Publications

Identification of asymptomatic patients at higher risk for suffering cardiac events remains controversial and challenging in Brugada syndrome (BS). In this work, we proposed an ECG-based classifier to predict BS-related symptoms, by merging the most predictive electrophysiological features derived from the ventricular depolarization and repolarization periods, along with autonomic-related markers. The initial feature space included local and dynamic ECG markers, assessed during a physical exercise test performed in 110 BS patients (25 symptomatic). Morphological, temporal and spatial properties quantifying the ECG dynamic response to exercise and recovery were considered. Our model was obtained by proposing a two-stage feature selection process that combined a resampled-based regularization approach with a wrapper model assessment for balancing, simplicity and performance. For the classification step, an ensemble was constructed by several logistic regression base classifiers, whose outputs were fused using a performance-based weighted average. The most relevant predictors corresponded to the repolarization interval, followed by two autonomic markers and two other makers of depolarization dynamics. Our classifier allowed for the identification of novel symptom-related markers from autonomic and dynamic ECG responses during exercise testing, suggesting the need for multifactorial risk stratification approaches in order to predict future cardiac events in asymptomatic BS patients.

JTD Keywords: brugada syndrome, depolarization disorders, ensemble classifier, heart-rate recovery, Acute myocardial-ischemia, Autonomics, Brugada syndrome, Brugadum syndrome, Cardiac death, Depolarization, Depolarization disorder, Depolarization disorders, Dynamic ecg, Electrocardiography, Electrophysiology, Ensemble classifier, Ensemble-classifier, Events, Exercise, Forecasting, Heart, Heart-rate, Heart-rate recovery, Prognosis, Qrs, Quantification, Recovery, Repolarization, Sudden cardiac death

Research into the development of therapeutic strategies is basedmainly on animal models and cell cultures. The ability to extrapolatedata from them is limited, and research on new drugs cannot beperformed efficiently. This is especially dramatic in rare diseases,which are intrinsically very heterogeneous. The generation of ad-vanced models using tissue engineering and patient-derived cellsallows fabricating new platforms for studying pathological processesand discovering new potential drugs. Here, we developed a patient-derived 3D functional skeletal muscle for Duchenne muscular dys-trophy (DMD). DMD is the most prevalent neuromuscular diseasediagnosed during childhood. The disease is characterized by pro-gressive degeneration of skeletal and cardiac muscle caused by thelack of dystrophin protein. Although there are several molecules indrug development for DMD, there is no treatment available for pa-tients to date. By using a 3D-printed casting mold, we encapsulatedpatient-derived myogenic precursor cells in a fibrin-composite ma-trix. This platform incorporated two flexible T-shaped pillars thatprovided continuous tension to the tissue, thus allowing the orien-tation of the muscle fibers. Our 3D muscle model expressed maturemuscle markers and responded to electric pulse stimulation (EPS).Besides, contraction dynamics between DMD and control tissueswere shown to be different. Moreover, an increase of damagemarkers after EPS was observed in DMD but not in healthy tissues.Finally, the tissues will be integrated into a microfluidic device tomonitor drug administration. Eventually, the microfluidic systemwill be connected to a biosensors system for the real-time detectionof biomarkers.

JTD Keywords: Casting, Contraction dynamics, Muscular dystrophy

3D printing is a competitive manufacturing technology, which has opened up new possibilities for the fabrication of complex ceramic structures and customised parts. Extrusion-based technologies, also known as direct ink writing (DIW) or robocasting, are amongst the most used for ceramic materials. In them, the rheological properties of the ink play a crucial role, determining both the extrudability of the paste and the shape fidelity of the printed parts. However, comprehensive rheological studies of printable ceramic inks are scarce and may be difficult to understand for non-specialists. The aim of this review is to provide an overview of the main types of ceramic ink formulations developed for DIW and a detailed description of the more relevant rheological tests for assessing the printability of ceramic pastes. Moreover, the key rheological parameters are identified and linked to printability aspects, including the values reported in the literature for different ink compositions.

JTD Keywords: 3-dimensional structures, behavior, deposition, direct ink writing, freeform fabrication, gelation, glass scaffolds, mechanical-properties, printability, rheology, robocasting, suspensions, 3d printing, Direct ink writing, Phosphate scaffolds, Printability, Rheology, Robocasting

Conventional direct ink writing uses circular nozzles and, therefore, results in cylindrical strands. 3D printing with non-circular nozzles adds new degrees of freedom to this versatile technology, and allows obtaining structures with higher specific surface area or even introducing concave surfaces in the printed architecture. This is an enticing prospect for countless applications, including tissue engineering, chemical reaction catalysts, water evaporators and electrochemical energy storage devices. Despite this, it has been hardly explored by the 3D-printing community. Herein, we develop for the first time 3D printed structures with complex filament section morphologies using a custom-made modular nozzle and a self-setting ceramic ink. The fast elastic recovery of the ink allows obtaining good shape fidelity in the printed filaments, permitting the creation of intricate surfaces with up to 30% concavity and increasing up to 2.5 times the specific surface area compared to cylindrical strands. The use of non-circular nozzles introduces some specific constraints in the printing process. The geometry of the nozzle determines the stable printing directions, and nozzle orientation becomes a critical parameter to achieve a stable printing. Strand torsion, a phenomenon that remains unnoticed with circular nozzles, may result in relevant changes in the geometrical features of the printed structures.

JTD Keywords: calcium phosphate, ceramic, ceramics, flow, geometry, microextrusion, robocasting, Calcium phosphate, Ceramic, Direct ink writing, Microextrusion, Robocasting, Scaffolds

© 2021 Elsevier B.V. Herein, for the first time is described the design of a novel porous zirconia scaffolds manufactured by using polymer-infiltrated ceramic network (PICN) and 3D-printing technologies. Cubic geometry of pieces was obtained by perpendicular layer-by-layer deposition of yttrium-stabilized tetragonal zirconia polycrystal (3Y-TZP) and Pluronic® hydrogel ceramic paste. The specimens were prepared by robocasting assembly with 50% infill and 50% of pores, as feed setup. Bisphenol A glycerolate dimethacrylate (Bis-GMA) and tri(ethylenglycol) dimethacrylate (TEGDMA) copolymer, a well-known biocompatible adhesive, which is widely used in dentistry field, was employed to reinforce the pores of the 3D-printed ceramic structure. The success of the acrylate polymer infiltration above the scaffold surface and among the 3Y-TZP filaments was achieved through previous ceramic functionalization with 3-(trimethoxysilyl)propyl methacrylate (γ-MPS). The well infiltration of the material on pores was evaluated by gravimetry, obtaining a value of 87.5 ± 6.6% of pores covered by the adhesive. Such successful infiltration of methacrylate copolymer had also a positive effect on the mechanical properties of the scaffold material, being the PICN sample that one with the highest elongation resistance. The new system showed reduced bacteria proliferation, over 24 h of incubation with Gram-negative Escherichia coli and Gram-positive Streptococcus salivarius bacteria lines, when compared to the control.

JTD Keywords: acrylate polymer, bacteria colonization, yttrium stabilized zirconia, Acrylate polymer, Bacteria colonization, Robocasting, Yttrium stabilized zirconia