientific and technological progress. This is an extremely broad research topic, and a distinction has to be made among different classes and types of biopolymers. Polyhydroxyalkanoate (PHA) is a particular family of polyesters, synthetized by microorganisms under unbalanced growth conditions, making them both bio-based and biodegradable polymers with a thermoplastic behavior. Recently, PHAs were used more intensively in biomedical applications because of their tunable mechanical properties, cytocompatibility, adhesion for cells, and controllable biodegradability. Similarly, the 3D-printing technologies show increasing potential in this particular field of application, due to their advantages in tailor-made design, rapid prototyping, and manufacturing of complex structures. In this review, first, the synthesis and the production of PHAs are described, and different production techniques of medical implants are compared. Then, an overview is given on the most recent and relevant medical applications of PHA for drug delivery, vessel stenting, and tissue engineering. A special focus is reserved for the innovations brought by the introduction of additive manufacturing in this field, as compared to the traditional techniques. All of these advances are expected to have important scientific and commercial applications in the near future.

Invisible orthodontic aligners (IOAs) have been introduced in the orthodontic field as an innovative alternative for fixed brackets, in relation to their ability to be easily inserted/removed from the oral cavity without affecting the chewing ability and the aesthetic of the patients. The paper provides a complete physicochemical and mechanical characterization of thermoplastic materials in the form of disks used for commercial IOAs. A wide palette of specific techniques is considered, from tensile tests and dynamic-mechanical analysis, to X-Ray diffraction (XRD), differential scanning calorimetry (DSC), Fourier transformation infrared spectroscopy (FTIR-ATR) analyses and water absorption tests. The disks are investigated before and after immersion into staining beverages (red wine, coffee, nicotine and artificial saliva), in terms of colour variations, transparency, and microscopic surface modifications by means of colorimetry, UV-VIS absorbance and scanning electron microscopy (SEM). Among all the samples, polyurethane (PU) exhibited the highest crystallinity and the highest values of mechanical and thermal resistance, while the poly(ethylene terephthalate)-glycol (PETG) samples presented better transparency and less ability to absorb water. Moreover, red wine and coffee give noticeable colour variations after 14 days of immersion, together with a slight reduction of transparency.

In this study proteins extracted from prepupae of Hermetia illucens, also known as black soldier fly, are investigated as promising base for a new type of bioplastics for agricultural purposes. Design of experiments techniques are employed to perform a rational study on the effects of different combination of glycerol as plasticizer, citric acid as cross-linking agent and distilled water as solvent on the capability of proteins to form a free-standing film through casting technique, keeping as fixed the quantity of proteins. Glycerol shows interesting properties as plasticizer contributing to the formation of homogenous and free-standing film. Moreover, mechanical and thermal characterizations are performed to estimate the effect of increasing amounts of proteins on the final properties and thickness of the specimens. Proteins derived from H. illucens can be successfully employed as base for bioplastics to be employed for agricultural purposes., (© 2018 Wiley Periodicals, Inc.)

Background and Objective: The inter-subject variability characterizing the patients affected by type 1 diabetes mellitus makes automatic blood glucose control very challenging. Different patients have different insulin responses, and a control law based on a non-individualized model could be ineffective. The definition of an individualized control law in the context of artificial pancreas is currently an open research topic. In this work we consider two novel identification approaches that can be used for individualizing linear glucose-insulin models to a specific patient., Methods: The first approach belongs to the class of black-box identification and is based on a novel kernel-based nonparametric approach, whereas the second is a gray-box identification technique which relies on a constrained optimization and requires to postulate a model structure as prior knowledge. The latter is derived from the linearization of the average nonlinear adult virtual patient of the UVA/Padova simulator. Model identification and validation are based on in silico data collected during simulations of clinical protocols designed to produce a sufficient signal excitation without compromising patient safety. The identified models are evaluated in terms of prediction performance by means of the coefficient of determination, fit, positive and negative max errors, and root mean square error., Results: Both identification approaches were used to identify a linear individualized glucose-insulin model for each adult virtual patient of the UVA/Padova simulator. The resulting model simulation performance is significantly improved with respect to the performance achieved by a linear average model., Conclusions: The approaches proposed in this work have shown a good potential to identify glucose-insulin models for designing individualized control laws for artificial pancreas., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

The need for new approaches to investigate ex vivo the causes and effects of tumor and to achieve improved cancer treatments and medical therapies is particularly urgent for malignant pathologies such as lymphomas and leukemias, whose tissue initiator cells interact with the stroma creating a three-dimensional (3D) protective environment that conventional mono- and bi-dimensional (2D) models are not able to simulate realistically. The solvent-casting particulate leaching (SCPL) technique, that is already a standard method to produce polymer-based scaffolds for bone tissue repair, is proposed here to fabricate innovative 3D porous structures to mimic the bone marrow niche in vitro. Two different polymers, namely a rigid polymethyl methacrylate (PMMA) and a flexible polyurethane (PU), were evaluated to the purpose, whereas NaCl, in the form of common salt table, resulted to be an efficient porogen. The adoption of an appropriate polymer-to-salt ratio, experimentally defined as 1:4 for both PMMA and PU, gave place to a rich and interconnected porosity, ranging between 82.1 vol% and 91.3 vol%, and the choice of admixing fine-grained or coarse-grained salt powders allowed to control the final pore size. The mechanical properties under compression load were affected both by the polymer matrix and by the scaffold's architecture, with values of the elastic modulus indicatively varying between 29 kPa and 1283 kPa. Preliminary tests performed with human stromal HS-5 cells co-cultured with leukemic cells allowed us to conclude that stromal cells grown associated to the supports keep their well-known protective and pro-survival effect on cancer cells, indicating that these devices can be very useful to mimic the bone marrow microenvironment and therefore to assess the efficacy of novel therapies in pre-clinical studies., (Copyright © 2018 Elsevier B.V. All rights reserved.)

In this paper we used high- and low-resolution solid state Nuclear Magnetic Resonance (NMR) techniques to investigate a series of polyisoprene samples filled with silica generated in situ from tetraethoxysilane by sol-gel process. In particular, ¹H spin-lattice and spin-spin relaxation times allowed us to get insights into the dynamic properties of both the polymer bulk and the bound rubber, and to obtain a comparative estimate of the amount of bound rubber in samples prepared with different compositions and sol-gel reaction times. In all samples, three fractions with different mobility could be distinguished by ¹H T ₂ and ascribed to loosely bound rubber, polymer bulk, and free chain ends. The amount of bound rubber was found to be dependent on sample preparation, and it resulted maximum in the sample showing the best dispersion of silica domains in the rubber matrix. The interpretation of the loosely bound rubber in terms of "glassy" behaviour was discussed, also on the basis of ¹H T ₁ and T 1 ρ data.

The aim of this review is a faithful report of the panorama of solutions adopted to fabricate a component using vat photopolymerization (VP) processes. A general overview on additive manufacturing and on the different technologies available for polymers is given. A comparison between stereolithography and digital light processing is also presented, with attention to different aspects and to the advantages and limitations of both technologies. Afterward, a quick overview of the process parameters is given, with an emphasis on the necessities and the issues associated with the VP process. The materials are then explored, starting from base matrix materials to composites and nanocomposites, with attention to examples of applications and explanations of the main factors involved.

Introduction In the past years, we developed a telemonitoring service for young patients affected by Type 1 Diabetes. The service provides data to the clinical staff and offers an important tool to the parents, that are able to oversee in real time their children. The aim of this work was to analyze the parents' perceived usefulness of the service. Methods The service was tested by the parents of 31 children enrolled in a seven-day clinical trial during a summer camp. To study the parents' perception we proposed and analyzed two questionnaires. A baseline questionnaire focused on the daily management and implications of their children's diabetes, while a post-study one measured the perceived benefits of telemonitoring. Questionnaires also included free text comment spaces. Results Analysis of the baseline questionnaires underlined the parents' suffering and fatigue: 51% of total responses showed a negative tendency and the mean value of the perceived quality of life was 64.13 in a 0-100 scale. In the post-study questionnaires about half of the parents believed in a possible improvement adopting telemonitoring. Moreover, the foreseen improvement in quality of life was significant, increasing from 64.13 to 78.39 ( p-value = 0.0001). The analysis of free text comments highlighted an improvement in mood, and parents' commitment was also proved by their willingness to pay for the service (median = 200 euro/year). Discussion A high number of parents appreciated the telemonitoring service and were confident that it could improve communication with physicians as well as the family's own peace of mind.

Objective: Contemporary and future outpatient long-term artificial pancreas (AP) studies need to cope with the well-known large intra- and interday glucose variability occurring in type 1 diabetic (T1D) subjects. Here, we propose an adaptive model predictive control (MPC) strategy to account for it and test it in silico., Methods: A run-to-run (R2R) approach adapts the subcutaneous basal insulin delivery during the night and the carbohydrate-to-insulin ratio (CR) during the day, based on some performance indices calculated from subcutaneous continuous glucose sensor data. In particular, R2R aims, first, to reduce the percentage of time in hypoglycemia and, secondarily, to improve the percentage of time in euglycemia and average glucose. In silico simulations are performed by using the University of Virginia/Padova T1D simulator enriched by incorporating three novel features: intra- and interday variability of insulin sensitivity, different distributions of CR at breakfast, lunch, and dinner, and dawn phenomenon., Results: After about two months, using the R2R approach with a scenario characterized by a random 30% variation of the nominal insulin sensitivity the time in range and the time in tight range are increased by 11.39% and 44.87%, respectively, and the time spent above 180 mg/dl is reduced by 48.74%., Conclusions: An adaptive MPC algorithm based on R2R shows in silico great potential to capture intra- and interday glucose variability by improving both overnight and postprandial glucose control without increasing hypoglycemia., Significance: Making an AP adaptive is key for long-term real-life outpatient studies. These good in silico results are very encouraging and worth testing in vivo.

The limited availability of materials with special properties represents one of the main limitations to a wider application of polymer-based additive manufacturing technologies. Filled resins are usually not suitable for vat photo-polymerization techniques such as stereolithography (SLA) or digital light processing (DLP) due to a strong increment of viscosity derived from the presence of rigid particles within the reactive suspension. In the present paper, the possibility to in situ generate silver nanoparticles (AgNPs) starting from a homogeneous liquid system containing a well dispersed silver salt, which is subsequently reduced to metallic silver during stereolithographic process, is reported. The simultaneous photo-induced cross-linking of the acrylic resin produces a filled thermoset resin with thermal-mechanical properties significantly enhanced with respect to the unfilled resin, even at very low AgNPs concentrations. With this approach, the use of silver salts having carbon-carbon double bonds, such as silver acrylate and silver methacrylate, allows the formation of a nanocomposite structure in which the release of by-products is minimized due to the active role of all the reactive components in the three dimensional (3D)-printing processes. The synergy, between this nano-technology and the geometrical freedom offered by SLA, could open up a wide spectrum of potential applications for such a material, for example in the field of food packaging and medical and healthcare sectors, considering the well-known antimicrobial effects of silver nanoparticles., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Recovering of significant skeletal defects could be partially abortive due to the perturbations that affect the regenerative process when defects reach a critical size, thus resulting in a non-healed bone. The current standard treatments include allografting, autografting, and other bone implant techniques. However, although they are commonly used in orthopedic surgery, these treatments have some limitations concerning their costs and their side effects such as potential infections or malunions. On this account, the need for suitable constructs to fill the gap in wide fractures is still urgent. As an innovative solution, scleral ossicles (SOs) can be put forward as natural scaffolds for bone repair. SOs are peculiar bony plates forming a ring at the scleral-corneal border of the eyeball of lower vertebrates. In the preliminary phases of the study, these ossicles were structurally and functionally characterized. The morphological characterization was performed by SEM analysis, MicroCT analysis and optical profilometry. Then, UV sterilization was carried out to obtain a clean support, without neither contaminations nor modifications of the bone architecture. Subsequently, the SO biocompatibility was tested in culture with different cell lines, focusing the attention to the differentiation capability of endothelial and osteoblastic cells on the SO surface. The results obtained by the above mentioned analysis strongly suggest that SOs can be used as bio-scaffolds for functionalization processes, useful in regenerative medicine., Competing Interests: The authors declare no conflict of interest.

Bacterial cellulose is composed of an ultrafine nanofiber network and well-ordered structure; therefore, it offers several advantages when used as native polymer or in composite systems.In this study, a pool of 34 acetic acid bacteria strains belonging to Komagataeibacter xylinus were screened for their ability to produce bacterial cellulose. Bacterial cellulose layers of different thickness were observed for all the culture strains. A high-producing strain, which secreted more than 23 g/L of bacterial cellulose on the isolation broth during 10 days of static cultivation, was selected and tested in optimized culture conditions. In static conditions, the increase of cellulose yield and the reduction of by-products such as gluconic acid were observed. Dried bacterial cellulose obtained in the optimized broth was characterized to determine its microstructural, thermal, and mechanical properties. All the findings of this study support the use of bacterial cellulose produced by the selected strain for biomedical and food applications.

Aim: To assess the impact on fear of hypoglycaemia and treatment satisfaction with an artificial pancreas system used for 2 consecutive months, as well as participant acceptance of the artificial pancreas system., Methods: In a randomized crossover trial patient-related outcomes associated with an evening-and-night artificial pancreas and sensor-augmented pump therapy were compared. Both intervention periods lasted 8 weeks. The artificial pancreas acceptance questionnaire (range 0-90, higher scores better), Hypoglycaemia Fear Survey II (range 0-72, higher scores worse) and Diabetes Treatment Satisfaction Questionnaire (range 0-36, higher scores better) were completed by 32 participants. Semi-structured interviews were conducted after study completion in a subset of six participants. Outcomes were compared using a repeated-measures anova model or paired t-test when appropriate., Results: The total artificial pancreas acceptance questionnaire score at the end of the artificial pancreas period was 69.1 (sd 14.7; 95% CI 63.5, 74.7), indicating a positive attitude towards the artificial pancreas. No significant differences were found among the scores at baseline, end of sensor-augmented pump therapy period or end of the artificial pancreas period with regard to fear of hypoglycaemia [28.2 (sd 17.5), 23.5 (sd 16.6) and 23.5 (sd 16.7), respectively; P = 0.099] or diabetes treatment satisfaction [29.0 (sd 3.9), 28.2 (sd 5.2) and 28.0 (sd 7.1), respectively; P = 0.43]. Themes frequently mentioned in the interviews were 'positive effects at work', 'improved blood glucose', 'fewer worries about blood glucose', but also 'frequent alarms', 'technological issues' and 'demand for an all-in-one device'., Conclusions: The psychological outcomes of artificial pancreas and sensor-augmented pump therapy were similar. Current artificial pancreas technology is promising but user concerns should be taken into account to ensure utility of these systems., (© 2016 The Authors Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)

Objective: To explore the experiences of children with type 1 diabetes and their parents taking part in an artificial pancreas (AP) clinical trial during a 7-day summer camp., Research Design and Methods: A semistructured interview, composed of 14 questions based on the Technology Acceptance Model, was conducted at the end of the clinical trial. Participants also completed the Diabetes Treatment Satisfaction Questionnaire (DTSQ, parent version) and the AP Acceptance Questionnaire., Results: Thirty children, aged 5-9 years, and their parents completed the study. A content analysis of the interviews showed that parents were focused on understanding the mechanisms, risks, and benefits of the new device, whereas the children were focused on the novelty of the new system. The parents' main concerns about adopting the new system seemed related to the quality of glucose control. The mean scores of DTSQ subscales indicated general parents' satisfaction (44.24 ± 5.99, range 32-53) and trustful views of diabetes control provided by the new system (7.8 ± 2.2, range 3-12). The AP Acceptance Questionnaire revealed that most parents considered the AP easy to use (70.5%), intended to use it long term (94.0%), and felt that it was apt to improve glucose control (67.0%)., Conclusions: Participants manifested a positive attitude toward the AP. Further studies are required to explore participants' perceptions early in the AP development to individualize the new treatment as much as possible, and to tailor it to respond to their needs and values., (© 2016 by the American Diabetes Association.)

Objective: The Pediatric Artificial Pancreas (PedArPan) project tested a children-specific version of the modular model predictive control (MMPC) algorithm in 5- to 9-year-old children during a camp., Research Design and Methods: A total of 30 children, 5- to 9-years old, with type 1 diabetes completed an outpatient, open-label, randomized, crossover trial. Three days with an artificial pancreas (AP) were compared with three days of parent-managed sensor-augmented pump (SAP)., Results: Overnight time-in-hypoglycemia was reduced with the AP versus SAP, median (25(th)-75(th) percentiles): 0.0% (0.0-2.2) vs. 2.2% (0.0-12.3) (P = 0.002), without a significant change of time-in-target, mean: 56.0% (SD 22.5) vs. 59.7% (21.2) (P = 0.430), but with increased mean glucose 173 mg/dL (36) vs. 150 mg/dL (39) (P = 0.002). Overall, the AP granted a threefold reduction of time-in-hypoglycemia (P < 0.001) at the cost of decreased time-in-target, 56.8% (13.5) vs. 63.1% (11.0) (P = 0.022) and increased mean glucose 169 mg/dL (23) vs. 147 mg/dL (23) (P < 0.001)., Conclusions: This trial, the first outpatient single-hormone AP trial in a population of this age, shows feasibility and safety of MMPC in young children. Algorithm retuning will be performed to improve efficacy., (© 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.)

Objective: After testing of a wearable artificial pancreas (AP) during evening and night (E/N-AP) under free-living conditions in patients with type 1 diabetes (T1D), we investigated AP during day and night (D/N-AP) for 1 month., Research Design and Methods: Twenty adult patients with T1D who completed a previous randomized crossover study comparing 2-month E/N-AP versus 2-month sensor augmented pump (SAP) volunteered for 1-month D/N-AP nonrandomized extension. AP was executed by a model predictive control algorithm run by a modified smartphone wirelessly connected to a continuous glucose monitor (CGM) and insulin pump. CGM data were analyzed by intention-to-treat with percentage time-in-target (3.9-10 mmol/L) over 24 h as the primary end point., Results: Time-in-target (mean ± SD, %) was similar over 24 h with D/N-AP versus E/N-AP: 64.7 ± 7.6 vs. 63.6 ± 9.9 (P = 0.79), and both were higher than with SAP: 59.7 ± 9.6 (P = 0.01 and P = 0.06, respectively). Time below 3.9 mmol/L was similarly and significantly reduced by D/N-AP and E/N-AP versus SAP (both P < 0.001). SD of blood glucose concentration (mmol/L) was lower with D/N-AP versus E/N-AP during whole daytime: 3.2 ± 0.6 vs. 3.4 ± 0.7 (P = 0.003), morning: 2.7 ± 0.5 vs. 3.1 ± 0.5 (P = 0.02), and afternoon: 3.3 ± 0.6 vs. 3.5 ± 0.8 (P = 0.07), and was lower with D/N-AP versus SAP over 24 h: 3.1 ± 0.5 vs. 3.3 ± 0.6 (P = 0.049). Insulin delivery (IU) over 24 h was higher with D/N-AP and SAP than with E/N-AP: 40.6 ± 15.5 and 42.3 ± 15.5 vs. 36.6 ± 11.6 (P = 0.03 and P = 0.0004, respectively)., Conclusions: D/N-AP and E/N-AP both achieved better glucose control than SAP under free-living conditions. Although time in the different glycemic ranges was similar between D/N-AP and E/N-AP, D/N-AP further reduces glucose variability., (© 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.)

Organic-inorganic hybrid materials have shown improved properties to be used as biocompatible coating in biomedical applications. Polyhedral oligomeric silsesquioxane (POSS) containing coatings are among hybrid materials showing promising properties for these applications. In this work an open cage POSS has been reacted with a titanium alkoxide to end cap the POSS molecule with titanium atom to obtain a so called polyhedral oligomeric metalized silsesquioxane (POMS). The synthesized POMS was characterized by FTIR, RAMAN and UV-visible spectroscopy as well as (29)Si NMR and matrix assisted laser desorption/ionization time-of-flight (MALDI-TOF) techniques. Appearance of peaks at 920 cm(-1) in FTIR and 491 cm(-1) and 1083 cm(-1) in Raman spectra confirmed Si-O-Ti linkage formation. It was also demonstrated that POMS was in a monomeric form. To evaluate the biocompatibility of hybrids films, pristine POSS and synthesized POMS were used in synthesis of a polycarbonate urethane polymer. Results revealed that POMS containing hybrid, not only had notable thermal and mechanical stability compared to POSS containing one, as demonstrated by DSC and DMTA analysis, they also showed controlled surface properties in such a manner that hydrophobicity and biocompatibility were both reachable to give rise to improved cell viability in presence of human umbilical vein endothelial cells (HUVEC) and MRC-5 cells., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: An artificial pancreas (AP) that can be worn at home from dinner to waking up in the morning might be safe and efficient for first routine use in patients with type 1 diabetes. We assessed the effect on glucose control with use of an AP during the evening and night plus patient-managed sensor-augmented pump therapy (SAP) during the day, versus 24 h use of patient-managed SAP only, in free-living conditions., Methods: In a crossover study done in medical centres in France, Italy, and the Netherlands, patients aged 18-69 years with type 1 diabetes who used insulin pumps for continuous subcutaneous insulin infusion were randomly assigned to 2 months of AP use from dinner to waking up plus SAP use during the day versus 2 months of SAP use only under free-living conditions. Randomisation was achieved with a computer-generated allocation sequence with random block sizes of two, four, or six, masked to the investigator. Patients and investigators were not masked to the type of intervention. The AP consisted of a continuous glucose monitor (CGM) and insulin pump connected to a modified smartphone with a model predictive control algorithm. The primary endpoint was the percentage of time spent in the target glucose concentration range (3·9-10·0 mmol/L) from 2000 to 0800 h. CGM data for weeks 3-8 of the interventions were analysed on a modified intention-to-treat basis including patients who completed at least 6 weeks of each intervention period. The 2 month study period also allowed us to asses HbA1c as one of the secondary outcomes. This trial is registered with ClinicalTrials.gov, number NCT02153190., Findings: During 2000-0800 h, the mean time spent in the target range was higher with AP than with SAP use: 66·7% versus 58·1% (paired difference 8·6% [95% CI 5·8 to 11·4], p<0·0001), through a reduction in both mean time spent in hyperglycaemia (glucose concentration >10·0 mmol/L; 31·6% vs 38·5%; -6·9% [-9·8% to -3·9], p<0·0001) and in hypoglycaemia (glucose concentration <3·9 mmol/L; 1·7% vs 3·0%; -1·6% [-2·3 to -1·0], p<0·0001). Decrease in mean HbA1c during the AP period was significantly greater than during the control period (-0·3% vs -0·2%; paired difference -0·2 [95% CI -0·4 to -0·0], p=0·047), taking a period effect into account (p=0·0034). No serious adverse events occurred during this study, and none of the mild-to-moderate adverse events was related to the study intervention., Interpretation: Our results support the use of AP at home as a safe and beneficial option for patients with type 1 diabetes. The HbA1c results are encouraging but preliminary., Funding: European Commission., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aims: To test in an outpatient setting the safety and efficacy of continuous subcutaneous insulin infusion (CSII) driven by a modular model predictive control (MMPC) algorithm informed by continuous glucose monitoring (CGM) measurement., Methods: 13 patients affected by type 1 diabetes participated to a non-randomized outpatient 42-h experiment that included two evening meals and overnight periods (in short, dinner & night periods). CSII was patient-driven during dinner & night period 1 and MMPC-driven during dinner&night period 2. The study was conducted in hotels, where patients could move around freely. A CGM system (G4 Platinum; Dexcom Inc., San Diego, CA, USA) and insulin pump (AccuChek Combo; Roche Diagnostics, Mannheim, Germany) were connected wirelessly to a smartphone-based platform (DiAs, Diabetes Assistant; University of Virginia, Charlottesville, VA, USA) during both periods., Results: A significantly lower percentage of time spent with glucose levels <3.9 mmol/l was achieved in period 2 compared with period 1: 1.96 ± 4.56% vs 12.76 ± 15.84% (mean ± standard deviation, p < 0.01), together with a greater percentage of time spent in the 3.9-10 mmol/l target range: 83.56 ± 14.02% vs 62.43 ± 29.03% (p = 0.04). In addition, restricting the analysis to the overnight phases, a lower percentage of time spent with glucose levels <3.9 mmol/l (1.92 ± 4.89% vs 12.7 ± 19.75%; p = 0.03) was combined with a greater percentage of time spent in 3.9-10 mmol/l target range in period 2 compared with period 1 (92.16 ± 8.03% vs 63.97 ± 2.73%; p = 0.01). Average glucose levels were similar during both periods., Conclusions: The results suggest that MMPC managed by a wearable system is safe and effective during evening meal and overnight. Its sustained use during this period is currently being tested in an ongoing randomized 2-month study., (© 2015 John Wiley & Sons Ltd.)

Objective: We estimate the effect size of hypoglycemia risk reduction on closed-loop control (CLC) versus open-loop (OL) sensor-augmented insulin pump therapy in supervised outpatient setting., Research Design and Methods: Twenty patients with type 1 diabetes initiated the study at the Universities of Virginia, Padova, and Montpellier and Sansum Diabetes Research Institute; 18 completed the entire protocol. Each patient participated in two 40-h outpatient sessions, CLC versus OL, in randomized order. Sensor (Dexcom G4) and insulin pump (Tandem t:slim) were connected to Diabetes Assistant (DiAs)-a smartphone artificial pancreas platform. The patient operated the system through the DiAs user interface during both CLC and OL; study personnel supervised on site and monitored DiAs remotely. There were no dietary restrictions; 45-min walks in town and restaurant dinners were included in both CLC and OL; alcohol was permitted., Results: The primary outcome-reduction in risk for hypoglycemia as measured by the low blood glucose (BG) index (LGBI)-resulted in an effect size of 0.64, P = 0.003, with a twofold reduction of hypoglycemia requiring carbohydrate treatment: 1.2 vs. 2.4 episodes/session on CLC versus OL (P = 0.02). This was accompanied by a slight decrease in percentage of time in the target range of 3.9-10 mmol/L (66.1 vs. 70.7%) and increase in mean BG (8.9 vs. 8.4 mmol/L; P = 0.04) on CLC versus OL., Conclusions: CLC running on a smartphone (DiAs) in outpatient conditions reduced hypoglycemia and hypoglycemia treatments when compared with sensor-augmented pump therapy. This was accompanied by marginal increase in average glycemia resulting from a possible overemphasis on hypoglycemia safety., (© 2014 by the American Diabetes Association.)

A series of novel Si-O-Si crosslinked organic/inorganic hybrid semi-crystalline polymers with shape memory properties was prepared from alkoxysilane-terminated poly(butylene succinate) (PBS) by water-induced silane crosslinking under organic solvent-free and catalyst-free conditions. The hydrolyzation and condensation of alkoxysilane end groups allowed for the generation of silica-like crosslinking points between the polymeric chains, acting not only as chemical net-points, but also as inorganic filler for a reinforcement effect. The resulting networks were characterized using differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), dynamic-mechanical analysis (DMA) and tensile and shape memory tests to gain insight into the relationship between the polymeric structure, the morphology and the properties. By controlling the molecular weight of the PBS precursor, a fine tuning of the crosslinking density and the inorganic content of the resulting network was possible, leading to different thermal, mechanical and shape memory properties. Thanks to their suitable morphology consisting of crystalline domains, which represent the molecular switches between the temporary and permanent shapes, and chemical net-points, which permit the shape recovery, the synthesized materials showed good shape memory characteristics, being able to fix a significant portion of the applied strain in a temporary shape and to restore their original shape above their melting temperature.

Objective: Inpatient studies suggest that model predictive control (MPC) is one of the most promising algorithms for artificial pancreas (AP). So far, outpatient trials have used hypo/hyperglycemia-mitigation or medical-expert systems. In this study, we report the first wearable AP outpatient study based on MPC and investigate specifically its ability to control postprandial glucose, one of the major challenges in glucose control., Research Design and Methods: A new modular MPC algorithm has been designed focusing on meal control. Six type 1 diabetes mellitus patients underwent 42-h experiments: sensor-augmented pump therapy in the first 14 h (open-loop) and closed-loop in the remaining 28 h., Results: MPC showed satisfactory dinner control versus open-loop: time-in-target (70-180 mg/dL) 94.83 vs. 68.2% and time-in-hypo 1.25 vs. 11.9%. Overnight control was also satisfactory: time-in-target 89.4 vs. 85.0% and time-in-hypo: 0.00 vs. 8.19%., Conclusions: This outpatient study confirms inpatient evidence of suitability of MPC-based strategies for AP. These encouraging results pave the way to randomized crossover outpatient studies.

Background: The objective of this research is to develop a new artificial pancreas that takes into account the experience accumulated during more than 5000 h of closed-loop control in several clinical research centers. The main objective is to reduce the mean glucose value without exacerbating hypo phenomena. Controller design and in silico testing were performed on a new virtual population of the University of Virginia/Padova simulator., Methods: A new sensor model was developed based on the Comparison of Two Artificial Pancreas Systems for Closed-Loop Blood Glucose Control versus Open-Loop Control in Patients with Type 1 Diabetes trial AP@home data. The Kalman filter incorporated in the controller has been tuned using plasma and pump insulin as well as plasma and continuous glucose monitoring measures collected in clinical research centers. New constraints describing clinical knowledge not incorporated in the simulator but very critical in real patients (e.g., pump shutoff) have been introduced. The proposed model predictive control (MPC) is characterized by a low computational burden and memory requirements, and it is ready for an embedded implementation., Results: The new MPC was tested with an intensive simulation study on the University of Virginia/Padova simulator equipped with a new virtual population. It was also used in some preliminary outpatient pilot trials. The obtained results are very promising in terms of mean glucose and number of patients in the critical zone of the control variability grid analysis., Conclusions: The proposed MPC improves on the performance of a previous controller already tested in several experiments in the AP@home and JDRF projects. This algorithm complemented with a safety supervision module is a significant step toward deploying artificial pancreases into outpatient environments for extended periods of time., (© 2013 Diabetes Technology Society.)

Polycaprolactone/hydroxyapatite (PCL/HA) composites were prepared by in situ generation of HA in the polymer solution starting from the precursors calcium nitrate tetrahydrate and ammonium dihydrogen phosphate via sol-gel process. Highly interconnected porosity was achieved by means of the salt-leaching technique using a mixture of sodium chloride and sodium bicarbonate as porogens. Structure and morphology of the PCL/HA composites were investigated by scanning electron microscopy, and mechanical properties were determined by means of tensile and compression tests. The possibility to employ the developed composites as scaffolds for bone tissue regeneration was assessed by cytotoxicity test of the PCL/HA composites extracts and cell adhesion and proliferation in vitro studies.

Two organophilic bentonites, based on nitrogen-containing compounds, have been synthesised via ion exchange starting from pristine bentonite with octadecyltrimethylammonium bromide (OTAB) and with synthetic melamine-derived N2,N4-dihexadecyl-1,3,5-triazine-2,4,6-triamine (DEDMEL). The chemical and morphological characterization of the organoclays was based on XRD, TEM, Laser Granulometry, X-Ray Fluorescence and CEC capacity. Copoly(styrene-butadiene-styrene)-nanocomposites (SBS-nanocomposites) were obtained by intercalation of the SBS-copolymer into these new organoclays by melt intercalation method. XRD and TEM analysis of the organoclays and of the micro/nano-composites obtained are presented. The effect of the organoclays on the SBS-nanocomposite's flammability properties was investigated using cone calorimeter. An encouraging decrease of 20% in the peak heat released rate (PHRR) has been obtained confirming the important role of melamine's based skeleton and its derived organoclays to act as effective fire retardants and for the improvement of this important functional property in SBS copolymers.

Different organic/inorganic compositions and deposition methods were used to prepare superhydrophobic surfaces using metal alkoxides and the sol-gel process. Both surface roughness and composition had to be adjusted in order to obtain very high contact angles and low contact angle hysteresis as a necessary requirement for superhydrophobicity. Multilayer samples with a fluorinated organic-inorganic top layer showed water contact angles of about 157 degrees with low hysteresis (2 degrees ). Water drops rolled easily off their surface at a tilt angle as low as 4 degrees .

This paper demonstrates that the addition of fluorinated block copolymers to PET solutions can be used to prepare PET films with controlled surface morphology, porosity and chemical composition, by exploiting the phenomenon known as breath figures (BF) formation during a spin-coating procedure. Surface features, such as number, depth and diameter of pores and chemical composition, can be tuned by varying the experimental conditions: relative humidity, solution composition and amount of the fluorinated block copolymer added to the PET solutions (in the range of 0.5-10 wt% with respect to PET). BF patterns are more evident at relatively high concentrations of PET (3 wt%) and content of fluorinated block copolymer (10 wt% with respect to PET) in the solution. According to the obtained results, the fluorinated block copolymer seems to play a role in different steps of the mechanism of BF formation. XPS measurements showed a surface composition much richer in fluorinated segments than expected from bulk composition. The combined surface roughness and surface segregation of fluorinated segments have only a limited effect on the macroscopic wettability of the surfaces.

Hepatic synthesis of lipoproteins and apolipoproteins was investigated in male Wistar rats with severe nephrotic syndrome induced by puromycin aminonucleoside by incubating liver slices with a mixture of 14C-amino acids. Labeled lipoproteins were separated by preparative ultracentrifugation from the incubation medium after the addition of carrier plasma. The incorporation of 14C-amino acids into very low density lipoproteins (VLDL) (1.006 g/ml), low density lipoproteins (LDL) (1.006-1.063 g/ml) and high density lipoproteins (HDL) (1.063-1.210 g/ml) was increased in nephrotic liver 6.1-, 5.7- and 5.0-fold, respectively. The measurement of radioactivity associated to apolipoproteins isolated by SDS-PAGE documented an increased incorporation into apolipoprotein E (apoE) of nephrotic VLDL (33.1% vs 20% of the total radioactivity incorporated into VLDL apoproteins) and a markedly increased incorporation into apolipoprotein A-I (apo-A-I) of nephrotic HDL (44.3% vs 16.3% of the total radioactivity incorporated into HDL apoproteins). In nephrotic liver, the total incorporation of amino acids into apolipoproteins (apoVLDL + apoLDL + apoHDL) was increased 12.6 times for apo-A-I, 6,4 times for apoB, 5.0 times for apoE, 4.2 times for apoC + apoA-II and 2.5 times for apoA-IV. We suggest that, in nephrotic liver: (a) the synthesis of VLDL, LDL and HDL is increased, and (b) the total synthesis of apoA-I is selectively increased when compared to that of the other apolipoproteins.

Some authors found higher lead levels in children whose parents are occupationally exposed to the metal, which is probably carried home with dirty work clothes. In order to verify the relevance of the risk in tile-workers' children we examined 3 groups of 5-7 years old children whose parents were: a) tile workers employed in lead areas; b) tile workers not employed in lead areas; c) workers not occupationally exposed to lead (control group). We found that lead workers children had PbB and PbH significantly higher than control children although all PbB values were lower than 30 micrograms/dl. Nevertheless this observation suggests that major attention must be paid to individual preventive measures, such as the change of work clothes and good personal hygiene after every work shift.