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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5361_Библиотеки_им_академика_М_И_Перельмана.pdf
X
- •Aim and Scope
- •Preface
- •Acknowledgments
- •Contents
- •Contributors
- •About the Editors
- •1.1 Introduction
- •1.2.1 Friction
- •1.2.1.3 Friction Under Lubricated Conditions
- •1.7.1 Joint Tribology
- •1.7.2 Skin Tribology
- •1.7.3 Oral Tribology
- •1.8 Summary
- •References
- •2.1 Introduction
- •2.3.1 Fluid Pressurization/Fluid-Film Lubrication
- •2.3.2 Boundary Lubrication
- •2.3.3 Hydrodynamic Lubrication
- •2.3.4 Squeeze-Film Lubrication
- •2.3.5 Synovial Fluid
- •2.3.6 Hydration Lubrication
- •2.5.2 Scaffolds
- •2.5.3 Synthetic Polymer
- •2.5.4 Polyacrylamide
- •2.5.5 PEG Hydrogel
- •2.5.6 PVA Hydrogel
- •2.5.7 Double Network Hydrogel
- •2.5.8 Triple Network Hydrogel
- •2.6.1 Polyacrylamide
- •2.6.2 PEG Hydrogel
- •2.6.3 PVA Hydrogel
- •2.6.4 Double Network Hydrogel
- •2.6.5 Triple Network Hydrogel
- •2.7.1 Mechanical Properties
- •2.7.2 Structural Properties
- •2.8 Conclusion
- •References
- •3.1 Introduction
- •3.3.1 Label-Based Biosensors
- •3.3.2 Label-Free Biosensors
- •3.4 Different Nanobiosensing Techniques
- •3.4.1 Optical Sensing
- •3.4.2 Electrochemical/Electrical Sensing
- •3.4.3 Magnetic Sensing
- •3.4.4 Mass-Based Sensing
- •3.6.2 Neurodegenerative Diseases
- •3.6.3 Infectious Diseases
- •3.6.4 Metabolic Diseases
- •References
- •4.1 Introduction
- •4.2.1 Surface Functionalization
- •4.2.2 Bioconjugation
- •4.3 Synthesis Approach
- •4.3.1 Hydrothermal Method
- •4.3.2 Chemical Vapor Deposition (CVD)
- •4.3.3 Wet Chemical Method
- •4.4 Plasmonic Black Bodies (PBBs)
- •4.4.1 Gold NP (AuNPs)-Based PBB
- •4.4.2 Silver NPs (Ag NPs)-Based PBB
- •4.4.3 Platinum NPs (Pt NPs)-Based PBB
- •4.5 Biomimetic NP
- •4.6 Upconverting NP (UCNP)
- •4.6.1 Synthesis
- •4.7 Inorganic NP
- •4.7.1 Synthesis
- •4.8 Photothermal Therapy (PTT)
- •4.9 Conclusion
- •References
- •5.1 Introduction
- •5.2 Human Skin
- •5.10 Future Scope
- •5.11 Conclusion
- •References
- •6.1 Introduction
- •6.1.1 Class 1
- •6.1.2 Class 2
- •6.1.3 Class 3
- •6.4.1.1 Surface Patterning
- •6.4.1.2 Direct-Write Patterning
- •6.4.1.5 Dip-Pen Nanotechnology
- •6.4.1.7 Composing Using Beams
- •6.4.1.8 Direct Write Photolithography (DWP)
- •6.4.1.9 Light-Beam Lithography Electron
- •6.4.1.10 Focused Ion Beam Lithography
- •6.4.2 Fabrication Techniques
- •6.4.2.4 Non-invasive Glucose Monitoring Devices Technique
- •6.4.2.6 Cost-Effective Electrochemical Voltametric Sensors Techniques
- •6.4.2.7 Three-Dimensional (3D) Printing Techniques
- •6.4.2.8 UV-LED Stereolithography Printer Technique
- •6.4.2.9 4D Printing Techniques
- •6.4.2.10 Advanced Biomedical Techniques Involving Biorobots
- •References
- •7.1 Introduction
- •7.6 Mechanical Biocompatibility Challenges
- •7.7 Poor Bio-Printing Resolution
- •7.9 Limited Biomaterial Selection
- •7.11 Conclusion
- •8.2 Animal Tribology
- •8.2.1 Joint
- •8.2.3 Integumentary Change
- •References
- •8.1 Introduction
- •8.3.1 Nanotribology
- •8.4 Green Tribology
- •8.5 Conclusion
- •References
- •9.1 Introduction
- •9.2 Bio-Tribological Issues
- •9.3.2 Bone Fracture Fixation
- •9.3.4 Cardiovascular Devices
- •9.3.5 Minimal Invasive Surgical Devices
- •References
- •10.1 Introduction
- •10.2.2.1 Structural Integrity
- •10.2.2.2 Controlled Release Properties
- •10.2.2.3 Enhanced Drug Loading Capacity
- •10.2.2.4 Tailored Material Properties
- •10.2.3.1 Biocompatibility
- •10.2.3.3 Mechanical Properties
- •10.2.3.4 Drug Compatibility
- •10.2.3.5 Fabrication Compatibility
- •10.3.1 Matrix Material Properties
- •10.3.4 Biocompatibility Assessment
- •10.3.4.1 In Vitro Cell Culture Studies
- •10.3.4.2 Hemocompatibility Studies
- •10.3.4.3 In Vivo Animal Studies
- •10.3.4.4 Histological Analysis
- •10.3.4.5 Immune Response Evaluation
- •10.3.4.6 Biodegradation Assessment
- •10.4 Surface Engineering Considerations
- •10.4.2.1 Surface Coatings
- •10.4.2.2 Plasma Treatment
- •10.4.2.3 Surface Grafting
- •10.4.2.4 Dip Coating
- •10.4.2.5 Spray Coating System
- •10.4.2.6 Electrotreated Coating
- •10.4.2.9 Microfabrication Techniques
- •10.4.2.10 Surface Roughness Control
- •10.5.1.2 Mechanical Properties
- •10.5.1.3 Surface Characteristics
- •10.5.1.4 Release Kinetics Analysis
- •10.5.1.5 Biological Compatibility
- •10.5.1.7 Other Analyses
- •10.6 Advanced Fabrication Techniques
- •10.8 Conclusion
- •References
- •11.1 Introduction
- •11.2 Shape Memory Alloys (SMA)
- •11.3 Shape Memory Polymers
- •11.3.1 Heat
- •11.3.2 Light
- •11.3.3 Magnetic Field
- •11.4 Shape-Changing Hydrogels
- •11.5 Biomedical Applications
- •11.6 Conclusion
- •References
- •12.1 Introduction
- •12.3 Bioresorbable Orthopedic Implants
- •12.4.1 Polylactides
- •12.4.2 Poly (Ortho Esters)
- •12.4.3 Polyphosphoesters
- •12.4.4 Polyphosphazenes
- •12.4.5 Polycaprolactone
- •12.4.6 Polyurethanes
- •12.4.7 Polycarbonates
- •12.5.1 Compression Molding
- •12.5.2 Transfer Molding
- •12.5.3 Injection Molding
- •12.5.4 Extrusion
- •12.5.5 Blow Molding
- •12.5.6 Calendering Process
- •12.5.7 Fiber Spinning
- •12.5.8 Thermoforming
- •12.5.9 Polymer Foaming
- •12.7 Challenges
- •12.8 Conclusion
- •References
- •13.1 Introduction
- •13.3.1.1 Total Hip Replacement (THR)
- •13.3.2 Resurfacing Hip Replacement (RHR)
- •13.5.1 Adhesive Wear
- •13.5.2 Abrasive Wear
- •13.5.3 Fatigue Wear
- •13.5.4 Corrosion/Oxidative Wear
- •13.5.5 Surface Cracking
- •13.6.1 Metallic Implants
- •13.6.1.1 Stainless Steel
- •13.6.1.2 Co-Cr Alloys
- •13.6.1.3 Ti-Alloy
- •13.6.2 Ceramic Implants
- •13.6.3 Polymer Implants
- •13.6.4 Composite Implants
- •13.6.5.2 Surface Coatings
- •13.7.2.1 Hydrodynamic Lubrication
- •13.7.2.2 Boundary Lubrication
- •13.7.2.3 Elastohydrodynamic Lubrication
- •13.7.3 Biomimetic Lubrication Approaches
- •13.7.3.1 Replicating Natural Lubrication Mechanisms
- •13.7.4.1 Implant Wear
- •13.7.4.3 Synovial Fluid Degradation
- •13.8.1 Hydroxyapatite Coatings
- •13.8.1.1 Bone Integration
- •13.8.1.2 Implant Stability
- •13.8.1.4 Biocompatibility
- •13.8.2 Diamond-Like Carbon Coatings
- •13.8.3 Metal Nitride Coatings
- •13.8.4 Polymeric Coatings
- •13.8.5 Nanocomposite Coatings
- •13.9.1 Pin-on-Disk Testing
- •13.9.2 Hip Joint Simulators
- •13.9.3 Knee Joint Simulators
- •13.9.4 Tribo-Corrosion Testing
- •13.9.5 Wear Debris Analysis Techniques
- •13.9.5.1 Scanning Electron Microscopy (SEM)
- •13.9.5.2 Energy-Dispersive X-Ray Spectroscopy (EDS)
- •13.10.1.1 Tailored Geometries
- •13.10.1.2 Improved Wear Characteristics
- •13.10.1.3 Accelerated Innovation
- •13.10.2.1 Real-Time Wear Monitoring
- •13.10.2.2 Functionality Assessment
- •13.10.2.3 Implant Status Monitoring
- •13.10.2.4 Patient-Centric Healthcare
- •13.10.3.1 Advanced Biomaterials
- •13.10.3.4 Multidisciplinary Approaches
- •13.10.4.1 Wear Data Analysis
- •13.10.4.2 Predictive Wear Patterns
- •13.10.4.3 Early Intervention Strategies
- •13.10.4.4 Personalized Treatment Plans
- •13.11 Conclusion
- •References
- •14.1 Introduction
- •14.2.1 Powder Bed Fusion (PBF)
- •14.2.2 Directed Energy Deposition
- •14.3.1 Extrusion-Based AM
- •14.5 Biomanufacturing
- •14.5.1 Tissue Engineering
- •14.5.2 Organ-on-a-Chip Models
- •14.6 Conclusion
- •References
- •Index

S. Chowdhury et al.
NiTi alloys shine in 3 medical devices: coils (for aneurysm clotting), stents (for
blood ow restoration), and micro guidewires (for stent positioning). These alloys
offer unique advantages like shape memory and controlled force, making them ideal
for delicate procedures. They even help treat neuromuscular syndromes by restoring
function and independence [12]. SMAs revolutionize minimally invasive surgery
(MIS) with their exibility and “remembered” shapes. From SMA baskets retrieving stones to intra-aortic balloons unblocking arteries, these unique materials enable
less intrusive procedures. Even breast cancer surgery benets from SMAs, helping
position and isolate tumors before removal. While NiTi SMAs excel at large deections, the reusable versions used in MIS tools prioritize lower strain limits (5%) to
prevent permanent deformation. Superelastic SMA shines in guidewires and
expanding stents, aiding radiology and treating narrowing caused by tumors [13]. In
short, SMA is transforming MIS, offering surgeons new tools for less invasive,
more precise procedures.
11.3 Shape Memory Polymers
SMPs were rst discovered around the 1960s, when gamma-ray irradiated polyethylene exhibited a one-way shape memory effect with a temperature change [14].
SMPs are a unique portfolio of polymers marked by distinct molecular phases,
switching segments, and netpoints [15]. This distinct molecular architecture in SMP
enables reversible shape recovery through a thermomechanical programming cycle,
i.e., xation and recovery. SMPs can change between permanent and temporary
shapes. The driving force behind shape memory is the entropic elasticity of the
polymeric chains, which is subject to change by specic processing steps. It is to be
noted that shape memory is not a fundamental property of a polymer. Rather, it must
be induced through fabrication programming [16]. The thermo-mechanical programming process of SMPs involves a cascade of events: deformation, shape xing,
and reheating to dissipate the stored internal energy (as depicted in Fig.11.1) [18].
The polymers are rst subjected to deformation under external stress and heating. A
high temperature raises the entropy of the polymer, thereby decreasing the activation energy barrier and giving access to manipulating its shape. After the deformation into a pre-programmed temporary shape, it can be xed using chemical
crosslinks, crystallization, or supramolecular interactions [17]. The pre-programmed
shape can be maintained indenitely as long as no exposure to external stimulus
exists. However, upon suitable thermal stimulation, the polymeric chains regain
mobility by dissipation of stored energy, enabling the recovery to their original
shape [19].
Various stimuli can be used to trigger shape memory in SMPs by incorporating
suitable nanollers in them, which are discussed in the following section.

11 Biological Smart Biomaterials: Materials forBiomedical Applications
Fig. 11.1 (A) Activation energy plot of a thermoresponsive SMP at different states. (a) High
entropy original/permanent state, (b) transition state wherein the SMP is deformed, and chains are
mobile to be reorganized, (c) low entropy metastable temporary state. (B) Schematic of the different steps of the thermomechanical programming procedure in a SMP [17]. (Reproduced with permission from Wiley)
317
11.3.1 Heat
Contact heating is the most widely adopted actuation method for SMPs. As shown
in Fig. 11.2, the macroscopic thermomechanical programming cycle of a SMP
includes fabrication of the SMP into an original shape, heating it above triggering
temperature (Ttrans), and deformation of the SMP via an external force, cooling the
SMP below Ttrans, withdrawal of the external force to dene a temporary preprogrammed shape, and nally reheating the SMP above its Ttrans to obtain the
original shape (recovered shape) [21].
However, the recovery rate is small for SMPs, as most polymers exhibit low
thermal conductivity. This necessitates that the surrounding medium be heated to
higher temperatures to trigger the shape recovery [22]. Also, thermally-triggered
SMPs exhibit low storage modulus and low shape recovery speed, making it imperative to modify them into SMP composites for various applications. SMPs. Most
shape-memory polymers reported so far belong to the category of thermo- responsive
SMPs. The trigger for these polymers, as the name suggests, is a temperature
change, which could be glass transition temperature (Tg) for purely amorphous
polymers or glass transition temperature and/or crystallization temperature (Tc) for
semicrystalline polymers [20]. The driving mechanism behind this property is
entropic elasticity, i.e., when an SMP is subjected to a temperature lower than its Tg,
the segmental motion of the chains is reduced, and they become frozen [22].
Above the Tg, some polymer chains regain mobility, and this effect can be used
to x the SMP into a temporary shape. Deformation of the polymer at a temperature
above its Tg causes the polymer chains to lose their random coil conguration and
enter into a low entropy state7. Cooling the polymer below its Tg restricts the
motion of molecular chains, thereby locking it in this temporary shape [20]. The
original shape can only be then recovered by reheating the polymer above its Tg,
thereby enabling chain motion and the polymer going into a high entropy random
coil state. To emphasize the role of polymer architecture in the entire process, the
permanent shape is governed by netpoints, which can be physical or chemical crosslinks. At the same time, the switching segments are the more ordered, i.e.,

318
S. Chowdhury et al.
Fig. 11.2 Role of polymer architectures in thermal-triggered SMPs [20]. (Reproduced with
permission)
crystalline regions in the SMP.Depending on whether the netpoints are physical or
chemical will determine the shape recovery efciency and rate. Physical net points
tend to be microscopic domains in the structure, which makes them reprocessable
[23]. Chemical crosslinks enable superior shape recovery but are not reprocessable.
A smart approach uses dynamic chemical crosslinks as net points, such as DielsAlder moieties, to achieve reprocessability and good shape memory capabilities
[24]. Switching segments are associated with reversible thermal transitions, such as
glass transition, melting-crystallization, etc. (shown in Fig.11.2).
11.3.2 Light
Light is a potential stimulus that triggers remote shape recovery and provides many
additional functionalities, such as safety to human tissues, the ability to travel long
distances, focusing on specic areas, etc. For the fabrication of light-triggered SMP

11 Biological Smart Biomaterials: Materials forBiomedical Applications
319
composites, photothermal nanollers that may be metallic, polymeric, or carbonaceous are incorporated in the matrices of SMPs. Metallic nanoparticles generate
heat from incident photons (light energy) through the surface plasmonic effect,
while polymeric and composite materials exhibit photothermal capabilities due to
their strong light absorption [25]. Usually, the light-induced heating is rapid and
non-equilibrium in nature. Some common examples of metallic nanostructures
include gold nanoparticles (AuNPs), nanorods (AuNRs), and silver nanoparticles
(Ag NPs). SMPs such as Poly(ethylene oxide)(PEO) [26], poly(vinyl alcohol)
(PVA) [27], and polyurethane [28] are reported as matrices in combination with
metallic nanollers such as AuNPs and AuNRs to yield light-responsive SMP composites. The visible and NIR regions of the light wavelengths (530, 532, 785, 805,
and 860 nm) have mostly been used owing to their benign nature and relatively
deeper tissue penetration capabilities [27]. The laser power densities and nanoller
content inuence the shape recovery efciency of the SMP composite. This, in turn,
allows for precise spatial and temporal control of the entire process, which is benecial for biomedical applications.
11.3.3 Magnetic Field
Magnetic eld is an athermal way of triggering the shape recovery in SMP composites. Most magneto-thermal-based SMPCs are fabricated by incorporating magnetic
particles in the SMP matrices that can generate heat via inductive heating under the
magnetic eld to trigger indirect shape recovery [29]. An amorphous SMP was
incorporated with two kinds of magnetic particles (Fe3O4 and NdFeB), wherein the
Fe3O4 particles enable inductive heating under alternating magnetic eld and
enable shape switching between temporary and permanent shapes. In contrast, the
NdFeB particles are magnetized for programmable shape deformation under actuating magnetic eld [30]. PLA and PLA-copolymer-based SMPs incorporated with
Fe3O4 nanollers have also been reported for minimally invasive biomedical applications, such as deployable stents [31] and tissue scaffolds (Fig.11.3) [25]. Since
Fe3O4 nanollers act as localized heating centers under alternating magnetic elds,
the SMP composite is also heated, and once the transition temperature is attained,
the composite undergoes contactless shape recovery. The important consideration is
that the temperatures attained from inductive heating should be within physiological levels to avoid any thermal necrosis of surrounding tissues. However, compared
with other athermal stimulation, the magnetism-driven SMPCs require a strong
magnetic eld (bulky setup) to generate enough heat, which can be deleterious for
the human body due to the many side effects, including nanoparticle-associated
toxicities.

320
Fig. 11.3 Magnetic eld-triggered SMP composites for biomedical applications. (a) Tracheal
stents and (b) porous bone scaffolds of PLA-Fe3O4 nanocomposites [32]. (Reproduced with
permission)
S. Chowdhury et al.
11.4 Shape-Changing Hydrogels
Hydrogels, polymers forming water-swollen networks, demonstrate signicant
expansion in aqueous solutions. They have evolved into a crucial category of biomaterials for diverse applications, including drug depots, wound dressings, and cell
scaffolds [33]. Despite their numerous benets, hydrogels face challenges such as
undesired temporal shape changes due to rapid swelling in aqueous solutions, leading to brittle failure under mechanical stress [34]. Consequently, it is essential to
design hydrogels that maintain their unique prole and mechanical belongings in
aqueous environments. In addition to controlling the swelling dynamics, research is
also focused on developing multi-component gels with distinct swelling properties
to enable shape alterations over time [35]. Such strategies, exemplied by the use of
a copolymer of PEG-PTMG and beeswax, have facilitated the creation of recongurable hygroscopic robots. This approach surpasses printer limitations, allowing for
customization based on viscoelastic tissue properties [36]. For instance, a designguided approach utilizing a multi-component gel system has been employed to fabricate tissue-mimetic structures, including hollow tubes for sutureless nerve guide
conduits (Fig.11.3) [37]. Other innovative approaches involve [38] the use of anisotropic cellulose nanoparticles embedded in an acrylamide matrix for directional 4D
printing and photocurable silk broin methacrylate-based gels for 4D bioprinting of
tracheal constructs. Beyond tissue constructs, 4D printing of hydrogels offers
opportunities for controlled drug delivery by incorporating micro and nanoscale
structures that respond to physiological triggers such as light, humidity, and temperature [39].

11 Biological Smart Biomaterials: Materials forBiomedical Applications
321
11.5 Biomedical Applications
Given the shortcomings of conventional treatments in meeting patient requirements, the need for enhanced tissue and organ substitutes is pressing. Tissue engineering seeks to produce biomedical scaffolds with diverse functionalities,
potentially offering effective solutions. Engineered materials’ ability to change
shape holds signicant promise in tissue engineering, as it can facilitate less invasive surgical procedures, smooth integration, and replication of the dynamic morphologies of natural tissues and organs [40–48]. In Fig. 11.4, the hydrogels
changing shapes in an aqueous solution is shown. In cardiac tissue engineering,
replicating the intricate architecture of natural tissues is crucial for successful
regeneration. Mimicking native cellular environments through biomimetic topographical cues enhances tissue and organ regeneration. Proper alignment of cardiomyocytes is essential for effective mechanical and electrical activation of the
heart’s ventricles in cardiac tissue engineering. However, producing complex biomimetic tissue scaffolds with integrated topographical cues remains challenging. A
possible remedy is provided by materials that can alter shape, allowing for creating
dynamic scaffolds with distinctive micropatterns and architectures [44, 49–55]. For
instance, Zhang etal. utilized smart natural lipids, such as soybean oil epoxidized
acrylate, to create biocompatible, 4D-dynamic shape-changing tissue scaffolds.
These thin lm scaffolds, less than 300μm thick, are bent or self-assembled into
rolling structures upon external stimulation (e.g., immersion in ethanol for 10min).
Human mesenchymal stem cells (hMSCs) were successfully regulated in their
behavior by this method, which offered stable surface structures across a wide
region, biocompatibility, and excellent integration. hMSCs were able to proliferate
along the created micropatterns and form continuous cellular sheets because of the
scaffolds’exceptional cell compatibility. Further evidence of these printed
scaffolds’high potential for cardiac tissue engineering applications comes from the
dramatically elevated marker expression during the cardiomyogenic differentiation
of hMSCs. Osteoprogenitor migration, proliferation, differentiation, and extracellular matrix (ECM) production are among the dynamic processes involved in bone
tissue engineering. Scientists have investigated synthetic and biodegradable shapememory polymer (SMP) scaffolds for this purpose, which show potential for minimally invasive surgical procedures. By using their ability to change shape, these
scaffolds may be compressed and placed at the location of a defect to allow for less
intrusive operations. Later, they could be activated to expand and regain their previous shape. Furthermore, by better conforming to the uneven boundaries of bone
defects, these scaffolds’ shape- memory capabilities offer advantages in bone tissue
engineering.

322
Fig. 11.4 Hydrogels that change form in aqueous solutions are 4D printed. (A) The printed construct’s many layers’ varying pore diameters result in a notable swelling and shape change variation. (B) FEA models and related tests yield predictable shape changes that enable programmable
movements by modifying inll angles [29]
S. Chowdhury et al.
11.6 Conclusion
Different types of smart classes of materials have been developed in recent years to
meet the stringent and complex biomedical applications. Be it SMAs to SMPs to
shape-changing hydrogels, the library of stimuli-responsive materials has expanded
signicantly. With the power of simulations, a good deal of predictive shape changes
are also enabled, giving control over the dynamics of the shape-changing process.
However, regarding the complexity of the nal product and the physiological relevance of the stimulation method being used, the eld has to go a long way. While
stimulation, like water and heat, is fairly simple and benign to use, other stimulations, such as light, even though advantageous, have not captured the size as much.
More research is to be focused on developing a library of materials for better tuning
the range of shape-changing efciencies, spatial and temporal control, and minimal
side effects caused by the material, stimulation, and the interactions between them.
Acknowledgement The authors would like to acknowledge all the gures mentioned with permission from the copyright clearance center having license numbers for Fig.11.1 5722631382885,
Fig.11.2 5723551495917, Fig.11.3a 5723571509318, Fig.11.3b 5723580183897 and Fig.11.4
5723560230163 form the concerned press.
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