1.Click Chemistry-Based Injectable Hydrogels and Bioprinting Inks for Tissue Engineering Applications.
Janarthanan GOPINATHAN ; Insup NOH
Tissue Engineering and Regenerative Medicine 2018;15(5):531-546
		                        		
		                        			
		                        			BACKGROUND: The tissue engineering and regenerative medicine approach require biomaterials which are biocompatible, easily reproducible in less time, biodegradable and should be able to generate complex three-dimensional (3D) structures to mimic the native tissue structures. Click chemistry offers the much-needed multifunctional hydrogel materials which are interesting biomaterials for the tissue engineering and bioprinting inks applications owing to their excellent ability to form hydrogels with printability instantly and to retain the live cells in their 3D network without losing the mechanical integrity even under swollen state. METHODS: In this review, we present the recent developments of in situ hydrogel in the field of click chemistry reported for the tissue engineering and 3D bioinks applications, by mainly covering the diverse types of click chemistry methods such as Diels–Alder reaction, strain-promoted azide-alkyne cycloaddition reactions, thiol-ene reactions, oxime reactions and other interrelated reactions, excluding enzyme-based reactions. RESULTS: The click chemistry-based hydrogels are formed spontaneously on mixing of reactive compounds and can encapsulate live cells with high viability for a long time. The recent works reported by combining the advantages of click chemistry and 3D bioprinting technology have shown to produce 3D tissue constructs with high resolution using biocompatible hydrogels as bioinks and in situ injectable forms. CONCLUSION: Interestingly, the emergence of click chemistry reactions in bioink synthesis for 3D bioprinting have shown the massive potential of these reaction methods in creating 3D tissue constructs. However, the limitations and challenges involved in the click chemistry reactions should be analyzed and bettered to be applied to tissue engineering and 3D bioinks. The future scope of these materials is promising, including their applications in in situ 3D bioprinting for tissue or organ regeneration.
		                        		
		                        		
		                        		
		                        			Biocompatible Materials
		                        			;
		                        		
		                        			Bioprinting*
		                        			;
		                        		
		                        			Click Chemistry
		                        			;
		                        		
		                        			Cycloaddition Reaction
		                        			;
		                        		
		                        			Hydrogel*
		                        			;
		                        		
		                        			Hydrogels*
		                        			;
		                        		
		                        			Ink*
		                        			;
		                        		
		                        			Regeneration
		                        			;
		                        		
		                        			Regenerative Medicine
		                        			;
		                        		
		                        			Tissue Engineering*
		                        			
		                        		
		                        	
2.Synthesis and Biocompatibility Characterizations of in Situ Chondroitin Sulfate–Gelatin Hydrogel for Tissue Engineering
Sumi BANG ; Ui Won JUNG ; Insup NOH
Tissue Engineering and Regenerative Medicine 2018;15(1):25-35
		                        		
		                        			
		                        			Novel hydrogel composed of both chondroitin sulfate (CS) and gelatin was developed for better cellular interaction through two step double crosslinking of N-(3-diethylpropyl)-N-ethylcarbodiimide hydrochloride (EDC) chemistries and then click chemistry. EDC chemistry was proceeded during grafting of amino acid dihydrazide (ADH) to carboxylic groups in CS and gelatin network in separate reactions, thus obtaining CS–ADH and gelatin–ADH, respectively. CS–acrylate and gelatin–TCEP was obtained through a second EDC chemistry of the unreacted free amines of CS–ADH and gelatin–ADH with acrylic acid and tri(carboxyethyl)phosphine (TCEP), respectively. In situ CS–gelatin hydrogel was obtained via click chemistry by simple mixing of aqueous solutions of both CS–acrylate and gelatin–TCEP. ATR-FTIR spectroscopy showed formation of the new chemical bonds between CS and gelatin in CS–gelatin hydrogel network. SEM demonstrated microporous structure of the hydrogel. Within serial precursor concentrations of the CS–gelatin hydrogels studied, they showed trends of the reaction rates of gelation, where the higher concentration, the quicker the gelation occurred. In vitro studies, including assessment of cell viability (live and dead assay), cytotoxicity, biocompatibility via direct contacts of the hydrogels with cells, as well as measurement of inflammatory responses, showed their excellent biocompatibility. Eventually, the test results verified a promising potency for further application of CS–gelatin hydrogel in many biomedical fields, including drug delivery and tissue engineering by mimicking extracellular matrix components of tissues such as collagen and CS in cartilage.
		                        		
		                        		
		                        		
		                        			Amines
		                        			;
		                        		
		                        			Cartilage
		                        			;
		                        		
		                        			Cell Survival
		                        			;
		                        		
		                        			Chemistry
		                        			;
		                        		
		                        			Chondroitin Sulfates
		                        			;
		                        		
		                        			Chondroitin
		                        			;
		                        		
		                        			Click Chemistry
		                        			;
		                        		
		                        			Collagen
		                        			;
		                        		
		                        			Extracellular Matrix
		                        			;
		                        		
		                        			Gelatin
		                        			;
		                        		
		                        			Hydrogel
		                        			;
		                        		
		                        			Hydrogels
		                        			;
		                        		
		                        			In Vitro Techniques
		                        			;
		                        		
		                        			Spectrum Analysis
		                        			;
		                        		
		                        			Tissue Engineering
		                        			;
		                        		
		                        			Transplants
		                        			
		                        		
		                        	
3.Synthetic Hydrogels with Stiffness Gradients for Durotaxis Study and Tissue Engineering Scaffolds.
Tissue Engineering and Regenerative Medicine 2016;13(2):126-139
		                        		
		                        			
		                        			Migration of cells along the right direction is of paramount importance in a number of in vivo circumstances such as immune response, embryonic developments, morphogenesis, and healing of wounds and scars. While it has been known for a while that spatial gradients in chemical cues guide the direction of cell migration, the significance of the gradient in mechanical cues, such as stiffness of extracellular matrices (ECMs), in directed migration of cells has only recently emerged. With advances in synthetic chemistry, micro-fabrication techniques, and methods to characterize mechanical properties at a length scale even smaller than a single cell, synthetic ECMs with spatially controlled stiffness have been created with variations in design parameters. Since then, the synthetic ECMs have served as platforms to study the migratory behaviors of cells in the presence of the stiffness gradient of ECM and also as scaffolds for the regeneration of tissues. In this review, we highlight recent studies in cell migration directed by the stiffness gradient, called durotaxis, and discuss the mechanisms of durotaxis. We also summarize general methods and design principles to create synthetic ECMs with the stiffness gradients and, finally, conclude by discussing current limitations and future directions of synthetic ECMs for the study of durotaxis and the scaffold for tissue engineering.
		                        		
		                        		
		                        		
		                        			Artificial Cells
		                        			;
		                        		
		                        			Cell Movement
		                        			;
		                        		
		                        			Chemistry
		                        			;
		                        		
		                        			Cicatrix
		                        			;
		                        		
		                        			Cues
		                        			;
		                        		
		                        			Embryonic Development
		                        			;
		                        		
		                        			Extracellular Matrix
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hydrogel*
		                        			;
		                        		
		                        			Hydrogels*
		                        			;
		                        		
		                        			Morphogenesis
		                        			;
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Regeneration
		                        			;
		                        		
		                        			Tissue Engineering*
		                        			;
		                        		
		                        			Wounds and Injuries
		                        			
		                        		
		                        	
4.Early Detection of Mycobacteria Using a Novel Hydrogel Culture Method.
Mi Hee JANG ; Shine Young KIM ; Chang Ki KIM ; Sang Hyun HWANG ; Byung Kyu PARK ; Sung Soo KIM ; Eun Yup LEE ; Chulhun L CHANG
Annals of Laboratory Medicine 2014;34(1):26-30
		                        		
		                        			
		                        			BACKGROUND: Early laboratory detection of Mycobacterium tuberculosis is crucial for controlling tuberculosis. We developed a hydrogel mycobacterial culture method that retains the advantages of both solid and liquid methods in terms of speed, cost, and efficiency. METHODS: Mycobacterium bovis bacillus Calmette-Guerin (BCG) suspensions and 200 acid-fast bacilli (AFB)-positive clinical specimens were inoculated in Middlebrook 7H9 liquid media (Becton-Dickinson and Company, USA) and mixed with 75 microL of 9-fluorenylmethoxycarbonyl (Fmoc)-Phe-Phe-OH hydrogel stock solution in an Eppendorf tube just before culture incubation. The mixtures were cultured at 37degrees C for as long as 14 days to monitor culture status. RESULTS: The number of M. bovis BCG increased with time. For 200 AFB smear-positive specimens, 155 of 158 conventional culture-positive specimens and 4 culture-negative or contaminated specimens yielded positive cultures within 14 days. For 128 specimens positive with the liquid culture method, the time to positive culture using the hydrogel method (mean, 12.6 days; range, 7 to 14 days) was significantly shorter than that for conventional liquid culture (mean, 16.2 days; range, 6 to 31 days; P<0.0001). CONCLUSIONS: The hydrogel scaffold culture system is useful for timely, economical, and efficient detection of mycobacteria in clinical specimens.
		                        		
		                        		
		                        		
		                        			Bacteriological Techniques/*methods
		                        			;
		                        		
		                        			Culture Media/chemistry
		                        			;
		                        		
		                        			Early Diagnosis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydrogel/*chemistry
		                        			;
		                        		
		                        			Mycobacterium tuberculosis/*isolation & purification
		                        			;
		                        		
		                        			Tuberculosis/diagnosis/*microbiology
		                        			
		                        		
		                        	
5.Compatibility of olfactory ensheathing cells with functionalized self-assembling peptide scaffold in vitro.
Ling-ling ZHANG ; Lin-hong HUANG ; Zhen-xing ZHANG ; Ding-jun HAO ; Bao-rong HE
Chinese Medical Journal 2013;126(20):3891-3896
BACKGROUNDOlfactory ensheathing cell (OEC) transplantation is a promising or potential therapy for spinal cord injury (SCI). However, the effects of injecting OECs directly into SCI site have been limited and unsatisfied due to the complexity of SCI. To improve the outcome, proper biomaterials are thought to be helpful since these materials would allow the cells to grow three-dimensionally and guide cell migration.
METHODSIn this study, we made a new peptide hydrogel scaffold named GRGDSPmx by mixing the pure RADA16 and designer peptide RADA16-GRGDSP solution, and we examined the molecular integration of the mixed nanofiber scaffolds using atomic force microscopy. In addition, we have studied the behavior of OECs in GRGDSPmx condition as well as on RADA16 scaffold by analyzing their phenotypes including cell proliferation, apoptosis, survival, and morphology.
RESULTSThe experimental results showed that GRGDSPmx could be self-assembled to form a hydrogel. Inverted optical microscopic and scanning electron microscopic analyses showed that OECs are viable and they proliferate within the nanostructured environment of the scaffold. Thiazolyl blue (MTT) assay demonstrated that OEC proliferation rate was increased on GRGDSPmx scaffold compared with the pure RADA16 scaffold. In addition, OECs on GRGDSPmx scaffolds also showed less apoptosis and maintained the original spindle-shaped morphology. Calcein-AM/PI fluorescence staining revealed that OECs cultured on GRGDSPmx grew well and the viable cell count was 95%.
CONCLUSIONThese results suggested that this new hydrogel scaffold provided an ideal substrate for OEC three-dimensional culture and suggested its further application for SCI repair.
Animals ; Cell Proliferation ; Cells, Cultured ; Hydrogel, Polyethylene Glycol Dimethacrylate ; chemistry ; Immunohistochemistry ; Male ; Microscopy, Atomic Force ; Microscopy, Confocal ; Olfactory Bulb ; cytology ; Peptides ; chemistry ; Rats ; Rats, Sprague-Dawley ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry
6.Comparison of rheologic properties between Ca-alginate hydrogel microspheres suspension and whole blood.
Pei XU ; Xiang WANG ; Yaojin LI ; Feifei WANG ; Ming DUAN ; Li YANG
Journal of Biomedical Engineering 2013;30(1):100-104
		                        		
		                        			
		                        			Starting from the form of red blood cells and the hematocrit (Hct, about 45 vol% of whole blood), we tried to prepare a kind of microspheres suspension to imitate non-Newtonian fluid property of whole blood, exploring its potentiality to be applied in blood viscosity quality control substance. In our study, we produced Ca-alginate hydrogel microspheres using emulsion polymerization, then we suspended the microspheres in 0.9 wt% NaCl solution to obtain a kind of liquid sample with the microspheres taking 45% volume. Then we used two types of viscometers to measure and analyse the changes of sample viscosity at different shear rate. We observed the forms of Ca-alginate hydrogel microspheres with microscope, and found them to be relatively complete, and their diameters to be normally distributed. Diameters of about 90% of the microspheres were distributed in a range from 6 to 22 micron. The samples were examined with viscometer FASCO-3010 and LG-R-80c respectively, both of which have shown a shear-thinning effect. After 5-week stability test, the CV of viscosity results corresponding to the two instruments were 7.3% to 13.8% and 8.9% to 14.2%, respectively. Although some differences existed among the results under the same shear rate, the general variation trends of the corresponding results were consistent, so the sample had the potentiality to be widely used in calibrating a different type of blood viscometer.
		                        		
		                        		
		                        		
		                        			Alginates
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Blood Viscosity
		                        			;
		                        		
		                        			Calcium
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Glucuronic Acid
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Hexuronic Acids
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydrogel, Polyethylene Glycol Dimethacrylate
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Microspheres
		                        			;
		                        		
		                        			Plasma Substitutes
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Rheology
		                        			;
		                        		
		                        			instrumentation
		                        			;
		                        		
		                        			Suspensions
		                        			;
		                        		
		                        			chemistry
		                        			
		                        		
		                        	
7.Experimental research on the compatibility of self-assembly nanofiber hydrogel from the amphipathic peptide containing IKVAV with olfactory ensheathing cells of rats.
Leyin ZHU ; Zhiming CUI ; Guanhua XU ; Zhikang ZHU ; Zhen HUANG ; Guofeng BAO ; Yuyu SUN ; Lingling WANG ; Ying CUI
Journal of Biomedical Engineering 2011;28(4):774-779
		                        		
		                        			
		                        			The present research was aimed to explore the biocompatibility of IKVAV self-assembling peptide nanofiber scaffold with olfactory ensheathing cells (OECs) of rats. The OECs were seeded onto the surface of coverslips covered with IKVAV self-assembling peptide nanofiber scaffold hydrogel (2D culture system), and implanted within IKVAV self-assembling peptide nanofiber scaffold hydrogel (3D culture system), respectively. The adhesion, viability of OECs were observed with inverted microscope. Then the characteristics for survival and adhesion of cells by image processing were observed, and statistical analysis on the number of S-100 positive cell, the area of the cell bodies and the perimeter of the cell and MTT method were carried out. It was found that the OECs could survive and migrate in IKVAV self-assembling peptide nanofiber scaffold. The result of the cell MTT exam, of the shape and quantity of cells had no significant difference compared to those of the OECs cultured with poly-L-lysine (PLL). It has been proved that IKVAV self-assembling peptide nanofiber scaffold has good biocompatibility with rat OECs.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Animals, Newborn
		                        			;
		                        		
		                        			Biocompatible Materials
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Cell Proliferation
		                        			;
		                        		
		                        			Cells, Cultured
		                        			;
		                        		
		                        			Hydrogel, Polyethylene Glycol Dimethacrylate
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Laminin
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Nanofibers
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Olfactory Bulb
		                        			;
		                        		
		                        			cytology
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			Peptide Fragments
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Rats, Sprague-Dawley
		                        			;
		                        		
		                        			Tissue Engineering
		                        			;
		                        		
		                        			methods
		                        			;
		                        		
		                        			Tissue Scaffolds
		                        			;
		                        		
		                        			chemistry
		                        			
		                        		
		                        	
8.Controlled release of transforming growth factor-beta receptor kinase inhibitor from thermosensitive Chitosan-based hydrogel: application for prevention of capsular contracture.
Zhi-Yong DIAO ; Hai-Liang FU ; Chun-Lei NIE ; Li-Jun HAO ; Da-Ping YANG ; Wei-Hua CHEN
Chinese Medical Journal 2011;124(2):284-290
BACKGROUNDCapsular contracture has become the most common complication associated with breast implant. Transforming growth factor-beta (TGF-β) is well known for a prominent role in fibrotic diseases. Due to the critical role of TGF-β in pathogenesis of capsular formation, we utilized thermosensitive C/GP hydrogel to controlled release of TGF-β receptor kinase inhibitor (SD208) and investigated their effects on capsular contracture.
METHODSIn vitro degradation and drug release of C/GP hydrogel were performed. Twenty-four rabbits underwent subpanniculus implantation with 30 ml smooth silicone implants and were randomly divided into four groups as follows: Group 1 received saline solution; Group 2 received SD208; Group 3 received SD208-C/GP; Group 4 received C/GP. At 8 weeks, the samples of capsular tissues were analyzed by hematoxylin and eosin and immunohistological staining. The mRNA expression of collagen III and TGF-β1 was detected by RT-PCR assay.
RESULTSC/GP hydrogel could be applied as an ideal drug delivery vehicle which supported the controlled release of SD208. SD208-C/GP treatment showed a significant reduction in capsule thickness with fewer vessels. The histological findings confirmed that the lower amounts of inflammatory cells and fibroblasts infiltrate in SD208-C/GP group. In contrast, typical capsules with more vessel predominance were developed in control group. We did not observe the same inhibitory effect of SD208 or C/GP treatment on capsular contracture. Moreover, SD208-C/GP therapy yielded an evident down-regulation of collagen III and TGF-β1 mRNA expression.
CONCLUSIONSThis study demonstrated that controlled release of TGF-β receptor kinase inhibitor from thermosensitive C/GP hydrogel could significantly prevent capsule formation after mammary implants.
Animals ; Breast Implantation ; adverse effects ; Chitosan ; chemistry ; Glycerophosphates ; chemistry ; Hydrogel, Polyethylene Glycol Dimethacrylate ; chemistry ; Immunohistochemistry ; Protein Kinase Inhibitors ; administration & dosage ; therapeutic use ; Rabbits ; Receptors, Transforming Growth Factor beta ; antagonists & inhibitors ; Reverse Transcriptase Polymerase Chain Reaction
9.Neural stem cells induced by neotype three-dimensional polypeptide-based self-assembled hydrogel.
Yulin SONG ; Qixin ZHENG ; Xiaodong GUO
Journal of Biomedical Engineering 2010;27(3):612-616
		                        		
		                        			
		                        			The amphiphilic polypeptide (PA) was self-assembled into three-dimensional (3-D) porous complex of hydrogel and cells with the addition of NSCs-containing DMEM/F12. Cell differentiation in the surface and that within hydrogel were described. Cells harvested from the cerebral cortex of neonatal mice were triturated and cultivated in serum-free media. 1wt% PA was added into same volume of DMEM/F12 with cell concentration of 1 x 10(5)/ml and self-supported into 3-D hydrogel-cell composition; cells suspended within hydrogel being maintained (Experiment group, EG). lwt% PA was self-assembled into two-dimensional (2-D) hydrogel films triggered by addition of DMEM/F12, and then 1 x 10(5)/ml NSCs was seeded in the surface of films (Control group, CG). Cells in EG and CG were incubated in serum-free media for two weeks and stained with immunocytochemistry methods. TEM showed that the hydrogel derived from PA was composed of network nanofibers with their diameter ranging from 3 to 5 nm and length ranging from 100 nm to 1. 5 microm. Above 50% of cells obtained were Nestin positive cells. LSCM observations demonstrated that above 90% of cells survived two days after incubation within hydrogel, and were differentiated into NF and GFAP positive cells one week after incubation, their differentiation rates were 50% +/- 4.2% and 20% +/- 2.8% respectively; however, cells in CG were also differentiated into NF and GFAP positive cells, their differentiation rates were only 40% +/- 3.4% and 31% +/- 2.3% separately. Peptide-based hydrogel was able to provide 3-D environments for cell survival and induce primarily the differentiation of NSCs into neurons. Our data indicated that peptide-directed self-assembly of hydrogels was useful and it served as the neotype nerve tissue engineering scaffolds.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Animals, Newborn
		                        			;
		                        		
		                        			Cell Culture Techniques
		                        			;
		                        		
		                        			Cell Differentiation
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			Cells, Cultured
		                        			;
		                        		
		                        			Hydrogel, Polyethylene Glycol Dimethacrylate
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Nanofibers
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Neural Stem Cells
		                        			;
		                        		
		                        			cytology
		                        			;
		                        		
		                        			Neurogenesis
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			Peptides
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Rats, Sprague-Dawley
		                        			;
		                        		
		                        			Tissue Scaffolds
		                        			;
		                        		
		                        			chemistry
		                        			
		                        		
		                        	
10.On the preparation and mechanical properties of PVA hydrogel bionic cartilage/bone composite artificial articular implants.
Haoye MENG ; Yudong ZHENG ; Xiaoshan HUANG ; Bingqing YUE ; Hong XU ; Yingjun WANG ; Xiaofeng CHEN
Journal of Biomedical Engineering 2010;27(5):1056-1061
		                        		
		                        			
		                        			In view of the problems that conventional artificial cartilages have no bioactivity and are prone to peel off in repeated uses as a result of insufficient strength to bond with subchondral bone, we have designed and prepared a novel kind of PVA-BG composite hydrogel as bionic artificial articular cartilage/bone composite implants. The effects of processes and conditions of preparation on the mechanical properties of implant were explored. In addition, the relationships between compression strain rate, BG content, PVA hydrogels thickness and compressive tangent modulus were also explicated. We also analyzed the effects of cancellous bone aperture, BG and PVA content on the shear strength of bonding interface of artificial articular cartilage with cancellous bone. Meanwhile, the bonding interface of artificial articular cartilage and cancellous bone was characterized by scanning electron microscopy. It was revealed that the compressive modulus of composite implants was correspondingly increased with the adding of BG content and the augments of PVA hydrogel thickness. The compressive modulus and bonding interface were both related to the apertures of cancellous bone. The compressive modulus of composite implants was 1.6-2.23 MPa and the shear strength of bonding interface was 0.63-1.21 MPa. These results demonstrated that the connection between artificial articular cartilage and cancellous bone was adequately firm.
		                        		
		                        		
		                        		
		                        			Biocompatible Materials
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Biomimetic Materials
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Bone Substitutes
		                        			;
		                        		
		                        			chemical synthesis
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Cartilage, Articular
		                        			;
		                        		
		                        			physiology
		                        			;
		                        		
		                        			surgery
		                        			;
		                        		
		                        			Compressive Strength
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydrogel, Polyethylene Glycol Dimethacrylate
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Polyvinyl Alcohol
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Prostheses and Implants
		                        			;
		                        		
		                        			Prosthesis Design
		                        			;
		                        		
		                        			Stress, Mechanical
		                        			
		                        		
		                        	
            
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