Bio-based epoxy resins have received significant attention in terms of concerns regarding carbon emission. Epoxidized soybean oil (ESO) derived from sustainable feedstock has been widely used to blend with traditional diglycidyl ether of bisphenol-A (DGEBA) to replace some of the petroleum-based components. In this work, molecular dynamics (MD) simulations were applied to track the network formation and predict the performance of methyl hexahydrophthalic anhydride (MHHPA)-cured ESO/DGEBA blend systems. The effects of ESO content and cross-linking degree on the mass density, volumetric shrinkage, glass transition temperature (Tg), coefficient of thermal expansion (CTE), Young\'s modulus, yield strength, and Poisson\'s ratio of the epoxy resin were systematically investigated. The results show that systems with high ESO content achieve gelation at low cross-linking degree. The Tg value, Young\'s modulus, and yield strength increase with the increase in cross-linking degree, but the CTE at the glassy state and Poisson\'s ratio decrease. The comparison results between the simulated and experimental data demonstrated that the MD simulations can accurately predict the thermal and mechanical properties of ESO-based thermosets. This study gains insight into the variation in thermo-mechanical properties of anhydride-cured ESO/DGEBA-based epoxy resins during the cross-linking process and provides a rational strategy for optimizing bio-based epoxy resins.

OBJECTIVE: The aim of this study was to investigate the corneal microstructure and Langerhans cells using in vivo confocal microscopy in keratoconus patients before and after cross-linking, and to correlate the morphologic findings with clinical and patient-reported outcomes, including eye rubbing (ER) behavior.
METHODS: Patients with progressive keratoconus undergoing iontophoresis-assisted epithelium-on cross-linking (I-CXL) were consecutively enrolled. In vivo confocal microscopy was performed before and 6 months after treatment. Patients were asked to quantify their ER behavior on a Visual Analogue Scale (VAS) and completed the Keratoconus Outcomes Research Questionnaire and the Ocular Surface Disease Index questionnaires at the same time points. Visual acuity, tear osmolarity, topography, aberrometry, and pachymetry of both eyes were assessed.
RESULTS: Thirteen patients were included in this pilot study. Preoperatively, the mean Langerhans cells density was 35,615 cells per mm2, and the median morphology was 3. The mean ER VAS before treatment was 7,077 out of 10. The ER VAS showed significant positive correlations with both Langerhans cells density and morphology of the study eye. After treatment, a statistically significant reduction in ER VAS and in Langerhans cells variables was observed. The mean sub-basal plexus nerve density was comparable to pre-operative values 6 months after I-CXL.
CONCLUSIONS: Based on this preliminary evidence, the presence of high density of mature Langerhans cells in the central cornea of keratoconus patients and its correlation with eye rubbing support the role of inflammation in keratoconus. The reduction in these markers after treatment may suggest a potential of CXL in moderating immune-related inflammation and eye rubbing in the medium term.

New composite materials were prepared via cross-linking of polyethylene glycol/2-hydroxypropyl-β-cyclodextrins polyrotaxane (PEG/HPβCD) and polyisoprene/HPβCD semi-polyrotaxane (PI/HPβCD SR) with 1,6-hexamethylene diizocyanate (HMDI). Advanced instrumental methods (such WAXS (wide angle X-ray scattering), AFM (atomic force microscopy), SEM (scanning electron microscopy), and thermal and dynamic vapor sorption) were employed for the structural, morphological and thermal characterization of the resulting composite materials. The roughness parameters calculated using AFM indicate a smoother surface for the composite material with 10 wt% of PI/HPβCD SR, denoting that a homogeneous film was obtained. SEM analysis reveals porous morphologies for both composite materials and the pore sizes increase with the increasing concentration of PI/HPβCD SR in the matrix. Dynamic vapor sorption/desorption measurements and type IV isotherms confirmed the hydrophilic and porous materials, which are in agreement with SEM analysis. The composite with a higher PI/HPβCD SR concentration in the matrix showed increased thermal stability than that of the pure cross-linked material. This material was further tested as a sorbent for methylene blue (MB) dye removal from an aqueous solution. The adsorption capacity of the composite film was found to be 2.58 mg g-1 at 25 °C.

In response to the pressing demand for functional nanomaterials synthesis and applications, two polyelectrolyte complexes (PECs) [electrostatic and cross-linked nanogels (NGs)] loaded individually with caffeic acid (CafA) and eugenol (Eug) demonstrating multifunctionalities were proposed for the first time. Curdlan (Curd) and glucomannan (GM) were carboxymethylated (CMCurd and CMGM) successfully and polymeric ratios of 1:1 and 4:1 (v/v) for chitosan (Cs): CMCurd and lactoferrin (Lf): CMGM were selected for the synthesis of Cs/CMCurd and Lf/CMGM NGs. Due to the use of EDC/NHS, Cs/CMCurd/CafA and Lf/CMGM/Eug NGs possessed very uniform particles sizes of 177 ± 18 and 230 ± 17 nm with marked encapsulation efficiencies (EEs) of 76 ± 4 and 88 ± 3 %, respectively. The formation of a carbonyl-amide linkage in both cross-linked NGs was confirmed by FTIR. It should be noted, the self-assembly was not reliable in retaining enough of the encapsulated compounds. Owing to the excellent physicochemical characteristics of the loaded cross-linked NGs, they were prioritized over the electrostatic ones. Both Cs/CMCurd/CafA and Lf/CMGM/Eug NGs exhibited high colloidal stability over 12 weeks, elevated hemocompatibility, and in vitro serum stability. The generated NGs were also tailored to possess controlled release profiles for CafA and Eug over 72 h. Cs/CMCurd/CafA and Lf/CMGM/Eug NGs had promising antioxidant efficacies and could remarkably inhibit 4 bacterial pathogens at low 2-16 μg/mL concentration of encapsulated NGs compared to their unencapsulated counterparts. Interestingly, the respective NGs could significantly decline the IC50 against colorectal cancer HCT-116 than conventional drugs. Based on these data, it was conferred that the investigated NGs could be promising candidates for functional foods and pharmaceutics.

Alginates are a family of natural polysaccharides with promising potential in biomedical applications and tissue regeneration. The design of versatile alginate-based structures or hydrogels and their stability and functionality depend on the polymer\'s physicochemical characteristics. The main features of alginate chains that determine their bioactive properties are the molar ratio of mannuronic and glucuronic residues (M/G ratio) and their distribution along the polymer chain (MM-, GG-, and MG blocks). The present study is focused on investigating the influence of the physicochemical characteristics of alginate (sodium salt) on the electrical properties and stability of the dispersion of polymer-coated colloidal particles. Ultrapure and well-characterized biomedical-grade alginate samples were used in the investigation. The dynamics of counterion charge near the vicinity of adsorbed polyion is studied via electrokinetic spectroscopy. The results show that the experimental values of the frequency of relaxation of the electro-optical effect are higher compared to the theoretical ones. Therefore, it was supposed that polarization of the condensed Na+ counterions occurs at specific distances according to the molecular structure (G-, M-, or MG-blocks). In the presence of Ca2+, the electro-optical behavior of the particles with adsorbed alginate molecules almost does not depend on the polymer characteristics but was affected by the presence of divalent ions in the polymer layer.

Dextran methacrylate (Dex-MA) is a biodegradable polysaccharide derivative that can be cross-linked by ionizing radiation. It is therefore considered a potential replacement for synthetic hydrophilic polymers in current radiation technologies used for synthesizing hydrophilic cross-linked polymer structures such as hydrogels, mainly for medical applications. This work is focused on the initial steps of radiation-induced cross-linking polymerization of Dex-MA in water. Rate constants of two major transient water radiolysis products-hydroxyl radicals (•OH) and hydrated electrons (eaq-)-with various samples of Dex-MA (based on 6-500 kDa dextrans of molar degree of substitution or DS with methacrylate groups up to 0.66) as well as non-substituted dextran were determined by pulse radiolysis with spectrophotometric detection. It has been demonstrated that these rate constants depend on both the molecular weight and DS; reasons for these effects are discussed and reaction mechanisms are proposed. Selected spectral data of the transient species formed by •OH- and eaq--induced reactions are used to support the discussion. The kinetic data obtained in this work and their interpretation are expected to be useful for controlled synthesis of polysaccharide-based hydrogels and nanogels of predefined structure and properties.

BACKGROUND: Keratoconus has a significant impact on patients\' quality of life (QoL), from diagnosis to the advanced stages of the disease. The aim of this research was to identify domains of QoL affected by this disease and its treatment.
METHODS: Phone interviews were conducted using a semi-structured interview guide, with patients with keratoconus stratified according to their current treatment. A board of keratoconus experts helped identify the guide\'s main themes.
RESULTS: Thirty-five patients (rigid contact lenses, n = 9; cross-linking, n = 9; corneal ring implants, n = 8; and corneal transplantation, n = 9) were interviewed by qualitative researchers. Phone interviews revealed several QoL domains affected by the disease and its treatments: \"psychological\", \"social life\", \"professional life\", \"financial costs\" and \"student life\". All domains were impacted, independently of the treatment history. Few differences were found between treatment regimens and keratoconus stages. Qualitative analysis enabled the development of a conceptual framework based on Wilson and Cleary\'s model for patient outcomes common to all patients. This conceptual model describes the relationship between patients\' characteristics, their symptoms, their environment, their functional visual impairment and the impact on their QoL.
CONCLUSIONS: These qualitative findings supported the generation of a questionnaire to evaluate the impact of keratoconus and its treatment on patients\' QoL. Cognitive debriefings confirmed its content validity. The questionnaire is applicable for all stages of keratoconus and treatments and may help tracking change over time in regular clinical settings. Psychometric validation is yet to be performed before its use in research and clinical practices.

OBJECTIVE: To analyse long-term outcomes of standard cross-linking (SCXL), accelerated cross-linking (ACXL) and transepithelial cross-linking (TCXL) in the treatment of progressive paediatric keratoconus regarding stability, safety and efficacy.
METHODS: This prospective multicentre randomized controlled trial included 97 eyes of 97 paediatric patients with stages I-III ABCD keratoconus grading system, who were randomized into three groups; SCXL group (control group, n = 32; 3 mW/cm2  × 30 min/5.4 J/cm2 ), ACXL (n = 33; 18 mW/cm2  × 5 min/5.4 J/cm2 ) and TCXL (n = 32; 18 mW/cm2  × 5 min/5.4 J/cm2 ). Subjective refraction, uncorrected and corrected visual acuity, keratometry and pachymetry measurements using corneal topography were recorded preoperatively and 1, 2 and 3 years postoperatively.
RESULTS: SCXL group exhibited significant successive improvements in the mean visual, refractive and keratometric parameters throughout the entire postoperative 3 years while ACXL group exhibited significant improvements in visual and keratometric parameters in the first postoperative year that remained stable in second and third postoperative years. TCXL group exhibited significant progressive deterioration in all mean parameters compared to SCXL and ACXL (p < 0.0001). Both SCXL and ACXL revealed final 100% success rate with good stability while TCXL revealed final 22% failure rate with keratoconus progression (p < 0.0001).
CONCLUSIONS: SCXL and ACXL were comparable in halting keratoconus progression and achieved good stability and safety; however, SCXL was more efficient than ACXL as it yielded greater significant postoperative mean visual, refractive and keratometric improvements achieving smoother corneal remodelling. Both SCXL and ACXL were much superior to TCXL. SCXL is the best CXL treatment option for paediatric keratoconus while ACXL is a good and effective alternative.

BACKGROUND: Corneal collagen cross-linking (CXL) is a procedure utilized for halting keratoconus progression with different approved protocols. The current study aimed to assess the corneal endothelial changes following the relatively new accelerated pulsed high-fluence protocol of epithelium-off corneal cross-linking for the treatment of mild to moderate keratoconus.
METHODS: This prospective case series study enrolled 45 eyes of 27 patients with mild to moderate progressive keratoconus who underwent accelerated pulsed high-fluence CXL (pl-ACXL, 30 mW/ cm2 UVA at 365 nm wavelength, 8 min pulsed mode 1 s on / 1 s off with a total energy of 7.2 J/ cm2). The main outcome measures were corneal endothelial changes assessed by specular microscopy at 3 and 6 months postoperatively including endothelial cell density (ECD), coefficient of variation, percentage of hexagonal cells, average, minimum and maximum endothelial cell sizes. Demarcation line depth was assessed 1 month following surgery.
RESULTS: The mean age of the studied sample was 24.89 ± 7.21. The mean preoperative ECD (2944.6 ± 247.41 cell/mm2) showed non-significant reduction at 3 and 6 months postoperatively (2931.03 ± 253.82 and 2924.7 ± 224.88 cell/mm2, respectively, P-value = 0.361). There were no significant changes in the mean coefficient of variation, percentage of hexagonal cells, average, minimum and maximum endothelial cell sizes at 3 and 6 months following pl-ACXL (P-value > 0.05). The mean demarcation line depth 1 month after pl-ACXL was 214 ± 17.43 μm.
CONCLUSIONS: Corneal endothelial changes following accelerated pulsed high-fluence CXL were minimal with stability of endothelial cell count and non-significant morphological changes.
BACKGROUND: Clinicaltrials.gov: NCT04160338 (13/11/2019).

Polysaccharides are one of the most abundant natural polymers and their molecular structure influences many crucial characteristics-inter alia hydrophobicity, mechanical, and physicochemical properties. Vibrational spectroscopic techniques, such as infrared (IR) and Raman spectroscopies are excellent tools to study their arrangement during polymerization and cross-linking processes. This review paper summarizes the application of the above-mentioned analytical methods to track the structure of natural polysaccharides, such as cellulose, hemicellulose, glucan, starch, chitosan, dextran, and their derivatives, which affects their industrial and medical use.