The release of a spin probe  from polymer films was studied by electron paramagnetic resonance (EPR). The films were fabricated from starch having different crystal structures  and disordering degrees. Film morphology ) depended on the presence of dopant  to a larger extent rather than on crystal structure ordering or polymorphic modification. The presence of nitroxide radical led to additional crystal structure disordering and reduced the crystallinity index from the X-ray diffraction (XRD) data. Polymeric films made of amorphized starch powder were able to undergo recrystallization , which manifested itself as an increase in crystallinity index and phase transition of the A- and C-type crystal structures to the B-type one. It was demonstrated that nitroxide radical does not form an individual phase during film preparation. According to the EPR data, local permittivity of starch-based films varied from 52.5 to 60.1 F/m, while bulk permittivity did not exceed 17 F/m, which demonstrates that local concentration of water is increased in the regions near the nitroxide radical. The mobility of the spin probe corresponds to small stochastic librations and is indicative of the strongly a mobilized state. The application of kinetic models made it possible to find out that substance release from biodegradable films consists of two stages: matrix swelling and spin probe diffusion through the matrix. Investigation of the release kinetics for nitroxide radical demonstrated that the course of this process depends on the type of crystal structure of native starch. Despite all the advances in implementing biodegradable materials, synthetic polymers are currently used most frequently for food packaging; the demand for packaging increases in direct proportion to the rise in the world’s population ,2. The uNatural polysaccharides such as cellulose, starch, and chitosan are the most promising feedstock for producing composite materials ,6,7. To Furthermore, biodegradable polymeric carrier materials are becoming increasingly common in pharmaceutics for designing capsules, films, aerogels, and emulsions to be administered through the oral, buccal, sublingual, ocular, and transdermal routes. The applicability of polymers for biomedical purposes is determined by the drug release kinetics ,14, whicElectron paramagnetic resonance (EPR) is a promising method for studying the kinetics and the mechanisms of release of encapsulated substances. EPR offers remarkable opportunities for focusing on the internal properties of materials , as well as spatial distribution of paramagnetic molecules (spin probes) in the matrix ,18,19. TStarch is fully biodegradable; its degradation in the body gives rise to non-toxic monomers. Starch-based materials are widely used for food packaging and as biodegradable medical products . These mThe properties of starch-based materials largely depend on the structure and the ratio of amylose and amylopectin, which form the amorphous-crystalline structure of the starch granule. Starches from different sources depending on the packing of double helices are subdivided into three polymorphic modifications of crystal structure: the A-, B-, and C-type having different patterns of X-ray diffraction . One of This study aimed to produce biodegradable polysaccharide-based materials with different types and degrees of crystal structure ordering suitable for manufacturing packaging and drug release materials with tailored properties. The main hypothesis tested in the presented work was that the crystal structure is responsible both for the nature of the amorphization/recrystallization processes and for the release of encapsulated substance from the polymer matrix.Corn starch , potato starch , and tapioca starch , ethanol  and glycerol  were used in this study. Nitroxide radical 3-carboxy-2,2,5,5-tetramethyl-1-pyrrolidine-1-oxyl  is shown in The probe was chosen due to its hydrophilic nature. According to the standard approach, hydrophilicity is defined as the octanol/water partition coefficient. It has been shown in Refs. ,29 that 2; nominal motor power 1.1 kW) using a procedure similar to that described in Ref. [Mechanical treatment (MT) of starch was carried out in a water-cooled AGO-2  laboratory planetary ball mill  was then added to the gellified starch suspension. The resulting solution was kept at room temperature under stirring at 300 rpm for 30 min, and vacuum degassing was performed. The degassed solutions were poured into round silicone molds 35 mm in diameter (0.36 g/cm2) and dried in a drying oven at 35 °C for 24 h to obtain films.Suspensions (3 wt.%) of native starches were subjected to gelatinization at 80 °C for 30 min. Nitroxide radical at a concentration of 0.04 mg/mL  analysis on a D8 Advance diffractometer  with monochromatic CuKα radiation in the Bragg–Brentano reflection geometry. The step size was 0.0195°. The analysis was performed in a broad range of 2θ angles (3 ÷ 70°) at a voltage of 40 kV and current of 40 mA. The X-ray wavelength was 1.5406 Å.The crystallinity index of the study objects was calculated using the previously proposed modification of the Nara and Komiya method ,30. A smThe crystallinity index (CrI) was calculated as the ratio between the area of the crystalline phase and the total area under the XRD curve using the formula:The specific surface area (SSA) of the samples was determined according to thermal desorption of nitrogen on a Sorptometer M instrument  using the Brunauer–Emmett–Teller equation (the BET method) .The particle size of native and mechanically treated starches was measured on a CAMSIZER X2 optical analyzer  equipped with a compressed air dispersion module ; the detection threshold was 0.8–8000 µm. The average particle size was determined by image (1000 images) analysis in compliance with ISO 13322-2:2006. Furthermore, we determined a sphericity parameter b/l, which is the ratio between the minimal and the maximal inscribed chords [The particle morphologies of native starches, mechanically treated starches, native starch films, and starch films with 3-carboxy-PROXYL were characterized by scanning electron microscopy (SEM) on a TM-1000 microscope  at an accelerating voltage of 15 kV; the sample surface was preliminarily coated with gold on a JFC-1600 magnetron sputter coater  .Moisture content in native and mechanically treated starches and starch-based films was determined on a WPS 50 SX moisture analyzer ; the samples were heated at 130 °C using a halogen lamp as a heating element until the sample weight became constant.Film thickness was measured using an MK 0–25 mm micrometer  (State Standard GOST 6507-90). The film thickness at 10 different spots was measured for each sample.Permittivity of the films prepared from native and mechanically treated starches with 3-carboxy-PROXYL added was measured using a Precision LCR Meter HP4284A analyzer of electrophysical properties operating at frequencies of 1 MHz and 100 Hz. The permittivity was calculated according to the measured data with allowance for the geometric parameters of the samples.2. Low-temperature measurements were conducted at −196 °C in a quartz Dewar. The 2Azz value was obtained as the distance between the maxima of low-field and high-field components. In order to improve the accuracy, the low-field and high-field components were fitted by a Gaussian function. The calibration of 2Azz on solvent polarity was carried out at series of frozen 0.1 μM water–glycerol solutions of 3-carboxy-PROXYL  was used for EPR measurements. Room-temperature experiments with fluid solutions were conducted in 50 μL capillary tubes . All other experiments were carried out in NMR tubes  . For convenience, starch-based films were cut into fragments sized 3 × 3 mmy-PROXYL . EPR acqhttps://easyspin.org/, accessed on 24 March 2023) [Parameters of hyperfine structure for 3-carboxy-PROXYL in starch films were obtained by fitting the −196 °C EPR spectra. We used EasySpin 5.2.35 Software (ch 2023) , namely ε is the permittivity, F/m; 2Azz is the distance between the maxima of low-field and high-field components.The 2Azz value in the starch films was then recalculated to the local permittivity using the obtained empirical equation:2 were placed into 5 mL tubes containing water-ethanol solution (77% ethanol). It turned out that in water, 3-carboxy-PROXYL was released from the film too quickly, making it difficult to properly monitor the process. On the contrary, in a 95% ethanol solution, the radical was almost never released from the matrix, so it was also impossible to adequately monitor the process. Similar observations of the release behavior of encapsulated red cabbage anthocyanin extract from polymer films of modified starch were shown in ref. [Starch-based films fragments sized 3 × 3 mm in ref. . TherefoSome of the kinetic models previously reported in Refs. ,37,38 we0 is the constant of apparent dissolution rate; and t is time.The zero-order kinetic equation:The first-order kinetic model:H is the release constant of Higuchi; and t is time.The Higuchi kinetics model:i/C0 represents the fraction of drug dissolved on time t; Kβ is the release constant; and t is time.The Hixson–Crowell kinetic model:0 is the amount of drug at the equilibrium state; Ci is the amount of drug released over time t; k is the constant of incorporation of structural modifications and geometric characteristics of the system ; n is the exponent of release (related to the drug release mechanism) in function of time t; and t is time.The Power-law kinetic model:i is the amount of the drug released at time instant t; C∞ is the amount released at the infinite t; m is constant (m = 0.45); KFick is the Fick’s constant; Kdegr is the degradation constant; and t is time.The Peppas–Sahlin kinetic model:t-test. The intergroup differences between starch sources were tested for statistical significance using the one-way analysis of variance (ANOVA). The p-value was considered non statistically significant at p ≥ 0.05; and significant, at p < 0.05.The results are presented as the mean ± standard deviation (SD). The intergroup differences in the groups of starch sources were tested for statistical significance using an unpaired Student’s According to IUPAC definition , crystalFirst, the polymorphic modifications of each starch were identified by X-ray diffraction . The XRDstatF = 42.3, p-value = 2.89 × 10−4). There are no significant differences in the values of the crystallinity index of partially disordered starches (MT30) . It is notable that disordering is strongly non-linear in time: the intermediate stage occurs already after processing for 30 s, but much more time is required for complete amorphization.Native starch (NS) samples were subjected to mechanical treatment for 30 and 600 s. The choice of treatment duration was based on our previous works ,43. ThusChanges occurring at the macroscopic level were monitored by SEM. Corn starch granules (A-type) are irregular polyhedra with concave faces a. PotatostatF = 11,668.0, p-value = 1.69 × 10−11). It is worth mentioning that mechanical treatment results in crushing as a result of high mechanical loads; it is accompanied by a decline in sphericity and stable particle aggregation . It can be observed that partial disordering of B-type (MT30 potato starch) provided the lowest SSA compared to A- and C-type starches (MT30 corn and tapioca starch) . The specific surface area after mechanical treatment for 600 s does not differ for all starch types .In terms of its specific surface area, native potato starch (B-type) differs significantly from native tapioca starch (C-type), while native corn starch (A-type) does not differ significantly from B- and C-type  were characterized by the most smooth and homogeneous surface and transparency (data not shown). X-ray diffraction analysis of films based on starches with different ordering degrees indicates that the crystallinity index of the resulting materials after gelatinization was significantly reduced . HoweverstatF = 4.5, p-value = 0.064).It means that the spin probe  acts as a plasticizer preventing the formation of perfect crystals. The interaction of the carboxyl group of 3-carboxy-PROXYL with OH-groups of starch stabilizes the amorphous phase. Thus, the formation of a large number of hydrogen bonds during film preparation predominantly prevents crystallization ,45 The Xp-value < 0.2) was observed. The thickness of the films without the spin probe added are shown in statF = 13.06, p-value > 0.002).Thickness of the films  based onOne can see that crystal structure disordering in a polymer has a significant effect on the characteristics  of the end products for edible packaging. Recrystallization  becomes available for the fully disordered samples subjected to mechanical treatment for 600 s, which manifests itself as an increase in the degree of crystallinity and transition of polymorphic modification to the B-type starch.In order to monitor the processes related to the encapsulation of substances, we prepared films with the 3-carboxy-PROXYL probe added. This spin probe was selected because it is hydrophilic, non-toxic, and stable both in the solid phase and in solutions.c:w0 is the linewidth of the central EPR line expressed in Gauss; h0 and h−1 are heights of the central and high-field lines, respectively. The obtained τc values are listed in c as, c = 40 ps local viscosity η is equal to 4.2 × 10−6 m2/s. The value exceeds the water viscosity at room temperature 4 times, 1.0 × 10−6 m2/s, but is significantly lower than the macroviscosity of the starch samples during the gelatinization stage. Disagreement between macro- and microviscosities is a typical feature of polymer solutions [At the gelatinization stage of all starch types, the spectra of the probe correspond to free rotation. According to the known approach in Ref.  we can colutions , but herNext, no exchange-narrowed EPR line belonging to crystalline 3-carboxy-PROXYL is observed in the spectra of the films; i.e., the spin probe is distributed in the films without forming a separate phase during film preparation.zz  is a criterion of transition from libration to the rotation model. It is considered that before ΔAzz ≈ 0.5 mT is reached, rotations are forbidden, and it is fully implemented for our systems because in our case ΔAzz ≈ 0.2 mT. In accordance with Ref. [In order to quantify nitroxide mobility in starch films, we used the model of small stochastic librations  . Indeed,ith Ref. , we can zz and Ayy are two of the three principal components of hyperfine tensor, defined from frozen spectra by simulation using the widely used EasySpin software [Here, Asoftware . For all−113) °C  and in d−113) °C . Therefoε of water–glycerol solutions onto the measured 2Azz value according to Equation (2).Moreover, EPR allows one to measure local dielectric permittivity (polarity of the medium near spin probe) in order to compare it with the macroscopic one. This was done by comparing the EPR spectra for films and water–glycerol solutions (50–100 wt.% of glycerol) at −196 °C. The permittivity of the solutions with different glycerol–water ratios over a broad range is well known ; therefoThe 2Azz value in starch films was then recalculated to the local permittivity. Obtained ε values lay in the range of 52.5–60.1 F/m .The comparison of permittivity determined from the EPR and dielectric spectroscopy data showed that polarity of the local environment of the nitroxide radical is higher than that for the polymer material as a whole.The permittivity ε of the films measured by dielectric spectroscopy is strongly non-linear with respect to moisture content, being indicative of the interplay between the bound and the free state of water . In our This means that nitroxide radical is preferentially distributed over the polymer regions with an increased water content (20–40%). This is important because the content and state of water (free or bound) plays a crucial role in the exchange of encapsulated substances from the carrier matrix. Here, for the films based on fully amorphized potato and tapioca starch, the local water concentration is noticeably higher than that for films from native starches.ε for all the types of polymorphic modifications . Mechanical treatment for 600 s leads to local polarity, which is noticeably higher than that for films made from native starches, but row ε (potato starch) > ε (tapioca starch) > ε (corn starch) initially measured for films from native starches (NS), being reliably reproduced for the MT600 samples.Films based on starch subjected to mechanical treatment for 30 s have similar The kinetics of spin probe transfer from the carrier matrix into the solution was studied by measuring its concentration in the solution. In order to minimize starch swelling in aqueous solutions and control the time of radical transfer from the film, the optimal composition of the water–ethanol mixture simulating the conditions of carrier matrix degradation was determined (data not shown) and a further experiment was carried out at the optimal concentration (77% ethanol in water).The time dependence between the total intensity of EPR peaks was plotted .2 coefficient of 0.9942 (The first-order kinetic model (Equation (4)) with an Rf 0.9942 b fits thThe Higuchi kinetics model (Equation (5)) describes the kinetics based on radical diffusion from the matrix, and the particle size remains unchanged during the diffusion. The mismatch between the kinetic data and the Higuchi model c indicat2) of 0.9963, which demonstrates that degradation, swelling, or carrier matrix relaxation make a significant contribution during probe release from the polymer film.The Hixson–Crowell kinetic model (Equation (6)), which is based on an assumption that the release process is limited by the swelling rate, describes the kinetics d with thAn analysis using the Power-law model (Equation (7)) in rectifying logarithmic coordinates shows e that thTherefore, the description of the process using the kinetic model proposed by Peppas and Sahlin (Equation (8))  seems mo2 coefficient > 0.9965. A similar analysis was performed for all the kinetic curves. Fick), the degradation constants (Kdegr), and coefficients (R2).Indeed, this model is most suitable for reliable fitting of the release kinetics of 3-carboxy-PROXYL radical from starch-based films with Ri achieved in the solution during the release of 3-carboxy-PROXYL has no regularity with the duration of mechanical treatment. The equilibrium concentration of films prepared from native corn starch (NS) differs significantly from the NS of potato and tapioca starch films . KFick, a parameter describing the diffusion rate of the probe in the matrix, increases for native starch-based films as a series of A- < B- = C-type . It can be observed that partial disordering of B-type (MT30 potato starch-based film) provided a higher diffusion rate compared to A- and C-type (MT30 corn and tapioca starch-based film) . Mechanical treatment for 600 s (MT600) does not lead to significant changes in KFick for all types of starches . Mechanical treatment (within the same type) does not lead to significant changes in KFick for all types of starches. The constant Kdegr, which describes the interaction between the matrix and the solvent, for films based on native corn starch (A-type) differs significantly from that of native tapioca starch (C-type), while films based on native potato starch (B-type) do not differ significantly from films A- and C-type . The films obtained from MT30 and MT600 do not have significant differences for all types of starches.The equilibrium concentration CThe release kinetics of encapsulated substances for a completely disordered starch structure becomes independent of the type of initial structure and physicochemical parameters of the native starches.The crystal structure of native starch plays an enormous role in controlling the characteristics of biodegradable materials. No explicit correlations between the nitroxide radical release rate and the crystallinity index for the main types of starch powders  were revealed in this study.Films have been prepared from starches with a different crystal structure  and disordering degrees; the resulting films have been characterized. All the films prepared from partially disordered starch have the lowest crystallinity index. Recrystallization  occurs when films are prepared from completely disordered starch, manifesting itself as an increase in crystallinity index and phase transition to the B-type structure.Mechanical pretreatment of starch affects the film morphology when dopants are added. Films based on native starch are characterized by a textured surface; mechanical disordering of starch powder contributes to the formation of a homogeneous regular microstructure without any inclusions. The morphology of the films without spin probe added was independent of the disordering degree of starch.Therefore, nitroxide radical acts as an plasticizing agent, resulting in lower crystallinity compared to the films not carrying the spin probe. Any additive will act as a plasticizer, the spin probe has no specificity in this case. Since this study focuses on drug release, special emphasis was placed on how the encapsulated substance changes the properties of the matrix. In this sense, it would be incorrect to study pure films without adding a probe and then conclude that doped films should have the same properties.It has been demonstrated that during film preparation (the incorporation of substances), nitroxide radical is distributed over the films without forming an individual phase. Moreover, EPR measurement allows one to sense the local environment of an encapsulated substance. First, the mobility of nitroxide radical in the resulting films was determined using the model of small stochastic librations; the angle The use of kinetic models revealed that the release of substances from biodegradable films is described by two processes: matrix swelling and spin probe diffusion through the matrix. Investigation of the release kinetics  showed that the course of this process depends on the type of crystal structure of native starch. However, further research is needed to gain a deeper understanding of the processes involved in the design and control over the operation properties of the biodegradable polysaccharide materials that are suitable for developing packaging and drug release materials.


Starch is the most important energy‐providing component of food. It is useful for maintaining the structural and rheological consistency of food, ad thus, in turn, is responsible for maintaining the freshness of food. Polyphenols are present in plant products in huge amounts as secondary metabolites. Gallic acid, one of the potent plant polyphenols, has been reported to have excellent anti‐inflammatory, antioxidative, anticarcinogenic, microbicidal, and antidiabetic properties. Till date, very few articles on the starch–polyphenol inclusion complex are present. Quite a few hypotheses have been proposed as to how the formation of an inclusion complex of starch with polyphenol can slower the digestion or the hydrolysis of starch. The efficient qualities of starch–polyphenol systems, such as reduced starch digestion, lower blood glucose and preserving food freshness, have formed a necessity for investigation in this area. The focus of this review centers on the recent research on starch–polyphenol interactions and starch–gallic acid inclusion complexes in native and extruded food systems, as well as how the production of these complexes can aid in the treatment of diseases, particularly diabetes mellitus. The three types of approaches  to improve insulin sensitivity and protect ß cells of the pancreas. Patients with diabetes mellitus may experience postprandial glycemic excursions as a result of dietary variables, particularly carbohydrates  inhibit glucose transporters  . Gallic acid may bind to starch by non‐covalent CH‐π bonds along α‐(1 4) glycosidic chains, as suggested by the significantly lower levels of phenolic proton intensities and hydrodynamic radii in starch–phenolic complexes than in control starch–phenolic mixes (p < .05) . Length of the alkyl chain plays a very important role in mediating efficient antibacterial action, especially octyl gallate , rice starch and gallic acid were combined by van der Waals and hydrogen bonding forces to form a single complex. The complex structure in this was made more compact with the increased addition of gallic acid as a result of the increased rearrangement and aggregation behavior of the degraded starch molecular chains. This characteristic decreased the starch molecules’ accessibility to digestive enzymes, demonstrating the potential value of HPH and gallic acid complexation in regulating the digestion of starch products with desired digestibility  were observed. The concentration of gallic acid distorted the comparative peak intensities of XRD for the development of the starch–gallic acid inclusion complex (Liu et al., To study the crystalline structure of starch and starch–gallic acid inclusion complexes, certain X‐Ray Diffraction patterns were observed. Upon the addition of gallic acid to rice starch, V‐type diffraction shapes with distinguishing peaks at 28The review highlights that the preparation and application of starch–gallic acid inclusion complexes would prove very beneficial in ameliorating many metabolic disorders, such as diabetes mellitus, atherosclerosis, cardiovascular disease, cholesterol, digestive disorders, cancer, periodontal diseases, and other diseases which occur on account of an increase in starch hydrolysis and increment in blood glucose levels. Therefore, this review will be beneficial to many food technologists for food modifications and pharmacists for synthesizing drugs encompassing starch–gallic acid inclusion complexes, necessary for applications in diet and in diseases.Authors state that there are no conflicts of interest in publication of this review.


Unpublished reports and abstracts from conferences were excluded from this review article. We discussed the applications of small- and large-animal models in heart transplantation-related studies. This review article aimed to provide researchers with a complete understanding of animal models for heart transplantation by focusing on the pathological conditions created by each model.Cardiac transplant recipients face many complications due to transplant rejection. Scientists must conduct animal experiments to study disease onset mechanisms and develop countermeasures. Therefore, many animal models have been developed for research topics including immunopathology of graft rejection, immunosuppressive therapies, anastomotic techniques, and graft preservation techniques. Small experimental animals include rodents, rabbits, and guinea pigs. They have a high metabolic rate, high reproductive rate, small size for easy handling, and low cost. Additionally, they have genetically modified strains for pathological mechanisms research; however, there is a lacuna, as these research results rarely translate directly to clinical applications. Large animals, including canines, pigs, and non-human primates, have anatomical structures and physiological states that are similar to those of humans; therefore, they are often used to validate the results obtained from small animal studies and directly speculate on the feasibility of applying these results in clinical practice. Before 2023, PubMed Central Heart transplantation is the final therapeutic option for the treatment of heart failure. Patients undergoing heart transplants face significant complications due to transplant rejection. Animal experiments are necessary to study the mechanisms of disease onset and develop treatments for these complications. Several animal models have been developed to investigate different research topics, including the immunopathology of graft rejection, immunosuppressive therapies, anastomotic techniques, and graft preservation techniques. The application of these studies’ findings and recommendations to clinical practice has led to significant increases in graft survival rate and improved overall patient prognosis. Researchers must understand the advantages and limitations of each animal model and select the appropriate model for their research objective to advance the research process efficiently and provide clinical references for precise treatments . VariousRodents, rabbits, and guinea pigs are frequently used in heart transplantation experiments . The use® at the United States National Institutes of Health’s National Library of Medicine before 2023. The unpublished reports and abstracts from conferences were excluded from this review article. The applications of small- and large-animal models in heart transplantation-related studies were discussed, with a focus on the pathological conditions established by each model to provide researchers with a more comprehensive understanding of heart transplantation animal models.In this review article, we conducted a literature search on animal models for heart transplantation, focusing on the pathological conditions using PubMed CentralAnimal models for heart transplantation include orthotopic transplantation and heterotopic transplantation models. Due to the small size of rodents, orthotopic transplantation is extremely difficult to perform and therefore not preferred by most researchers; consequently, heterotopic transplantation is primarily discussed in this review section .In mouse abdominal heterotopic cardiac transplantation ,29, the Matzinger et al. reported that signals induced by damaged tissue may play a greater role in activating the immune response than in recognizing foreignness . AdditioTLR4−/− and C57BL/6 TLR2−/− mice, respectively, to study the issue. Their results demonstrated that TLR2 and TLR4 are positively correlated with the occurrence of I/R injury [The innate immune system responds to sequences exhibited by pathogens or damaged cells, including carbohydrates and lipid moieties . TLRs plR injury .TLR4−/− mice to verify the role of the HMGB1-TLR4-interleukin (IL)-23-IL-17A axis in cardiac transplant-induced I/R injury [MyD88+/+ mouse heart or BALB/c MyD88−/− mouse heart into a C57BL/6 mouse is a commonly used model for investigating the roles of MYD88 in heart transplantation [Researchers have also analyzed the interaction between TLR-induced downstream molecular pathways and cardiac allograft rejection. I/R injury induces necrosis in donor allografts, and necrotic cells release danger signals that induce metabolic changes in innate immune cells ,46,47. AR injury . AdditioR injury . The intR injury ,50. Tranantation .RAG1−/− recipients with BALB/c cardiac allografts to induce antibody-mediated rejection (AMR). P-selectin upregulation in cardiac allograft endothelial cells and macrophage infiltration into cardiac allografts were then analyzed. Furthermore, they used rPSGL-1, a selectin antagonist, to determine the effect of P-selectin inhibition on monocyte infiltration into allografts [Innate immune cells are crucial in initiating an immune response to allografts. Clinical data has shown that most cells infiltrating the transplanted organ during allograft rejection are macrophages ,61,62. Clografts . In addiCreTraf6fl/fl C57BL/6 mice (non-TRAF6 expressing), and LysMCreMtorfl/fl C57BL/6 mice (non-mTOR-expressing) to examine the effects of TRAF6 and mTOR on macrophage differentiation during allograft rejection. Furthermore, they elucidated a coinhibitory role in graft rejection by inhibiting the PD-1/PD-L1 pathway in LysMCreMtorfl/fl C57BL/6 cardiac recipients [Macrophages are versatile effector cells that exhibit a high degree of phenotypic plasticity and develop into functionally diverse subsets in response to environmental stimuli or other immunological effector cells. Activated macrophages are classified within a spectrum of polarization states, with the M1-polarized phenotype  and M2-polarized phenotype  representing the two extremes of the spectrum. Interferon-γ (IFN-γ) and lipopolysaccharides stimulate the M1-polarized phenotype, while IL-4 or IL-13 induces the M2-polarized phenotype. Macrophages exposed to other stimuli can be categorized based on their phenotypic similarity to M1-polarized or M2-polarized macrophages ,66,67,68cipients . Braza elo (M2) macrophages during tolerance induction. Braza et al. used Fucci transgenic mice as heart transplantation recipients to study the cell cycle and proliferative potential of Ly6Clo macrophages during tolerance [lo M2 in a heart transplant recipient. BALB/c hearts were transplanted into C57BL/6 CD169 diphtheria toxin receptor recipient mice, and Ly6Clo M2 was depleted by administration of diphtheria toxin. This model was used to investigate the mechanism of action of mTOR in regulatory macrophages (Mreg) that produce graft tolerance [Additionally, CSF1 may contribute to the formation of suppressive Ly6Colerance . Braza eolerance .tm/LauNos2/J mice were also used to investigate the role of inducible nitric oxide synthase in Mreg action in cardiac allograft rejection [In addition to the states of macrophage polarization previously identified, mouse monocytes exposed to macrophage CSF and IFN-γ were differentiated into a suppressive phenotype known as Mreg. Mouse Mregs are novel macrophage polarization states distinct from M1 and M2 subsets and monocyte-derived dendritic cells ,56. RiquCXCR2−/− C57BL/6 mice. The PMN-attractant chemokines were depleted to study PMN infiltration and expression of proinflammatory cytokines in grafts. The researchers developed models to investigate the synergistic effects of PMN depletion and costimulation blockade [RAG1−/− mouse that had received a heart transplant from a B10.BR mouse. This prevented the development of cardiac allograft vasculopathy and demonstrated the importance of NK cells in chronic allograft rejection [Neutrophils participate in innate immune responses after organ transplantation. El-Sawy et al. investigated the impact of graft infiltration by polymorphonuclear leukocytes (PMNs) in graft rejection. A/J mouse hearts were heterotopically transplanted into CXCR2-antisera-treated C57BL/6 or blockade . In anotejection .Complement activation is an important component of the innate immune system, with higher activity during the early stages of transplantation, including I/R injury and hyperacute and acute rejection . Like TLMHC disparity typically results in alloimmunity in mouse heart transplantation models, and it is an important issue for adaptive immune response. Based on the differences in research objectives and designs, researchers can select from a complete MHC disparate transplantation model, a single class I/II MHC mismatch model, or a minor histocompatibility antigens mismatch model to meet the research requirements for the intensity of rejection. Additionally, researchers can also select appropriate models for specific rejection reactions to further elucidate the rejection mechanism after heart transplantation.Corry et al. and Schenk et al. have proposed fully MHC-disparate mouse abdominal heterotopic heart allograft transplant models. Corry et al. used the heart of an A/J mouse as the donor and the offspring of 129 and C57BL/10 (B10) mice as the recipient; this transplantation combination produced MHC disparity in H-2K, H-2D, and multiple non-H-2, eliciting an alloimmune response . Schenk Results of studies using single class I or class II MHC mismatch models enable researchers to understand the roles of MHC and T cells in complex rejection reactions. Corry et al. developed the class I MHC mismatch model using B10.D2 and B10.BR mice as donors and transplanted the hearts into the abdominal aortas of the F1 hybrid mice between C57BL/6 and A/J mice. This combination caused a mismatch between the H-2K and H-2D regions on the class I MHC, resulting in an immune response to the specific antigen in the recipient mouse . Schenk However, transplantation of the heart of a non-Ld-expressing DBA/1 mouse does not induce a rejection reaction in the recipient, allowing the study of immune rejection induced by class I MHC mismatches . Schenk bm122 mouse into the abdominal aorta of a wild-type C57BL/6 mouse. B6C.H-bm122 is a spontaneous mutation of the 1-Ab molecule that results in a 3-aa substitution in the third hypervariable region of the A-beta chain that differs from that of wild-type C57BL/6 mice at the 1-A locus of class II MHC but is identical at class I MHC and minor MHC loci [Additionally, a class II MHC mismatch model has been developed. Researchers transplanted the heart of a B6C.H-MHC loci ,74. ThisMHC loci ,76.Minor mismatched histocompatibility antigens (mH-Ags) also contribute to rejection reactions in the recipient, in addition to MHC mismatch-induced rejection ,19. In aIn conclusion, the MHC mismatch model is a fundamental technique used by researchers to understand cardiac allotransplantation rejection. Transplantation between distinct strains of rats or between mutant, inbred, or gene-modified animal strains generates specific rejection responses. The appropriate selection of models allows for the effective and precise control of the intensity of the immune response induced by transplantation and the analysis of related rejection and pathological mechanisms.In addition to cell-mediated rejection, antibody-mediated rejection has a significant impact on recipient outcomes and the longevity of transplanted organs. Therefore, murine abdominal heterotopic cardiac transplantation models with antibody-mediated allograft rejection have been developed for transplantation-related studies ,78,79.Researchers must first identify the target antigens on the transplanted heart graft, then administer the donor antigen-reactive monoclonal antibody directly into the recipient mouse; this is a common method of establishing an antibody-mediated rejection model. Most studies use anticlass I MHC antibodies ,80,81,82CCR5−/− or wild-type C57BL/6 mice, then collected the sensitized serum, which was injected into C57BL/6 RAG-1−/− mice that received A/J mouse heart transplantation. This study showed that the intensity of rejection induced by heart transplantation into C57BL/6 RAG-1−/− mice is related to the titer of donor-specific antibodies and is caused by the serum of sensitized C57BL/6 CCR5−/− with higher antibody titers than those in wild-type C57BL/6 mice [Nozaki et al. investigated the relationship between antibody concentration and rejection by injecting the serum of sensitized animals into unsensitized animals. They transplanted the hearts of A/J (H-2a) mice into the abdominal aortas of C57BL/6 L/6 mice . In summGalT−/− (H-2b) mouse unable to produce αGal as the recipient [αGal−/− mice to induce anti-αGal antibodies [αGal+/+ mouse into their abdominal aortas [Rag/GT-deficient mouse [Previous studies have reported that antibody-mediated rejection is the cause of hyperacute rejections after organ transplantation, and antibody-induced complement activation is another major cause of hyperacute rejections ,9,11,12.ecipient . Gock etl aortas ,82,87. DMurine antibody-induced rejection models have some limitations. First, murine and human hearts have significant anatomical differences ,89. In hStreptococcus pyogenes (Ides), complement and proteasome inhibitors, anti-CD20 treatment, and IL-6 receptor blockers hold the potential to be applied in AMR management [Successful desensitization has improved the survival rate of organ transplants; however, AMR induced by human leukocyte antigen (HLA) incompatibility between the donor and recipient remains a major obstacle to successful allografting. Scientists have gained a deeper understanding of the mechanisms of AMR, the characteristics of anti-HLA antibodies, and gene expression profiles of allografts after more than 20 years of research . Recent nagement .Immunosuppressive agents are the most direct method to induce tolerance of the donor graft in the recipient. In addition to medication, researchers have developed several animal models of graft tolerance in the recipient for use in relevant studies. The injection of blood or blood cells from an allogeneic donor into a recipient can induce tolerance for a specific allograft. Kishimoto et al. , HancockOver the past decade, regulatory T cells (Tregs) have emerged as key mediators of immune stability. A study investigating Treg cell therapy in mice found that pretreatment with donor alloantigen and anti-CD4 mAb promoted the generation of CD4+CD25+ T cells in vivo, which effectively regulated skin allograft rejection . HumanizPrevious studies have reported that rejection reactions induced after heart and skin transplantation differ in intensity and pathological features. Skin grafts with MHC-mismatched or mH-Ags disparities typically induce acute rejection reactions ,100, wheCardiac allograft vasculopathy (CAV) is a sign of chronic rejection due to atherosclerosis of the transplanted heart’s blood vessels ,103. CAVn) rats to Lewis (RT11) rats, Lewis (RT11) rats to Fischer (RT11) rats, DA (RT1a) rats to Wistar–Firth  rats, or PVG/Seac (RT1c) rats to ACI/NKyo (RT1a) rats. Aortic grafts from Lewis rat, Fischer rat, and WF rat donors often induce acute vascular rejection in the recipient after transplantation; the long-term outcomes may differ from the vasculopathy caused by chronic rejection [CAV is a major contributor to chronic graft failure caused by chronic rejection after heart transplantation. Heterotopic or orthotopic aortic transplantation is a common model used to investigate the CAV mechanisms . The abdejection .However, aortic transplantation in the PVG/Seac rats to ACI/NKyo rats model is more appropriate for studies regarding chronic rejection-induced allograft vasculopathy as the ACI/NKyo rat develops a weak acute rejection response against the graft aorta from the PVG/Seac rat. Lin et al. transplanted a thoracic aorta from a PVG/Seac rat to the abdominal aorta of an ACI/NKyo rat to study the endothelial mesenchymal transition as a mechanism that induces CAV and identify treatments for CAV by monitoring cell–cell interactions ,26,27. IRodents are suitable model organisms in the field of heart transplantation research, though there are some limitations. The immune systems of rodents are structurally and functionally different from the human immune system ,106. FurLarge animals, including canines, pigs, and non-human primates, share anatomical structures and physiological functions that are similar to those of humans. Therefore, these animals are often used as model organisms in organ transplantation, especially in preclinical trials involving heart transplantation. During the early stages of heart transplantation research, canines were commonly used, though pigs and non-human primates are currently used more commonly. The cardiovascular structures of pigs closely resemble those of humans. The low cost and genetic manipulability of pigs have led to several preclinical trials related to heart transplantation and the development of allogeneic transplants. However, the left hemiazygos vein of pigs directly perfuses the coronary sinus; therefore, it must be ligated to avoid post-transplant bleeding ,124. FurOrthotopic heart transplantation models involve transplanting the donor heart into the recipient’s heart. Since 1994, several researchers have used 40–50 kg male Yorkshire pigs as donors and recipients. The surgical procedure in this model is similar to that in humans, and the recipient requires a cardiopulmonary bypass to support blood circulation and respiration during surgery. A biatrial anastomotic technique is used to suture the left and right atria of the donor heart to the posterior wall of the recipient’s atrium and to prevent the development of arrhythmias in the transplanted heart ,112,113.Unlike orthotopic heart transplantation, heterotopic heart implantation involves implanting the donor heart into a site in the recipient that differs from the normal site, such as the neck, abdomen, or thoracic cavity. Different implantation sites can be used according to the specific research objectives. In large animals, heterotopic transplantation is classified into non-working and working heterotopic heart transplantations.In the non-working heterotopic heart transplantation model, the implanted donor heart cannot support the recipient’s hemodynamic system. This heart transplantation model is primarily used to study the immunopathological changes caused by rejection or during the development of immunosuppressive agents/modulators. However, the implantation site differs from the original site of the heart, resulting in altered hemodynamic pressure on the myocardium or the absence of the natural pulsation of the myocardium, limiting the non-working heterotopic heart transplantation model. Early non-working heterotopic heart implantation studies were primarily conducted in canines. Carrel et al. transplanted the hearts of young dogs into the shoulders of mature dogs, combining the aorta, pulmonary artery, vena cava, and pulmonary veins of the donor’ heart with the external jugular vein and common carotid artery of the recipient. However, their work was unsuccessful as the cardiac chambers filled with thrombi ,115. ManFurthermore, as the abdominal cavity is not opened, there is no obstruction after surgery ,115. TheTransplantation of a heart graft to the neck limits the size of the graft and may compress the pharynx of the recipient. Therefore, the abdominal cavity is also an implantation site for heterotopic transplanted models. Ohmi et al. removed the interatrial septum and tricuspid valve of a canine donor heart. They sutured the graft aorta to the abdominal aorta of the recipient and the graft superior vena cava to the IVC of the recipient. This approach allows for the maintenance of partial pulsatile pressure in the LV and simulates the working environment of the heart, although the blood flow to the donor heart is minimal . AdditioMinanov et al. selected the retroperitoneum as a heterotopic cardiac transplantation site for the heart of a Yorkshire piglet into the retroperitoneum of a 3–7-week-old baboon, anastomosing the aorta and pulmonary artery of the donor heart to the common iliac artery and common iliac vein, respectively, of the baboon . AdditioAlthough using the abdomen or retroperitoneum as the graft site is more favorable, its susceptibility to complications, including postoperative ileus, intestinal obstruction, and intussusception, must be considered . Non-worWorking heart transplantation models are necessary to maintain the transplanted heart close to the normal physiological environment and obtain similar results to clinical conditions. Demikhov et al. created a canine intrathoracic heterotopic heart transplant model that allows the LV of the donor heart to continue to contract and achieve a working load even after transplantation . FurtherUwe et al. used Yorkshire pigs to develop a biventricular working model that could be used to compare the changes in the LV in non-working and working conditions. They anastomosed the left pulmonary artery of the donor heart to the left atrial appendage of the recipient prior to implantation. The aorta and right pulmonary artery of the donor heart were then anastomosed to the recipient’s descending aorta and infrarenal IVC, respectively. Researchers created a donor heart working model by blocking the right pulmonary artery; however, right ventricle blood flow was directed into the recipient’s IVC by blocking the left pulmonary artery and depriving the LV of the preload of the right heart, which led to left heart atrophy .In the non-working heart transplantation model, atrial septal defects are often created and the atrial-ventricular valve is often disrupted before implanting the donor heart into the recipient. These changes cause the venous return of the recipient to flow to the right ventricle of the donor heart after transplantation. The blood returns to the left atrium, and ultimately flows through the recipient’s aorta during contraction. Therefore, non-working models in which the donor heart is pretreated may be considered partially or monoventricular working models ,118,120.Allograft heart transplantation is currently the only treatment method for patients with end-stage heart failure. However, allogenic donor hearts are inadequate to meet clinical needs; therefore, xenotransplantation has been proposed as a possible solution that requires further research. Xenotransplantation of pig hearts has potential, though several challenges remain ,127,128.The pig-to-primates non-working heterotopic heart xenotransplantation model has been used previously to study immune and rejection reactions after transplantation and the survival rate of the grafted heart. Several studies using this model have reported that the most important factors affecting graft and animal survival are the immunobiological barriers. Different immunosuppressive agents have been developed to modulate the various immune responses that occur in xenograft rejection. In practice, these methods allow for effective control of xenograft rejection. These rejection prevention methods may be applied to orthotopic xenograft transplantation and implemented clinically in the future ,127,128.Galactose-α-1,3-galactose  is expressed in grafts, and anti-Gal antibodies present in the blood of non-human primate recipients lead to the activation of complement, resulting in humoral hyperacute rejection. These changes lead to acute failure of the graft and the subsequent failure of the pig-to-non-human primate xenotransplantation model. In 2005, Kuwaki et al. transplanted a non-Gal expressing α1,3-galactosyltransferase gene knockout porcine heart into baboons and recorded lower anti-Gal antibody levels in the blood. Furthermore, the expression of complement-regulatory proteins and their induced complement activation was reduced, suggesting a method to overcome hyperacute rejection and prolong the duration of graft survival . This meThe α1,3-galactosyltransferase gene knockout/CD46 and thrombomodulin transgenic pig-to-non-human primate non-working heterotopic xenotransplantation model has been stable for over 2 years ,126. It In 2021 and 2022, researchers at the Langone Transplant Institute in New York University, USA and University of Maryland Medical Center, USA, transplanted hearts and kidneys from genetically modified pigs into humans. In 2021, Dr. Rober A. Montgomery et al. transplanted α-1,3 galactosyl-transferase-knockout pig kidney  into patients determined to be brain-dead but were still on artificial ventilators to maintain physiological function and conducted two experiments . Within Heart transplantation research in various animal models has advanced tremendously over the years. Animal models have been crucial in developing and refining heart transplantation techniques, studying the immune response to transplanted organs, and testing new immunosuppressive therapies. Establishing stable and controllable animal models is essential for studying the pathological mechanisms of organ transplantation and the development of xenografts. However, different animal models have provided significant contributions at different stages of organ transplantation and graft development studies. The earliest heart transplantation studies were performed in dogs in the 1950s and 1960s. These studies provided the first evidence that heart transplant from one animal to another was possible and that immunosuppressive therapy could reduce the risk of rejection. The dog model was instrumental in developing the surgical techniques and postoperative management protocols required for successful heart transplantation. In the 1970s, the pig model was introduced as a more practical alternative to the dog model. Pigs have human-like anatomy and physiology, and their larger size makes surgical procedures and monitoring easier. Pig models have been used to test new immunosuppressive therapies, improve surgical techniques, and develop new techniques for preserving donor hearts. Non-human primates have also been used extensively in heart transplantation research. Non-human primates have a more human-like immune system, and their usage has led to significant advancement in understanding the immune response to transplanted organs and the development of new immunosuppressive therapies. However, because of ethical considerations and the high cost of research, the use of non-human primates is controversial. Small-animal models, including rodents, rabbits, and guinea pigs, have also been used in heart transplantation research. These models have advantages, including high metabolic rates, high reproductive rates, small size for easy handling, and low cost. However, these models do not fully recapitulate the human immune system, and their use is limited to specific aspects of heart transplantation research, such as studying the mechanisms of graft rejection and testing new immunosuppressive therapies.Overall, heart transplantation research in various animal models has advanced significantly over the years, providing valuable insights into the immunological and surgical aspects of the procedure. Continued breakthroughs in animal models will likely lead to further advancements in heart transplantation techniques and improved outcomes for patients in need of a heart transplant.


Scanning electron microscopy (SEM), moisture absorption and mechanical measurements were used to characterize the unique sandwich-like inner structure of the foam which allowed for the modulable release of SO2. The starch-based foam exhibited sufficient resilience (~100%) to provide ideal cushioning to prevent physical damage to fresh fruits during transportation. When 25 g/m2 of Na2S2O5 was applied, the foam stably released over 100 ppm SO2 and demonstrated satisfactory antifungal performance (inhibition over 60%) in terms of maintaining the appearance and nutritional values  of fresh grapes during a 21 day storage period. Additionally, the residual SO2 (14 mg/kg) also meets the safety limits (<30 mg/kg). These research findings suggest great potential for the utilization of this novel foam in the food industry.To improve the fresh-keeping of highly perishable fruits with high commercial value, a novel starch-based foam packaging material was developed in this study. The foam incorporated the antiseptic ingredient Na Foam is a commonly used packaging material for fruit preservation and protection. Foam boxes, typically made from polystyrene (PS), can provide partial protection against bruising caused by external physical damage. However, they are not effective in delaying the natural decay process caused by microbial metabolism. For example, grapes, being a typical type of berry fruit, are highly susceptible to the gray mold pathogen Botrytis cinerea Pers ,2,3. The2S2O5, a fungicide, has been used to chemically react with moisture from the fruit surface or surroundings, leading to the release of sulfur dioxide (SO2) to effectively kill harmful microbes within the packaging box [To minimize the economic loss of post-harvest fruit, Naging box ,7. HowevStarch foam has recently gained attention as a substitute for petrochemical-based products due to its abundant and renewable nature, low cost, and biodegradability. It has been particularly used in loose-fill packaging applications . Additio2S2O5 powder between two starch foam sheets. It is expected that this structure will enable the foam to absorb moisture from fruit respiration or the external environment, and then chemically react with Na2S2O5 to release SO2 as an antifungal ingredient in a modulable manner. Previous research has indicated the potential of utilizing composite packaging materials to modify the environmental atmosphere and improve the preservation of fruits. For instance, the effectiveness of aloe vera composite packaging has been demonstrated in suppressing the growth of aerobic mesophilic bacteria, yeast, and mold. This ultimately helps to preserve the essential nutrients and minimize loss during the fruit’s shelf life [2. The antimicrobial effects and real performance of this novel starch-based biodegradable foam on fresh grapes were also assessed. It is hypothesized that this innovative foam could serve as a long-term effective fresh-keeping shield for susceptible perishable fruits with high commercial value.To achieve this goal, a novel strategy was proposed in this study, involving the development of a starch-based foam with a sandwich-like structure that incorporates pre-loaded Naelf life . Multipl2S2O5 was supplied by Aladdin Chemical Co., . All chemicals used were of analytical grade. The Botrytis cinerea was from BeNa Culture Collection Co., Ltd. , and Potato Dextrose Agar (PDA) medium was from BeNa Culture Collection Co., Ltd. .In this work, the starch-based foam was prepared using hydroxypropyl cornstarch with about 25% amylose content, which was provided by Derui Starch Co.,  and the initial water content was about 13%. Polyvinyl alcohol (078-20) and glycerol were obtained from Sinopec Petrochemical Co., Ltd. . Calcium carbonate was purchased from Yifeng Co. . Na‘Kyoho’ grapes were purchased from local fruit market . The preservation experiment was performed in 5.5 L airtight containers at room temperature (about 25 °C).w/w), glycerol (5% w/w), polyvinyl alcohol (PVA) (5% w/w), fiber (4% w/w), and water (6% w/w) were homogeneously mixed by a high-speed mixer , and then were processed into pellets using a twin-screw co-rotating extruder  at a speed of 120 rpm. The temperature profile of the barrels was set at 30, 30, 80, 110, 110, 110, 80, and 80 °C, respectively. Subsequently, the pellets were dried for a constant moisture content of 16% and fed into a single-screw extruder  at a speed of 180 rpm. The temperature profile of the barrels was of 100, 180, 180 °C, and a sheet die with 400 mm width was heated to 200 °C. After it, the foams were cut into sheets with a size of 4 cm × 3 cm.Starch-based foam was produced by two-step extrusions according to our previous method . Firstly2 atmosphere was newly designed and the preparation procedure was shown in 2S2O5 was evenly spread and loaded between two starch foam sheets, which were subsequently pressed together by using a hot-pressing method. In this case, a little amount of water was used as an adhesive and sprinkled on the narrow inner edge of the sheets, improving starch foam sticking without interference with the chemical reaction. In order to ensure that the residual concentration of SO2 remains below the safe limit of 30 mg/kg, the concentration range of Na2S2O5 was carefully selected through trial testing to meet the necessary safety requirements. The objective of the study is to achieve a Na2S2O5 concentration that is as low as possible while still providing effective antiseptic performance against microbial decay in grapes. This approach will also help reduce the manufacturing cost of the novel starch-based foam packaging. Thus, different dosages of Na2S2O5  were used. The control group was also prepared without the addition of Na2S2O5. In the study, Na2S2O5 was manually cast into the starch-based pads. However, it is important to note that for practical applications, the process should be automated using a machine to ensure the most even distribution possible.In this study, the starch-based foam with dynamic modulation of SOSEM  was used to observe the raw materials and the cross-section of starch-based foams. A lower voltage of 10 kV was used during the test in order not to damage the cell structures. The samples were coated with gold before measurement .2SO4 and K2SO4 solutions, respectively. Absorbed moisture was calculated by the weight difference [Mt) after storage at the containers with different levels of RH for 1 week. The samples were fastened and compressed by a metal plate at a rate of 5 mm/min to a depth of 50% of its height. The detailed measurement was performed according to our previous study .The packages were designed with and without starch-based foams, respectively, and then they were applied for grape preservation. Grapes were preserved by a one-day vibration testbed  at a frequency of 2 Hz to simulate vibrating during transportation .2 was measured using a handheld gas analyzer [2S2O5 were kept in an airtight container with a hole of 0.5 mm in diameter. Humidity of the container was adjusted according to the experimental requirement. The release of SO2 under room humidity of 86, 93, and 98% were recorded and calculated according to the growing indication of h, respectively. The indication was separated by 24 h.The yield of SOanalyzer  . Briefly, 5.0 g grapes were accurately weighed and SO2 is extracted by distillation in the iodine measuring bottle. Then titrating with iodine standard solution and recording the volume. The SO2 residues were calculated according to Equation (3)V and V0 are the volume of iodine standard solution consumed for titration of grape samples and the blank group, respectively, c is the concentration of iodine standard solution, and m is the mass of grape samples.The residual SOp < 0.05 were considered as significantly different.The experiment was arranged based on a completely randomized design with three replicates. One-way ANOVA was used to analyze the differences, and results with w/w) within the first three to five days, followed by a slower phase that gradually reached equilibrium by the end of the 21-day assay period. A higher room humidity (98 vs. 86%) resulted in faster absorption rates and higher maximal moisture absorption content (25 vs. 15% w/w), as confirmed by the Peleg kinetic model characterization of higher K1 and lower K2 values  regardless of the increase of humidity from 60 to 98%. Additionally, the Recovery Percentage showed only a slight decrease from ~90 to 70%. This suggests that the starch-based foam can still play an ideal cushioning role as a fresh-package material, particularly under high humid conditions. The compression test is conducted to simulate the physical conditions experienced by the starch-based foam package during transportation. Its purpose is to verify whether the foam can withstand the considerable external pressure exerted on the package during fruit transportation. This test aims to ensure the reliability of the foam in protecting the fruits from physical damage prior to the onset of microbial decay.2S2O5 as a preservative (1 and a2). In contrast, the grapes packed inside the starch-based foam remained almost fresh without any visible physical damage (see b1 and b2). The starch-based foam was thus confirmed to play a satisfactory cushioning role in protecting susceptible fresh fruits during transportation [All these mechanical properties can help maximally reduce the physical damage to the susceptible fruits during transportation. In the study, fresh grapes were packed using starch-based foam and subjected to a one-day assessment at 25 °C under artificial vibrating conditions without the application of the Naervative . The conortation ,28,29.2S2O5 powder  is often applied in food preservation [2S2O5 powder without any packaging is not an appropriate strategy, as it can result in the excessive and uncontrollable release of SO2 (red lines in 2 content released from Na2S2O5 (5 g/m2) under typical high humidity (98%) was initially high within the first three days but quickly declined afterwards  resulted in excessive accumulation of SO2 atmosphere, which may incur safety risks . 2 during the 21-day trail. The safe level of SO2 often refer to its residual content on grapes, which is clearly indicated as 30 mg/kg in last Figure and well discussed below in The release of SO2 must comply with both antiseptic and food safety requirements. As shown in 2 of pre-loading Na2S2O5 powder may not be sufficient to generate a safe level of SO2 atmosphere compared to higher contents (15 or 25 g/m2) over a 21 day storage period, which may result in inadequate protection against microbial decay. On the other hand, excessive usage of Na2S2O5 poses a food safety risk as it may leave residual SO2 content on the fresh fruits above the threshold limit [The release of SOld limit . Both of2S2O5 preloaded starch-based foam could effectively inhibit the growth of Botrytis cinerea, the main culprit behind the microbial decay of fresh grapes. During a seven-day assay, the Na2S2O5 preloaded starch-based foam was tested for effectiveness against the typical Botrytis cinerea . The antimicrobial effectiveness was evaluated through the quantification of inhibition percentages  helped maintain the grapes’ fresh appearance for up to 18 days. Further increasing the amount of Na2S2O5 to 15–25 g/m2 preserved the fresh appearance of the grapes throughout the entire 21 day storage period. Total soluble solids, acidity, and vitamin C are recognized as the three key nutritional parameters of grapes, which tend to decrease due to microbial metabolism during storage [2 atmosphere from Na2S2O5 has been previously validated as an effective method to inhibit microbial growth and preserve the nutritional quality of grapes during storage [2S2O5 (from 5 to 25 g/m2) was found to better preserve the total soluble solids, acidity, and Vitamin C, which would otherwise be quickly lost during storage. However, considering the common safety threshold of SO2 residues , the results indicate that adding Na2S2O5 powder at ~25 g/m2 is ideal (only ~14 mg/kg of SO2 residues) for achieving a good balance between fresh-keeping effectiveness and food safety.The use of antiseptic Na cinerea  [7,33,34 storage . The rel storage   of fresh grapes during a 21-day storage period, indicating its great potential for fresh-keeping of perishable fruits with high commercial value in the food industry.A novel starch-based foam was successfully developed in this study as a packaging material for fresh fruits, featuring a unique sandwich-like inner structure. This foam not only provided sufficient resilience to protect the fruits from physical damage during transportation but also facilitated the pre-loaded Na2S2O5 to meet specific requirements and enhance the overall performance of the packaging system.In summary, the research successfully validates the hypothesis by developing a novel starch-based foam packaging that effectively preserves highly perishable fresh grapes of significant commercial value. However, there are several limitations that should be addressed in future studies. Firstly, there is a need for characterizing the grapes’ microbial stability and sensory properties during storage in the starch-based foam package. Furthermore, the applicability of the starch-based foam packaging in dry regions with lower humidity needs to be explored. Additionally, its potential for wider application to other perishable fruits beyond grapes should be investigated. Further applied research is necessary to optimize the dosage and distribution of Na


This article has been retracted by the Cureus editorial department due to major concerns with the methodology  that, in the view of the journal, affects the results and conclusions and calls into question the accuracy of the study. The authors do not agree with the decision to retract, but given the aforementioned concerns that call into question the study's accuracy, the journal has made the decision to retract without author consent. The journal greatly regrets that these issues were not identified during peer or editorial review prior to publication.


No study had directly compared the reliability, correlation with clinical symptoms, and surgical outcomes of dural sac cross-sectional area (DCSA), nerve root sedimentation sign (SedSign), and morphological grade for lumbar spinal stenosis (LSS).From January 2017 to December 2020, 202 patients with LSS were retrospectively analyzed. The narrowest segments were assessed via T2-weighted cross-sectional images using DCSA, morphological grade, and SedSign by two independent observers. Three classifications’ reliabilities were evaluated. Correlations between three classifications and between each of the classifications and symptoms or surgical outcomes 12 months postoperatively were evaluated.P < 0.01). For preoperative symptoms, DCSA was correlated with leg pain (LP) (r =  − 0.14), Oswestry Disability Index (ODI) (r =  − 0.17), and claudication (r =  − 0.19). Morphological grade was correlated with LP (r = 0.19) and claudication (r = 0.27). SedSign was correlated with ODI (r = 0.23). For postoperative outcomes, morphological grade was correlated with LP (r =  − 0.14), and SedSign was correlated with ODI (r = 0.17).There were 144 males and 58 females; 23, 52, and 127 patients had the narrowest segment in L2–3, L3–4, and L4–5, respectively. The intra-observer reliability of DCSA ranged from 0.91 to 0.93, and the inter-observer reliability was 0.90. The intra-observer reliability of SedSign ranged from 0.83 to 0.85, and the inter-observer reliability was 0.75. The intra-observer reliability of morphological grade ranged from 0.72 to 0.78, and the inter-observer reliability was 0.61. Each of these classifications was correlated with the other two (Substantial to almost perfect intra and inter-observer reliabilities for the three classifications were found; however, these classifications had either weak correlations with symptoms and surgical outcomes or none at all. Based on our findings, using one of them without conducting other tests for LSS will have limited or uncertain value in surgical decision-making or evaluating the prognostic value. Lumbar spinal stenosis (LSS) is defined as a decrease in the anatomical diameter or volume of the spinal canal and the compression of nerves and blood vessels due to bone or soft tissue hyperplasia and hypertrophy . These cTo better guide the treatment of LSS, several imaging classifications were proposed to evaluate LSS severity and attempt to correlate with preoperative symptoms and surgical outcomes of LSS –12. SomeTo the best of our knowledge, there is no direct comparison in DCSA, morphological grade, and SedSign for evaluating LSS. Therefore, this study aimed to analyze the reliability of these three classifications and their correlations with preoperative symptoms and clinical outcomes at 12 months postoperatively, determining which method can better aid clinical practice.This study retrospectively analyzed the data of 521 patients with LSS who underwent surgery in our hospital from January 2017 to December 2020. Following the inclusion and exclusion criteria, 202 patients were finally included in this study  patients with the most stenotic level in L5/S1; 2) those with previous lumbar surgery history; 3) those with severe spinal deformity, such as scoliosis, kyphosis, and severe spondylolisthesis; 4) those with comorbidities affecting lower limb function, such as severe knee osteoarthritis or peripheral vascular diseases or neuropathy; 5) those with a spinal tumor or infection; 6) those with severe metabolic diseases, such as osteoporosis or thyroid hypofunction; and 7) those who had missing or poor quality of T2 axial magnetic resonance image (MRI) or inadequate clinical data.MRI scans  were performed on each patient in the supine position with both lower limbs extended. All evaluations were performed on cross-sectional T2-weighted images. For multi-segmental stenosis, the images of the narrowest segment  were selected for the following evaluation and analysis. Three images of the surgical level, including the most stenotic layer and above or below the layer, were collected and sent to two independent observers  who were blinded to all identifying information  and performed the measurements and observations based on the three classifications, including DCSA, morphological grade, and SedSign.DCSA was measured and calculated using the method proposed by Hamanishi et al. . We usedAll observations and measurements were performed on the image browser workstation 4.1 . The measurement accuracy was ± 0.1 mm. The images of each segment were evaluated thrice at different time points. For qualitative methods , to evaluate the correlation between the stenotic degree and symptoms, the final grade for the level was identified based on one of the following criteria: A) If evaluation results revealed the same grade ≥ 4 times, the grade was considered the final result; and B) If the evaluation results revealed the same grade < 4 times, the final decision regarding the grade was made by consensus between the two observers.A representative image is presented in Fig. The symptomatic and functional parameters at the preoperative stage and 12 months postoperatively included a visual analog scale (VAS) for LBP and LP, the Oswestry Disability Index (ODI), and claudication distance. For patients with bilateral lower limb symptoms, the score in the leg with more severe symptoms was analyzed. The claudication distance based on patients’ reports was divided into the following four degrees: 1 =  > 500 m, 2 = 201–500 m, 3 = 50–200 m, and 4 =  < 50 m. Baseline data were obtained from the inpatient registry system, and follow-up data were acquired from outpatient or telephone visiting. This retrospective study was approved by the ethics committee of our hospital.P < 0.05 was considered statistically significant.SPSS version 24.0  was used for statistical analysis, and the Shapiro–Wilk test was used to test the normality of all data. Continuous and normally distributed data were expressed as means ± standard deviations. Non-normal continuous data were represented by the median . An intraclass correlation coefficient test was conducted to detect the intra- and inter-observer reliability. The Spearman rank correlation coefficient was used to evaluate the correlations between each of the three imaging methods and the symptoms. P < 0.01). The VAS of LBP decreased from 4.43 ± 1.16 preoperatively to 1.99 ± 1.11 postoperatively; VAS of LP from 6.60 ± 0.84 preoperatively to 1.49 ± 0.82 postoperatively; ODI from 44.66 ± 4.69 preoperatively to 21.35 ± 3.79 postoperatively; the claudication distance was also significantly improved (P < 0.01). More detailed information was presented in Table Of the 202 patients included, 144 (71.2%) were male and 58 (28.8%) were female. The median age was 69  years, and the median symptom duration was 48  months. The distributions of the narrowest segment were 23 (11.4%), 52 (25.7%), and 127 (62.9%) patients in L2–3, L3–4, and L4–5, respectively. Postoperatively, the symptoms of these patients were significantly improved , 47 23.3%), 113 (55.9%), and 31 (15.4%) patients with Grades A, B, C, and D, respectively. There were eight (3.9%) SedSign-negative patients, 68 (33.7%) SedSign-positive ( +) patients, and 126 (62.4%) SedSign-positive ( −) patients. The mean DCSA of all patients was 69.93 ± 22.21 mm.3%, 113 In these three classifications, the highest intra-observer reliability of the DCSA ranged from 0.91 to 0.93, and the inter-observer reliability was 0.90. The intra-observer reliability of the SedSign ranged from 0.83 to 0.85, and the inter-observer reliability was 0.75. The intra-observer reliability of the morphological grade ranged from 0.72 to 0.78, and the inter-observer reliability was 0.61  (Table Each of the three classifications was correlated with the other two (1) Table .Table 3Tr =  − 0.14, P = 0.04), ODI , and claudication . The morphological grade was correlated with LP  and claudication . A correlation between the SedSign and ODI was observed . These three evaluation methods were not correlated with other parameters (P > 0.05). The correlations between evaluation classifications and preoperative symptoms are presented in Table DCSA was correlated with LP (P > 0.05). The morphological grade was correlated with LP . A correlation between the SedSign and ODI was noted . The morphological grade and SedSign were not correlated with other parameters (P > 0.05). The detailed information is shown in Table DCSA was not correlated with any parameters P > 0.0. The morThe present study sought to compare the reliability of DCSA, morphological grade, and SedSign for evaluating LSS on MRI and correlated each of them with preoperative symptoms and clinical outcomes at 12 months postoperatively. We found that there was a substantial to almost perfect intra- and inter-observer reliability for the three classifications. However, since only a few clinical parameters were weakly correlated with these classifications, no moderate or strong correlations were noted between each of these three methods and clinical outcomes preoperatively and 12 months postoperatively.In this study, DCSA had the highest reliability, which was consistent with the results of Winklhofer S et al. . In theiThe reliability of SedSign in our study was significantly lower than the intra and inter-observer reliability of 1.00 and 0.93, respectively, reported by Barz et al.  and wereP < 0.01). The correlation between DCSA and SedSign was similar to that of a previous study [P < 0.01), which was higher than that of a previous study [Strong correlations were noted among the three classifications  [Despite we found a trend that a more severe degree of stenosis  was associated with lesser DCSA, no strong correlation between each of the imaging classifications and clinical outcomes was noted. For preoperative clinical symptoms, several parameters were correlated with the three classifications in this study. DCSA was only correlated with LP, ODI, and claudication; morphological grade was correlated with LP and claudication; SedSign was correlated with ODI. Furthermore, the strength of correlations was weak. The result of DCSA was close to that of Ogikubo et al.  who repo > 0.05) .r =  − 0.14), and SedSign was correlated with ODI (r = 0.17). To date, the correlations between LSS severity and postoperative clinical outcomes remain debatable [For postoperative clinical outcomes, only two parameters were correlated with the three classifications in this study. The morphological grade was correlated with LP (ebatable , 23, 24.ebatable  reportedebatable . Howeverebatable . Previouebatable , 23.Therefore, based on our results, it is difficult to conclude whether these three classifications are correlated with preoperative symptoms and surgical outcomes 12 months postoperatively or which one of these methods is better to correlate with preoperative symptoms and surgical outcomes. The following reasons may account for this. First, these methods, including DCSA, morphological grade, and SedSign, were designed to mainly evaluate the central spinal stenosis; therefore, they were insufficient to assess the lateral recess stenosis and foraminal stenosis . Second,First, the retrospective design was a major limitation of this study, and some potential biases were difficult to eliminate. Second, the excluded rate of 10.3% in this study, including missing or inadequate clinical data or missing or poor quality of T2 axial MRI, may affect the results to some extent. Lastly, we did not analyze the stenosis at the L5/S1 level because the SedSign was included.This is the first study with large sample size to compare the reliability of DCSA, morphological grade, and SedSign for evaluating LSS on MRI and correlated each of them with preoperative symptoms and clinical outcomes at 12 months postoperatively. A substantial to almost perfect intra and inter-observer reliability for the three classifications was noted; however, they had either a weak correlation with symptoms and surgical outcomes or none at all. Based on our findings, using one of them without conducting other tests for LSS will have limited or uncertain value in making surgical decisions or evaluating the prognostic value.


Introduction: Independent augmentation technology based on reinforcing devices has been reported to signifi-cantly reduce the elongation behavior of graft and improve knee stability after anterior cruciate ligament reconstruction (ACLR). Using biodegradable devices could reduce the risk of severe inflammatory reactions due to particle accumulation from foreign bodies. Given the limitations of the mechanical properties of biodegradable materials, partially biodegradable composite devices may offer a compromise strategy.Methods: Three types of partially absorbable core-sheath sutures, including low-absorbable cord (LA-C), medium-absorbable cord (MA-C) and high-absorbable cord (HA-C), were braided using unabsorbable ultra-high molecular weight polyethylene (UHMWPE) yarn and absorbable polydioxanone (PDO) monofil-ament bundle based on the desired configuration. The feasibility of these partially absorbable cords were verified by biomechanical testing, material degradation testing, and cell experiments, all performed in vitro.Results: Reinforcement of an 8 mm graft with the cords decreased dynamic elongation by 24%–76%, was positively related to dynamic stiffness, and increased the failure load by 44%–105%, during which LA-C showed maximum enhancement. Human ligament-derived fibroblasts showed good proliferation and vitality on each cord over 2 weeks and aligned themselves in the direction of the fibers, especially the UHMWPE portion.Discussion: This study supports the potential of partially degradable UHMWPE/PDO cords, particularly LA-C, for graft protection. Nervertheless, a higher proportion of biodegradable material results in lower stiffness, which may impair the protective and lead to mechanical instability during degradation. In the United States, it is reported that more than 100,000 ACLRs are performed annually , and priThe Kennedy LAD, which appeared in 1980, was proved to significantly enhance the mechanical strength of the patellar tendon graft used for ACLR  but was in vivo failure of these devices have been reported  and UHMWPE yarn  by a custom 16 spindle braiding machine , the matPhotos of each suture and cord (n = 3) were taken using a depth-of-field microscope . The diameter and braiding angle of the sutures and the width and pitch of the cords were measured by ImageJ software , randomly selecting three positions of each photo for measurement and calculating the mean value. The mechanical properties of the sutures and cords (n = 3) were tested by a dynamic machine equipped with 20 kN mechanical units . Bypassing the suture or cord through the suspension shaft of the upper and lower clamp and tying four half-hitch knots, a loop of 10 cm in length was formed, which was stretched to failure at a speed of 50 mm/min. Data were recorded by Wavematrix software  with a sampling rate of 500 Hz, and stiffness was calculated in the linear region.Bovine flexor tendons from the hind limbs of adult bovine were selected as grafts for their mechanical and structural properties as they are similar to human hamstring tendons . A singlThe custom cylindrical clamps contain two adjacent 35 mm long tunnels that can independently accommodate and secure the graft and reinforcing cords. Dynamic mechanical tests were performed on isolated cord groups, graft groups, and cord-reinforced graft groups (n = 3). The fixing process for the above construct was as follows: 1) For the isolated cord groups, the cord bypassed the suspension shaft in the tunnel exits of both clamps and tied four half-hitch knots to form a 100 mm loop; 2) For the graft group, the buttons connected at both ends of the graft were passed through both clamp tunnel exits sequentially and were then flipped. The graft was preloaded with a constant force of 20 N for 1 minute and dynamically stretched 20 times with an applied force between 20 and 80 N at 0.75 Hz  to simulin vivo loads of ACL during the early and late rehabilitation stages after ACLR  and sealed, maintaining the ratio of buffer volume in milliliters to sample mass in grams to within 30–40. Samples were placed on a shaker and swayed at 37 °C, PBS degradation solution was exchanged every 2 weeks, and pH was measured (n = 3).Degradation testing was performed according to ISO standard 13,781 To assess any morphological changes in the material during degradation, a 1 cm suture was cut from the end of the cord. The sample was washed thrice with sterile distilled water and dried overnight in a fume cupboard. After gold coating, three areas of the sample were randomly selected under SEM , and images were taken at magnifications of×100, ×300, and ×1,000 (n = 1).At selected time points, the cord was removed from the degradation solution, vacuum dried, and then fixed to the cylindrical clamps described above and secured into a 10 cm loop. The following test procedure was the same as the biomechanical test protocol, including the recording method of dynamic stiffness and failure load (n = 3).2 Modified Eagle Medium  supplemented with 10% (v/v) fetal bovine serum, 1% (v/v) L-glutamine  and 1% (v/v) penicillin/streptomycin , and the media was replaced every third day. During the compatibility experiment, it was found that Dapi could be hardly removed from the cord after staining, so the nucleus could not be clearly observed through the fluorescent signal, and the green fluorescent protein (GFP) gene was transfected into hFBs by lentivirus to make cells spontaneously fluorescent. First, P2 hFBs were implanted in a T25 flask . When the cells had reached approximately 90% confluency overnight, the original medium was replaced with 5 mL media containing 1.2 × 106 TU/mL GFP-Lentivirus (MOI 20)  and 5 μg/mL Polybrene . The flasks were cultured under standard conditions  for 24 h and then replaced with the standard medium. After 72 h, green fluorescence expression of GFP-hFBs was observed under fluorescent microscope  and cultured in media containing 1 μg/mL Puromycin for further screening.Primary human ligament-derived fibroblasts (hFBs)  were maintained at 37 °C in 5% CO2, 37 °C for 2 h to allow cells to attach. Then, the cords were transferred to a fresh 24-well plate, and the gradient number of cells  were directly implanted into wells for cell attachment analysis and proliferation comparison, then 500 μL media was added to each well.The cord was cut into 1 cm sections and placed on a 24-well plate . All cords were sterilized using 70% ethanol for 2 hours. P4-6 hFBs and GFP-hFBs were used for seeding. After counting, a high concentration cell suspension was prepared, and 30 ul (1.5 × 105) was dropped on each sample, which was then placed in a 5% CO2), 100 µL of CCK-8 medium samples from each well were transferred to 96-well plates  for analysis. The optical density value at 450 nm was measured using a microplate reader . The remaining CCK-8 media was removed and replaced with fresh standard media.Cell proliferation was assessed by CCK-8 at selected time points. Cords with hFBs were transferred to a fresh 24-well plate, and media were aspirated from wells implanted with gradient numbers of cells. The wells were rinsed thrice with PBS before adding 500 μL medium containing 10% (v/v) CCK-8 reagent  (n = 3). After 2 h of incubation under standard conditions  for 10 min each step. Samples were further dehydrated in tertiary butanol for 2 h and vacuum dried overnight. Three areas were randomly observed and photographed on each sample at magnifications of×100, ×500, and ×1,000 after gold-coating (n = 1).Cell viability was assessed by live/dead assay. In brief, because GFP-hFBs already have a green fluorescence signal, samples were incubated in a medium containing only 4.5 μmol/L propidium iodide  for 10 min to stain dead cells. After washing twice in PBS, green and red fluorescence was visualized using confocal microscopy , and a specific thickness layer scan was performed (n = 1). The fluorescence signal synthesis was performed using NIS-Elements Viewer software .p < 0.05.The statistical analysis was performed using GraphPad Prism software version 9 . Data in graphs were expressed as mean ± standard mean error. t-Tests and standard ANOVA with Tukey’s multiple comparisons testing were used to examine statistical differences between groups. Results were considered significant for Four groups of sutures were braided according to different core-sheath material configurations. UA-S was a complete UHMWPE suture , and UHMTest data for the graft group and each isolated cord group are shown in F value compared to the graft group, respectively.Test data for graft with or without reinforcing cord are shown in The last cycle curves of the 250 N load module from a representative test sample of the graft group and cord reinforced groups were within the defined native ACL function zone . HoweverPDO hydrolysate is acidic . The degF of UA-C decreased slightly, but the other groups showed no significant changes , which may be due to the cutting effect on the UHMWPE/PDO sheath by the UHMWPE core under a specific load (>600 N).The concept of the reinforcement technique combines the reinforcing device and tendon graft to form a load-sharing system in ACLR. The goal is to reduce graft elongation, which decides the laxity degree of the knee. The mechanical properties of the 8 mm tendon graft used in this study are close to the data in the literature . The dynRegarding biomechanical results, the reinforcement effects of UHMWPE/PDO cords on the graft were mainly reflected in the reduction of dynamic elongation and the increase of failure load. In addition, the dynamic stiffness of the structure was determined by both the graft and the cords. The UHMWPE/PDO reinforced group differed from the UA-C reinforced group that showed similar dynamic stiffness to the graft group in the test environment of this study, which indicated that the graft was the dominant stabilizer in this state. Finally, it is worth noting that the HA-C reinforced group showed lower stiffness at the end of cyclic stretching than the graft group, which may be due to its limited protective effect. HA-C becomes the dominant stabilizer when the graft reaches a specific elongation, and the stiffness of the construction converges on the cord.In this study, load and displacement data of native ACLs during walking activities were used to establish a functional model to more intuitively evaluate whether the biomechanical behavior of reconstructed ACLs restores native ACL function. Compared with the 250 N load module, the cord showed a more prominent protective effect after the 400 N load module because tendency for laxity of the reinforced graft groups was significantly inhibited compared to the graft group, and the degree of significance was positively correlated with the cord stiffness. Finally, only UA-C and LA-C reinforced grafts remained in the functional area after dynamic tensile testing.in vitro degradation reported in the literature (If ACLR was enhanced by a device containing degradable components, changes in mechanical properties and structure caused by material degradation should be considered. According to the pH value of the degradation solution and SEM images, a rapid degradation phase began at week 8. The UHMWPE fibers crushed PDO monofilaments hydrolyzed in the sheath during cyclic stretching, resulting in the elongation of the MA-C and HA-C. After a 250 N load module, MA-C elongation was less than HA-C. Nonetheless, this difference was not evident after applying a 400 N load module, and it appears that the UHMWPE core could limit cord elongation under a smaller load. The decreasing braiding angle and increasing weaving pitch during cord elongation led to greater dynamic stiffness. The dynamic stiffness of MA-C and HA-C gradually increased to match that of the UA-C from weeks 8–16, which was consistent with the time point of significant change in mechanical properties of different PDO devices after 9 weeks of terature . In additerature , and theterature . Researcterature . In thisIn vivo studies have reported that UHMWPE (t UHMWPE and PDO (t UHMWPE  have goot UHMWPE . Cell prt UHMWPE . Hence, This study demonstrated the feasibilityof a partially biodegradable reinforcing device for assisted ACLR through physical and biological assessments. A composite material scheme was adopted, and four types of cords were manufactured by a two-step process according to the planned material configuration and parameters, namely, one UHMWPE cord and three UHMWPE/PDO cords. The proportion of PDO in the cord is inversely related to its dynamic stiffness, while the latter is positively related to the reduction of graft elongation. Therefore, the stiffer cord provided better protection against elongation. During degradation, all the cords maintained their failure load. Only LA-C showed the same stable dynamic stiffness and elongation as that of UA-C, while material degradation in the sheath resulted in the other two UHMWPE/PDO cords growing longer and stiffer during dynamic stretching. Cells showed good proliferation and vitality on all cords and were aligned parallel to the fiber.Overall, this study supports the potential of partially degradable UHMWPE/PDO cords, particularly LA-C, in internal bracing technology for graft protection. Nevertheless, a higher content of biodegradable material results in lower stiffness may impair the protective effect and lead to mechanical instability during early degradation.


Access to appropriate resources is crucial to the successful dissemination of scientific knowledge. Publishing research results is also essential, as it enables the sharing of findings that are significant to the scientific community and society.The list of publications presented in a curriculum vitae provides an objective measure of academic progress at individual level, facilitates access to funding, and brings a competitive advantage in the evaluation of researchers, universities, and scientific institutions.ML) contributes to the dissemination of scientific knowledge and will help researchers demonstrate their professional development. Fully aware of the impact that a new journal would have on the career of researchers in the field of Laboratory Medicine in Spain led us to include it in SEQCMC 2018–2020 Strategic Plan.The launching of the new journal of the Spanish Society of Laboratory Medicine  journal aimed at improving the visibility of the scientific literature on Laboratory Medicine.The new journal will enhance the flow of original articles and scientific documents on our field with their publication in a high-impact, open-access journal.The number of publications of a researcher throughout their academic career (or in a specific period of their career), the impact of the journal where they were published, and the number of citations received are some of the criteria used to evaluate their scientific activity. The use of these “bibliographic indexes” has largely contributed to expand the reach of scientific publications.The use of impact factor as an indicator, however, has been a subject of controversy , 2], al, al2], aEnglish has become the global language of communication in the field of scientific research. However, it is essential that knowledge reaches an audience for whom English is a barrier. For this reason, the Board of Editors decided to create a bilingual journal that was published both, in English and Spanish. Publishing in two languages will help laboratory researchers and professionals improve the impact of their scientific works.The availability of high-quality online bibliographic databases led us to choose an open-access journal. Providing open access will help the journal to achieve a high impact factor.Advancements in Laboratory Medicine, expresses our aim that scientific findings are applied to Laboratory Medicine practice.The name of the journal, The ultimate role of Laboratory Medicine is to provide data that facilitates the detection or changes the course of a disease, thereby improving the health of the population. We are firmly committed to this approach, and with this purpose this journal is born.This is an exciting project that requires the involvement and collaboration of the scientific community to create a high-quality journal that facilitates the improvement in scientific knowledge on Laboratory Medicine.