Evaluation of the Wharton׳s jelly poroelastic parameters through compressive tests on placental and foetal ends of human umbilical cords

The umbilical cord is a conduit between the developing foetus and the placenta. In physiological conditions it contains two arteries and one vein immersed in a mucoid tissue called Wharton׳s jelly. Although the extreme importance of such a structure is fully recognized, the umbilical cord and its components have been scarcely studied. A deep investigation on the biomechanics of the umbilical cord could help to understand if the pregnancy outcome is influenced by umbilical cord mechanical properties, however, detailed biomechanical data are still lacking. In the present study, the mechanical properties during compression of the human Wharton׳s jelly have been evaluated using a poroelastic approach. Multi-ramp stress-relaxation tests in both confined and unconfined configurations were performed on Wharton׳s jelly samples extracted from foetal and placental sides of twenty human umbilical cords. The Young modulus and Aggregate modulus were calculated at three strain levels and the hydraulic permeability was found by fitting the confined stress-relaxation data to the analytical solution and minimizing the stress least square differences. The Wharton׳s jelly exhibits a highly non linear and viscoelastic behaviour showing a dependence on the applied strain values and a ~90% and ~85% relaxation in unconfined and confined configuration, respectively. Moreover, equilibrium Young and Aggregate moduli resulted significantly higher and the permeability significantly lower at the foetal than the placental site, showing a dependence of the three material parameters on the location (foetal or placental) and, consequently, a non-homogeneity in the Wharton׳s jelly mechanical properties

Validation of the ONKOTEV Risk Prediction Model for Venous Thromboembolism in Outpatients With Cancer

Importance: The assessment of the risk of venous thromboembolism (VTE) among outpatients with cancer represents an unsolved topic. Current international guidelines recommend primary prophylaxis for patients at intermediate to high risk of VTE, indicated by a Khorana score of 2 or more. A previous prospective study developed the ONKOTEV score, a 4-variable risk assessment model (RAM) consisting of a Khorana score of more than 2, metastatic disease, vascular or lymphatic compression, and previous VTE event. Objective: To validate the ONKOTEV score as a novel RAM to assess the risk of VTE among outpatients with cancer. Design, setting, and participants: ONKOTEV-2 is a noninterventional prognostic study conducted in 3 European centers located in Italy, Germany, and the United Kingdom among a prospective cohort of 425 ambulatory patients with a histologically confirmed diagnosis of a solid tumor who were receiving active treatments. The total study duration was 52 months, with an accrual period of 28 months (from May 1, 2015, to September 30, 2017) and an overall follow up-period of 24 months (data were censored September 30, 2019). Statistical analysis was performed in October 2019. Exposures: The ONKOTEV score was calculated for each patient at baseline by collecting clinical, laboratory, and imaging data from tests performed for routine practice. Each patient was then observed to detect any thromboembolic event throughout the study period. Main outcomes and measures: The primary outcome of the study was the incidence of VTE, including deep vein thrombosis and pulmonary embolism. Results: A total of 425 patients (242 women [56.9%]; median age, 61 years [range, 20-92 years]) were included in the validation cohort of the study. The cumulative incidences for the risk of developing VTE at 6 months were 2.6% (95% CI, 0.7%-6.9%), 9.1% (95% CI, 5.8%-13.2%), 32.3% (95% CI, 21.0%-44.1%), and 19.3% (95% CI, 2.5%-48.0%), respectively, among 425 patients with an ONKOTEV score of 0, 1, 2, and greater than 2 (P < .001). The time-dependent area under the curve at 3, 6, and 12 months was 70.1% (95% CI, 62.1%-78.7%), 72.9% (95% CI, 65.6%-79.1%), and 72.2% (95% CI, 65.2%-77.3%), respectively. Conclusions and relevance: This study suggests that, because the ONKOTEV score has been validated in this independent study population as a novel predictive RAM for cancer-associated thrombosis, it can be adopted into practice and into clinical interventional trials as a decision-making tool for primary prophylaxis

Addressing the Role of Angiogenesis in Patients with Advanced Pancreatic Neuroendocrine Tumors Treated with Everolimus: A Biological Prospective Analysis of Soluble Biomarkers and Clinical Outcomes

Simple Summary Despite the approval of new targeted therapies for pancreatic neuroendocrine tumors (PanNETs) over the past decades, the early identification of resistant tumors remains the major challenge, mainly because clear signs of tumor shrinkage are rarely achieved by imaging assessment. Starting from the hypothesis that angiogenesis can be implicated in the resistance to mTOR inhibitors, we evaluated a specific angiogenesis panel (through the measurement of soluble biomarkers for angiogenesis turnover, circulating endothelial cells, and circulating progenitors) as possible predictors of resistance to everolimus or everolimus efficacy in PanNETs. Our study showed that none of the investigated categories of biomarkers had a predictive value for everolimus resistance or efficacy. However, we suggest that circulating endothelial progenitors might be surrogate biomarkers for angiogenesis activity in PanNETs during everolimus treatment, and their baseline levels might correlate with survival outcomes. These data have never been reported before for NETs. Background: The success of targeted therapies in the treatment of pancreatic neuroendocrine tumors has emphasized the strategy of targeting angiogenesis and the PI3K/AKT/mTOR pathway. However, the major challenge in the targeted era remains the early identification of resistant tumors especially when the efficacy is rarely associated to a clear tumor shrinkage at by imaging assessment. Methods: In this prospective study (NCT02305810) we investigated the predictive and prognostic role of soluble biomarkers of angiogenesis turnover (VEGF, bFGF, VEGFR2, TSP-1) circulating endothelial cells and progenitors, in 43 patients with metastatic panNET receiving everolimus. Results: Among all tested biomarkers, we found a specific subpopulation of circulating cells, CD31+CD140b-, with a significantly increased tumor progression hazard for values less or equal to the first quartile. Conclusion: Our study suggested the evidence that circulating cells might be surrogate biomarkers of angiogenesis activity in patients treated with everolimus and their baseline levels can be correlated with survival. However, further studies are now needed to validate the role of these cells as surrogate markers for the selection of patients to be candidates for antiangiogenic treatments

The biomaterialist’s task: scaffold biomaterials and fabrication technologies

This paper focuses on tissue engineering (TE) from the biomaterialist’s point of view. With the aim of answering some simple but key questions about TE, the related literature is here reviewed. In order to obtain an engineered tissue the following steps are mandatory: (a) cell selection, (b) identification of the ideal three-dimensional scaffold for cell seeding and proliferation, (c) choice of the most suitable type of cell culture. Whereas the biotechnologist working in the TE field is responsible for optimizing the cell seeding and culture, the biomaterialist has the challenging task of optimizing the three-dimensional cell support, or scaffold. Therefore, in the present paper, scaffold properties, biomaterials and fabrication technologies are analyzed in depth and reviewed on the basis of the current literature. Finally, mention is also made of the most recently emerging and innovative technologies relating to scaffolds for TE applications

Preparation and characterization of Collagen/hydroxyapatite microsphere composite scaffold for bone regeneration

In the present work Collagen/Hydroxyapatite microsphere (Col/mHA) scaffold with a multiscale porosity was prepared. Col/mHA composite scaffold was prepared by freezedrying/ dehydrothermal crosslinking method. The HA microspheres (mHA) were obtained by spray drying of nano hydroxyapatite slurry prepared by precipitation technique. XRD analysis revealed that the microspheres were composed only of pure HA phase and EDS analysis revealed that Ca/P ratio was 1.69. The obtained microsphere had an average diameter 6 microns, specific surface area of 40 m2/g by BET analysis and BJH analysis shows meso porous structure having an average pore diameter 16nm. SEM analysis shows that the obtained Col/mHA scaffold had a macro porosity ranging from micron to 200 microns with meso porous mHA embedded in the collagen matrix