Frontiers in Bioengineering and Biotechnology

We present three quantitative methods: 1) estimation of exoskeleton mechanical power and energy ratio from published data, 2) a systematic review of the exoskeleton literature on reported energy ratios, and 3) timing correction analysis of the replication experiment, to address concerns raised by Collins et al. (2026) about Luo et al. (2024). Together, these analyses support the reported metabolic reductions and the validity of exoskeleton control via learning in simulation. The critique rests on an unsupported premise: that exoskeleton energy ratios above 4 are physiologically implausible. This premise of Collins et al. (2026) is not supported by the cited evidence, and the error originates in their own cited source. Sawicki and Ferris (2009), the paper they invoke as authority for the limit of 4, state explicitly that "reported values of the muscular efficiency range from 0.10 to 0.34, with many sources assuming an average of [~]0.25." The value of 4 corresponds to this average, it is not a physiological ceiling. Treating an average as a physiological upper limit is a fundamental error. The published exoskeleton literature further contradicts the claim, including work by the authors of the critique themselves (Collins et al., 2015: 4.3; Young et al., 2017: 5.0) and independent work (Malcolm et al., 2013: 4.8; Seo et al., 2017: 6.7). In contrast, our walking energy ratio is 2.4, calculated directly from Fig. 4 of our paper. Our device delivers higher peak torque (14.1 Nm vs. 10.9 Nm, Lim et al., 2019) and achieves a slightly larger metabolic reduction (24.3% vs. 21%). Independent groups have since demonstrated meaningful metabolic reductions using learning-in-simulation frameworks, including Barati et al. (2026, 15.2% mean and 22.5% maximum) and Zhou et al. (2025, [~]20% during running). The claim of Collins et al. (2026) that this problem "remains unsolved" is directly contradicted by these independent results. The experiment in the critique is not a valid replication of our method. Our controller is a neural network with [~]10,000 parameters learned through deep reinforcement learning in musculoskeletal simulation; the critique instead applies a pre-programmed fixed torque curve with no learnable parameters. Beyond this, the replication contains three methodological errors: 1) a heel-strike timing assumption producing offsets up to 30% of the gait cycle; 2) an averaged torque profile that discards subject-specific control; and 3) a device [~]50% heavier than ours (4.8 kg vs. 3.2 kg) without measuring the metabolic penalty of the added weight. The critique also misreports Samsung data, with reported values approximately double those in the original publication, errors that directly underpin their physiological limit argument.

Human pluripotent stem cells (hPSCs) hold significant promise for regenerative medicine, yet optimizing their expansion in three-dimensional bioreactor systems remains challenging due to complex interactions between mechanical forces, metabolic constraints, and aggregate formation dynamics. This study developed and validated a mechanistic mathematical model to predict hPSC proliferation dynamics in vertical-wheel bioreactor (VWBR) systems, incorporating the effects of shear stress and energy dissipation rate (EDR) on cell growth and aggregate dynamics. Seven model variants employing different kinetic formulations for shear stress and energy dissipation rate effects were systematically evaluated through model selection, identifiability analyses, and experimental validation. Experimental data from six bioreactor conditions varying in initial cell density (2 x 104-15 x 104 cells/mL), agitation rate (30-60 RPM), and working volume (100-500 mL) were used for model calibration and selection. Bayesian Information Criterion analysis identified a model combining Michaelis-Menten kinetics for shear stress inhibition with a EDR-mediated aggregate detachment formulation as the best-performing variant, achieving a Mean Relative Prediction Error of 13.97%, comparable to the experimental variability of 16.29%. Independent validation experiments using leave-out data gathered under different media exchange schedules confirmed model accuracy with prediction errors below 14%, consistent with observed experimental variability around 12%. The validated model was used to optimize the media exchange protocol, leading to a 37.5% reduction in media consumption with only a 13.5% reduction in final cell yield, demonstrating its utility for prospective, quantitative bioprocess design in VWBR systems.

Gene therapy has been the subject of extensive research following the advent of gene-editing technologies. Genetic disorders with difficult-to-target tissues, such as cystic fibrosis (CF), still face many challenges in developing efficacious gene therapy. The potential universal approach of gene replacement involves inserting a functional CFTR gene after generating DNA double strand breaks using gene editors such as CRISPR/Cas9. However, this strategy has not achieved clinical significance, as CRISPR/Cas9-mediated integration of CFTR is limited primarily by the infrequent activity of the homology-directed repair (HDR) pathway. To circumvent this limitation and improve CFTR transgene integration and expression, we explored a method of adding a second integration site, which we termed the dual-locus-targeting method. Using a helper-dependent adenoviral vector (HDAd)-delivered CRISPR/Cas9 system in porcine epithelial cells, we found that sequential delivery of two vectors, one targeting the CFTR locus and the other the genomic safe harbour site GGTA1, enhanced the integration efficiency of lacZ and CFTR donor genes to 16.5% and 3.4%, respectively. These results demonstrated a potential strategy to improve the efficacy of CFTR replacement for the development of a universal and permanent gene therapy treatment for CF lung disease. GRAPHICAL ABSTRACT O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=76 SRC="FIGDIR/small/731381v1_ufig1.gif" ALT="Figure 1"> View larger version (17K): org.highwire.dtl.DTLVardef@1774590org.highwire.dtl.DTLVardef@1782915org.highwire.dtl.DTLVardef@1d13b12org.highwire.dtl.DTLVardef@17d3f93_HPS_FORMAT_FIGEXP M_FIG C_FIG

Long-term ex situ machine perfusion of donor organs is an emerging clinical strategy that creates a window for advanced therapeutic interventions. Replacing donor endothelial cells during machine perfusion with recipient endothelium could conceal the allogeneic epithelium from the recipients (humoral) immune response. We postulated that brief exposure to low concentrations of decellularizing agents could selectively remove vascular endothelium. Porcine kidneys were partially decellularized with five 2-minute infusions of either 0.01%, 0.1% or 1.0% SDS during acellular perfusion. As proof-of-concept, fluorescently-labelled porcine endothelial colony forming cells (ECFCs) were infused into the renal vein and artery of a partially decellularized kidney. Tissue analysis identified 0.1% SDS effectively removed endothelial cells from glomerular and peritubular capillaries. Infused ECFCs could be found back within the glomeruli. However, partial decellularization significantly impaired renal flow and increased vascular resistance. While partial decellularization successfully removed donor endothelium, the loss of vascular patency limits its clinical potential. Future research should prioritize modifying rather than removing donor endothelial cells.

Background Occupational exoskeletons are used to reduce physical workload and prevent work-related musculoskeletal disorders in physically demanding jobs. Although laboratory studies demonstrate reduced muscle load during simulated manual work tasks, evidence from long-term, real-world implementations remains very limited. The RELAX project aims to investigate the long-term effects of a passive back-support exoskeleton (BSE) during manual order-picking work in a Danish warehouse, focusing on health and socio-economic outcomes. Methods This 18-month controlled in-field intervention study compares outcomes at two warehouse departments: one where workers use a passive BSE and a control group where workers perform work tasks as usual. Approximately 90 full-time workers will be followed during the intervention period with questionnaires, interviews and company-registered performance indicators. Primary outcomes include perceived work intensity and musculoskeletal discomfort, while secondary outcomes include sickness absence, employee turnover, productivity and cost effectiveness. Furthermore, a process evaluation will be conducted based on questionnaires, focus-group interviews, and reported exoskeleton use. Quantitative effects will be analysed using difference-in-difference analysis with generalized linear mixed models to account for repeated measures over time. Employee turnover will be analysed using time-to-event analysis, and qualitative focus-group interviews will be analysed using reflexive thematic analysis to explore implementation processes and contextual factors. Cost-effectiveness and return on investment will be assessed by comparing the investment with potential savings in costs and resource use. Discussion By combining longitudinal quantitative outcomes with qualitative process evaluation, the study seeks to provide ecologically valid evidence on the effectiveness, feasibility and sustainability of occupational exoskeleton implementation. This approach will help clarify whether long-term exoskeleton use improves worker health without compromising productivity and may inform future workplace guidelines and large-scale adoption strategies.

ObjectiveOur prior studies have demonstrated that lateral spinal cord stimulation can evoke somatosensory percepts in the missing foot in individuals with a lower-limb amputation. However, subjects reported concurrent sensations in their residual limb. In this study, we evaluate the hypothesis that using high-density paddle electrodes with smaller contact sizes, and multipolar stimulation configurations could evoke more focal sensations in the foot over a wide range of stimulation amplitudes. ApproachWe used a combination of electrophysiology and computational modelling methods to investigate the selective activation of distal nerve branches in response to lateral spinal cord stimulation in cats. In six acute feline experiments, we performed an L3-S1 laminectomy and placed custom 32-electrode paddles laterally over the dura of the spinal cord. We recorded antidromic action potentials in the distal branches of the sciatic and femoral nerve trunks in response to stimulation using three contact diameters (150, 500 and 1000 {micro}m) and two stimulation configurations - monopolar and bipolar stimulation. We replicated the neural recruitment patterns from those experiments in a computational model of the feline lumbar spinal cord. We then used the model to examine neural recruitment with 1.8 mm and 2.5 mm contacts, as well as a tripolar guarded-cathode configuration. Main resultsIn the electrophysiology experiments, the 500 {micro}m-diameter electrodes achieved the most selective nerve activation (68%) compared to 62% for both 150 and 1000 {micro}m-diameter electrodes. The minimum amplitudes for recruiting nerve branches (i.e., threshold) as well as the dynamic ranges were largely similar for the different contact diameters (median: 35 {micro}A) and stimulation configurations (30 {micro}A for bipolar stimulation; 35 {micro}A for monopolar stimulation). The computational model reproduced the finding that selectivity did not differ significantly among the three contact sizes tested in cat experiments, though it revealed that increasing contact diameter above 1000 {micro}m raised the minimum amplitude required for selective activation and reduced spinal root selectivity. Across both approaches, we consistently recruited large-diameter afferents that are critical for somatosensory applications of spinal cord stimulation. SignificanceOur results indicate that, relative to clinical electrodes, reducing the contact diameter of stimulation electrodes can evoke focal sensations, but further reductions below 1000 {micro}m may fail to improve selectivity. This study highlights potential constraints with achieving focal selectivity that are not dependent on the design of the electrodes.

Different in vitro models are widely used as experimental platforms to assess neuronal responses to metabolic stress and test potential treatments for patients with ischemic stroke. Results of those studies depend on the stress models used, and the link between cell viability-based readouts and electrophysiological activity remains poorly explored. We investigated the neuronal network activity of human-derived neuronal networks generated from human induced pluripotent stem cells (hiPSCs) under three commonly used metabolic stress models: hypoxia alone, oxygen and glucose deprivation (OGD), and hypoxia combined with different concentrations of glutamate. We aim to clarify the differences between three commonly used in vitro models, including the relation between microscopic and electrophysiological readouts. These conditions produced distinct effects on neuronal network activity. Hypoxia alone induced a progressive decline in activity over time. In contrast, OGD triggered a biphasic response, characterized by an early increase in activity followed by a decline. High concentration glutamate exposure under hypoxia also altered network dynamics, inducing a triphasic pattern consisting of a rapid activity decrease, a transient increase, and a subsequent decline. Across all these pathological conditions, neuronal activity progressively declined and converged toward network failure after prolonged hypoxia. Following reoxygenation, recovery was limited and condition-dependent: hypoxia alone, OGD, and high glutamate conditions showed limited recovery. On the other hand, low glutamate concentration was associated with good recovery. Microscopic assessment revealed that cellular viability was differentially affected across conditions. OGD was associated with the highest levels of cell death, whereas glutamate exposure, particularly at high concentrations, led to a marked reduction in synaptic puncta despite partial preservation of cell viability. These findings highlight that commonly used in vitro ischemia models induce distinct neuronal responses and highlight the importance of integrating electrophysiological and structural analyses to better characterize metabolic stress in human neuronal networks better.

The human spine is a complex, coordinated biomechanical system. Physiologically, its tissues are also highly interdependent in terms of function and viability. The interaction between mechanical stress and biological/biochemical activity over time constitutes a key driver of spinal degeneration. Research to date providing mechanistic insights into this process has focused on individual components (vertebra and disc tissue analogues), in isolation or as basic functional units. However, many observations from individual units will not translate to whole spine behaviour. The intricate complexity of the spine requires novel experimental models (synthetic and biotic), which must consider the spine at an organ level and adopt an integrative approach that can capture the dynamics which govern its function. Here, we report the development of a biomimetic spinal model prototype, amenable to cellular integration, which is miniaturised to the in vitro scale to provide a controlled environment and testbed for axial biological mechanics. The research presented here encompasses more than a decade of systematic investigations during which the gradual emergence of key manufacturing innovations progressively enabled addressing an exceptionally complex bioengineering challenge - organotypic spine engineering. The model comprises the full anatomical range of spinal vertebrae/bones (C1 to Sacrum & Coccyx), reproduced using bioceramic materials, assembled in sequence into a relevant columnar architecture and mechanically connected end-to-end by biochemically active interfaces. A range of assessments examining anatomical design, material behaviour and manufacturing processes is presented. The work explores concepts such as longitudinal mechanobiology and multi-segment coupling as well as manufacturing strategies using autonomous materials and instrumentation. This prototype introduces for the first time columnar level behaviour and the ability to study time dependent adaptations. This model is important because it can support tissue maturation, evolving mechanical properties and adaptive behaviour and it represents an intermediate step between isolated skeletal tissue models and future organ-level spinal constructs.

Acidithiobacillus ferrooxidans, a chemolithoautotrophic iron- and sulfur-oxidizing acidophile, is a key contributor to industrial-scale copper metal bioleaching. These cells naturally produce magnetosomes, and they may serve as an emerging platform for magnetosome bioproduction, as magnetotactic bacteria (MTB) are difficult to cultivate and to genetically modify. Here we manipulated the expression of the endogenous homologs to the magA and mamB genes in A. ferrooxidans, which are implicated in iron transport required for magnetosome synthesis. Modulation of mamB had no impact on cell behavior. Overexpression of magA increased magnetosome formation and magnetic responsiveness and theses effects were attenuated by CRISPRi knockdown of magA. The augmented magnetosome formation in the magA overexpression cells also led to enhanced bioleaching of pyrite, which is weakly paramagnetic, and this could be further enhanced by addition of an external magnetic field. These results confirm that magA plays a critical role in magnetosome formation in A. ferrooxidans and that magnetosome expression can be enhanced through genetic engineering. In addition, these results demonstrate the potential to improve metal sulfide bioleaching through the manipulation of genes involved in magnetosome formation. TOC Graphic O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=143 SRC="FIGDIR/small/727969v1_ufig1.gif" ALT="Figure 1"> View larger version (21K): org.highwire.dtl.DTLVardef@593bd9org.highwire.dtl.DTLVardef@685e35org.highwire.dtl.DTLVardef@10a9corg.highwire.dtl.DTLVardef@5f89d1_HPS_FORMAT_FIGEXP M_FIG C_FIG

Plasmids are widely used for gene expression, yet their coding potential beyond the intended coding sequence (CDS) is often poorly characterized. Here, we explored putative "hidden open reading frames" (hidden ORFs) embedded within non-canonical reading frames of plasmid sequences through a computational workflow for their identification. Using enhanced green fluorescent protein (eGFP) as a target gene, we observed unexpectedly uninterrupted ORFs in both the +2 coding frame and the reverse frame. Immunoblotting detected stable expression of the +2 frame-derived protein, but not the reverse-frame ORF. Motivated by these observations, we developed a computational pipeline and analyzed 6,308 eGFP-containing plasmids, identifying putative hidden ORFs in approximately 21% of constructs. Approximately 25% of hidden ORFs occurred in the +2 frame, with the remainder occurring in the reverse frame. The same analytical pipeline, if utilized for plasmids beyond eGFP plasmids, can contribute to avoiding unintended outcomes, in applications such as gene replacement therapy.

BackgroundThe use of autologous or allogeneic cell therapies has now entered to the clinical practice in several fields of medicine, especially in oncology and hematology. From this regard, 2D-cell manufacturing is complex and costly and bioreactors have attracted major interest for efficient and cost-effective mass production of cells. Bioreactors have several advantages such as homogeneous repartition of nutrients and gas, control of all culture parameters and increased yield. However, the important shear stress generated by those bioreactors is an important disadvantage as it can affect cell survival or cell quality. This important shear stress is the result of the mixing method using either blades (used in stirred-tanked bioreactors) or gas bubbles (used in airlift bioreactors). Another downside of the use of bioreactors is the difficulty to scale-up. As the volume increases, the shear stress generated by blades radically increases leading to cell death and a decrease of cell quality. DescriptionIn this study, we describe a bioreactor developed using a different mixing method effectively reducing the shear stress and facilitating scale-up. This bladeless method uses an inclination of the bioreactor as well as rotation to mix fluids in a container. Here we described different steps that led to the adaptation of this bioreactor, initially developed for fragile microalgae culture, for mammalian cell culture amplification. The bioreactor was tested to amplify a natural killer (NK) cell line NK92 which is an IL-2 dependent cell line used in clinical trials for cancer therapy. We have tested the influence of 1-The number of cells seeded; 2-The influence of the rotation speed on cell growth and viability; 3-The influence of the bioreactor angle on the above parameters; 4-The duration of the culture. ResultsCells were initially seeded at 2.5.105 / ml in a volume of 380 ml. According to the rotation speed of 15, 30, 45 and 60 rpm, we have observed an increase of cell numbers at day 3 (3-fold), day 5 (7-fold) and day 7 (10-fold) compared to seeding, the best expansion being obtained at day 7 with a rotation speed of 45 rpm. The optimal angle of rotation was found to be 3 degree, with an optimal amplification at day 7 versus day 3 (p < 0.01). The viability was also found to be optimal in the latter condition. ConclusionsThese preliminary results demonstrate that NK92 cells could be amplified using this bioreactor. In the best tested condition, neither cell viability nor cell growth was impacted. These results strongly suggest the potential use of this device in future clinically applicable conditions.

At neutral pH, Clostridial fermentative catabolism is typically acidogenic, with a product profile dominated by acetate and butyrate. H2 acts as a terminal electron acceptor via hydrogenases, which increases ATP-producing potential from glucose. Acetate production is characterised by both higher ATP and H2 yields, rendering it desirable but more thermodynamically limited. For this reason, is commonly understood that Clostridia can adjust the ratio of acetate to butyrate (Ace:But) produced to maximise ATP while maintaining sufficient pathway driving forces to sustain a high flux. We identify three redox-balanced product profiles that underlie the spectrum of Clostridial catabolic Ace:But ratios: Homoacetic (Ace:But = 2:0), Equimolar (0.67:0.67), and Homobutyric (0:1). To reach Ace:But ratios intermediate to these, the elementary flux modes (EFMs) underlying the aforementioned product profiles must be blended. We performed a maximum-minimum driving force (MDF) analysis to test the thermodynamic favourability of the pathways underlying different Ace:But ratios at varying H2 partial pressures (pH2). We find that blended EFMs are less efficient than their constituent EFMs at all pH2, allocating excessive driving force (DF) to certain reactions, thereby lowering the DF of others. This is, in part, due to the co-occurrence of hydrogenases with different optimal redox carrier ratios. One hydrogenase inevitably has very high DF, which decreases the DF available for other reactions. This leads to a lower minimum DF and a higher enzyme cost for operating blended EFMs. This implies that certain discrete Ace:But ratios are most favourable for large ranges of pH2, contradicting the continuity assumption in literature.

Recombinant adeno-associated viruses (rAAVs) have gained increasing importance in gene therapy due to their safe and precise gene delivery. However, certain indications require substantially higher vector doses, pushing manufacturing capacity and cost of goods (COG) to its limits. In this study, we present for the first time a continuous twin-column capture process (CaptureSMB) enabling direct purification of rAAV5 from unprocessed perfusion harvest without prior concentration or processing. This approach differs fundamentally from conventional batch workflows which typically mandate clarification and concentration before affinity capture and offers a novel process integration in viral vector manufacturing. A single-column batch capture process was developed first and subsequently compared to continuous CaptureSMB configurations. Optimized CaptureSMB operation achieved consistent yields over four cycles, with recoveries exceeding batch operation (+ 14.3%) with concomitant higher productivity (+ 11.4%) and reduced buffer consumption (- 79.2%). Critical quality attribute analysis showed lower host cell protein levels and lower residual DNA in early CaptureSMB cycles, while full capsid ratios, thermal stability and transduction efficiency of rAAV5 particles remained unaltered across cycles and process modes. These findings highlight that continuous twin-column CaptureSMB directly from perfusion harvest can not only improve yield and manufacturing efficiency but also maintain and in some respects enhance product quality. This novel strategy provides a promising route to address manufacturing capacity and cost challenges in rAAV gene therapy production.

Background and AimsActive capsule endoscopy could advance gastrointestinal diagnostics by enabling controlled navigation beyond passive peristalsis. However, current systems are often limited by inefficient propulsion, high power demands, or reliance on external actuation. Herein, we designed, developed and evaluated a novel electromagnetic impact-actuated capsule endoscope incorporating a ferromagnetic rail-enhanced locomotion mechanism. MethodsThe capsule employed an internal electromagnetic actuator comprising a movable coil-armature assembly guided along a ferromagnetic rail and surrounded by permanent magnets. Controlled current pulses generated reciprocating motion and propulsion through momentum transfer. Bench-top testing using a deformable intestinal model assessed locomotion and power consumption. Ex-vivo experiments were subsequently performed in porcine intestine under dry and physiologically simulated wet conditions. Transit speed, power consumption, and system stability were recorded. ResultsBench-top testing demonstrated stable propulsion at speeds up to 8.5 mm/s with a mean power consumption of 84 mW. During ex-vivo evaluation, mean capsule velocities were 1.95 mm/s and 7.2 mm/s under dry and wet conditions, respectively. Average power consumption was 96 mW and 193 mW. The actuator maintained reliable locomotion while preserving a compact system volume of [~]6.19 cm3. Lubricated conditions, representative of the intestinal environment, resulted in enhanced propulsion efficiency despite a concomitant increase in instantaneous power consumption. ConclusionThe electromagnetic impact-actuated capsule demonstrated reliable locomotion in biologically relevant ex-vivo environments while maintaining compact dimensions and moderate power requirements. Ferromagnetic rail-enhanced flux concentration offers a promising propulsion strategy for future actively navigated and therapeutic capsule endoscopy platforms.

As the United Kingdom (UK) targets net-zero emissions by 2050, anaerobic digestion (AD) has become a cornerstone of renewable energy infrastructure. However, mathematical models, such as the Anaerobic Digestion Model No. 1 (ADM1), often struggle with high-solids agricultural feedstocks because they rely on Chemical Oxygen Demand (COD), a metric that introduces significant experimental error. To overcome this, this study applies an established mass-based ADM1 framework tailored for the co-digestion of maize silage and cow manure sourced from a UK AD site. This study uses a parallel reactor framework, using two identical laboratory-scale reactors to physically replicate the dynamic conditions of the full-scale site. A Global Sensitivity Analysis was first conducted, identifying biomass decay and carbohydrate breakdown rates as the most influential factors affecting system stability and model accuracy. The model was calibrated using data from the first reactor and then tested against an independent second reactor subjected to significant organic loading stress. Results show high predictive capabilities, with the model achieving a R2 of 0.81 for biogas production during calibration. The model maintained high predictive accuracy during the validation test of the second physical twin, achieving an R2 of 0.85, proving that the framework is robust and not overfitted to a single dataset. While predicting rapid fluctuations in pH and alkalinity remains challenging, the mass-based approach effectively forecasts gas yields and process stability. This methodology provides a reliable foundation for robust process modelling, offering a scalable tool for the UK biogas sector to optimise AD. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=93 SRC="FIGDIR/small/721061v1_ufig1.gif" ALT="Figure 1"> View larger version (32K): org.highwire.dtl.DTLVardef@92c7e2org.highwire.dtl.DTLVardef@80d723org.highwire.dtl.DTLVardef@ac3d24org.highwire.dtl.DTLVardef@1e21a51_HPS_FORMAT_FIGEXP M_FIG C_FIG

Carbon monoxide (CO) poisoning is responsible for around 50,000 emergency department visits per year in the U.S. alone. With the present standard of care, persistent neurological sequelae occur in [~]30-40% of severe CO poisoning cases. Currently, there is no available targeted molecular antidote for CO poisoning. In previous work, we have developed an antidotal therapy for CO poisoning based on an engineered hemeprotein, human neuroglobin (Ngb-H64Q-CCC). Intravenous infusion of Ngb-H64Q-CCC removes CO from the circulating red blood cells and improves survival in a lethal CO-poisoning mouse model. However, the infusion of heme-containing proteins has inherent heme toxicity risks that may limit the dose that can be used safely without liver or kidney toxicity. In order to overcome these problems, we have investigated the development of immobilized Ngb in a solid matrix. This approach allows for the development of a CO removal system using an extracorporeal blood circulating system coupled with a stationary matrix with immobilized Ngb-H64Q-CCC. Such system avoids drug infusion and possible organ injury, allows for antidote recycling, and provides advantages for storage and handling of the antidote. By assessing the efficacy of Ngb-H64Q-CCC immobilized through different linkage strategies, we have identified N-hydroxysuccinimide agarose resin as a viable stationary phase. The immobilized protein shows preserved heme redox activity, can be chemically reduced/oxidized for activation/CO release purposes, and retains its CO removal capacity after successive regeneration cycles. We expect that this novel approach will advance the development of new scavenger-based therapies for CO poisoning.

The optimization and control of bioprocesses require robust in silico models that can accurately capture the complex and dynamic behavior of living cells. While hybrid models that combine machine learning with mechanistic equations have emerged as a powerful tools, they often require relatively large datasets and might yield inconsistent predictions that violate the stoichiometry of metabolism. In this study, we introduce FBA-Hyb, a multi-scale hybrid modeling framework that tightly integrates genome-scale metabolic networks via flux balance analysis (FBA) into its architecture. In our FBA-Hyb framework, artificial neural networks predict key FBA inputs (substrate uptake rates and cellular objectives) while a surrogate FBA module translates them into the metabolic fluxes that govern the bioprocess. A key novelty is that the FBA optimization step is replaced by a surrogate generated with symbolic regression, which encapsulates the FBA model into a compact analytical expression. This allows easy backpropagation through the integration of the neural controlled differential equationbased FBA-Hyb bioprocess model. We validated FBA-Hyb against a standard hybrid model (Std-Hyb) using two Escherichia coli fedbatch case studies. In the first study, FBA-Hyb achieved a 42 % average improvement in predictive accuracy (R2) during a leave-one-process-out cross validation. Crucially, FBA-Hyb maintains strict stoichiometric feasibility even during extrapolation. Meanwhile, an alternative approach based on standard architectures leads to stoichiometrically inconsistent solutions in 22 % of the cases analyzed. In the second case study, we demonstrate how FBA-Hyb effectively simulates unmeasured chemical species and discovers a metabolic shift in sulfate-limited regimes during bioprocessing. By providing a modular, biologically consistent, and computationally efficient architecture, FBA-Hyb offers a robust foundation for the next generation of bioprocess models and sustainable process optimization. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=81 SRC="FIGDIR/small/720062v1_ufig1.gif" ALT="Figure 1"> View larger version (28K): org.highwire.dtl.DTLVardef@16f011eorg.highwire.dtl.DTLVardef@b25b5borg.highwire.dtl.DTLVardef@18bd178org.highwire.dtl.DTLVardef@65274e_HPS_FORMAT_FIGEXP M_FIG C_FIG HighlightsO_LIFBA-Hyb integrates flux balance analysis (FBA) into hybrid bioprocess models. C_LIO_LISymbolic regression discovers a simple closed-form FBA surrogate model. C_LIO_LIThe FBA surrogate ensures accurate reaction stoichiometry. C_LIO_LIA neural network predicting the FBA objective keeps the model flexible. C_LIO_LIFBA-Hyb has superior capabilities and accuracy compared to the current standard. C_LI

Research on targeted genetic therapies for myocardial diseases, such as cardiomyopathies, currently focuses on (r)AAVs as the delivery method. Despite substantial efforts and advances in animal trials, predicting biodistribution and transduction efficacy in human tissue remains challenging due to interspecies differences in tissue tropism and the difficulty of accurately assessing alternative delivery routes and vector differences. The application in humans has also proven challenging, in part due to severe adverse events associated with systemic administration of (r)AAVs. This necessitates implementing alternative trial designs and stringent evaluation methods that minimize harm or risk to patients. Applying a predesigned vector carrying a gene-editing tool to a normothermic machine-perfused living beating heart in an ex vivo setting could overcome conventional obstacles and limitations. This can serve as a basis for safe and effective gene-therapy testing and assist in evaluating effects at the molecular level. Boxed-Breathing-Heart is a translational trial assessing the feasibility of ex vivo gene editing and gene translation in normothermic machine-perfused human hearts. Human hearts explanted from cardiomyopathy patients undergoing heart transplantation are donated for research and immediately placed in an Organ Care System, where they are surgically connected. The viability of the heart is maintained through normothermic perfusion of system solutions and donor blood. A predesigned AAV containing a CRISPR-Cas system is infused into the circulation and dispersed throughout the tissue via coronary perfusion. The changes at the cellular and molecular levels are assessed continuously via frequent sequential myocardial biopsies. Furthermore, after the pre-planned 72-hour perfusion, the heart is sectioned and analyzed using spatial and single-cell omics. The aim is to provide a proof-of-concept for genetic therapeutic options delivered to the human heart via AAV in an ex vivo perfusion setup. In summary, Boxed-Breathing-Heart provides an ex vivo translational platform for evaluating targeted cardiac gene therapies, enabling molecular analysis directly in human hearts and accelerating clinical translation without posing risks to patients.

Accurate cell counting is essential in tissue engineering and cancer research. The ongoing transition towards advanced 3D in vitro tumour models raises a question about the validity of the standard cell counting protocols, particularly in the systems containing extracellular matrix-based scaffolds. Here, we provide a quantitative analysis of the performance of three popular plate reader-based cell counting/viability assays, such as the Alamar Blue, MTT, CellTiter Glo 3D assays, in 2D monolayer and 3D scaffold-based cultures of U251 human glioblastoma cells, including cell-laden Matrigel plugs, and original tissue engineering constructs based on the decellularised sheep brain scaffolds. We quantitatively characterized the assays linearity, precision, biological and technical reproducibility, proportionality, and inter-assay agreement. The study revealed that assays performance is highly platform-dependent, with 2D cultures allowing significantly more precise and reliable measurements than in 3D ECM scaffold-based cultures. The numerical results provided in this study can help researchers make informed decisions when working with 3D scaffold-based in vitro tumour models and for other tissue engineering purposes where precise cell counting is essential. ToC O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=184 SRC="FIGDIR/small/720021v1_ufig1.gif" ALT="Figure 1"> View larger version (39K): org.highwire.dtl.DTLVardef@16018d9org.highwire.dtl.DTLVardef@1ff7d6dorg.highwire.dtl.DTLVardef@838021org.highwire.dtl.DTLVardef@1510d5b_HPS_FORMAT_FIGEXP M_FIG C_FIG

Glioblastoma (GBM) is a highly aggressive brain tumor with a five-year survival rate of less than 5%. The current standard of care established 20 years ago includes maximal surgical resection and administration of alkylating agent temozolomide (TMZ). GBM is highly invasive, and GBM cells that evade surgical resection can become resistant to TMZ and develop new aggressive secondary tumors. Post-relapse there are few treatment options available to patients. Tissue engineering approaches suggest the opportunity to develop in vitro models of the GBM tumor microenvironment that may accelerate the discovery of novel therapies for GBM. Here, we report the adaptation of hydrogel microdroplets (microgels) to encapsulate GBM cells in a tailorable 3D matrix to assess patterns of growth and to screen TMZ drug response using patient-derived xenograft (PDX) specimens. We exploit a unique aspect of the microgel system to account for the cellular heterogeneity within the tumor microenvironment (TME). We combine cell-laden microgels generated from TMZ-resistant and TMZ responsive variants of the same PDX specimens to create heterogeneous populations with varying levels of drug sensitivity. We demonstrate a range of drug resistance phenotypes as a function of the ratio of TMZ-responsive to resistance cells and identify the population required for TMZ-resistance to overtake take the response. We then investigate the influence of tumor mimetic shifts in hyaluronic acid bioavailability and hypoxia on patterns of TMZ resistance. We show exposure to matrix-bound hyaluronan increases TMZ resistance and the glioma stem cell population in both cell variants. Lastly, we report an increase in TMZ sensitivity but divergent changes in the GSC subfraction for TMZ resistant vs responsive GBM in the presence of hypoxia. Together, we demonstrate the versatility of cell-laden microgel approach to replicate heterogenous tumor populations, model shifts in the tumor microenvironment, and rapidly screen therapeutic response.