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Background: Bowel perforation is the loss of intestinal wall integrity and can occur by several mechanisms including infection, obstruction, inflammation, trauma and iatrogenic causes. Incidences of bowel perforation range from 1-7% in pediatric trauma patients and 0.02-8% in adults. There is no specific classification for gastrointestinal perforations, but several methods have been used to describe perforations based on etiology, including systemic, inflammatory, medication, neoplastic and instrumentation-induced perforations. We assessed the feasibility of closing small intestine perforations with a mesh patch instead of sutures only. Methods and Findings: Nine porcine ex-vivo small intestine specimens were incised 0.5 cm to simulate bowel perforations. Control group perforations were sutured closed without mesh. The two experimental groups were closed by mesh sewn to the outside (first group) or inside (second group) of the bowel wall. Each specimen was submerged in normal saline and insufflated until air bubbles leaked from the perforation. That insufflation pressure was recorded as the burst pressure. The control group burst at 78.0±17.9 mmHg. The “patch outside” group burst at 54.7±9.1 mmHg. The “patch inside” group burst at 32.0 ±4.6 mmHg. Only the “patch inside” group had statistically significant inferiority, but both groups trended towards inferiority. Conclusions: Preliminary research indicates that patch repair of intestinal perforations is likely inferior to sutures alone, although repair with the patch outside the bowel wall cannot be completely excluded because of the high variability of the data. Further research may try alternate patch types or different variations to find a non-inferior closure method. A sample size of n=9 each would give 80% power to detect a minimal detectable difference of 20 mmHg.

The proliferation and migration of porcine adipose-derived stem cells (ASCs) have only begun to be studied in detail in vitro. The primary aim of these studies was to analyse in vitro ASC migration in varying concentrations of growth factors derived from the platelet-rich fraction of centrifuged plasma, the so-called platelet-rich plasma (PRP). ASCs were hypothesized to migrate at a faster velocity with increasing PRP concentrations. Whole blood was collected with a sodium citrate anticoagulant and subjected to two centrifugations. The first slower spin was to remove red blood cells to collect plasma, and the second faster spin was to collect the fraction with a high platelet concentration. Platelet concentration increased 3.5-fold compared to plasma, within the prescribed therapeutic range. For long-term culture of ASCs, DMEM supplemented with no more than 20% was necessary to maintain cell viability. ASC proliferation rate in PRP-supplemented media was comparable to that in fetal bovine serum (FBS), a standard cell culture media supplement. In addition, the velocity of ASC migration increased in cultures supplemented with 10%, 20% or 30% PRP. Generally, PRP was determined to be a media supplement with similar effects as FBS, potentially making it a suitable substitute for in vitro expansion of ASC populations. These results are likely partly explained by similarities in growth factor concentrations and their effects. Further characterization of PRP will be necessary to tease out the specific growth factor(s) responsible for the increase in swine ASC migration.

Background: Intestinal damage from various etiologies can result in the potentially dangerous complication of bowel perforation. Emergent treatment of small bowel perforation includes surgical repair with or without small bowel resection. As the number of therapeutic and diagnostic endoscopic procedures increase, more studies may be required to properly evaluate and report incidences of bowel perforation. Given the advantages of interventional procedures, novel endoscopic technologies which may prove beneficial in bowel perforation repair are continuously undergoing development. Bowel perforation can lead to peritonitis and sepsis – a medical emergency requiring immediate attention. Following diagnosis, hemodynamically stable patients may be treated conservatively whereas unstable patients undergo more intensive surgical procedures. Endoscopic procedures for bowel perforation repair also exist and recent advances in technology are furthering the scope of such closure methods. Methods and Findings: Endoscopic suturing technologies, while capable, require extensive training and entail prolonged activation processes. Wound vacuum sponge closure via endoscopy provides convergence of wound defects but may not be efficacious in defects larger than 5 cm. Furthermore, this method may be limited by inadequate seal and placement in the intestine. Endoscopic clipping is another modality beneficial for smaller perforations only. T-tag suturing has shown promising results in ex-vivo studies but entails blind placement of T-tags for perforation closure. Stents can be inserted endoscopically under fluoroscopic visual guidance. This technique, however, may result in stent migration, perforations and potential occlusions. Sealants can be injected for perforation closure but have not demonstrated clear efficacy. Robotic flexible endoscopy provides several novel features yet may require advanced training and sometimes more than one operator. As interventional procedures continue to gain popularity, a better understanding of endoscopic modalities is helpful for furthering their development. Regarding bowel perforation, this review aids in an overall understanding of the technologies which exist and are advancing further into more standard modalities for practical medical applications. Conclusion: There are currently various methods to repair perforation of the gastrointestinal wall and except for urgent exploratory laparotomy when indicated, there is likely no single method that is superior to others. It may be beneficial for the physician to consider all options for repair when evaluating a potential bowel perforation, considering physician preference and individual success or difficulty with a given modality. In more recent years as the focus has narrowed on minimally invasive procedures, future modalities will likely include increased automation and ease of use with the help of robotics, which will hopefully lead to decreased time to diagnosis, faster recovery and reduced morbidity and mortality.

Objective: We assessed the feasibility of closing small intestine perforations with a mesh patch instead of sutures only. Methods: Nine porcine ex vivo small intestine specimens were incised 0.5 cm to simulate bowel perforations. Control group perforations were sutured closed without mesh. The two experimental groups were closed by mesh sewn to the outside (first group) or inside (second group) of the bowel wall. Each specimen was submerged in normal saline and insufflated until air bubbles leaked from the perforation. That insufflation pressure was recorded as the burst pressure. Results: The control group burst at 78.0±17.9 mmHg. The “patch outside” group burst at 54.7±9.1 mmHg. The “patch inside” group burst at 32.0 ±4.6 mmHg. Only the “patch inside” group had statistically significant inferiority, but both groups trended towards inferiority. Discussion: Preliminary research indicates that patch repair of intestinal perforations is likely inferior to sutures alone, although repair with the patch outside the bowel wall cannot be completely excluded because of the high variability of the data. Further research may try alternate patch types or different variations to find a non-inferior closure method. A sample size of n=9 each would give 80% power to detect a minimal detectable difference of 20 mmHg.

Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited. Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery. Study Design: Cohort study; Level of evidence, 3. Methods: Using SRC data from the Ivy League–Big Ten Epidemiology of Concussion Study among varsity athletes through February 2020, we identified the 4 affective symptoms from the Sport Concussion Assessment Tool symptom inventory. We modeled the relationship between a 4-category affective symptom variable and time to symptom resolution, RTP, and RTP progression, adjusting for nonaffective symptom prevalence and concussion history. Cox regressions were used to estimate hazard ratios for time to event outcomes, and linear regressions were used to evaluate mean differences for continuous outcomes. Results: Among 2077 student-athletes (men, 63.5%) with SRC symptoms, affective symptom prevalence was 47.6% and 44.3% in women and men, respectively, and nervous-anxious prevalence was 24.2% and 22.5%, respectively. When comparing women with and without co-occurring affective symptoms, rates of symptom resolution and RTP were significantly lower in those with affective symptoms, and women with nervous-anxious symptoms spent significantly longer in RTP progression. When comparing men with and without co-occurring affective symptoms, rates of symptom resolution and RTP were significantly lower in those with co-occurring affective symptoms, and affective symptoms were not associated with time in RTP progression. Conclusion: Student-athletes with affective symptoms and nervous-anxious symptoms exhibited delayed clinical recovery and RTP timelines, particularly for time in RTP. Symptom prevalence and concussion history contributed to this; however, unmeasured confounding remains, as indicated by the poor model fit. This study motivates future work to explore affective symptoms and RTP timelines, considering anxiety and risk/protective factors over time.

Pre-clinical biomechanical study of topology-optimization versus standard ring design for bioresorbable poly-ε-caprolactone cervical spine fusion cages delivering BMP-2 using a porcine model.To evaluate range of motion (ROM) and bone fusion, as a function of topology optimization and bone morphogenetic protein-2 (BMP-2) delivery method.3D printing technology enables fabrication of topology-optimized cages using bioresorbable materials, offering several advantages including customization, and lower stiffness. Delivery of BMP-2 using topology optimization may enhance the quality of fusion.Twenty-two 6-month old pigs underwent anterior cervical discectomy fusion at one level using 3D-printed PCL cages. Experimental groups (N=6 each) included: Group1: ring design with surface adsorbed BMP-2, Group 2: topology-optimized rectangular design with surface adsorbed BMP-2, and Group 3: ring design with BMP-2 delivery via collagen sponge. Additional specimens, two of each design, were implanted without BMP-2, as controls. Complete cervical segments were harvested 6 months post-op. Nano-CT was performed to assess complete bony bridging. Pure moment biomechanical testing was conducted in all three planes, separately. Continuous 3D motions were recorded and analyzed.Three subjects suffered early surgical complications and were not evaluated. Overall, ROM for experimental specimens, regardless of design or BMP-2 delivery method, was comparable, with no clinically significant differences among groups. Among experimental specimens at the level of the fusion, ROM was1.0° in flexion and extension, indicative of fusion, based on clinically applied criteria for fusion of2-4°. Despite the measured biomechanical stability, using CT evaluation, complete bony bridging was observed in 40% of the specimens in Group 1, 50% of Group 2, 100% of Group 3, and none of the control specimens.A topology optimized PCL cage with BMP-2 is capable of resulting in an intervertebral fusion, similar to a conventional ring-based design of the same bioresorbable material.

In response to the shortage of ventilators caused by the COVID-19 pandemic, many organizations have designed low-cost emergency ventilators. Many of these devices are pressure-cycled pneumatic ventilators, which are easy to produce but often do not include the sensing or alarm features found on commercial ventilators. This work reports a low-cost, easy-to-produce electronic sensor and alarm system for pressure-cycled ventilators that estimates clinically useful metrics such as pressure and respiratory rate and sounds an alarm when the ventilator malfunctions. A low-complexity signal processing algorithm uses a pair of nonlinear recursive envelope trackers to monitor the signal from an electronic pressure sensor connected to the patient airway. The algorithm, inspired by those used in hearing aids, requires little memory and performs only a few calculations on each sample so that it can run on nearly any microcontroller., Comment: Open-source hardware and software: https://rapidalarm.github.io/

Significance The high incidence of human male factor infertility suggests a need for examining new ways of evaluating sperm cells. We present an approach that combines label-free imaging and artificial intelligence to obtain nondestructive markers for reproductive outcomes. Our phase-imaging system reveals nanoscale morphological details from unlabeled cells. Deep learning, on the other hand, provides a structural specificity map segmenting with high accuracy the head, midpiece, and tail. Using these binary masks applied to the quantitative phase images, we measure precisely the dry-mass content of each component. Remarkably, we found that the dry-mass ratios represent intrinsic markers with predictive power for zygote cleavage and blastocyst development., The ability to evaluate sperm at the microscopic level, at high-throughput, would be useful for assisted reproductive technologies (ARTs), as it can allow specific selection of sperm cells for in vitro fertilization (IVF). The tradeoff between intrinsic imaging and external contrast agents is particularly acute in reproductive medicine. The use of fluorescence labels has enabled new cell-sorting strategies and given new insights into developmental biology. Nevertheless, using extrinsic contrast agents is often too invasive for routine clinical operation. Raising questions about cell viability, especially for single-cell selection, clinicians prefer intrinsic contrast in the form of phase-contrast, differential-interference contrast, or Hoffman modulation contrast. While such instruments are nondestructive, the resulting image suffers from a lack of specificity. In this work, we provide a template to circumvent the tradeoff between cell viability and specificity by combining high-sensitivity phase imaging with deep learning. In order to introduce specificity to label-free images, we trained a deep-convolutional neural network to perform semantic segmentation on quantitative phase maps. This approach, a form of phase imaging with computational specificity (PICS), allowed us to efficiently analyze thousands of sperm cells and identify correlations between dry-mass content and artificial-reproduction outcomes. Specifically, we found that the dry-mass content ratios between the head, midpiece, and tail of the cells can predict the percentages of success for zygote cleavage and embryo blastocyst formation.

The primary aim of this study was to assess the therapeutic effects of autologous platelet-rich plasma and fibrin scaffolds combined with autologous adipose stem cells (ASCs) for critical-size defects in the pig mandible. Fibrin scaffolds supplemented with calcium hydrogen phosphate and platelet-derived growth factors were hypothesized to accelerate healing in porcine mandible bone compared to ASC-only injections and untreated controls. Three treatments included the use of autologous ASCs from liposuction with the addition of platelet-rich plasma, fibrin scaffolds, or as cell-only controls. All three treatments using ASCs were determined to increase bone mineral density and bone volume fraction compared to untreated controls. In general, the addition of both platelet-rich plasma and fibrin scaffolds to autologous ASCs from liposuction improved bone healing of critical-size defects.

Large bone defects present a tremendous challenge to the treating surgeon. Tissue engineering using scaffolds of various sizes and shapes that contain stem cells and other osteoinductive molecules offer a potential solution to this difficult problem. The aim of this project was to evaluate if standard osteogenic medium infused with either vitamin D3, vitamin K, or vitamin B12 influences the differentiation of adiposederived stem cells (ASC) into osteoblasts. Only the 100 nM vitamin D3 treatment had a positive influence on ASC differentiation into osteoblasts. Moreover, we found higher levels (statistically significant) of osteocalcin production in all vitamin groups compared with the standard osteogenic medium.

Defects in craniofacial bones occur congenitally, after high-energy impacts, and during the course of treatment for stroke and cancer. These injuries are difficult to heal due to the overwhelming size of the injury area and the inflammatory environment surrounding the injury. Significant inflammatory response after injury may greatly inhibit regenerative healing. We have developed mineralized collagen scaffolds that can induce osteogenic differentiation and matrix biosynthesis in the absence of osteogenic media or supplemental proteins. The amniotic membrane is derived from placentas and has been recently investigated as an extracellular matrix to prevent chronic inflammation. Herein, we hypothesized that a mineralized collagen–amnion composite scaffold could increase osteogenic activity in the presence of inflammatory cytokines. We report mechanical properties of a mineralized collagen–amnion scaffold and investigated osteogenic differentiation and mineral deposition of porcine adipose-derived stem cells within these scaffolds as a function of inflammatory challenge. Incorporation of amniotic membrane matrix promotes osteogenesis similarly to un-modified mineralized collagen scaffolds, and increases in mineralized collagen–amnion scaffolds under inflammatory challenge. Together, these findings suggest that a mineralized collagen–amnion scaffold may provide a beneficial environment to aid craniomaxillofacial bone repair, especially in the course of defects presenting significant inflammatory complications.

Dairy and beef cattle make a vital contribution to global nutrition, and since their domestication, they have been continuously exposed to natural and artificial selection to improve production characteristics. The technologies of transgenesis and gene editing used in cattle are responsible for generating news characteristics in bovine breeding, such as alteration of nutritional components of milk and meat enhancing human health benefits, disease resistance decreasing production costs and offering safe products for human food, as well as the recombinant protein production of biomedical significance. Different methodologies have been used to generate transgenic cattle as bioreactors. These methods include the microinjection of vectors in pronuclear, oocyte or zygote, sperm-mediate transgenesis, and somatic cell nuclear transfer. Gene editing has been applied to eliminate unwanted genes related to human and animal health, such as allergy, infection, or disease, and to insert transgenes into specific sites in the host genome. Methodologies for the generation of genetically modified cattle are laborious and not very efficient. However, in the last 30 years, transgenic animals were produced using many biotechnological tools. The result of these modifications includes (1) the change of nutritional components, including proteins, amino acids and lipids for human nutrition; (2) the removal allergic proteins milk; (3) the production of cows resistant to disease; or (4) the production of essential proteins used in biomedicine (biomedical proteins) in milk and blood plasma. The genetic modification of cattle is a powerful tool for biotechnology. It allows for the generation of new or modified products and functionality that are not currently available in this species.

Regenerative medicine approaches for massive craniomaxillofacial bone defects face challenges associated with the scale of missing bone, the need for rapid graft-defect integration, and challenges related to inflammation and infection. Mineralized collagen scaffolds have been shown to promote mesenchymal stem cell osteogenesis due to their porous nature and material properties, but are mechanically weak, limiting surgical practicality. Previously, these scaffolds were combined with 3D-printed polycaprolactone mesh to form a scaffold-mesh composite to increase strength and promote bone formation in sub-critical sized porcine ramus defects. Here, we compare the performance of mineralized collagen-polycaprolactone composites to the polycaprolactone mesh in a critical-sized porcine ramus defect model. While there were no differences in overall healing response between groups, our data demonstrated broadly variable metrics of healing regarding new bone infiltration and fibrous tissue formation. Abscesses were present surrounding some implants and polycaprolactone polymer was still present after 9-10 months of implantation. Overall, while there was limited successful healing, with 2 of 22 implants showed substantial levels of bone regeneration, and others demonstrating some form of new bone formation, the results suggest targeted improvements to improve repair of large animal models to more accurately represent craniomaxillofacial bone healing. Notably, strategies to increase osteogenesis throughout the implant, modulate the immune system to support repair, and employ shape-fitting tactics to avoid implant micromotion and resultant fibrosis. Improvements to the mineralized collagen scaffolds involve changes in pore size and shape to increase cell migration and osteogenesis and inclusion or delivery of factors to aid vascular ingrowth and bone regeneration.

There are many potential applications of transgenic methodologies for developing new and improved strains of livestock. One practical application of transgenic technology in pig production is to improve milk production or composition. The first week after parturition is the period of greatest loss for pig producers, with highest morbidity and mortality attributed to malnutrition and scours. Despite the benefits to be gained by improving lactation performance, little progress has been made in this area through genetic selection or nutrition. Transgenic technology provides an important tool for addressing the problem of low milk production and its detrimental impact on pig production. Transgenic pigs over-expressing the milk protein bovine alpha-lactalbumin were developed. alpha-Lactalbumin was selected for its role in lactose synthesis and regulation of milk volume. Sows hemizygous for the transgene produced as much as 0.9 g bovine alpha-lactalbumin l-1 pig milk. The outcomes assessed were milk composition, milk yield and piglet growth. First parity alpha-lactalbumin gilts had higher milk lactose content in early lactation and 20-50% greater milk yield on days 3-9 of lactation than did non-transgenic gilts. Weight gain of piglets suckling alpha-lactalbumin gilts was greater (days 7-21 after parturition) than that of control piglets. Thus, transgenic over-expression of milk proteins may provide a means for improving the lactation performance of pigs.

Fluorescence microscopy has been proven a valid method of classifying sperm with different characteristics such as gender. However, it has been observed that they introduced an increase in oxidative stress as well as undesired bias. We show that spatial light interference microscopy, a QPI method that can reveal the intrinsic contrast of cell structures, is ideal for the study of sperm. To enable high-throughput sperm quality assessment using QPI, we propose a new analysis method based on deep learning and the U-Net architecture. We show that our model can achieve satisfying precision and accuracy and that it can be integrated within our image acquisition software for near real-time analysis.

The goal of this study was to characterize sperm populations resulting from three different methods of sperm selection used for bovine in vitro fertilization. We compared sperm selection with discontinuous Percoll gradients, Swim-Up, and electro-channel. Spatial light interference microscopy (SLIM) was used to evaluate the morphology of the spermatozoa and computer-assisted semen analysis (CASA) was used to evaluate the motility behavior of the sperm. Using these two technologies, we analyzed morphometric parameters and the kinetic (motility) patterns of frozen-thawed Holstein bull spermatozoa after sperm selection. For the first time, we have shown that these methods used to select viable spermatozoa for in vitro fertilization (IVF) result in very different sperm subpopulations. Almost every parameter evaluated resulted in statistical differences between treatment groups. One novel observation was that the dry mass of the sperm head is heavier in spermatozoa selected with the electro-channel than in sperm selected by the other methods. These results show the potential of SLIM microscopy in reproductive biology.Abbreviations: SLIM: spatial light interference microscopy; CASA: computer aided sperm analysis; IVF: in vitro fertilization; BSA: bovine serum albumin; QPI: quantitative phase imaging; IVEP: in vitro embryo production; IACUC: institutional animal care and use committee; CSS: Certified Semen Services; AI: artificial insemination; TALP: Tyrode's Albumin Lactate Pyruvate; MEC: medium for electro-channel; PDMS: polydimethylsiloxane; EC: electro-channel; TM, %: total motility; PM, %: progressive motility; RM, %: percentage of rapid sperm motility; VAP, μm/s: average path velocity; VSL, μm/s: straight-line velocity; VCL, μm/s: curvilinear velocity; ALH, μm: amplitude of lateral head displacement; BCF, Hz: beat cross frequency; STR, %: straightness; LIN, %: and linearity; GLS: generalized least squares; ANOVA: analysis of variance; LSD: Least Significant Difference; SPSS: Statistical Package for the Social Sciences; PCA: principal components analysis.

In PubMed, it is possible to find more than 40,000 papers on embryo evaluation in various species. However, there is no consensus or gold standard method on how to assess their developmental potential. In assisted reproduction the evaluation "problem" is not only limited to embryos but involves the gametes as well. This manuscript provides an overview of some possible applications of label-free microscopy, in particular we describe the potential of the holographic microscopy in the IVF lab. We describe the positive aspects of several currently available microscopy label-free systems. In conclusion, we believe that a next generation of microscopy able to give objective markers for gamete and embryo quality is around the corner.

The COVID-19 pandemic disrupted the world in 2020 by spreading at unprecedented rates and causing tens of thousands of fatalities within a few months. The number of deaths dramatically increased in regions where the number of patients in need of hospital care exceeded the availability of care. Many COVID-19 patients experience Acute Respiratory Distress Syndrome (ARDS), a condition that can be treated with mechanical ventilation. In response to the need for mechanical ventilators, designed and tested an emergency ventilator (EV) that can control a patient’s peak inspiratory pressure (PIP) and breathing rate, while keeping a positive end expiratory pressure (PEEP). This article describes the rapid design, prototyping, and testing of the EV. The development process was enabled by rapid design iterations using additive manufacturing (AM). In the initial design phase, iterations between design, AM, and testing enabled a working prototype within one week. The designs of the 16 different components of the ventilator were locked by additively manufacturing and testing a total of 283 parts having parametrically varied dimensions. In the second stage, AM was used to produce 75 functional prototypes to support engineering evaluation and animal testing. The devices were tested over more than two million cycles. We also developed an electronic monitoring system and with automatic alarm to provide for safe operation, along with training materials and user guides. The final designs are available online under a free license. The designs have been transferred to more than 70 organizations in 15 countries. This project demonstrates the potential for ultra-fast product design, engineering, and testing of medical devices needed for COVID-19 emergency response.

Rapid, sensitive and specific detection and reporting of infectious pathogens is important for patient management and epidemic surveillance. We demonstrated a point-of-care system integrated with a smartphone for detecting live virus from nasal swab media, using a panel of equine respiratory infectious diseases as a model system for corresponding human diseases such as COVID-19. Specific nucleic acid sequences of five pathogens were amplified by loop-mediated isothermal amplification on a microfluidic chip and detected at the end of reactions by the smartphone. Pathogen-spiked horse nasal swab samples were correctly diagnosed using our system, with a limit of detection comparable to that of the traditional lab-based test, polymerase chain reaction, with results achieved in ∼30 minutes.

Ethanol is used routinely to dilute cell culture media supplements with little or no water solubility. This study evaluates the effect of low concentration of ethanol on the follicular development, oocyte maturation, hormone production, gene expression, and metabolomics profile of spent culture medium after long-term culture of isolated ovine preantral follicles. For this, follicles were cultured for 18 days in α-Minimum Essential Medium+ alone (control treatment) or supplemented with 100 ng/mL recombinant bovine FSH (rbFSH treatment) or with 0.2%-v/v ethanol (ethanol treatment). Ethanol treatment increased the percentage of degenerated follicles and oocytes significantly, however, it showed the highest estradiol secretion. Also, the rate of meiosis resumption was higher in ethanol treatment than Control treatment. Ethanol treatment decreased the mRNA levels of B-cell lymphoma 2 (BCL2), BCL2 associated X, Aquaporin 3, Connexin 43, Inhibin Subunit Beta A, kit ligand, Heat Shock Protein (HSP A1A) significantly when compared to the Control treatment. However, mRNA levels of cytochrome P450 family 19, and FSH receptors were significantly higher in ethanol treatment than in the Control treatment. The levels of some metabolites, which are likely amino acids, lipids, an analog of Cyclic guanosine monophosphate, and a derivative of phosphoinositol phosphate metabolism, had higher relative concentrations in ethanol and rbFSH treatments than the Control treatment. In conclusion, ethanol addition augmented the follicular and oocyte degeneration rates but increased the estradiol production and the meiotic resumption. Furthermore, the follicular metabolomic profile was similar between ethanol and rbFSH treatments being both treatments; however, different from the Control treatment.

A tissue engineering approach to address craniofacial defects requires a biomaterial that balances macro-scale mechanical stiffness and strength with the micron-scale features that promote cell expansion and tissue biosynthesis. Such criteria are often in opposition, leading to suboptimal mechanical competence or bioactivity. We report the use of a multiscale composite biomaterial that integrates a polycaprolactone (PCL) reinforcement structure with a mineralized collagen-glycosaminoglycan scaffold to circumvent conventional tradeoffs between mechanics and bioactivity. The composite promotes activation of the canonical bone morphogenetic protein 2 (BMP-2) pathway and subsequent mineralization of adipose-derived stem cells in the absence of supplemental BMP-2 or osteogenic media. We subsequently examined new bone infill in the acellular composite, scaffold alone, or PCL support in 10 mm dia. ramus mandibular defects in Yorkshire pigs. We report an analytical approach to quantify radial, angular, and depth bone infill from micro-computed tomography data. The collagen-PCL composite showed improved overall infill, and significantly increased radial and angular bone infill versus the PCL cage alone. Bone infill was further enhanced in the composite for defects that penetrated the medullary cavity, suggesting recruitment of marrow-derived cells. These results indicate a multiscale mineralized collagen-PCL composite offers strategic advantages for regenerative repair of craniofacial bone defects.

Objectives/hypothesis Reconstruction of craniofacial cartilagenous defects are among the most challenging surgical procedures in facial plastic surgery. Bioengineered craniofacial cartilage holds immense potential to surpass current reconstructive options, but limitations to clinical translation exist. We endeavored to determine the viability of utilizing adipose-derived stem cell-chondrocyte co-culture and three-dimensional (3D) printing to produce 3D bioscaffolds for cartilage tissue engineering. We describe a feasibility study revealing a novel approach for cartilage tissue engineering with in vitro and in vivo animal data. Methods Porcine adipose-derived stem cells and chondrocytes were isolated and co-seeded at 1:1, 2:1, 5:1, 10:1, and 0:1 experimental ratios in a hyaluronic acid/collagen hydrogel in the pores of 3D-printed polycaprolactone scaffolds to form 3D bioscaffolds for cartilage tissue engineering. Bioscaffolds were cultured in vitro without growth factors for 4 weeks and then implanted into the subcutaneous tissue of athymic rats for an additional 4 weeks before sacrifice. Bioscaffolds were subjected to histologic, immunohistochemical, and biochemical analysis. Results Successful production of cartilage was achieved using a co-culture model of adipose-derived stem cells and chondrocytes without the use of exogenous growth factors. Histology demonstrated cartilage growth for all experimental ratios at the post-in vivo time point confirmed with type II collagen immunohistochemistry. There was no difference in sulfated-glycosaminoglycan production between experimental groups. Conclusion Tissue-engineered cartilage was successfully produced on 3D-printed bioresorbable scaffolds using an adipose-derived stem cell and chondrocyte co-culture technique. This potentiates co-culture as a solution for several key barriers to a clinically translatable cartilage tissue engineering process. Level of evidence NA. Laryngoscope, 128:E251-E257, 2018.

Advances in stem cell biology and materials science have provided a basis for developing tissue engineering methods to repair muscle injury. Among stem cell populations with potential to aid muscle repair, adipose-derived mesenchymal stem cells (ASC) hold great promise. To evaluate the possibility of using porcine ASC for muscle regeneration studies, we co-cultured porcine ASC with murine C2C12 myoblasts. These experiments demonstrated that porcine ASC display significant myogenic potential. Co-culture of ASC expressing green fluorescent protein (GFP) with C2C12 cells resulted in GFP+ myotube formation, indicating fusion of ASC with myoblasts to form myotubes. The presence of porcine lamin A/C positive nuclei in myotubes and RTqPCR analysis of porcine myogenin and desmin expression confirmed that myotube nuclei derived from ASC contribute to muscle gene expression. Co-culturing GFP+ASC with porcine satellite cells demonstrated enhanced myogenic capability of ASC, as the percentage of labeled myotubes increased compared to mouse co-cultures. Enhancing myogenic potential of ASC through soluble factor treatment or expansion of ASC with innate myogenic capacity should allow for their therapeutic use to regenerate muscle tissue lost to disease or injury.

To compare the efficiency of North Carolina State University medium 23 (NCSU23) and Alpha Minimum Essential Medium (α-MEM) as a base medium, and to evaluate the effects of Anti-Müllerian Hormone (AMH) alone or in combination with Follicle Stimulating Hormone (FSH) on the in vitro development and steroid production of isolated porcine preantral follicles. Porcine secondary follicles were cultured in NCSU23 or α-MEM media for 4 days. Once α-MEM was determined to be the optimal culture medium, secondary follicles were cultured in α-MEM alone or supplemented with FSH (1.5 ng/mL), AMH (50 ng/mL) or the combination of the two hormones. Follicle development was evaluated by measuring follicular growth, morphology and hormone production. There was no difference between the media NCSU23 and α-MEM in terms of follicle survival and growth (P > 0.05). However, at day 2, the antrum formation rate tended to be (P < 0.074) higher in α-MEM than NCSU23. At day 4 of culture, the estradiol and progesterone secretion were higher in α-MEM than NCSU23 (P < 0.01), while the opposite was observed for testosterone (P < 0.01). The addition of AMH and/or FSH did not affect follicular survival and growth. Nevertheless, the secretion of estradiol and progesterone induced by FSH was reduced with AMH (P < 0.01). α-MEM is a more effective base medium than NCSU23 for the in vitro follicular development of pig preantral follicles and AMH reduces the steroid production induced by FSH. Comparar la eficiencia del medio 23 de la Universidad Estatal de Carolina del Norte (NCSU23) y el medio esencial alfa mínimo (α-MEM) como medio base y evaluar los efectos de la hormona antimülleriana (AMH) sola o en combinación con el folículo estimulante de la hormona (FSH) sobre el desarrollo in vitro y la producción de esteroides a partir de folículos preantrales porcinos aislados. Se cultivaron folículos secundarios porcinos en medio NCSU23 o α-MEM durante 4 días. Una vez que se determinó que α-MEM era el medio de cultivo ideal, los folículos secundarios se cultivaron en α-MEM solo o suplementados con FSH (1,5 ng/ml), AMH (50 ng/ml) o una combinación de las dos hormonas. El desarrollo folicular se evaluó midiendo el crecimiento folicular, la morfología y la producción de hormonas. No hubo diferencia entre los medios NCSU23 y α-MEM en términos de supervivencia y crecimiento folicular (P > 0,05). Sin embargo, en el día 2, la tasa de formación de antro tendió a ser (P < 0.074) más alta en α-MEM que en NCSU23. En el día 4 de cultivo, la secreción de estradiol y progesterona fue mayor en α-MEM que en NCSU23 (P < 0,01), mientras que se observó lo contrario para la testosterona (P < 0,01). La adición de AMH y/o FSH no afectó la supervivencia y el crecimiento folicular. Sin embargo, la secreción de estradiol y progesterona inducida por FSH se redujo con AMH (P < 0,01). α-MEM es un medio de fondo más eficaz que NCSU23 para el desarrollo folicular in vitro de folículos preantrales porcinos y la AMH reduce la producción de esteroides inducida por FSH. Comparar a eficiência do meio 23 da Universidade Estadual da Carolina do Norte (NCSU23) e do meio alfa essencial mínimo (α-MEM) como meio de base e avaliar os efeitos do hormônio anti-Mülleriano (AMH) sozinho ou em combinação com o hormônio folículo estimulante (FSH) no desenvolvimento in vitro e na produção de esteroides de folículos pré-antrais suínos isolados. Folículos secundários suínos foram cultivados em meio NCSU23 ou α-MEM por 4 dias. Uma vez que α-MEM foi determinado ser o meio de cultivo ideal, os folículos secundários foram cultivados em α-MEM sozinho ou suplementado com FSH (1,5 ng/mL), AMH (50 ng/mL) ou na combinação dos dois hormônios. O desenvolvimento folicular foi avaliado medindo o crescimento folicular, a morfologia e a produção hormonal. Não houve diferença entre os meios NCSU23 e α-MEM em termos de sobrevivência e crescimento folicular (P > 0,05). No entanto, no dia 2, a taxa de formação de antro tendeu a ser (P < 0,074) maior em α-MEM do que NCSU23. No dia 4 de cultivo, a secreção de estradiol e progesterona foram maiores no α-MEM do que no NCSU23 (P < 0,01), enquanto o oposto foi observado para a testosterona (P < 0,01). A adição de AMH e/ou FSH não afetou a sobrevivência e o crescimento folicular. No entanto, a secreção de estradiol e progesterona induzida pelo FSH foi reduzida com o AMH (P < 0,01). α-MEM é um meio de base mais eficaz do que o NCSU23 para o desenvolvimento folicular in vitro de folículos pré-antrais suínos e o AMH reduz a produção de esteroides induzida por FSH.

Objective: This study investigated the effect of two different follicle stimulating hormone (FSH) preparations (diluted/dynamised and diluted) on the in vitro development and steroid production (estradiol, progesterone and testosterone) of isolated porcine preantral follicle after in vitro culture. Methods: Secondary follicles were cultured in Alpha Minimum Essential Medium (α-MEM+) supplemented with grain ethanol (AL – 0.2%, v/v), diluted/dynamised FSH (rFSH 6cH – 0.05 fg/mL) or diluted-only FSH (1.5 ng/mL) for 4 days. Follicle development was evaluated on the basis of follicular growth, morphology and hormone production. Results: The percentage of follicular integrity and extrusion were not affected by the treatments after culture. For all treatments, follicular diameter increased significantly from Day 0 to Day 4. On Day 2 of culture, the estradiol production was significantly higher in AL and diluted-only FSH treatments compared with diluted/dynamised FSH. However, diluted/dynamised FSH showed a significantly higher progesterone production on Day 2. Only on Day 4, the testosterone production was higher in the AL than diluted-only FSH treatments, but similar to diluted/dynamised FSH treatment. Except for diluted/dynamised FSH treatment, progesterone production increased (P < 0.05) from Day 2 to Day 4; only for AL treatment, a significant increase of testosterone production was observed during culture. Conclusion: Compared to control the diluted/dynamised FSH addition increased progesterone production but decreased the estradiol production after in vitro culture of isolated porcine preantral follicles. Taken together the results suggest that at least for progesterone production the mechanism of action of diluted/dynamised FSH differs from its vehicle.

Bone is a plastic tissue with a large healing capability. However, extensive bone loss due to disease or trauma requires extreme therapy such as bone grafting or tissue-engineering applications. Presently, bone grafting is the gold standard for bone repair, but presents serious limitations including donor site morbidity, rejection, and limited tissue regeneration. The use of stem cells appears to be a means to overcome such limitations. Bone marrow mesenchymal stem cells (BMSC) have been the choice thus far for stem cell therapy for bone regeneration. However, adipose-derived stem cells (ASC) have similar immunophenotype, morphology, multilineage potential, and transcriptome compared to BMSC, and both types have demonstrated extensive osteogenic capacity both in vitro and in vivo in several species. The use of scaffolds in combination with stem cells and growth factors provides a valuable tool for guided bone regeneration, especially for complex anatomic defects. Before translation to human medicine, regenerative strategies must be developed in animal models to improve effectiveness and efficiency. The pig presents as a useful model due to similar macro- and microanatomy and favorable logistics of use. This review examines data that provides strong support for the clinical translation of the pig model for bone regeneration.

The aims of this study were: (1) to evaluate the effect of different insulin concentrations, alone or in combination with either a fixed FSH concentration or increasing FSH concentrations on the in vitro culture of isolated caprine preantral follicles and (2) to analyze the efficiency of two IVM media and maturation culture systems (with or without coculture with in vivo grown oocytes) on the meiosis resumption. Secondary follicles were cultured for 18 days in a basic medium supplemented with low- or high-insulin concentration alone or with a fixed FSH concentration or with increasing FSH concentrations. Oocytes grown in vivo or in vitro were matured alone or cocultured. The high-insulin concentration associated with fixed FSH treatment had higher meiotic resumption rate (P < 0.05) and was the only treatment capable of producing oocytes in metaphase II. The rates of germinal vesicle, germinal vesicle breakdown, metaphase I, metaphase II (MII), meiotic resumption, and oocyte diameter were similar between the maturation media. In conclusion, a basic medium supplemented with 10-μg/mL insulin and 100-μg/mL FSH throughout the culture period improved meiotic resumption rate and produced MII oocytes from caprine preantral follicles cultured in vitro. The MII rate was similar between in vivo and in vitro grown oocytes ≥110 μm.

In the past few years, new technologies have arisen that enable higher efficiency of gene editing. With the increase ease of using gene editing technologies, it is important to consider the best method for transferring new genetic material to livestock animals. Microinjection is a technique that has proven to be effective in mice but is less efficient in large livestock animals. Over the years, a variety of methods have been used for cloning as well as gene transfer including; nuclear transfer, sperm mediated gene transfer (SMGT), and liposome-mediated DNA transfer. This review looks at the different success rate of these methods and how they have evolved to become more efficient. As well as gene editing technologies, including Zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and the most recent clustered regulatory interspaced short palindromic repeats (CRISPRs). Through the advancements in gene-editing technologies, generating transgenic animals is now more accessible and affordable. The goals of producing transgenic animals are to 1) increase our understanding of biology and biomedical science; 2) increase our ability to produce more efficient animals; and 3) produce disease resistant animals. ZFNs, TALENs, and CRISPRs combined with gene transfer methods increase the possibility of achieving these goals.

The aims of this study were to investigate the effects of medium replacement system (experiment I) and of FSH presentations (homeopathic - FSH 6cH and allopathic FSH - rFSH; experiment II) on the in vitro development, hormone production and gene expression of isolated ovine preantral follicles cultured for 6 days. In experiment I, secondary follicles were cultured in the α-MEM+ supplemented with FSH 6cH (0.05 fg/ml) or recombinant bovine FSH (100 ng/ml) without/with daily medium addition. The homeopathic FSH treatments with/without medium addition improved (p

Despite significant advances in 3D biomaterial printing, the potential of 3D printing for patient specific implants and tissue reconstruction has not been fully exploited. This is due in part to the lack of integration of image-based patient specific design with 3D biomaterial printing within a relevant regulatory framework, namely design control, required by the FDA. In this manuscript, we describe the integration of image-based, multi-scale patient specific design with 3D biomaterial printing within a design control framework for clinical translation. Specifically, we define design inputs for patient specific implants and scaffolds, and utilize image-based patient specific design to achieve these design inputs. We then illustrate realization of these topology designed patient specific implants by laser sintering of polycaprolactone (PCL). Finally, we present initial results in large animal models using 3D printed PCL implants addressing two challenging problems in tissue reconstruction: 1) designing and 3D printing implantable devices to allow growth in pediatric airway applications and 2) utilizing 3D printed scaffolds as foundations for pre-fabricated flaps to obtain vascularization and bone formation for large volume bone/soft tissue reconstruction. We illustrate these challenging problems as they need to be incorporated in design control, but as of yet there is little data to direct how growth and vascularization should be utilized in design control.

Fluorescence-based cell sorting instruments are capable of classifying sperm for desired characteristics such as gender. It is not surprising that, as these techniques are approaching clinical use, closer scrutiny has revealed that the sorting process introduces a signification increase in oxidative stress in addition to an undesired selection bias due to fragmented DNA. Although some of the damage can be attributed to rough mechanical handling, from studies on adherent cells, it is well known that these defects are also associated with the intrinsic toxicity of the fluorescence labels. In effect, fluorescence-based markers reduce viability, motivating the use of intrinsic contrast methods. Here we present recent progress on evaluating reproductive outcomes using Spatial Light Interference Microscopy (SLIM) for high sensitivity phase imaging. We compared our label-free markers to existing staining techniques. We show how the compatibility of our system with fluorescence/color image acquisition allows our techniques to be used concurrently rather than as an alternative, to conventional methods.

The capacity for microscopic evaluation of sperm is useful for assisted reproductive technologies (ART), because this can allow for specific selection of sperm cells for in vitro fertilization (IVF). The objective of this study was to analyze the same sperm samples using two high-resolution methods: spatial light interference microscopy (SLIM) and atomic force microscopy (AFM) to determine if with one method there was more timely and different information obtained than the other. To address this objective, there was evaluation of sperm populations from boars and stallions. To the best of our knowledge, this is the first reported comparison when using AFM and high-sensitivity interferometric microscopy (such as SLIM) to evaluate spermatozoa. Results indicate that with the use of SLIM microscopy there is similar nanoscale sensitivity as with use of AFM while there is approximately 1,000 times greater throughput with use of SLIM. With SLIM, there is also allowace for the measurement of the dry mass (non-aqueous content) of spermatozoa, which may be a new label-free marker for sperm viability. In the second part of this study, there was analysis of two sperm populations. There were interesting correlations between the different compartments of the sperm and the dry mass in both boars and stallions. Furthermore, there was a correlation between the dry mass of the sperm head and the length and width of the acrosome in both boars and stallions. This correlation is positive in boars while it is negative in stallions.

Craniomaxillofacial bone defects can occur as a result of congenital, post-oncologic, and high-energy impact conditions. The scale and irregularity of such defects motivate new biomaterials to promote regeneration of the damaged bone. We have recently described a mineralized collagen scaffold capable of instructing stem cell osteogenic differentiation and new bone infill in the absence of traditional osteogenic supplements. Herein, we report the integration of a millimeter-scale reinforcing poly (lactic acid) frame fabricated via 3D-printing into the mineralized collagen scaffold with micron-scale porosity to form a multi-scale mineralized collagen-PLA composite. We describe modifications to the PLA frame design to increase the compressive strength (Young's Modulus, ultimate stress and strain) of the composite. A critical challenge beyond increasing the compressive strength of the collagen scaffold is addressing challenges inherent with the irregularity of clinical defects. As a result, we examined the potential for modifying the frame architecture to render the composite with increased compressive strength in one axis or radial compressibility and shape-fitting capacity in an orthogonal axis. A library of mineralized collagen-PLA composites was mechanically characterized via compression testing and push-out test to describe mechanical performance and shape-fitting capacity. We also report in vitro comparison of the bioactivity of porcine adipose derived stem cells in the mineralized collagen-PLA composite versus the mineralized collagen scaffold via metabolic activity, gene expression, and functional matrix synthesis. The results suggest that incorporation of the PLA reinforcing frame does not negatively influence the osteoinductive nature of the mineralized collagen scaffold. Together, these findings suggest a strategy to address often competing bioactivity, mechanical strength, and shape-fitting design requirements for biomaterials for craniomaxillofacial bone regeneration.

In the past 20+ years, several studies of bovine embryo production showed how the ratio of male to female embryos changes if embryos are made in vivo or in vitro. It is known that in in vitro systems, the sex ratio is in favor of males when there are high levels of glucose, and favors females when the principal energetic substrate is one other than glucose, like citrate. The aim of this study was to evaluate the embryo metabolism during three important periods of in vitro development: the early development (from day 1 until day 3), the middle of culture (day 3 until day 5), and later development (day 5 until day 7). To obtain this information we evaluated the spent medium from each time period by 1H NMR. Our results confirm that embryo metabolism is different between sexes. The new information obtained by identifies markers that we can use to predict the embryo sex. These results open a new, non-invasive method to evaluate sex of the embryos before the transfer. In the first period of embryo culture, valine concentration is good indicator (66.7% accurate), while in the last phase of culture, pyruvate depletion is the best marker (64% accurate) to evaluate the sex of the embryo.

The primary thrust of tissue engineering is the clinical translation of scaffolds and/or biologics to reconstruct tissue defects. Despite this thrust, clinical translation of tissue engineering therapies from academic research has been minimal in the 27 year history of tissue engineering. Academic research by its nature focuses on, and rewards, initial discovery of new phenomena and technologies in the basic research model, with a view towards generality. Translation, however, by its nature must be directed at specific clinical targets, also denoted as indications, with associated regulatory requirements. These regulatory requirements, especially design control, require that the clinical indication be precisely defined a priori, unlike most academic basic tissue engineering research where the research target is typically open-ended, and furthermore requires that the tissue engineering therapy be constructed according to design inputs that ensure it treats or mitigates the clinical indication. Finally, regulatory approval dictates that the constructed system be verified, i.e., proven that it meets the design inputs, and validated, i.e., that by meeting the design inputs the therapy will address the clinical indication. Satisfying design control requires (1) a system of integrated technologies (scaffolds, materials, biologics), ideally based on a fundamental platform, as compared to focus on a single technology, (2) testing of design hypotheses to validate system performance as opposed to mechanistic hypotheses of natural phenomena, and (3) sequential testing using in vitro, in vivo, large preclinical and eventually clinical tests against competing therapies, as compared to single experiments to test new technologies or test mechanistic hypotheses. Our goal in this paper is to illustrate how design control may be implemented in academic translation of scaffold based tissue engineering therapies. Specifically, we propose to (1) demonstrate a modular platform approach founded on 3D printing for developing tissue engineering therapies and (2) illustrate the design control process for modular implementation of two scaffold based tissue engineering therapies: airway reconstruction and bone tissue engineering based spine fusion.

If one were to compare today's animal growth research to research from a mere 50 yr ago, one would see programs with few similarities. The evolution of this research from whole-animal through cell-based and finally molecular and genomic studies has been enhanced by the identification, isolation, and in vitro evaluation of adipose- and muscle-derived stem cells. This paper will highlight the struggles and the milestones that make this evolving area of research what it is today. The contribution of adipose and muscle stem cell research to development and growth, tissue regeneration, and final carcass composition are reviewed.

Characterization of spermatozoon viability is a common test in treating infertility. Recently, it has been shown that label-free, phase-sensitive imaging can provide a valuable alternative for this type of assay. Here, we employ spatial light interference microscopy (SLIM) to decouple the thickness and refractive index information of individual cells. This procedure was enabled by quantitative phase imaging cells on media of two different refractive indices and using a numerical tool to remove the curvature from the cell tails. This way, we achieved ensemble averaging of topography and refractometry of 100 cells in each of the two groups. The results show that the thickness profile of the cell tail goes down to 150 nm and the refractive index can reach values of 1.6 close to the head.

The search for non-invasive signs of oocyte meiotic competence is very important for the development of in vitro follicle culture (IVFC) systems. The aims of the present study were: (1) to investigate the effect of in vitro maturation (IVM) of in vivo grown goat COCs, in group or individually, on oocyte chromatin configuration (Experiment 1), and (2) the influence of IVFC period (12 vs. 18 days) on the ability of the oocyte to resume meiosis immediately after IVFC (before in vitro maturation; IVM), or after IVM (Experiment 2). In experiment 1, in vivo grown cumulus-oocyte complexes (COCs) were submitted to IVM in groups (10 COCs/100 μL-drop) or individually (1 COC/10 μL-drop), and chromatin configuration was assessed. In experiment 2, isolated follicles were individually cultured for 12 or 18 days, and submitted to individual IVM afterwards. The following end points were evaluated: follicular growth and morphology, oocyte diameter, viability and chromatin configuration, as well as individual follicular estradiol production. Similar maturation rates were obtained between in vivo grown COCs matured individually and in groups (66.7% vs. 63.6%, respectively) (Experiment 1). Only after 18 days of IVFC, oocytes were able to grow during IVM, reaching a mean oocyte diameter of 119 μm. Also, this treatment produced the highest rate of metaphase II oocytes (46.2% out of the total number of cultured follicles). Finally, it was observed that follicles with a daily growth rate7.1 μm/day (fast-growing) and that reached at least 600 μm in diameter, were more likely (P 0.05) to produce oocytes capable of attaining MII. In conclusion, caprine oocytes can be individually matured in vitro, as efficiently as in groups. This result was essential to pair in vitro follicle development and in vitro oocyte maturation with specific individual follicles. Using this approach, it was possible to establish non-invasive signs for the efficiency of IVFC based on follicle daily growth rate and diameter, and oocyte diameter: follicle daily growth7 μm, follicle diameter of at least 600 μm, and oocyte diameter ≥120 μm. In addition, 18 days seems to be the most suitable culture time for caprine early antral follicles.