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  1. Article ; Online: Standing left recurrent laryngeal neurectomy for prospective evaluation of laryngeal hemiplegia evaluated by a high-speed treadmill test.

    Lean, Natasha E / Franklin, Samantha H / Ahern, Benjamin J

    American journal of veterinary research

    2023  Volume 85, Issue 2

    Abstract: Objective: To describe left recurrent laryngeal neurectomy (LRLn) performed under standing sedation and evaluate the effect of LRLn on upper respiratory tract function using a high-speed treadmill test (HST). We hypothesized that (1) unilateral LRLn ... ...

    Abstract Objective: To describe left recurrent laryngeal neurectomy (LRLn) performed under standing sedation and evaluate the effect of LRLn on upper respiratory tract function using a high-speed treadmill test (HST). We hypothesized that (1) unilateral LRLn could be performed in standing horses, resulting in ipsilateral arytenoid cartilage collapse (ACC); and (2) HST after LRLn would be associated with alterations in upper respiratory function consistent with dynamic ACC.
    Animals: 6 Thoroughbred horses.
    Methods: The horses were trained and underwent a baseline HST up to 14 m/s at 5% incline until fatigue. Evaluation included; airflow, pharyngeal and tracheal pressures, and dynamic upper respiratory tract endoscopy. Trans-laryngeal impedance (TLI) and left-to-right quotient angle ratio (LRQ) were calculated after testing. The following day, standing LRLn was performed in the mid-cervical region. A HST was repeated within 4 days after surgery.
    Results: Standing LRLn was performed without complication resulting in Havemayer grade 4 ACC at rest (complete paralysis) and Rakestraw grade C or D ACC (collapse up to or beyond rima glottis midline) during exercise. Increasing treadmill speed from 11 to 14 m/s increased TLI (P < .001) and reduced LRQ (P < .001). Neurectomy resulted in an increase in TLI (P = .021) and a reduction in LRQ (P < .001).
    Clinical relevance: Standing LRLn induces laryngeal hemiplegia that can be evaluated using a HST closely after neurectomy. Standing LRLn may be useful for future prospective evaluations of surgical interventions for laryngeal hemiplegia.
    MeSH term(s) Horses ; Animals ; Exercise Test/veterinary ; Hemiplegia/etiology ; Hemiplegia/surgery ; Hemiplegia/veterinary ; Vocal Cord Paralysis/surgery ; Vocal Cord Paralysis/veterinary ; Larynx/surgery ; Denervation/veterinary ; Horse Diseases/surgery
    Language English
    Publishing date 2023-12-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 390796-x
    ISSN 1943-5681 ; 0002-9645
    ISSN (online) 1943-5681
    ISSN 0002-9645
    DOI 10.2460/ajvr.23.08.0185
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  2. Article ; Online: Influence of unilateral and bilateral vocal cordectomy on airflow across cadaveric equine larynges at different Rakestraw grades of arytenoid abduction.

    Lean, Natasha E / Bertin, Francois R / Ahern, Benjamin J

    Veterinary surgery : VS

    2022  Volume 51, Issue 6, Page(s) 974–981

    Abstract: Objective: To assess the effect of vocal cordectomy on airflow across equine larynges at different Rakestraw grades of arytenoid abduction using a unidirectional airflow model.: Study design: Ex vivo, repeated measures.: Sample population: Twenty ... ...

    Abstract Objective: To assess the effect of vocal cordectomy on airflow across equine larynges at different Rakestraw grades of arytenoid abduction using a unidirectional airflow model.
    Study design: Ex vivo, repeated measures.
    Sample population: Twenty cadaveric equine larynges.
    Methods: The right arytenoid cartilage was maximally abducted in all larynges. Each larynx was assigned a Rakestraw grade A or B, and the left arytenoid was abducted accordingly. Each larynx was tested under 3 conditions: intact, left vocal cordectomy (LVC), and bilateral vocal cordectomy (BVC). Translaryngeal pressure and airflow were measured, and digital video footage was obtained. Translaryngeal impedance (TLI) was calculated, and the arytenoid left-to-right quotient angle (LRQ) and rima glottis cross-sectional area (CSA) were measured from standardized still images.
    Results: Vocal cordectomy reduced TLI by 14.5% in LVC in comparison with intact larynges at Rakestraw grade B (P = .014). In Rakestraw grade A position, neither unilateral nor bilateral vocal cordectomy had any effect on TLI. Regardless of Rakestraw allocation, both LVC and BVC increased CSA in comparison with intact larynges (P < .005), with BVC larynges experiencing a greater effect than LVC (P < .0001).
    Conclusion: Using a unilateral airflow model, LVC improved TLI in larynges where arytenoid position approximated Rakestraw grade B. However, when the arytenoid position approximated Rakestraw grade A, there was no effect on TLI following LVC or BVC.
    Clinical significance: Surgeons considering a vocal cordectomy should take into account the degree of arytenoid abduction before performing the procedure, as it may not be warranted from a TLI point of view.
    MeSH term(s) Animals ; Arytenoid Cartilage/surgery ; Cadaver ; Horse Diseases/surgery ; Horses/surgery ; Humans ; Laryngoplasty/methods ; Laryngoplasty/veterinary ; Larynx/surgery ; Vocal Cords/surgery
    Language English
    Publishing date 2022-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1491071-8
    ISSN 1532-950X ; 0161-3499
    ISSN (online) 1532-950X
    ISSN 0161-3499
    DOI 10.1111/vsu.13823
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  3. Article ; Online: Laryngeal tie-forward in standing sedated horses.

    Lean, Natasha E / Sole-Guitart, Albert / Ahern, Benjamin J

    Veterinary surgery : VS

    2022  Volume 52, Issue 2, Page(s) 229–237

    Abstract: Objectives: To investigate the feasibility and describe the clinical experience of performing laryngeal tie-forward (LTF) in standing horses unaffected (experimental) and affected (clinical) by intermittent dorsal displacement of the soft palate (iDDSP). ...

    Abstract Objectives: To investigate the feasibility and describe the clinical experience of performing laryngeal tie-forward (LTF) in standing horses unaffected (experimental) and affected (clinical) by intermittent dorsal displacement of the soft palate (iDDSP).
    Study design: Experimental study and case series.
    Animals: Five normal experimental controls and five client owned horses affected by iDDSP.
    Methods: Standing LTF was performed and evaluated in five experimental horses and five clinical cases diagnosed with iDDSP. Standing LTF was performed under endoscopic guidance with horses sedated and the surgical site desensitized with local anesthetic solution. Short term outcome was assessed using radiography, resting and (in clinical cases) dynamic upper respiratory tract (URT) endoscopy.
    Results: Standing LTF was well tolerated and completed in all horses. Radiographic assessment demonstrated that compared to preoperatively, the basihyoid bone and thyrohyoid-thyroid articulation were positioned dorsally (9.6 mm, p = .006 and 20.4 mm, p = .007, respectively) at 2 days postoperatively. During repeat dynamic URT endoscopy at 48 hours postoperatively, 3/5 horses showed resolution of iDDSP and 2/5 marked improvement. One horse experienced brief iDDSP associated with neck flexion which corrected after swallowing. The second achieved a greater speed and total distance prior to iDDSP.
    Conclusions: Standing LTF did not incur any major peri- or postoperative complications. The laryngohyoid apparatus was repositioned dorsally and in a small case series had a similar surgical effect on laryngeal position.
    Clinical significance: Standing LTF is feasible, mitigates the risk of general anesthesia related complications and reduces cost.
    MeSH term(s) Horses/surgery ; Animals ; Larynx/surgery ; Palate, Soft/surgery ; Endoscopy/veterinary ; Nose ; Radiography ; Horse Diseases/surgery
    Language English
    Publishing date 2022-11-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1491071-8
    ISSN 1532-950X ; 0161-3499
    ISSN (online) 1532-950X
    ISSN 0161-3499
    DOI 10.1111/vsu.13920
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  4. Article ; Online: Laryngeal tie‐forward in standing sedated horses

    Lean, Natasha E. / Sole‐Guitart, Albert / Ahern, Benjamin J.

    Veterinary Surgery. 2023 Feb., v. 52, no. 2 p.229-237

    2023  

    Abstract: OBJECTIVES: To investigate the feasibility and describe the clinical experience of performing laryngeal tie‐forward (LTF) in standing horses unaffected (experimental) and affected (clinical) by intermittent dorsal displacement of the soft palate (iDDSP). ...

    Abstract OBJECTIVES: To investigate the feasibility and describe the clinical experience of performing laryngeal tie‐forward (LTF) in standing horses unaffected (experimental) and affected (clinical) by intermittent dorsal displacement of the soft palate (iDDSP). STUDY DESIGN: Experimental study and case series. ANIMALS: Five normal experimental controls and five client owned horses affected by iDDSP. METHODS: Standing LTF was performed and evaluated in five experimental horses and five clinical cases diagnosed with iDDSP. Standing LTF was performed under endoscopic guidance with horses sedated and the surgical site desensitized with local anesthetic solution. Short term outcome was assessed using radiography, resting and (in clinical cases) dynamic upper respiratory tract (URT) endoscopy. RESULTS: Standing LTF was well tolerated and completed in all horses. Radiographic assessment demonstrated that compared to preoperatively, the basihyoid bone and thyrohyoid‐thyroid articulation were positioned dorsally (9.6 mm, p = .006 and 20.4 mm, p = .007, respectively) at 2 days postoperatively. During repeat dynamic URT endoscopy at 48 hours postoperatively, 3/5 horses showed resolution of iDDSP and 2/5 marked improvement. One horse experienced brief iDDSP associated with neck flexion which corrected after swallowing. The second achieved a greater speed and total distance prior to iDDSP. CONCLUSIONS: Standing LTF did not incur any major peri‐ or postoperative complications. The laryngohyoid apparatus was repositioned dorsally and in a small case series had a similar surgical effect on laryngeal position. CLINICAL SIGNIFICANCE: Standing LTF is feasible, mitigates the risk of general anesthesia related complications and reduces cost.
    Keywords anesthesia ; endoscopy ; horses ; larynx ; local anesthetics ; neck ; palate ; radiography ; risk
    Language English
    Dates of publication 2023-02
    Size p. 229-237.
    Publishing place John Wiley & Sons, Inc.
    Document type Article ; Online
    Note JOURNAL ARTICLE
    ZDB-ID 1491071-8
    ISSN 1532-950X ; 0161-3499
    ISSN (online) 1532-950X
    ISSN 0161-3499
    DOI 10.1111/vsu.13920
    Database NAL-Catalogue (AGRICOLA)

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  5. Article ; Online: Evaluation of recurrent laryngeal neuropathy in domestic and feral horse populations in Australia using histologic and immunohistochemical analysis: A pilot study.

    Lean, Natasha E / Franklin, Samantha H / Steel, Cate / Woolford, Lucy / White, Jason / Ahern, Benjamin J

    Veterinary medicine and science

    2023  Volume 9, Issue 4, Page(s) 1610–1617

    Abstract: Background: Little is known about potential differences in the left recurrent laryngeal nerve (Lrln) and left cricoarytenoideus dorsalis (LCAD) muscle between domestic and feral horse populations. If a difference exists, feral horses may provide a ... ...

    Abstract Background: Little is known about potential differences in the left recurrent laryngeal nerve (Lrln) and left cricoarytenoideus dorsalis (LCAD) muscle between domestic and feral horse populations. If a difference exists, feral horses may provide a useful control population for research related to recurrent laryngeal neuropathy (RLN) and increase our understanding of potential population pressures influencing the incidence RLN.
    Objectives: The objective of this study was to compare the Lrln and LCAD of domestic and feral horses using histological and immunohistochemical techniques (IHC).
    Methods: Sixteen horses, domestic (n = 8) and feral (n = 8), without clinical or ancillary examinations that were processed at an abattoir had the Lrln and LCAD muscle harvested immediately following death. Carcass weights were recorded. Subjective and morphometric histologic assessment were performed on Lrln sections. The LCAD was assessed for myosin heavy chain (fibre type proportion, diameter and grouping using IHC.
    Results: Fibre-type grouping consistent with RLN was seen in both groups. Regenerating fibre clusters were more common in domestic compared to feral horses (p = 0.04). No other histologic differences occurred between groups. Muscle fibre typing demonstrated a lower mean percentage of type IIX fibres in the feral group compared to the domestic group (p = 0.03). There was no difference in type I or IIA proportions or mean diameter of any fibre type between the groups.
    Conclusions: The domestic population showed evidence of nerve regeneration suggesting RLN in this group, yet this was not supported by the higher proportion of type IIX muscle fibres compared to the feral population. Further evaluation to clarify the significance and wider occurrence of the differences is indicated.
    MeSH term(s) Horses ; Animals ; Pilot Projects ; Horse Diseases/epidemiology ; Horse Diseases/pathology ; Laryngeal Muscles/innervation ; Laryngeal Muscles/pathology ; Muscles ; Australia
    Language English
    Publishing date 2023-06-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2819409-3
    ISSN 2053-1095 ; 2053-1095
    ISSN (online) 2053-1095
    ISSN 2053-1095
    DOI 10.1002/vms3.1186
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  6. Article: Influence of unilateral and bilateral vocal cordectomy on airflow across cadaveric equine larynges at different Rakestraw grades of arytenoid abduction

    Lean, Natasha E. / Bertin, Francois R. / Ahern, Benjamin J.

    Veterinary surgery. 2022 Aug., v. 51, no. 6

    2022  

    Abstract: OBJECTIVE: To assess the effect of vocal cordectomy on airflow across equine larynges at different Rakestraw grades of arytenoid abduction using a unidirectional airflow model. STUDY DESIGN: Ex vivo, repeated measures. SAMPLE POPULATION: Twenty cadaveric ...

    Abstract OBJECTIVE: To assess the effect of vocal cordectomy on airflow across equine larynges at different Rakestraw grades of arytenoid abduction using a unidirectional airflow model. STUDY DESIGN: Ex vivo, repeated measures. SAMPLE POPULATION: Twenty cadaveric equine larynges. METHODS: The right arytenoid cartilage was maximally abducted in all larynges. Each larynx was assigned a Rakestraw grade A or B, and the left arytenoid was abducted accordingly. Each larynx was tested under 3 conditions: intact, left vocal cordectomy (LVC), and bilateral vocal cordectomy (BVC). Translaryngeal pressure and airflow were measured, and digital video footage was obtained. Translaryngeal impedance (TLI) was calculated, and the arytenoid left‐to‐right quotient angle (LRQ) and rima glottis cross‐sectional area (CSA) were measured from standardized still images. RESULTS: Vocal cordectomy reduced TLI by 14.5% in LVC in comparison with intact larynges at Rakestraw grade B (P = .014). In Rakestraw grade A position, neither unilateral nor bilateral vocal cordectomy had any effect on TLI. Regardless of Rakestraw allocation, both LVC and BVC increased CSA in comparison with intact larynges (P < .005), with BVC larynges experiencing a greater effect than LVC (P < .0001). CONCLUSION: Using a unilateral airflow model, LVC improved TLI in larynges where arytenoid position approximated Rakestraw grade B. However, when the arytenoid position approximated Rakestraw grade A, there was no effect on TLI following LVC or BVC. CLINICAL SIGNIFICANCE: Surgeons considering a vocal cordectomy should take into account the degree of arytenoid abduction before performing the procedure, as it may not be warranted from a TLI point of view.
    Keywords air flow ; cartilage ; horses ; larynx ; models ; surgery
    Language English
    Dates of publication 2022-08
    Size p. 974-981.
    Publishing place John Wiley & Sons, Inc.
    Document type Article
    Note JOURNAL ARTICLE
    ZDB-ID 1491071-8
    ISSN 1532-950X ; 0161-3499
    ISSN (online) 1532-950X
    ISSN 0161-3499
    DOI 10.1111/vsu.13823
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  7. Article ; Online: Evaluation of locking compression plate fixation of the distal phalanx to the hoof wall as a potential therapy for laminitis

    Lean, Natasha E. / Zedler, Steven T. / Van Eps, Andrew William / Engiles, Julie B. / Ford, Matthew / Stefanovski, Darko / Walsh, Donald Mark / Pollitt, Christopher C.

    Equine Veterinary Journal. 2023 July, v. 55, no. 4 p.707-716

    2023  

    Abstract: BACKGROUND: Surgical stabilisation of the distal phalanx (DP) is a potential therapeutic strategy for severe acute laminitis. OBJECTIVE: To evaluate the effects of locking compression plate (LCP) fixation of the DP to the dorsal hoof wall. STUDY DESIGN: ... ...

    Abstract BACKGROUND: Surgical stabilisation of the distal phalanx (DP) is a potential therapeutic strategy for severe acute laminitis. OBJECTIVE: To evaluate the effects of locking compression plate (LCP) fixation of the DP to the dorsal hoof wall. STUDY DESIGN: Ex vivo and in vivo experiments. METHODS: A T‐shaped LCP was applied to one limb per pair in six pairs of cadaver forelimbs subjected to a combination of thermally induced lamellar failure and vertical load to simulate severe acute laminitis. Standard radiographic measurements were used to compare DP displacement. The LCP was then applied to one forefoot in 12 healthy Standardbred horses either standing (n = 6) or under general anaesthesia (n = 6). Lameness was evaluated daily, then horses were euthanised (day 8) and lamellar tissue analysed using light microscopy, histomorphometery and molecular markers of apoptosis. RESULTS: In the cadaver limb model, LCP fixation prevented the significant changes in hoof‐distal phalanx distance, coronary extensor process distance and sole depth that characterised DP displacement in untreated limbs (p < 0.05). Application of the construct in vivo was well tolerated with minimal lameness (10/12 horses were sound at the trot on day 8); however, histology revealed dorsal lamellar pathology consistent with laminitis, but with extensive keratinocyte apoptosis. Adjacent to the LCP, caspase‐3 positive cell counts were approximately 20‐fold higher than control (p < 0.001). MAIN LIMITATIONS: Pathology was evaluated at a single time point. Microvascular perfusion was not evaluated. CONCLUSIONS: Rigid fixation of the DP to the hoof capsule was achieved with the LCP construct in a cadaver limb laminitis model. In live horses, LCP fixation caused regional lamellar pathology with extensive apoptosis, likely due to disturbed lamellar microvascular perfusion and/or mechanostasis. Understanding these mechanisms is critical for refinement of the technique in order to avoid iatrogenic lamellar damage.
    Keywords Standardbred ; anesthesia ; apoptosis ; cadaver ; caspase-3 ; histology ; hooves ; horses ; keratinocytes ; lameness ; laminitis ; light microscopy ; models ; radiography
    Language English
    Dates of publication 2023-07
    Size p. 707-716.
    Publishing place John Wiley & Sons, Ltd
    Document type Article ; Online
    Note JOURNAL ARTICLE
    ZDB-ID 41606-x
    ISSN 0425-1644
    ISSN 0425-1644
    DOI 10.1111/evj.13877
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  8. Article ; Online: Evaluation of locking compression plate fixation of the distal phalanx to the hoof wall as a potential therapy for laminitis.

    Lean, Natasha E / Zedler, Steven T / Van Eps, Andrew William / Engiles, Julie B / Ford, Matthew / Stefanovski, Darko / Walsh, Donald Mark / Pollitt, Christopher C

    Equine veterinary journal

    2022  Volume 55, Issue 4, Page(s) 707–716

    Abstract: Background: Surgical stabilisation of the distal phalanx (DP) is a potential therapeutic strategy for severe acute laminitis.: Objective: To evaluate the effects of locking compression plate (LCP) fixation of the DP to the dorsal hoof wall.: Study ... ...

    Abstract Background: Surgical stabilisation of the distal phalanx (DP) is a potential therapeutic strategy for severe acute laminitis.
    Objective: To evaluate the effects of locking compression plate (LCP) fixation of the DP to the dorsal hoof wall.
    Study design: Ex vivo and in vivo experiments.
    Methods: A T-shaped LCP was applied to one limb per pair in six pairs of cadaver forelimbs subjected to a combination of thermally induced lamellar failure and vertical load to simulate severe acute laminitis. Standard radiographic measurements were used to compare DP displacement. The LCP was then applied to one forefoot in 12 healthy Standardbred horses either standing (n = 6) or under general anaesthesia (n = 6). Lameness was evaluated daily, then horses were euthanised (day 8) and lamellar tissue analysed using light microscopy, histomorphometery and molecular markers of apoptosis.
    Results: In the cadaver limb model, LCP fixation prevented the significant changes in hoof-distal phalanx distance, coronary extensor process distance and sole depth that characterised DP displacement in untreated limbs (p < 0.05). Application of the construct in vivo was well tolerated with minimal lameness (10/12 horses were sound at the trot on day 8); however, histology revealed dorsal lamellar pathology consistent with laminitis, but with extensive keratinocyte apoptosis. Adjacent to the LCP, caspase-3 positive cell counts were approximately 20-fold higher than control (p < 0.001).
    Main limitations: Pathology was evaluated at a single time point. Microvascular perfusion was not evaluated.
    Conclusions: Rigid fixation of the DP to the hoof capsule was achieved with the LCP construct in a cadaver limb laminitis model. In live horses, LCP fixation caused regional lamellar pathology with extensive apoptosis, likely due to disturbed lamellar microvascular perfusion and/or mechanostasis. Understanding these mechanisms is critical for refinement of the technique in order to avoid iatrogenic lamellar damage.
    MeSH term(s) Horses ; Animals ; Hoof and Claw/surgery ; Hoof and Claw/pathology ; Lameness, Animal/surgery ; Foot Diseases/surgery ; Foot Diseases/veterinary ; Foot Diseases/etiology ; Horse Diseases/pathology ; Foot ; Inflammation/pathology ; Inflammation/veterinary
    Language English
    Publishing date 2022-09-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 41606-x
    ISSN 2042-3306 ; 0425-1644
    ISSN (online) 2042-3306
    ISSN 0425-1644
    DOI 10.1111/evj.13877
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  9. Article ; Online: Thermoresponsive and Injectable Hydrogel for Tissue Agnostic Regeneration.

    Calder, Dax / Fathi, Ali / Oveissi, Farshad / Maleknia, Simin / Abrams, Terence / Wang, Yiwei / Maitz, Joanneke / Tsai, Kevin Hung-Yueh / Maitz, Peter / Chrzanowski, Wojtek / Canoy, Ivan / Menon, Vivek Ashoka / Lee, Kenneth / Ahern, Benjamin J / Lean, Natasha E / Silva, Dina M / Young, Paul M / Traini, Daniela / Ong, Hui Xin /
    Mahmoud, Rasoul Seyed / Montazerian, Hossein / Khademhosseini, Ali / Dehghani, Fariba

    Advanced healthcare materials

    2022  Volume 11, Issue 23, Page(s) e2201714

    Abstract: Injectable hydrogels can support the body's innate healing capability by providing a temporary matrix for host cell ingrowth and neovascularization. The clinical adoption of current injectable systems remains low due to their cumbersome preparation ... ...

    Abstract Injectable hydrogels can support the body's innate healing capability by providing a temporary matrix for host cell ingrowth and neovascularization. The clinical adoption of current injectable systems remains low due to their cumbersome preparation requirements, device malfunction, product dislodgment during administration, and uncontrolled biological responses at the treatment site. To address these challenges, a fully synthetic and ready-to-use injectable biomaterial is engineered that forms an adhesive hydrogel that remains at the administration site regardless of defect anatomy. The product elicits a negligible local inflammatory response and fully resorbs into nontoxic components with minimal impact on internal organs. Preclinical animal studies confirm that the engineered hydrogel upregulates the regeneration of both soft and hard tissues by providing a temporary matrix to support host cell ingrowth and neovascularization. In a pilot clinical trial, the engineered hydrogel is successfully administered to a socket site post tooth extraction and forms adhesive hydrogel that stabilizes blood clot and supports soft and hard tissue regeneration. Accordingly, this injectable hydrogel exhibits high therapeutic potential and can be adopted to address multiple unmet needs in different clinical settings.
    MeSH term(s) Hydrogels/pharmacology
    Chemical Substances Hydrogels
    Language English
    Publishing date 2022-10-17
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2649576-4
    ISSN 2192-2659 ; 2192-2640
    ISSN (online) 2192-2659
    ISSN 2192-2640
    DOI 10.1002/adhm.202201714
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