**Bioactive Peptides from Algae: Traditional and Novel Generation Strategies, Structure-Function Relationships, and Bioinformatics as Predictive Tools for Bioactivity**

**Jack O'Connor 1,2, Marco Garcia-Vaquero 3,\*, Steve Meaney 1 and Brijesh Kumar Tiwari 2**

> 1 School of Biological & Health Sciences, Technological University Dublin, Dublin 2, Ireland<EMAIL_ADDRESS>(J.O<EMAIL_ADDRESS>(S.M.)

**Abstract:** Over the last decade, algae have been explored as alternative and sustainable protein sources for a balanced diet and more recently, as a potential source of algal-derived bioactive peptides with potential health benefits. This review will focus on the emerging processes for the generation and isolation of bioactive peptides or cryptides from algae, including: (1) pre-treatments of algae for the extraction of protein by physical and biochemical methods; and (2) methods for the generation of bioactive including enzymatic hydrolysis and other emerging methods. To date, the main biological properties of the peptides identified from algae, including anti-hypertensive, antioxidant and antiproliferative/cytotoxic effects (for this review, anti-proliferative/cytotoxic will be referred to by the term anti-cancer), assayed in vitro and/or in vivo, will also be summarized emphasizing the structure–function relationship and mechanism of action of these peptides. Moreover, the use of in silico methods, such as quantitative structural activity relationships (QSAR) and molecular docking for the identification of specific peptides of bioactive interest from hydrolysates will be described in detail together with the main challenges and opportunities to exploit algae as a source of bioactive peptides.

**Keywords:** in silico; biotechnology; cryptides; anti-hypertensive; antioxidant; anti-cancer


*2.2. Major Anthocyanin Compounds in P. limprichtii*

UPLC analysis revealed that four anthocyanins and derivatives were detected in both the pigmented and white flower petals: Cyanidin 3-O-glucosyl-malonylglucoside, cyanidin 3-O-malonylhexoside, cyanidin, and delphinidin (Table 3). The cyanidin accumulation and delphinidin accumulation branches of the ABP in *P. limprichtii* indicate that anthocyanins and their derivatives are the main flower color pigments.


**4. Advantages**

#### **4.1. DALK**

The advantages of performing DALK corneal transplants are [1] as follows:

**4.2. DSAEK/DMEK**

• less transurgical risks

**5. Surgical technique**

which will be described here.

**5.1. DALK**

• small incision

• lower immunologic rejection rate

on the right the same eye 12 months later.

• less sutures or absence of them

• less complications related to ocular surface

• preservation of the anatomic integrity of the cornea

• preservation of the corneal innervation

The advantages of performing endothelial transplants are [8] as follows:

**Figure 2.** Clinical photographs of an endothelial transplant. On the left a photograph taken at the end of the surgery and

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101

• visual acuity recovery is faster, more stable and more predictable (**Figure 2**)

Nowadays, due to its elevated success rate, the authors use the pachy-bubble technique,

The technique begins with a partial trepanation of 80% of the corneal thickness and an average diameter of 8 mm. Afterward, an ultrasound pachymeter is utilized to measure the corneal thickness in MXII, at a distance of 3 mm from the visual axis. The diamond scalpel is

**Figure 1.** Wound dehiscence in a patient with DALK surgery. The patient received an ocular trauma 1 month postsurgery and eight stitches broke, yet the Descemet remained intact without aqueous humor leakage.

Intraoperative OCT in Lamellar Corneal Transplants (DALK, DSAEK, DMEK) http://dx.doi.org/10.5772/intechopen.79322 101

**Figure 2.** Clinical photographs of an endothelial transplant. On the left a photograph taken at the end of the surgery and on the right the same eye 12 months later.

#### **4.2. DSAEK/DMEK**

• postsurgical bullous keratopathy

• traumatic endothelial dysfunction • iridocorneal endothelial syndrome

• no immunologic endothelial rejection

• higher resistance to traumatic injuries (**Figure 1**)

• extra-ocular procedure

• higher transurgical safety

• endothelium preservation

• better refractive stability

• less postsurgical use of steroids

• corneal transplant rejection

• posterior polymorphous corneal dystrophy

The advantages of performing DALK corneal transplants are [1] as follows:

**Figure 1.** Wound dehiscence in a patient with DALK surgery. The patient received an ocular trauma 1 month postsurgery

and eight stitches broke, yet the Descemet remained intact without aqueous humor leakage.

• Fuchs dystrophy

100 OCT - Applications in Ophthalmology

**4. Advantages**

**4.1. DALK**

The advantages of performing endothelial transplants are [8] as follows:

### **5. Surgical technique**

#### **5.1. DALK**

Nowadays, due to its elevated success rate, the authors use the pachy-bubble technique, which will be described here.

The technique begins with a partial trepanation of 80% of the corneal thickness and an average diameter of 8 mm. Afterward, an ultrasound pachymeter is utilized to measure the corneal thickness in MXII, at a distance of 3 mm from the visual axis. The diamond scalpel is calibrated for 90% of the pachymetric measurement and a 4-mm incision is performed in this area. Air is injected into the anterior chamber, which will help verify the formation of the big bubble. A specially designed cannula is inserted and moved through the pre-Descemet plane until the visual axis is reached. It is in this zone were air will be injected. Afterward, the stroma is perforated to reach the stroma-Descemet interphase, which is now full of air (**Figure 3**). The stroma is removed and the donor cornea (with no endothelium) is sutured with nylon 10–0.

• detritus, hemorrhage, vascularization, microbial infections and epithelial growth in the

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There are many variations to the original endothelial transplant DSAEK technique. The one

The donor cornea is prepared using a Moria microkeratome adapted to an artificial anterior chamber. The ideal thickness is between 90 and 120 μm. Afterward, the donor cornea is trep-

Once the donor tissue is obtained, surgery begins by inserting an anterior chamber maintainer. Trypan blue solution is inserted to the anterior chamber for better visualization of the Descemet membrane. A circular descemetorhexis is performed with a diameter of 8.25 mm. A 2-mm incision is done on the temporal limbus and a 4-mm incision on the nasal limbus. An iridotomy is performed on the meridian at six o´clock and the donor tissue is inserted through the nasal incision using a Busin glide or any other type of injector designed for this purpose. The temporal incision is used for the instrument used to help during the insertion of the donor tissue. Finally, the anterior chamber is filled with air for adequate fixation of the graft.

The most reported complication in endothelial transplants is the lack of adherence of the donor tissue to the recipient's stroma. The key to reducing the dislocation is a meticulous reconstruction of the wound (so that there is no leakage of aqueous humor) and complete removal of fluid from the interphase. Whenever a graft is dislocated, it can be accommodated once again with air injections; nevertheless, this may cause damage to the endothelial cells.

To obtain the donor tissue, the Blister technique is used, a technique developed by Eric Abdullayev (Manager of Clinical Development and Innovations at Lions Eye Institute for

• pupillary block glaucoma secondary to injected air in anterior chamber

• recurrence of the stromal corneal dystrophy

• Difficulty in re-epithelization

used by the authors is described here.

anated with an average diameter of 8.25 mm.

• lack of adherence of the donor tissue • foldings or tears in the donated tissue

• inverted positioning of the tissue

• pneumatic pupillary block

**5.3. DMEK**

The DSAEK procedure has some complications including:

• endothelial dysfunction secondary to surgical trauma

The DMEK technique used by the authors is described below.

interphase

**5.2. DSAEK**

It is important to mention that to achieve an adequate Descemet detachment, the air injection should be very deep, unfortunately leading to an increased perforation risk [2]. This step continues to be the most challenging part of the surgery.

If the injection of air is too superficial or if it remains in the medium stroma, it will usually disseminate laterally without detaching the Descemet and will give the cornea a diffuse-white appearance. When this happens, the surgeon must try to inject the air deeper or change to a manual dissection (layer by layer) technique, which frequently leads to perforation. This technique is a challenge in advanced keratoconus with a severe corneal thinning or scarring and has a reserved success rate when there are dense corneal opacities due to the bad depth visibility [6].

Some of the disadvantages of this type of transplant are its steep learning curve and its longer surgical time compared to a PK [1]. In many countries, including Mexico, this technique does not have a widespread use secondary to its difficulty and longer time requirements. Nowadays, even a skilled surgeon performs with a risk of perforation between 10 and 30% [10].

The DALK procedure has some complications including [1]:

**Figure 3.** Perforation of the corneal stroma in a DALK corneal transplant.

#### **5.2. DSAEK**

calibrated for 90% of the pachymetric measurement and a 4-mm incision is performed in this area. Air is injected into the anterior chamber, which will help verify the formation of the big bubble. A specially designed cannula is inserted and moved through the pre-Descemet plane until the visual axis is reached. It is in this zone were air will be injected. Afterward, the stroma is perforated to reach the stroma-Descemet interphase, which is now full of air (**Figure 3**). The stroma is removed and the donor cornea (with no endothelium) is sutured

It is important to mention that to achieve an adequate Descemet detachment, the air injection should be very deep, unfortunately leading to an increased perforation risk [2]. This step

If the injection of air is too superficial or if it remains in the medium stroma, it will usually disseminate laterally without detaching the Descemet and will give the cornea a diffuse-white appearance. When this happens, the surgeon must try to inject the air deeper or change to a manual dissection (layer by layer) technique, which frequently leads to perforation. This technique is a challenge in advanced keratoconus with a severe corneal thinning or scarring and has a reserved success rate when there are dense corneal opacities due to the bad depth

Some of the disadvantages of this type of transplant are its steep learning curve and its longer surgical time compared to a PK [1]. In many countries, including Mexico, this technique does not have a widespread use secondary to its difficulty and longer time requirements. Nowadays,

even a skilled surgeon performs with a risk of perforation between 10 and 30% [10].

continues to be the most challenging part of the surgery.

The DALK procedure has some complications including [1]:

**Figure 3.** Perforation of the corneal stroma in a DALK corneal transplant.

with nylon 10–0.

102 OCT - Applications in Ophthalmology

visibility [6].

• Descemet membrane rupture

• loss of endothelial cells secondary to air/gas

• interphase opacities or irregularities

• double anterior chamber

There are many variations to the original endothelial transplant DSAEK technique. The one used by the authors is described here.

The donor cornea is prepared using a Moria microkeratome adapted to an artificial anterior chamber. The ideal thickness is between 90 and 120 μm. Afterward, the donor cornea is trepanated with an average diameter of 8.25 mm.

Once the donor tissue is obtained, surgery begins by inserting an anterior chamber maintainer. Trypan blue solution is inserted to the anterior chamber for better visualization of the Descemet membrane. A circular descemetorhexis is performed with a diameter of 8.25 mm. A 2-mm incision is done on the temporal limbus and a 4-mm incision on the nasal limbus. An iridotomy is performed on the meridian at six o´clock and the donor tissue is inserted through the nasal incision using a Busin glide or any other type of injector designed for this purpose. The temporal incision is used for the instrument used to help during the insertion of the donor tissue. Finally, the anterior chamber is filled with air for adequate fixation of the graft.

The DSAEK procedure has some complications including:

The most reported complication in endothelial transplants is the lack of adherence of the donor tissue to the recipient's stroma. The key to reducing the dislocation is a meticulous reconstruction of the wound (so that there is no leakage of aqueous humor) and complete removal of fluid from the interphase. Whenever a graft is dislocated, it can be accommodated once again with air injections; nevertheless, this may cause damage to the endothelial cells.

#### **5.3. DMEK**

The DMEK technique used by the authors is described below.

To obtain the donor tissue, the Blister technique is used, a technique developed by Eric Abdullayev (Manager of Clinical Development and Innovations at Lions Eye Institute for

830 and 1325 nm. OCT has revolutionized clinical ophthalmology, and its development continues providing opportunities for a better diagnosis and even management of eye diseases. Originally introduced in the 1990´s at the Massachusetts Institute of Technology in 1991 as a technique for noninvasive transverse imaging of biological systems, the image of the retina was the first application of this technology [11]. OCT devices have undergone modifications in their original technique to see and measure anterior segment structures such as the cornea, iris, and the lens [12]. In 1994, Izatt described the use of OCT for the anterior segment with a resolution close to histological level [13]. Since then, it has been used for the diagnosis and

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**Figure 5.** OPMI LUMERA & RESCAN 700 microscope, where OCT images can be observed in real time.

**Figure 6.** OPMI LUMERA & RESCAN 700 microscope, OCT images can be appreciated for all members of the surgical

team.

**Figure 4.** Blister technique for the isolation of corneal Descemet-endothelium prior to a DMEK surgery.

Transplant and Research, Tampa, Florida, USA). In this technique, balanced saline solution is injected to achieve separation of the Descemet membrane (**Figure 4**). Currently, it is possible to get the tissue prepared and preloaded by the staff of some eye banks, which facilitates the procedure and eliminates the risks of tissue preparation in the operating room.

Once the donor tissue is obtained, surgery is performed on the recipient, initiating with the introduction of trypan blue to improve Descemet visualization, then the circular descemetorhexis of an average of 8.25 mm is performed. The Descemet can be extracted using the irrigation-aspiration piece of the phacoemulsification equipment, through a previously performed 3 mm incision. An iridectomy is performed in MVI, and the donor tissue is introduced and unfolded with delicate hydraulic and pressure-counter-pressure maneuvers, finally introducing the air/gas in the anterior chamber once the correct unfolding of the graft has been ensured. The eye must be completely sealed with or without sutures.

The DMEK procedure has some complications including:

Currently, the number of surgeons performing DMEK is on the rise because of its better visual acuity results when compared to DSAEK.


*Article* **Association between Cardiovascular Health and Incident Atrial Fibrillation in the General Japanese Population Aged** *≥***40 Years**

**Tetsuo Nishikawa 1,†, Yoshihiro Tanaka 2,3,†, Hayato Tada 1,\*, Toyonobu Tsuda 1, Takeshi Kato 1, Soichiro Usui 1, Kenji Sakata 1, Kenshi Hayashi 1, Masa-aki Kawashiri 1, Atsushi Hashiba 4 and Masayuki Takamura 1**

**Abstract:** This study explores the association between lifestyle behavior and incident atrial fibrillation (AF) in the general Japanese population. Japanese residents aged ≥40 years undergoing a national health checkup in Kanazawa City were included. We hypothesized that better lifestyle behavior is associated with lower incidence of AF. Lifestyle behavior was evaluated by the total cardiovascular health (CVH) score (0 = poor to 14 = ideal), calculated as the sum of the individual scores on seven modifiable risk factors: smoking status, physical activity, obesity, patterns of eating schedule, blood pressure, total cholesterol, and blood glucose. The association between CVH and incident AF was assessed, adjusting for other factors. A total of 37,523 participants (mean age 72.3 ± 9.6 years, 36.8% men, and mean total CVH score 9 ± 1) were analyzed. During the median follow-up period of 5 years, 703 cases of incident AF were observed. Using a low CVH score as a reference, the upper group (ideal CVH group) had a significantly lower risk of incident AF (hazard ratio [HR] = 0.79, 95% confidence interval 0.65–0.96, *p* = 0.02), especially among those aged <75 years (HR = 0.68, 95% confidence interval 0.49–0.94, *p* = 0.02). Thus, ideal CVH is independently associated with a lower risk for incident AF, particularly in younger Japanese individuals (<75 years).

**Keywords:** cardiovascular health; atrial fibrillation; Japanese


**Author details**

Lethiwe Nzama1 \*, Thanda Sithole2 and Sezer Bozkus Kahyaoglu3,4,5

1 University of Johannesburg, College of Business and Economics School of Accounting, Department of Commercial Accounting, Rossmore, Johannesburg, South Africa

2 Senior Economist, Johannesburg, South Africa

3 Izmir Bakircay University, Izmir, Turkiye

4 University of Johannesburg, Johannesburg, South Africa

5 Manas University, Bishkek, Kyrgyz Republic

\*Address all correspondence to<EMAIL_ADDRESS>
© 2022 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

*Asymmetric TVP-VAR Connectedness Approach: The Case of South Africa DOI: http://dx.doi.org/10.5772/intechopen.107248*


*Article* **Simulating the E**ff**ect of Torrefaction on the Heating Value of Barley Straw**

### **Dimitrios K. Sidiras \*, Antonios G. Nazos, Georgios E. Giakoumakis and Dorothea V. Politi**

Laboratory of Simulation of Industrial Processes, Department of Industrial Management and Technology, School of Maritime and Industrial Studies, University of Piraeus, 80 Karaoli & Dimitriou, GR 18534 Piraeus, Greece<EMAIL_ADDRESS>(A.G.N<EMAIL_ADDRESS>(G.E.G<EMAIL_ADDRESS>(D.V.P.) **\*** Correspondence<EMAIL_ADDRESS>Tel.: +30-210-4142360

Received: 29 December 2019; Accepted: 5 February 2020; Published: 7 February 2020

**Abstract:** Many recent studies focused on the research of thermal treated biomass in order to replace fossil fuels. These studies improved the knowledge about pretreated lignocellulosics contribution to achieve the goal of renewable energy sources, reducing CO2 emissions and limiting climate change. They participate in renewable energy production so that sustainable consumption and production patterns can by ensured by meeting Goals 7 and 12 of the 2030 Agenda for Sustainable Development. To this end, the subject of the present study relates to the enhancement of the thermal energy content of barley straw through torrefaction. At the same time, the impact of the torrefaction process parameters, i.e., time and temperature, was investigated and kinetic models were applied in order to fit the experimental data using the severity factor, *R*0, which combines the effect of the temperature and the time of the torrefaction process into a single reaction ordinate. According to the results presented herein, the maximum heating value was achieved at the most severe torrefaction conditions. Consequently, torrefied barley straw could be an alternative renewable energy source as a coal substitute or an activated carbon low cost substitute (with/without activation treatment) within the biorefinery and the circular economy concept.

**Keywords:** barley straw; torrefaction; higher heating value; severity factor; sustainable development; enhancement factor; energy yield


**ORBITAL INTEGRALS ON REDUCTIVE LIE GROUPS AND THEIR ALGEBRAS**

by **Francisco Bulnes**

### **Orbital Integrals on Reductive Lie Groups and Their Algebras**

http://dx.doi.org/10.5772/55875 Edited by Francisco Bulnes

### **© The Editor(s) and the Author(s) 2013**

The moral rights of the and the author(s) have been asserted.

All rights to the book as a whole are reserved by INTECH. The book as a whole (compilation) cannot be reproduced, distributed or used for commercial or non-commercial purposes without INTECH's written permission. Enquiries concerning the use of the book should be directed to INTECH rights and permissions department (permissions@intechopen.com).

Violations are liable to prosecution under the governing Copyright Law.

Individual chapters of this publication are distributed under the terms of the Creative Commons Attribution 3.0 Unported License which permits commercial use, distribution and reproduction of the individual chapters, provided the original author(s) and source publication are appropriately acknowledged. If so indicated, certain images may not be included under the Creative Commons license. In such cases users will need to obtain permission from the license holder to reproduce the material. More details and guidelines concerning content reuse and adaptation can be foundat http://www.intechopen.com/copyright-policy.html.

### **Notice**

Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book.

First published in Croatia, 2013 by INTECH d.o.o. eBook (PDF) Published by IN TECH d.o.o. Place and year of publication of eBook (PDF): Rijeka, 2019. IntechOpen is the global imprint of IN TECH d.o.o. Printed in Croatia

Legal deposit, Croatia: National and University Library in Zagreb

Additional hard and PDF copies can be obtained from<EMAIL_ADDRESS>
Orbital Integrals on Reductive Lie Groups and Their Algebras Edited by Francisco Bulnes p. cm. ISBN 978-953-51-1007-1 eBook (PDF) ISBN 978-953-51-5029-9


3.5.1. PV Potential on Roofs

The Pomerania Voivodeship has average/good conditions for the development of solar energy. At the end of 2020, there were already 89 photovoltaic (PV) farms in the region, with a total capacity of 59.2 MW [78]. There are also thousands of prosumer installations and thousands of solar collectors.

It was assumed that 10% of roofs in the Pomerania Voivodeship will be covered by PV. The value of electricity that can be obtained from the PV panels can be obtained from the following formula [55]:

$$\mathbf{E}\_{\mathbf{f}} = \mathbf{0}.1 \cdot \mathbf{0}.15 \cdot \mathbf{P}\_{\mathbf{d}} \cdot \mathbf{U} \cdot \mathbf{N},\tag{14}$$

where: Er—electricity that can be obtained annually from PV on roofs (J/year), Pd—roof area (62.3 km2) (m2), U—insolation (h/year), converted to (s/year), N—insolation (W/m2). Thereceivedannualamountofenergy is 0.231TWh(833TJ).


**13.10.** *Musanga* **c***ecropioides* **R. Br. Ex Tedlie**

This plant is widely found in the tropical rainforest, particularly in West Africa. In Nigeria, the boiled leaves are used by the Igbo tribe as a powerful oxytocic to induce or augment labor while others use the decoction as a remedy for hypertension [92]. Parts of the plant have been used by traditional healers in the treatment of an array of diseases including lumbago, rheumatism, leprosy, chest infections and trypanosomiasis [92].

#### *13.10.1. Animal toxicity*

observed. Gastro-intestinal effects were not observed in either male or female mice used in the experiments. The median acute toxicity value (LD50) of the extract was above 20.0 g/kg body weight [86]. There was no significant change observed in the protein levels of the rats treated with lower doses of the extract (50 and 100 mg/kg) compared with control, while an observed significant decrease in the protein levels of the rats treated with a high dose (500 mg/kg) may be a sign of impaired renal function. Also, there was a significant increase (*p* < 0.05) in the plasma creatinine levels of all the treated groups [86]. There was no significant increase in AST and alanine aminotransferase (ALT) in the animals treated with lower doses of the extract compared with control but a significant increase in ALT was observed in the group treated with a high dose of the extract (500 mg/kg). This implies that the extract at the doses used had no effects on the heart tissue but at a high dose could have some deleterious effects on the liver tissue. The extract did neither improve nor produced any deleterious effects on

The popular herbal tea, rooibos, also known as the 'long-life tea' in South Africa [86], is produced from the plant *A. linearis*. It is endemic to the South Africa [87]. Rooibos tea is known to have several health benefits, including antispasmodic, antioxidant, antiaging and antieczema

Rooibos is exported to the East and Europe [88] and is currently sold in several countries including The Netherlands, Japan, the United Kingdom, Germany and the United States of America. The tea is mainly patronized due to its health-promoting properties when compared to black tea (*Camellia sinensis*) [89]. Rooibos is used as a beverage by the Khoi-descended people of the Cape; pregnant women take it for the iron content, and to relieve nausea and heartburns associated with pregnancy. It also serves as a milk substitute for infants and as colic relief in babies. Rooibos is well known for its antioxidant activity which also relates to its hepatoprotective properties [87] and immune-modulating effect in stimulating antibody

The safety assessment of rooibos has been addressed by some studies [87, 89]. Although some compounds in rooibos have been shown to contain mutagenic properties [91], it is, however, very unlikely that the mutagenic effect of rooibos would be relevant to tea drinkers when considering the quantities consumed [87]. In a study in rats, chronic consumption of aqueous extracts of unfermented and fermented rooibos over a period of 10 weeks did not cause any

This plant is widely found in the tropical rainforest, particularly in West Africa. In Nigeria, the boiled leaves are used by the Igbo tribe as a powerful oxytocic to induce or augment labor while others use the decoction as a remedy for hypertension [92]. Parts of the plant have been

the hematological parameters [86].

activities [87].

78 Herbal Medicine

production [90].

*13.9.1. Animal toxicity*

**13.9.** *Aspalathus linearis* **(Burm. F.) Dahlg**

adverse effects in the liver and kidney [87].

**13.10.** *Musanga* **c***ecropioides* **R. Br. Ex Tedlie**

Acute toxicity study of *M. cecropioides* aqueous stem bark extract showed no mortality in rats, at a limit dose of 3000 mg/kg body weight given orally. This is an indication that the extract has low acute toxicity when orally administered. Administration of the aqueous extract for 28 days in a chronic study did not affect most of the biochemical parameters except for creatinine which was significantly elevated. Hematological parameters were not significantly affected during the 28-day treatment. Liver enzymes, AST and ALT, were not affected in the treatment showing that the extract is non-toxic on the hepatocytes. The study concluded that the absence of clinical signs of acute toxicities in human when the extract was orally administered as an antihypertensive may reflect the oral route of administration, low dose administration as well as short duration of exposure when used as an antihypertensive agent [93].


3.2.2. Softness Properties

Softness is also a characteristic that is highly appreciated by consumers, resulting in the combination of structure flexibility, bulk and surface softness. Softness properties of the different formulations are shown in Figure 6b. The HF (handfeel) values decreased with the additives loaded in the paper 3D matrix. The increase in fiber flexibility, fine elements and, consequently, the number of inter-fiber bonds promoted a more closed and compact 3D matrix with less bulk, resulting in a structure with less softness. The addition of CBA in formulation 2 promoted a decrease in softness HF by 4% compared with formulation 1. The addition of CMF (formulation 3) showed a tissue structure with lower softness compared with formulation 1 with a decrease of 8%. The combination of these versatile additives (formulation 4) also promoted a decrease of 14% in the softness HF of the tissue structure compared with formulation 1. The reduction of the reinforcement fibers in the formulations increased softness properties by 2% compared with formulations 1 and 5. As with bulk properties, the same trend was also observed for softness properties. Formulations 6, 7 and 8 promoted a reduction in softness by 3%, 4% and 6%, respectively, compared with formulation 5. Regarding Figure 8, the softness HF values decreased by 0.2%, 2% and 4% with the incorporation of CBA, CMF and the combination of both, respectively. The production of structures with a low content of SW fibers and versatile additives promoted a small reduction in softness, improving strength properties, as reported below, contributing to the formation of a fibrous structure with less stiffness [37].

Softness TS7 is inversely related to softness HF values; therefore, it is influenced by the presence of fibers in the structure surface. TS7 values increased with the addition of additives in the structure (Figure 6b). This result indicated that the fibers in the structure presented higher bonds, causing structure densification and rigidity. The fibers in the z-direction were more adherent to the paper structure, reducing the number of free fibers on the tissue surface compared with the structures without additives (Figure 7). Compared with formulation 1, softness TS7 of the tissue structure increased by 33%, 65% and 67% with the incorporation of CBA, CMF and both, respectively (formulations 2–4). With the reduction of the reinforcement fibers in the formulations, this property also increased by 13% compared with formulations 1 and 5. Additionally, formulations 6, 7 and 8 promoted an increase in softness TS7 by 2%, 12% and 18%, respectively, compared with formulation 5. Compared with formulation 1 (75:25), softness TS7 increased by 15%, 27% and 34% with

the incorporation of CBA, CMF and both, respectively, in formulations with a softwood fiber reduction (90:10) (Figure 8).


**4. Conclusions**

Currently, the guidelines approve the use of ECMO support in cardiogenic shock or cardiac arrest patients. There are limited data on the use of ECMO support for PCI in stable angina and NSTE-ACS patients without hemodynamic disturbances. However, the use of ECMO for PCI support has a theoretical and practical rationale and showed encouraging results in our single-center observation. Our single-center experience demonstrated that PCI supported by ECMO may be an alternative for high-risk revascularization (CABG and PCI) for both stable angina and NSTE-ACS patients. The extremely poor prognosis in high-risk patients treated with a pharmacological approach who are often refused a CABG surgery or standard PCI makes PCI + ECMO method very promising as it improves the access to revascularization.

Our experience in this study allowed us to come to the following conclusions. A detailed assessment of the viable myocardium in a group of patients with stable coronary artery disease can improve the 12-month results as a more accurate selection of patients for PCI + ECMO support will be done. A particular attention should be paid to factors that increase the probability of stent thrombosis. The role of this revascularization method for NSTE-ACS patients is more obvious. PCI + ECMO is a life-saving technique that significantly improves hospital and 12-month survival of patients who were refused a CABG surgery or standard PCI. Unfortunately, we do not know the exact indications for ECMO in the elective pre-procedural setting, therefore, we need to develop a methodology (calculator) to immediately assess the need for mechanical circulatory support devices during high-risk PCI. In the end, selection of mechanical circulatory support devices is a matter of a personalized approach and should be based on the results of upcoming large randomized comparative studies.


*2.2.2 Static contact angle and dynamic contact angle*

During the measurement, the contact area between liquid and solid is not changed from outside, but the dynamic contact angle can produce during wetting (advancing angle) or de-wetting (receding angle). Besides water droplets, other organic liquids can be also used for testing the surface wettability. When oil on a solid substrate, it can be observed four fundamental states: oleophilic, oleophobic, superoleophilic, and superoleophobic.