An overview of the effects of thermal processing on bioactive glasses

Bioglass® 45S5 is widely used in biomedical applications due to its ability to bond to bone and even to soft tissues. The sintering ability of Bioglass® powders is a key factor from a technological point of view, since its govern the production of advanced devices, ranging from highly porous scaffolds to functionalized coatings. Unfortunately this particular glass composition is prone to crystallize at the temperature required for sintering and this may impair the bioactivity of the original glass. For these reasons, a prerequisite to tailor the fabrication of Bioglass®-derived implants is to understand the interaction between sintering, crystallization and bioactivity. In this work the structural transformations which occur during the heat treatment of Bioglass® are reviewed and a special attention is paid to the sintering and crystallization processes. Moreover the bioactivity of the final glass-ceramics is discussed and some alternative glass formulations are reported

Mechanical performance of epoxy coated AR-glass fabric Textile Reinforced Mortar: Influence of coating thickness and formulation

The mechanical performance of epoxy coated AR-glass fabric reinforced composite is investigated. A three-stage manufacturing process is considered, which involves fabric surface functionalization, liquid coating deposition and long-term setting and finally fabric embedment in the mortar matrix. Two epoxy coatings are considered, which only differ by the hardening agent. However, coating thickness is significantly diverse as a result of modified viscosity during liquid deposition. Performance is assessed in uni-axial tension as well as in three-point bending and it is expressed in terms of strength curves, data dispersion, crack pattern and failure mechanism. Remarkably, despite being very similar, the analyzed coatings produce a significantly different performance, especially when data dispersion is incorporated and design limits are considered. Indeed, although both coatings are able to consistently deliver fabric rupture at failure, only the thinnest is associated with small data scattering and an almost plastic post-peak behavior in bending. The associated design elongation limit reaches the maximum allowed value according to the ICC guidelines. In fact, it appears that coating thickness plays a crucial role in determining mechanical performance and fabric flexibility. The proposed manufacturing process proves extremely effective at enhancing matrix-to-fabric adhesion and thereby prevent telescopic failure

Lime-cement textile reinforced mortar (TRM) with modified interphase

Background: Lack of interphase compatibility between the fabric and the matrix significantly impairs the load-bearing capacity of textile reinforced mortar (TRM). In this study, we consider the application of two inorganic surface coatings for enhancing the interphase bond properties. Methods: Either of two silica-based coatings, namely nano- and micro-silica, were applied to alkali-resistant glass (ARG) and to hybrid carbon–ARG woven fabric. Mechanical performance of TRM reinforced with the uncoated and the coated fabric was compared in uniaxial tensile tests. Results: Mechanical testing provides evidence of a remarkable enhancement in terms of ultimate strength and deformability for the coated specimens. This effect can be ascribed to the improved hydrophilicity of the fibers’ surface and to the activation of pozzolanic reaction at the interphase. In addition, penetration of nano- and microparticles in the bundle of the textile yarns reduces the occurrence of telescopic failure

Fatigue behavior of as-built L-PBF A357.0 parts

Laser-based powder bed fusion (L-PBF) is nowadays the preeminent additive manufacturing (AM) technique to produce metal parts. Nonetheless, relatively few metal powders are currently available for industrial L-PBF, especially if aluminum-based feedstocks are involved. In order to fill the existing gap, A357.0 (also known as A357 or A13570) powders are here processed by L-PBF and, for the first time, the fatigue behavior is investigated in the as-built state to verify the net-shaping potentiality of AM. Both the low-cycle and high-cycle fatigue areas are analyzed to draw the complete Wohler diagram. The infinite lifetime limit is set to 2 7 106stress cycles and the staircase method is applied to calculate a mean fatigue strength of 60 MPa. This value is slightly lower but still comparable to the published data for AlSi10Mg parts manufactured by L-PBF, even if the A357.0 samples considered here have not received any post-processing treatment

Development of laser-based powder bed fusion process parameters and scanning strategy for new metal alloy grades: A holistic method formulation

In spite of the fast growth of laser-based powder bed fusion (L-PBF) processes as a part of everyday industrial practice, achieving consistent production is hampered by the scarce repeatability of performance that is often encountered across different additive manufacturing (AM) machines. In addition, the development of novel feedstock materials, which is fundamental to the future growth of AM, is limited by the absence of established methodologies for their successful exploitation. This paper proposes a structured procedure with a complete test plan, which defines step-by-step the standardized actions that should be taken to optimize the processing parameters and scanning strategy in L-PBF of new alloy grades. The method is holistic, since it considers all the laser/material interactions in different local geometries of the build, and suggests, for each possible interaction, a specific geometry for test specimens, standard energy parameters to be analyzed through a design of experiment, and measurable key performance indicators. The proposed procedure therefore represents a sound and robust aid to the development of novel alloy grades for L-PBF and to the definition of the most appropriate processing conditions for them, independent of the specific AM machine applied

Sol-gel derived bioactive glasses with low tendency to crystallize: synthesis, post-sintering bioactivity and possible application for the production of porous scaffolds.

A new sol-gel (SG) method is proposed to produce special bioactive glasses (BG_Ca family) characterized by a low tendency to devitrify. These formulations, derived from 45S5 Bioglass®, are characterized by a high content of CaO (45.6 mol%) and by a partial or complete substitution of sodium oxide with potassium oxide (total amount of alkaline oxides: 4.6 mol%), which increases the crystallization temperature up to 900°C. In this way, it is possible to produce them by SG preserving their amorphous nature, in spite of the calcination at 850°C. The sintering behavior of the obtained SG powders is thoroughly investigated and the properties of the sintered bodies are compared to those of the melt-derived (M) counterparts. Furthermore, the SG glass powders are successfully used to produce scaffolds by means of a modified replication technique based on the combined use of polyurethane sponges and polyethylene particles. Finally, in the view of a potential application for bone tissue engineering, the cytotoxicity of the produced materials is evaluated in vitro

Development of solvent-casting particulate leaching (SCPL) polymer scaffolds as improved three-dimensional supports to mimic the bone marrow niche

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

A new highly bioactive composite for scaffold applications: a feasibility study

Hydroxyapatite (HA) has been widely investigated as scaffolding material for bone tissue engineering, mainly for its excellent biocompatibility. Presently, there is an increasing interest in the composites of hydroxyapatite with bioactive glasses, with the aim to obtain systems with improved bioactivity or mechanical properties. Moreover, modifying the ratio between bioactive glass and hydroxyapatite results in the possibility of controlling the reaction rate of the composite scaffold in the human body. However, high temperature treatments are usually required in order to sinter HA-based composites, causing the bioactive glass to crystallize into a glass-ceramic, with possible negative effects on its bioactivity. In the present research work, a glass composition belonging to the Na2O-CaO-P2O5-SiO2 system, with a reduced tendency to crystallize, is applied to realize HA-based composites. The novel samples can be sintered at a relative low temperature (750 °C) compared to the widely studied HA/45S5 Bioglass® composites. This fact greatly helps to preserve the amorphous nature of the glass, with excellent effects in terms of bioactivity, according to in vitro tests. As a first application, the obtained composites are also tested to realize highly porous scaffolds by means of the standard burning out method

Long-term disability trajectories in relapsing multiple sclerosis patients treated with early intensive or escalation treatment strategies

Background and aims: No consensus exists on how aggressively to treat relapsing-remitting multiple sclerosis (RRMS) nor on the timing of the treatment. The objective of this study was to evaluate disability trajectories in RRMS patients treated with an early intensive treatment (EIT) or with a moderate-efficacy treatment followed by escalation to higher-efficacy disease modifying therapy (ESC). Methods: RRMS patients with ⩾5-year follow-up and ⩾3 visits after disease modifying therapy (DMT) start were selected from the Italian MS Registry. EIT group included patients who received as first DMT fingolimod, natalizumab, mitoxantrone, alemtuzumab, ocrelizumab, cladribine. ESC group patients received the high efficacy DMT after ⩾1 year of glatiramer acetate, interferons, azathioprine, teriflunomide or dimethylfumarate treatment. Patients were 1:1 propensity score (PS) matched for characteristics at the first DMT. The disability trajectories were evaluated by applying a longitudinal model for repeated measures. The effect of early versus late start of high-efficacy DMT was assessed by the mean annual Expanded Disability Status Scale (EDSS) changes compared with baseline values (delta-EDSS) in EIT and ESC groups. Results: The study cohort included 2702 RRMS patients. The PS matching procedure produced 363 pairs, followed for a median (interquartile range) of 8.5 (6.5-11.7) years. Mean annual delta-EDSS values were all significantly (p < 0.02) higher in the ESC group compared with the EIT group. In particular, the mean delta-EDSS differences between the two groups tended to increase from 0.1 (0.01-0.19, p = 0.03) at 1 year to 0.30 (0.07-0.53, p = 0.009) at 5 years and to 0.67 (0.31-1.03, p = 0.0003) at 10 years. Conclusion: Our results indicate that EIT strategy is more effective than ESC strategy in controlling disability progression over time

AIRO Breast Cancer Group Best Clinical Practice 2022 Update

Introduction: Breast cancer is the most common tumor in women and represents the leading cause of cancer death. Radiation therapy plays a key-role in the treatment of all breast cancer stages. Therefore, the adoption of evidence-based treatments is warranted, to ensure equity of access and standardization of care in clinical practice.Method: This national document on the highest evidence-based available data was developed and endorsed by the Italian Association of Radiation and Clinical Oncology (AIRO) Breast Cancer Group.We analyzed literature data regarding breast radiation therapy, using the SIGN (Scottish Intercollegiate Guidelines Network) methodology (www.sign.ac.uk). Updated findings from the literature were examined, including the highest levels of evidence (meta-analyses, randomized trials, and international guidelines) with a significant impact on clinical practice. The document deals with the role of radiation therapy in the treatment of primary breast cancer, local relapse, and metastatic disease, with focus on diagnosis, staging, local and systemic therapies, and follow up. Information is given on indications, techniques, total doses, and fractionations.Results: An extensive literature review from 2013 to 2021 was performed. The work was organized according to a general index of different topics and most chapters included individual questions and, when possible, synoptic and summary tables. Indications for radiation therapy in breast cancer were examined and integrated with other oncological treatments. A total of 50 questions were analyzed and answered.Four large areas of interest were investigated: (1) general strategy (multidisciplinary approach, contraindications, preliminary assessments, staging and management of patients with electronic devices); (2) systemic therapy (primary, adjuvant, in metastatic setting); (3) clinical aspects (invasive, non-invasive and micro-invasive carcinoma; particular situations such as young and elderly patients, breast cancer in males and cancer during pregnancy; follow up with possible acute and late toxicities; loco-regional relapse and metastatic disease); (4) technical aspects (radiation after conservative surgery or mastectomy, indications for boost, lymph node radiotherapy and partial breast irradiation).Appendixes about tumor bed boost and breast and lymph nodes contouring were implemented, including a dedicated web application. The scientific work was reviewed and validated by an expert group of breast cancer key-opinion leaders.Conclusions: Optimal breast cancer management requires a multidisciplinary approach sharing therapeutic strategies with the other involved specialists and the patient, within a coordinated and dedicated clinical path. In recent years, the high-level quality radiation therapy has shown a significant impact on local control and survival of breast cancer patients. Therefore, it is necessary to offer and guarantee accurate treatments according to the best standards of evidence-based medicine