Bioengineering

10 pages, 2266 KiB

Open AccessCommunication

In Situ Quantification of Polyhydroxybutyrate in Photobioreactor Cultivations of Synechocystis sp. Using an Ultrasound-Enhanced ATR-FTIR Spectroscopy Probe

by Philipp Doppler, Christoph Gasser, Ricarda Kriechbaum, Ardita Ferizi and Oliver Spadiut

Bioengineering 2021, 8(9), 129; https://doi.org/10.3390/bioengineering8090129 - 21 Sep 2021

Cited by 5 | Viewed by 3161

Abstract

Polyhydroxybutyrate (PHB) is a very promising alternative to most petroleum-based plastics with the huge advantage of biodegradability. Biotechnological production processes utilizing cyanobacteria as sustainable source of PHB require fast in situ process analytical technology (PAT) tools for sophisticated process monitoring. Spectroscopic probes supported [...] Read more.

Polyhydroxybutyrate (PHB) is a very promising alternative to most petroleum-based plastics with the huge advantage of biodegradability. Biotechnological production processes utilizing cyanobacteria as sustainable source of PHB require fast in situ process analytical technology (PAT) tools for sophisticated process monitoring. Spectroscopic probes supported by ultrasound particle traps provide a powerful technology for in-line, nondestructive, and real-time process analytics in photobioreactors. This work shows the great potential of using ultrasound particle manipulation to improve spectroscopic attenuated total reflection Fourier-transformed mid-infrared (ATR-FTIR) spectra as a monitoring tool for PHB production processes in photobioreactors. Full article

(This article belongs to the Special Issue Advances in Polyhydroxyalkanoate (PHA) Production, Volume 3)

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21 pages, 7812 KiB

Open AccessArticle

The “Federica” Hand

by Daniele Esposito, Sergio Savino, Emilio Andreozzi, Chiara Cosenza, Vincenzo Niola and Paolo Bifulco

Bioengineering 2021, 8(9), 128; https://doi.org/10.3390/bioengineering8090128 - 21 Sep 2021

Cited by 12 | Viewed by 3897

Abstract

Hand prostheses partially restore hand appearance and functionalities. In particular, 3D printers have provided great opportunities by simplifying the manufacturing process and reducing costs. The “Federica” hand is 3D-printed and equipped with a single servomotor, which synergically actuates its five fingers by inextensible [...] Read more.

Hand prostheses partially restore hand appearance and functionalities. In particular, 3D printers have provided great opportunities by simplifying the manufacturing process and reducing costs. The “Federica” hand is 3D-printed and equipped with a single servomotor, which synergically actuates its five fingers by inextensible tendons; no springs are used for hand opening. A differential mechanical system simultaneously distributes the motor force on each finger in predefined portions. The proportional control of hand closure/opening is achieved by monitoring muscle contraction by means of a thin force sensor, as an alternative to EMG. The electrical current of the servomotor is monitored to provide sensory feedback of the grip force, through a small vibration motor. A simple Arduino board was adopted as the processing unit. A closed-chain, differential mechanism guarantees efficient transfer of mechanical energy and a secure grasp of any object, regardless of its shape and deformability. The force sensor offers some advantages over the EMG: it does not require any electrical contact or signal processing to monitor muscle contraction intensity. The activation speed (about half a second) is high enough to allow the user to grab objects on the fly. The cost of the device is less then 100 USD. The “Federica” hand has proved to be a lightweight, low-cost and extremely efficient prosthesis. It is now available as an open-source project (CAD files and software can be downloaded from a public repository), thus allowing everyone to use the “Federica” hand and customize or improve it. Full article

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17 pages, 1217 KiB

Open AccessArticle

Thermo-Responsive Hydrogel-Based Soft Valves with Annular Actuation Calibration and Circumferential Gripping

by Manivannan Sivaperuman Kalairaj, Hritwick Banerjee, Kirthika Senthil Kumar, Keith Gerard Lopez and Hongliang Ren

Bioengineering 2021, 8(9), 127; https://doi.org/10.3390/bioengineering8090127 - 20 Sep 2021

Cited by 4 | Viewed by 3491

Abstract

Valves are largely useful for treatment assistance devices, e.g., supporting fluid circulation movement in the human body. However, the valves presently used in biomedical applications still use materials that are rigid, non-compliant, and hard to integrate with human tissues. Here, we propose biologically-inspired, [...] Read more.

Valves are largely useful for treatment assistance devices, e.g., supporting fluid circulation movement in the human body. However, the valves presently used in biomedical applications still use materials that are rigid, non-compliant, and hard to integrate with human tissues. Here, we propose biologically-inspired, stimuli-responsive valves and evaluate N-Isopropylacrylamide hydrogels-based valve (NPHV) and PAAm-alginate hydrogels-based valve (PAHV) performances with different chemical syntheses for optimizing better valve action. Once heated at 40

^{\circ}

C, the NPHV outperforms the PAHV in annular actuation (NPHV: 1.93 mm displacement in 4 min; PAHV: 0.8 mm displacement in 30 min). In contrast, the PAHV exhibits a flow rate change of up to 20%, and a payload of 100% when the object is at 100

^{\circ}

C. The PAHV demonstrated a completely soft, stretchable circular gripper with a high load-to-weight ratio for diversified applications. These valves are fabricated with a simple one-pot method that, once further optimized, can offer transdisciplinary applications. Full article

(This article belongs to the Special Issue Hydrogels Used for Biomanufacturing)

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5 pages, 898 KiB

Open AccessCase Report

Success of Thrombectomy in Management of Ischemic Stroke in Two Patients with SynCardia Total Artificial Heart in Bridge-to-Transplantation

by Brendan Le Picault, Charles-Henri David, Pierre-Louis Alexandre, Cédric Lenoble, Philippe Bizouarn, Thierry Lepoivre, Nicolas Groleau, Bertrand Rozec, Hubert Desal, Jean-Christian Roussel and Thomas Sénage

Bioengineering 2021, 8(9), 126; https://doi.org/10.3390/bioengineering8090126 - 19 Sep 2021

Cited by 1 | Viewed by 3216

Abstract

Introduction: Circulatory assistance from a SynCardia Total Artificial Heart (SynCardia-TAH) is a reliable bridge-to-transplant solution for patients with end-stage biventricular heart failure. Ischemic strokes affect about 10% of patients with a SynCardia-TAH. We report for the first time in the literature two successful [...] Read more.

Introduction: Circulatory assistance from a SynCardia Total Artificial Heart (SynCardia-TAH) is a reliable bridge-to-transplant solution for patients with end-stage biventricular heart failure. Ischemic strokes affect about 10% of patients with a SynCardia-TAH. We report for the first time in the literature two successful thrombectomies to treat the acute phase of ischemic stroke in two patients treated with a SynCardia-TAH in the bridge-to-transplant (BTT). Case report: We follow two patients with circulatory support from a SynCardia-TAH in the bridge-to-transplant for terminal biventricular cardiac failure with ischemic stroke during the support period. An early in-hospital diagnosis enables the completion of a mechanical thrombectomy within the first 6 h of the onset of symptoms. There was no intracranial hemorrhagic complication during or after the procedure and the patients fully recovered from neurological deficits, allowing a successful heart transplant. Conclusion: This case report describes the possibility of treating ischemic strokes under a SynCardia-TAH by mechanical thrombectomy following the same recommendations as for the general population with excellent results and without any hemorrhagic complication during or after the procedure. Full article

(This article belongs to the Special Issue The New Frontiers of Artificial Organs Engineering)

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15 pages, 5809 KiB

Open AccessArticle

Distinct Methodologies to Produce Capped Mesoporous Silica with Hydroxyapatite and the Influence in Intracellular Signaling as Cytotoxicity on Human Umbilical Vein Endothelial Cells

by Aline Oliveira da Silva de Barros, Luciana Magalhães Rebêlo Alencar, Frank Alexis and Ralph Santos-Oliveira

Bioengineering 2021, 8(9), 125; https://doi.org/10.3390/bioengineering8090125 - 12 Sep 2021

Cited by 3 | Viewed by 2421

Abstract

Mesoporous silica has unique properties such as controllable mesoporous structure and size, good biocompatibility, high specific surface area, and large pore volume. For that reason, this material has been broadly functionalized for biomedical applications, such as optical imaging, magnetic resonance imaging (MRI), positron [...] Read more.

Mesoporous silica has unique properties such as controllable mesoporous structure and size, good biocompatibility, high specific surface area, and large pore volume. For that reason, this material has been broadly functionalized for biomedical applications, such as optical imaging, magnetic resonance imaging (MRI), positron emission tomography (PET), computed tomography (CT), ultrasound imaging, and widely employed as drug delivery systems. In this study, we synthesized fiber-type mesoporous silica capped with hydroxyapatite (ordered SiO₂–CaO–P₂O₅ mesoporous silica). Its biological activity was evaluated through a cellular and molecular approach using HUVEC cell culture. Two distinct methodologies have produced the ordered SiO₂–CaO–P₂O₅ mesoporous silica: (i) two-step Ca-doped silica matrix followed by hydroxyapatite crystallization inside the Ca-doped silica matrix and (ii) one-step Ca-doped silica matrix formed with the hydroxyapatite crystallization. Further analysis included: elemental analysis, transmission, scanning electron microscopy images, Small and Wide-Angle X-ray Diffraction analysis, Fourier Transform Infrared, and in vitro assays with HUVEC (cytotoxicity and immunoblotting). The hydroxyapatite capping methodology significantly affected the original mesoporous material structure. Furthermore, no cellular or molecular effect has been observed. The promising results presented here suggest that the one-step method to obtain hydroxyapatite capped mesoporous silica was effective, also demonstrating that this material has potential in biomedical applications. Full article

(This article belongs to the Special Issue Engineered Biomaterials: Design, Modeling, Synthesis, Characterization and Applications)

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17 pages, 4994 KiB

Open AccessArticle

A Loss of Nuclear—Cytoskeletal Interactions in Vascular Smooth Muscle Cell Differentiation Induced by a Micro-Grooved Collagen Substrate Enabling the Modeling of an In Vivo Cell Arrangement

by Kazuaki Nagayama

Bioengineering 2021, 8(9), 124; https://doi.org/10.3390/bioengineering8090124 - 12 Sep 2021

Cited by 3 | Viewed by 3166

Abstract

Vascular smooth muscle cells (VSMCs) remodel vascular walls actively owing to mechanical cues and dedifferentiate to the synthetic phenotype from contractile phenotype in pathological conditions. It is crucial to clarify the mechanisms behind the VSMC phenotypic transition for elucidating their role in the [...] Read more.

Vascular smooth muscle cells (VSMCs) remodel vascular walls actively owing to mechanical cues and dedifferentiate to the synthetic phenotype from contractile phenotype in pathological conditions. It is crucial to clarify the mechanisms behind the VSMC phenotypic transition for elucidating their role in the vascular adaptation and repair and for designing engineered tissues. We recently developed novel micro-grooved collagen substrates with “wavy wrinkle” grooves to induce cell–substrate adhesion, morphological polarization, and a tissue-like cell arrangement with cytoskeletal rearrangements similar to those in vascular tissue in vivo. We found that cultivation with this micro-grooved collagen significantly induced VSMC contractile differentiation. Nonetheless, the detailed mechanism underlying the promotion of such VSMC differentiation by micro-grooved collagen has not been clarified yet. Here, we investigated the detailed mechanism of the cell arrangement into a tissue and contractile-differentiation improvement by our micro-grooved collagen substrates in terms of nuclear–cytoskeletal interactions that possibly affect the nuclear mechanotransduction involved in the activation of transcription factors. We found that VSMCs on micro-grooved collagen manifested significant cell arrangement into a tissue and nucleus slimming with a volume reduction in response to the remodeling of the actin cytoskeleton, with consequent inhibition of nuclear shuttling of a transcriptional coactivator, Yes-associated protein (YAP), and improved contractile differentiation. Furthermore, VSMC nuclei rarely deformed during macroscopic cell stretching and featured a loss of nesprin-1–mediated nuclear–cytoskeletal interactions. These results indicate that our micro-grooved collagen induces a cell alignment mimicking in vivo VSMC tissue and promotes contractile differentiation. In such processes of contractile differentiation, mechanical interaction between the nucleus and actin cytoskeleton may diminish to prevent a nuclear disturbance from the excess mechanical stress that might be essential for maintaining vascular functions. Full article

(This article belongs to the Special Issue Mechanobiology and Cellular Mechanotransduction: Basic Science and Clinical Implications)

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34 pages, 2891 KiB

Open AccessReview

Biofabrication Strategies for Musculoskeletal Disorders: Evolution towards Clinical Applications

by Saman Naghieh, Gabriella Lindberg, Maryam Tamaddon and Chaozong Liu

Bioengineering 2021, 8(9), 123; https://doi.org/10.3390/bioengineering8090123 - 10 Sep 2021

Cited by 11 | Viewed by 3966

Abstract

Biofabrication has emerged as an attractive strategy to personalise medical care and provide new treatments for common organ damage or diseases. While it has made impactful headway in e.g., skin grafting, drug testing and cancer research purposes, its application to treat musculoskeletal tissue [...] Read more.

Biofabrication has emerged as an attractive strategy to personalise medical care and provide new treatments for common organ damage or diseases. While it has made impactful headway in e.g., skin grafting, drug testing and cancer research purposes, its application to treat musculoskeletal tissue disorders in a clinical setting remains scarce. Albeit with several in vitro breakthroughs over the past decade, standard musculoskeletal treatments are still limited to palliative care or surgical interventions with limited long-term effects and biological functionality. To better understand this lack of translation, it is important to study connections between basic science challenges and developments with translational hurdles and evolving frameworks for this fully disruptive technology that is biofabrication. This review paper thus looks closely at the processing stage of biofabrication, specifically at the bioinks suitable for musculoskeletal tissue fabrication and their trends of usage. This includes underlying composite bioink strategies to address the shortfalls of sole biomaterials. We also review recent advances made to overcome long-standing challenges in the field of biofabrication, namely bioprinting of low-viscosity bioinks, controlled delivery of growth factors, and the fabrication of spatially graded biological and structural scaffolds to help biofabricate more clinically relevant constructs. We further explore the clinical application of biofabricated musculoskeletal structures, regulatory pathways, and challenges for clinical translation, while identifying the opportunities that currently lie closest to clinical translation. In this article, we consider the next era of biofabrication and the overarching challenges that need to be addressed to reach clinical relevance. Full article

(This article belongs to the Special Issue Bioprinting of Tissue-Engineered Scaffolds: Design Strategies & Printability of Smart Biomaterials)

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Graphical abstract

18 pages, 3946 KiB

Open AccessArticle

Multiscale Entropy Analysis of Heart Rate Variability in Neonatal Patients with and without Seizures

by Lorenzo Frassineti, Antonio Lanatà, Benedetta Olmi and Claudia Manfredi

Bioengineering 2021, 8(9), 122; https://doi.org/10.3390/bioengineering8090122 - 09 Sep 2021

Cited by 12 | Viewed by 3219

Abstract

The complex physiological dynamics of neonatal seizures make their detection challenging. A timely diagnosis and treatment, especially in intensive care units, are essential for a better prognosis and the mitigation of possible adverse effects on the newborn’s neurodevelopment. In the literature, several electroencephalographic [...] Read more.

The complex physiological dynamics of neonatal seizures make their detection challenging. A timely diagnosis and treatment, especially in intensive care units, are essential for a better prognosis and the mitigation of possible adverse effects on the newborn’s neurodevelopment. In the literature, several electroencephalographic (EEG) studies have been proposed for a parametric characterization of seizures or their detection by artificial intelligence techniques. At the same time, other sources than EEG, such as electrocardiography, have been investigated to evaluate the possible impact of neonatal seizures on the cardio-regulatory system. Heart rate variability (HRV) analysis is attracting great interest as a valuable tool in newborns applications, especially where EEG technologies are not easily available. This study investigated whether multiscale HRV entropy indexes could detect abnormal heart rate dynamics in newborns with seizures, especially during ictal events. Furthermore, entropy measures were analyzed to discriminate between newborns with seizures and seizure-free ones. A cohort of 52 patients (33 with seizures) from the Helsinki University Hospital public dataset has been evaluated. Multiscale sample and fuzzy entropy showed significant differences between the two groups (p-value < 0.05, Bonferroni multiple-comparison post hoc correction). Moreover, interictal activity showed significant differences between seizure and seizure-free patients (Mann-Whitney Test: p-value < 0.05). Therefore, our findings suggest that HRV multiscale entropy analysis could be a valuable pre-screening tool for the timely detection of seizure events in newborns. Full article

(This article belongs to the Special Issue Advances in Multivariate Physiological Signal Analysis)

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15 pages, 4832 KiB

Open AccessEditor’s ChoiceArticle

Amphiphilic and Perfluorinated Poly(3-Hydroxyalkanoate) Nanocapsules for ¹⁹F Magnetic Resonance Imaging

by Marion Le Gal, Estelle Renard, Christelle Simon-Colin, Benoit Larrat and Valérie Langlois

Bioengineering 2021, 8(9), 121; https://doi.org/10.3390/bioengineering8090121 - 09 Sep 2021

Cited by 2 | Viewed by 2883

Abstract

Nanoparticles have recently emerged as valuable tools in biomedical imaging techniques. Here PEGylated and fluorinated nanocapsules based on poly(3-hydroxyalkanoate) containing a liquid core of perfluorooctyl bromide PFOB were formulated by an emulsion-evaporation process as potential ¹⁹F MRI imaging agents. Unsaturated poly(hydroxyalkanoate), PHAU, [...] Read more.

Nanoparticles have recently emerged as valuable tools in biomedical imaging techniques. Here PEGylated and fluorinated nanocapsules based on poly(3-hydroxyalkanoate) containing a liquid core of perfluorooctyl bromide PFOB were formulated by an emulsion-evaporation process as potential ¹⁹F MRI imaging agents. Unsaturated poly(hydroxyalkanoate), PHAU, was produced by marine bacteria using coprah oil and undecenoic acid as substrates. PHA-g-(F; PEG) was prepared by two successive controlled thiol-ene reactions from PHAU with firstly three fluorinated thiols having from 3 up to 17 fluorine atoms and secondly with PEG-SH. The resulting PHA-g-(F; PEG)-based PFOB nanocapsules, with a diameter close to 250–300 nm, are shown to be visible in ¹⁹F MRI with an acquisition time of 15 min. The results showed that PFOB-nanocapsules based on PHA-g-(F; PEG) have the potential to be used as novel contrast agents for ¹⁹F MRI. Full article

(This article belongs to the Special Issue Nano-Based Drug Delivery System: Recent Developments and Future Prospects)

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16 pages, 1201 KiB

Open AccessReview

Autotransplantation of the Third Molar: A Therapeutic Alternative to the Rehabilitation of a Missing Tooth: A Scoping Review

by Mario Dioguardi, Cristian Quarta, Diego Sovereto, Giuseppe Troiano, Michele Melillo, Michele Di Cosola, Angela Pia Cazzolla, Luigi Laino and Lorenzo Lo Muzio

Bioengineering 2021, 8(9), 120; https://doi.org/10.3390/bioengineering8090120 - 02 Sep 2021

Cited by 13 | Viewed by 4726

Abstract

Introduction: Tooth autotransplantation is the repositioning of an erupted, partially erupted, or non-erupted autologous tooth from one site to another within the same individual. Several factors influence the success rate of the autotransplant, such as the stage of root development, the morphology of [...] Read more.

Introduction: Tooth autotransplantation is the repositioning of an erupted, partially erupted, or non-erupted autologous tooth from one site to another within the same individual. Several factors influence the success rate of the autotransplant, such as the stage of root development, the morphology of the tooth, the surgical procedure selected, the extraoral time, the shape of the recipient socket, the vascularity of the recipient bed, and the vitality of the cells of the periodontal ligament. The aim of this scoping review was to provide the most up-to-date information and data on the clinical principles of the third-molar autograft and thus provide clinical considerations for its success. Materials and methods: This review was conducted based on PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). The research was conducted by searching for keywords in three databases—PubMed, Scopus and Google Scholar—by two independent reviewers following the PRISMA protocol, from which 599 records were identified. Conclusions: Third-molar autotransplantation is a valid solution to replace missing teeth. The key to the success of this technique is the surgical procedure, which must be as atraumatic as possible to preserve the periodontal ligament of the tooth to be transplanted. The success rate is also linked to the stage of development of the root, with a worse prognosis in the case of a complete root. Full article

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21 pages, 2821 KiB

Open AccessEditor’s ChoiceReview

Pichia pastoris (Komagataella phaffii) as a Cost-Effective Tool for Vaccine Production for Low- and Middle-Income Countries (LMICs)

by Salomé de Sá Magalhães and Eli Keshavarz-Moore

Bioengineering 2021, 8(9), 119; https://doi.org/10.3390/bioengineering8090119 - 31 Aug 2021

Cited by 25 | Viewed by 6389

Abstract

Vaccination is of paramount importance to global health. With the advent of the more recent pandemics, the urgency to expand the range has become even more evident. However, the potential limited availability and affordability of vaccines to resource low- and middle-income countries has [...] Read more.

Vaccination is of paramount importance to global health. With the advent of the more recent pandemics, the urgency to expand the range has become even more evident. However, the potential limited availability and affordability of vaccines to resource low- and middle-income countries has created a need for solutions that will ensure cost-effective vaccine production methods for these countries. Pichia pastoris (P. pastoris) (also known as Komagataella phaffii) is one of the most promising candidates for expression of heterologous proteins in vaccines development. It combines the speed and ease of highly efficient prokaryotic platforms with some key capabilities of mammalian systems, potentially reducing manufacturing costs. This review will examine the latest developments in P. pastoris from cell engineering and design to industrial production systems with focus on vaccine development and with reference to specific key case studies. Full article

(This article belongs to the Special Issue From Yeast to Biotechnology)

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22 pages, 107896 KiB

Open AccessArticle

Improved Repopulation Efficacy of Decellularized Small Diameter Vascular Grafts Utilizing the Cord Blood Platelet Lysate

by Panagiotis Mallis, Dimitrios P. Sokolis, Michalis Katsimpoulas, Alkiviadis Kostakis, Catherine Stavropoulos-Giokas and Efstathios Michalopoulos

Bioengineering 2021, 8(9), 118; https://doi.org/10.3390/bioengineering8090118 - 27 Aug 2021

Cited by 1 | Viewed by 3241

Abstract

Background: The development of functional bioengineered small-diameter vascular grafts (SDVGs), represents a major challenge of tissue engineering. This study aimed to evaluate the repopulation efficacy of biological vessels, utilizing the cord blood platelet lysate (CBPL). Methods: Human umbilical arteries (hUAs, n = 10) [...] Read more.

Background: The development of functional bioengineered small-diameter vascular grafts (SDVGs), represents a major challenge of tissue engineering. This study aimed to evaluate the repopulation efficacy of biological vessels, utilizing the cord blood platelet lysate (CBPL). Methods: Human umbilical arteries (hUAs, n = 10) were submitted to decellularization. Then, an evaluation of decellularized hUAs, involving histological, biochemical and biomechanical analysis, was performed. Wharton’s Jelly (WJ) Mesenchymal Stromal Cells (MSCs) were isolated and characterized for their properties. Then, WJ-MSCs (1.5 × 10⁶ cells) were seeded on decellularized hUAs (n = 5) and cultivated with (Group A) or without the presence of the CBPL, (Group B) for 30 days. Histological analysis involving immunohistochemistry (against Ki67, for determination of cell proliferation) and indirect immunofluorescence (against activated MAP kinase, additional marker for cell growth and proliferation) was performed. Results: The decellularized hUAs retained their initial vessel’s properties, in terms of key-specific proteins, the biochemical and biomechanical characteristics were preserved. The evaluation of the repopulation process indicated a more uniform distribution of WJ-MSCs in group A compared to group B. The repopulated vascular grafts of group B were characterized by greater Ki67 and MAP kinase expression compared to group A. Conclusion: The results of this study indicated that the CBPL may improve the repopulation efficacy, thus bringing the biological SDVGs one step closer to clinical application. Full article

(This article belongs to the Special Issue Modern Approaches in Cardiovascular Disease Therapeutics: From Molecular Genetics to Tissue Engineering)

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14 pages, 10366 KiB

Open AccessArticle

Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair

by Marco Penso, Mauro Pepi, Valentina Mantegazza, Claudia Cefalù, Manuela Muratori, Laura Fusini, Paola Gripari, Sarah Ghulam Ali, Enrico G. Caiani and Gloria Tamborini

Bioengineering 2021, 8(9), 117; https://doi.org/10.3390/bioengineering8090117 - 25 Aug 2021

Cited by 9 | Viewed by 3650

Abstract

Background: Mitral valve regurgitation (MR) is the most common valvular heart disease and current variables associated with MR recurrence are still controversial. We aim to develop a machine learning-based prognostic model to predict causes of mitral valve (MV) repair failure and MR recurrence. [...] Read more.

Background: Mitral valve regurgitation (MR) is the most common valvular heart disease and current variables associated with MR recurrence are still controversial. We aim to develop a machine learning-based prognostic model to predict causes of mitral valve (MV) repair failure and MR recurrence. Methods: 1000 patients who underwent MV repair at our institution between 2008 and 2018 were enrolled. Patients were followed longitudinally for up to three years. Clinical and echocardiographic data were included in the analysis. Endpoints were MV repair surgical failure with consequent MV replacement or moderate/severe MR (>2+) recurrence at one-month and moderate/severe MR recurrence after three years. Results: 817 patients (DS1) had an echocardiographic examination at one-month while 295 (DS2) also had one at three years. Data were randomly divided into training (DS1: n = 654; DS2: n = 206) and validation (DS1: n = 164; DS2 n = 89) cohorts. For intra-operative or early MV repair failure assessment, the best area under the curve (AUC) was 0.75 and the complexity of mitral valve prolapse was the main predictor. In predicting moderate/severe recurrent MR at three years, the best AUC was 0.92 and residual MR at six months was the most important predictor. Conclusions: Machine learning algorithms may improve prognosis after MV repair procedure, thus improving indications for correct candidate selection for MV surgical repair. Full article

(This article belongs to the Special Issue Machine Learning-Based Heart, Brain and Nerve Tissue Engineering)

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Bioengineering, Volume 8, Issue 9 (September 2021) – 13 articles

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