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The extracellular matrix (ECM) has evolved around complex covalent and non-covalent interactions to create impressive function-from cellular signaling to constant remodeling. A major challenge in the biomedical field is the de novo design and control of synthetic ECMs for applications ranging from tissue engineering to neuromodulation to bioelectronics. As we move towards recreating the ECM's complexity in hydrogels, the field has taken several approaches to recapitulate the main important features of the native ECM (i.e. mechanical, bioactive and dynamic properties). In this review, we first describe the wide variety of hydrogel systems that are currently used, ranging from fully natural to completely synthetic to hybrid versions, highlighting the advantages and limitations of each class. Then, we shift towards supramolecular hydrogels that show great potential for their use as ECM mimics due to their biomimetic hierarchical structure, inherent (controllable) dynamic properties and their modular design, allowing for precise control over their mechanical and biochemical properties. In order to make the next step in the complexity of synthetic ECM-mimetic hydrogels, we must leverage the supramolecular self-assembly seen in the native ECM; we therefore propose to use supramolecular monomers to create larger, hierarchical, co-assembled hydrogels with complex and synergistic mechanical, bioactive and dynamic features.

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Low molecular weight gels are formed via the self-assembly of small molecules into fibrous structures. In the case of hydrogels, these networks entrap large volumes of water, yielding soft materials. Such gels tend to have weak mechanical properties and a high permeability for cells, making them particularly appealing for regenerative medicine applications. Ureido-pyrimidinone (UPy) supramolecular gelators are self-assembling systems that have demonstrated excellent capabilities as biomaterials. Here, we combine UPy-gelators with another low molecular weight gelator, the functionalized dipeptide 2NapFF. We have successfully characterized these multicomponent systems on a molecular and bulk scale. The addition of 2NapFF to a crosslinked UPy hydrogel significantly increased hydrogel stiffness from 30 Pa to 1300 Pa. Small-angle X-ray scattering was used to probe the underlying structures of the systems and showed that the mixed UPy and 2NapFF systems resemble the scattering data produced by the pristine UPy systems. However, when a bifunctional UPy-crosslinker was added, the scattering was close to that of the 2NapFF only samples. The results suggest that the crosslinker significantly influences the assembly of the low molecular weight gelators. Finally, we analysed the biocompatibility of the systems using fibroblast cells and found that the cells tended to spread more effectively when the crosslinking species was incorporated. Our results emphasise the need for thorough characterisation at multiple length scales to finely control material properties, which is particularly important for developing novel biomaterials.

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The cellular microenvironment is composed of a dynamic hierarchical fibrillar architecture providing a variety of physical and bioactive signals to the surrounding cells. This dynamicity, although common in biology, is a challenge to control in synthetic matrices. Here, responsive synthetic supramolecular monomers were designed that are able to assemble into hierarchical fibrous structures, combining supramolecular fiber formation via hydrogen bonding interactions, with a temperature-responsive hydrophobic collapse, resulting in cross-linking and hydrogel formation. Therefore, amphiphilic molecules were synthesized, composed of a hydrogen bonding ureido-pyrimidinone (UPy) unit, a hydrophobic alkyl spacer, and a hydrophilic oligo(ethylene glycol) tail. The temperature responsive behavior was introduced by functionalizing these supramolecular amphiphiles with a relatively short poly(N-isopropylacrylamide) (PNIPAM) chain (M n ∼ 2.5 or 5.5 kg/mol). To precisely control the assembly of these monomers, the length of the alkyl spacer between the UPy moiety and PNIPAM was varied in length. A robust sol-gel transition, with the dodecyl UPy-PNIPAM molecule, was obtained, with a network elasticity enhancing over 2000 times upon heating above room temperature. The UPy-PNIPAM compounds with shorter alkyl spacers were already hydrogels at room temperature. The sol-gel transition of the dodecyl UPy-PNIPAM hydrogelator could be tuned by the incorporation of different UPy-functionalized monomers. Furthermore, we demonstrated the suitability of this system for microfluidic cell encapsulation through a convenient temperature sol-gel transition. Our results indicate that this novel thermoresponsive supramolecular system offers a modular platform to study and guide single-cell behavior.

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Recent advances in the field of ophthalmology show great potential in the design of bioengineered constructs to mimic the corneal stroma. Hydrogels based on synthetic supramolecular polymers, are attractive synthetic mimics of the natural highly hydrated corneal stroma. Here, a fully synthetic corneal stromal construct is developed via engineering of an injectable supramolecular hydrogel based on ureido-pyrimidinone (UPy) moieties. The hydrogel displays a dynamic and tunable behavior, which allows for control of biochemical and mechanical cues. Two hydrogels are developed, a fully synthetic hydrogel functionalized with a bioactive cyclic arginine-glycine-aspartate UPy (UPy-cRGD) additive, and a hybrid hydrogel based on UPy-moieties mixed with collagen type I fibers. Both hydrogels supported cell encapsulation and associated cellular deposition of extracellular matrix (ECM) proteins after 21 days. Excitingly, the hydrogels support the activation of isolated primary keratocytes into stromal fibroblasts as well as the differentiation toward more quiescent corneal stromal keratocytes, demonstrated by their characteristic long dendritic protrusions and a substantially diminished cytokine secretion. Furthermore, cells survive shear stresses during an injectability test. Together, these findings highlight the development of an injectable supramolecular hydrogel as a synthetic corneal stromal microenvironment able to host primary keratocytes.

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This study identifies non-homogeneous stiffnesses in a non-destructive manner from simulated noisy measurements of a structural response. The finite element method serves as a discretization for the respective cantilever beam example problems: static loading and modal analysis. Karhunen-Loève expansions represent the stiffness random fields. We solve the inverse problems using Bayesian inference on the Karhunen-Loève coefficients, hereby introducing a novel resonance frequency method. The flexible descriptions of both the structural stiffness uncertainty and the measurement noise characteristics allow for straightforward adoption to measurement setups and a range of non-homogeneous materials. Evaluating the inversion performance for varying stiffness covariance functions shows that the static analysis procedure outperforms the modal analysis procedure in a mean sense. However, the solution quality depends on the position within the beam for the static analysis approach, while the confidence interval height remains constant along the beam for the modal analysis. An investigation of the effect of the signal-to-noise ratio reveals that the static loading procedure yields lower errors than the dynamic procedure for the chosen configuration with ideal boundary conditions.

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Recent advances in the field of cardiac regeneration show great potential in the use of injectable hydrogels to reduce immediate flush-out of injected factors, thereby increasing the effectiveness of the encapsulated drugs. To establish a relation between cardiac function and retention of the drug-encapsulating hydrogel, a quantitative in vivo imaging method is required. Here, the supramolecular ureido-pyrimidinone modified poly(ethylene glycol) (UPy-PEG) material is developed into a bioactive hydrogel for radioactive imaging in a large animal model. A radioactive label is synthesized, being a ureido-pyrimidinone moiety functionalized with a chelator (UPy-DOTA) complexed with the radioactive isotope indium-111 (UPy-DOTA-111 In) that is mixed with the hydrogel. Additionally, bioactive and adhesive properties of the UPy-PEG hydrogel are increased by supramolecular introduction of a UPy-functionalized recombinant collagen type 1-based material (UPy-PEG-RCPhC1). This method enables in vivo tracking of the nonbioactive and bioactive supramolecular hydrogels and quantification of hydrogel retention in a porcine heart. In a small pilot, cardiac retention values of 8% for UPy-PEG and 16% for UPy-PEG-RCPhC1 hydrogel are observed 4 h postinjection. This work highlights the importance of retention quantification of hydrogels in vivo, where elucidation of hydrogel quantity at the target site is proposed to strongly influence efficacy of the intended therapy.

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Despite having great value across a wide variety of scientific fields, two-photon polymerizations currently suffer from two significant problems: the need for photoinitiators, which generate toxic side products, and the irreversibility of the process. Hence, the design of a versatile approach that circumvents these issues represents a major scientific challenge. Herein, we report a two-photon absorption strategy where reversible [2 + 2] cycloaddition of bis-thymines was achieved without the need for any photoinitiator. The cycloaddition and cycloreversion reactions could be induced by simply changing the irradiation wavelength, and repeated writing and erasing cycles were performed. The simplicity, reversibility, and biocompatibility of this strategy open up a whole new toolbox for applications across a wide variety of scientific fields.

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Biological hydrogels can become many times stiffer under deformation. This unique ability has only recently been realised in fully synthetic gels. Typically, these networks are composed of semi-flexible polymers and bundles and show such large mechanical responses at very small strains, which makes them particularly suitable for application as strain-responsive materials. In this work, we introduced strain-responsiveness by crosslinking the architecture with a multi-functional virus-like particle. At high stresses, we find that the virus particles disintegrate, which creates an (irreversible) mechanical energy dissipation pathway, analogous to the high stress response of fibrin networks. A cooling-heating cycle allows for re-crosslinking at the damaged site, which gives rise to much stronger hydrogels. Virus particles and capsids are promising drug delivery vehicles and our approach offers an effective strategy to trigger the release mechanically without compromising the mechanical integrity of the host material.

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In the 20th century, the complications of head injuries were controlled but not eliminated. The wars of the 21st century turned attention to blast, the instant of impact and the primary injury of concussion. Computer calculations have established that in the first 5 milliseconds after the impact, four independent injuries on the brain are inflicted: 1) impact and its shockwave, 2) deceleration, 3) rotation and 4) skull deformity with vibration (or resonance). The recovery, pathology and symptoms after acute brain trauma have always been something of a puzzle. The variability of these four modes of injury, along with a variable reserve of neurones, explains some of this problem.

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BACKGROUND: Helicobacter pylori (H. pylori) is the main etiologic agent of chronic gastritis and it is an important cause of gastric damage. The celiac disease can affect the morphology and the function of the gastrointestinal tract from the stomach to the colon and it is frequently associated with chronic gastritis. AIM: to assess the presence of H. pylori in gastric biopsies and in feces of pediatric patients with celiac disease and to relate it with the symptoms. PATIENTS AND METHODS: Pediatric patients with celiac disease attending the Gastroenterology Service at the "Avelino Castelán" Hospital in Resistencia (Argentina) were included in the study. Gastric biopsies samples were obtained by endoscopy for histological studies, the symptoms and socio-epidemiological characteristics were recorded and the polimerase chain reaction(PCR) was applied in feces in order to detect the presence of H. pylori. RESULTS: Thirty one patients with celiac disease were studied (16 female and 15 male; age range:1-14 years; median 6.7 years); 14 (45.2%) were positive for H. pylori in gastric biopsy and among them, only 2 (14.2%) were positive for H. pylori in stool samples. There were not significant differences between symptoms between H. pylori positive and negative patients. CONCLUSION: 45.2% of the patients with celiac disease were infected by H. pylori. There was no correlation between the frequencies of bacterial detection in feces and in gastric biopsies. The clinical manifestations of celiac disease did not increase in children infected with H. pylori.

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The cognitive deficits are described in a 20-year-old right-handed man with asymmetrical bilateral thalamic lesions and a lesion resulting in the 'locked-in' syndrome. Memory and intellectual assessment, modified due to the physical and communication difficulties, suggested that the patient had little impairment of verbal intelligence and performed normally on memory test involving immediate recall of new material. There was, however, considerable impairment of organization, planning and in the recall of visual and especially verbal memory, over longer periods. Remote memory was relatively intact, except for chronological errors in time-tagged material, and he was disoriented for year, month and day.

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OBJECT: Current clinical neuromonitoring techniques lack adequate surveillance of cerebral perfusion. In this article, a novel thermal diffusion (TD) microprobe is evaluated for the continuous and quantitative assessment of intraparenchymal regional cerebral blood flow (rCBF). METHODS: To characterize the temporal resolution of this new technique, rCBF measured using the TD microprobe (TD-rCBF) was compared with rCBF levels measured by laser Doppler (LD) flowmetry during standardized variations of CBF in a sheep model. For validation of absolute values, the microprobe was implanted subcortically (20 mm below the level of dura) into 16 brain-injured patients, and TD-rCBF was compared with simultaneous rCBF measurements obtained using stable xenon-enhanced computerized tomography scanning (sXe-rCBF). The two techniques were compared using linear regression analysis as well as the Bland and Altman method. Stable TD-rCBF measurements could be obtained throughout all 3- to 5-hour sheep experiments. During hypercapnia, TD-rCBF increased from 49.3+/-15.8 ml/100 g/min (mean +/- standard deviation) to 119.6+/-47.3 ml/100 g/ min, whereas hypocapnia produced a decline in TD-rCBF from 51.2+/-12.8 ml/100 g/min to 39.3+/-5.6 m/100 g/min. Variations in mean arterial blood pressure revealed an intact autoregulation with pressure limits of approximately 65 mm Hg and approximately 170 mm Hg. After cardiac arrest TD-rCBF declined rapidly to 0 ml/100 g/min. The dynamics of changes in TD-rCBF corresponded well to the dynamics of the LD readings. A comparison of TD-rCBF and sXe-rCBF revealed a good correlation (r = 0.89; p < 0.0001) and a mean difference of 1.1+/-5.2 ml/100 g/min between the two techniques. CONCLUSIONS: The novel TD microprobe provides a sensitive, continuous, and real-time assessment of intraparenchymal rCBF in absolute flow values that are in good agreement with sXe-rCBF measurements. This study provides the basis for the integration of TD-rCBF into multimodal monitoring of patients who are at risk for secondary brain injury.

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Perfusion, the rate at which blood in tissue is replenished at the capillary level, is a primary factor in the transport of heat, drugs, oxygen and nutrients. While there have been many measurement techniques proposed, most do not lend themselves to routine, continuous and real-time use. A minimally invasive probe, called the thermal diffusion probe (TDP), which uses a self-heated thermistor to measure absolute perfusion continuously and in real time, was validated at low flows with the microsphere technique. In 27 rabbits, simultaneous TDP measurements were made in liver from 0 to 60 ml min-1 100 g-1. The TDP perfusion correlated well with the microspheres (R2 = 0.898) and the agreement between techniques is very good with a slope close to unity (0.921) and an intercept close to zero (0.566 ml min-1 100 g-1). Variability between the two techniques was primarily due to the sampling error from the microsphere 'snap shot' of periodic blood flow when compared with the continuous TDP perfusion measurement. The ability to quantify local perfusion continuously and in real time may have a profound impact on patient management in a number of clinical areas such as organ transplantation, neurosurgery, oncology and others, in which quantitative knowledge of perfusion is of value.

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A large number of epidemiological and experimental studies suggest that prolonged (>100 s) weak 50-60-Hz electric and magnetic field (EMF) exposures may cause biological effects(NIEHS Working Group, NIH, 1998; Bersani, 1999). We show, however, that for typical temperature sensitivities of biochemical processes, realistic temperature variations during long exposures raise the threshold exposure by two to three orders of magnitude over a fundamental value, independent of the biophysical coupling mechanism. Temperature variations have been omitted in previous theoretical analyses of possible weak field effects, particularly stochastic resonance (Bezrukov and Vodyanoy 1997a. Nature. 385:319-321; Astumian et al., 1997 Nature. 338:632-633; Bezrukov and Vodyanoy, 1997b. Nature. 338:663; Dykman and McClintock, 1998. Nature. 391:344; McClintock, 1998;. Gammaitoni et al., 1998. Rev. Mod. Phys. 70:223-287). Although sensory systems usually respond to much shorter (approximately 1 s) exposures and can approach fundamental limits (Bialek, 1987 Annu. Rev. Biophys. Biophys. Chem. 16:455-468; Adair et al, 1998. Chaos. 8:576-587), our results significantly decrease the plausibility of effects for nonsensory biological systems due to prolonged, weak-field exposures.

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Review of a personal series of 25 first rib resections for thoracic outlet syndrome shows that operation offers a 60% chance of improvement for an acceptable morbidity. This series is the first to consist solely of patients operated on for brachial plexus compression and diagnosed by stated criteria, which were: (1) pain and paraesthesiae running down the arm into the fingers (usually ulnar, but not exclusively); (2) reproduction of distal symptoms by pulling the shoulder down and back, and/or straight down, and/or forwards; (3) pressure in the supraclavicular fossa over the brachial plexus is painful and may reproduce the distal symptoms; and (4) a normal radiculogram.

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A system for the noninvasive localized, hyperthermia treatment of benign prostatic hyperplasia was investigated. The system uses a microwave transrectal antenna with a water cooled jacket to achieve localized hyperthermia. The purpose of this study is to model the temperature rise in the prostate and in the surrounding tissue during treatment. The SAR distribution for the transrectal probe is measured in a muscle tissue equivalent phantom. The SAR information is used with a finite element solution of the bioheat transfer equation to give the temperature rise during the treatment. Also the finite element solution is further used to determine the effect of the microwave power, the cooling fluid temperature and the blood perfusion on the tissue temperature rise. The results of the solution are compared to temperature measurements in a canine protocol. It was found that the maximum temperature rise in the tissue during treatment is 44 degrees C at a depth of 2 cm from the rectal mucosa.

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Schistosomiasis, a group of parasitic diseases caused by Schistosoma parasites, is associated with water resources development and affects more than 200 million people in 76 countries. Depending on the species of parasite involved, disease of the liver, spleen, gastrointestinal or urinary tract, or kidneys may result. A computer-assisted teaching package has been developed by WHO for use in the training of public health workers involved in schistosomiasis control. The package consists of the software, ZOOM, and a schistosomiasis information file, Dr Schisto, and uses hypermedia technology to link pictures and text. ZOOM runs on the IBM-PC and IBM-compatible computers, is user-friendly, requires a minimal hardware configuration, and can interact with the user in English, French, Spanish or Portuguese. The information files for ZOOM can be created or modified by the instructor using a word processor, and thus can be designed to suit the need of students. No programming knowledge is required to create the stacks.

PIP: In 1989, staff at WHO headquarters in Geneva, Switzerland developed teaching software that can be used on IBM-PC and IBM-compatible computers to train public health workers in schistosomiasis. They tested in several schools of public health. They then improve it by incorporating a schistosomiasis information file (stack) in ASCII file format and a routine to organize and present data. The program allows the addition of other stacks without abandoning the user interface and the instructor can change data in the stacks as needed. In fact, any text editor such as Word-Perfect can create a stack. This software teaching program (ZOOM) organizes and presents the information (Dr. Schisto). Dr. Schisto is divided into 8 chapters: introduction, epidemiology, parasitology, diagnostics, treatment, data analysis, primary health care, and global database. Users can command ZOOM to communicate in either English, French, Spanish, or Portuguese. Basic hardware requirements include MS-DOS, 8086 microprocessor, 512 Kbytes RAM, CGA or MGA screen, and 2 floppy disc drives. ZOOM can also configured itself to adapt to the hardware available. ZOOM and Dr. Schisto are public domain software and thus be copied and distributed to others. Each information stack has chapters each of which contains slides, subslides, text, graphics, and dBASE, Lotus or EpiInfo files. ZOOM has key words and an index file to access more information. It also can do user defined searches using Boolean logic. Since ZOOM can be used with any properly formatted data, it has the potential to become the standard for global information exchange and for computer assisted teaching purposes.

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