This group of inventions is related to the method of materials creation for restoration of bone tissue defects in orthopedics, dentistry, traumatology, reconstructive surgery, maxillofacial surgery, and other fields.
Bone is a mineral-organic composite consisting mainly of calcium phosphate (CP) also including proteins (mainly type I collagen) and water. In bone tissue CP is presented in the form of crystallized or partly crystallized hydroxyapatite (HA) [1]. Therefore, application of 3D scaffold based on CP is a promising solution for bone defects restoration. The use of CPs as material for bone transplant has some advantages such as biodegradability, biocompatibility and osteoconductive properties. Most synthetic CP materials used in clinical practice are based on α-tricalcium phosphate (α-TCP) ceramics which is a reliable osteoconductive material commercially available in the form of granules, cements, or blocks [2-4]. However, degradation rate is often lower than osteogenesis rate which leads to accumulation of CP materials in a bone defect area. HA synthesis can be achieved using several methods, but in all cases synthesized phase differs from native HA [5]. For this reason, a biomimetic approach was suggested using octacalcium phosphate (OCP) as HA predecessor in a natural bone tissue [6]. It is worth noting that reproduction of OCP phase in chemical reaction is a very difficult task which usually takes about two weeks [7]. Therefore, development of technology for faster and reliable OCP phase preparation is an important objective for fabrication of scaffolds intended for bone defect restoration. Furthermore, synthetic OCP granules may be considered as building blocks for fast prototyping, i.e. 3D printing of tissue-engineered bone scaffolds [7].
In the past decade several widely used methods were developed for fast prototyping of 3D bone transplant based on ceramics [8-11]. Fast prototyping is an additive technology based on layer-by-layer fabrication of 3D objects including several steps: (i) target object computer model creation; (ii) 3D model slicing; (iii) layer-by-layer fabrication of an object of required size, shape and inner structure using different approaches to 3D printing such as laser stereolithography [12], extrusion printing [7], material jetting [13,14]. Material jetting is the most suitable approach to fabrication of solid scaffolds (frameworks) with predefined geometry. During material jetting process printing head moves in accordance with preset trajectories over the surface where powder is homogeneously distributed. Printing head applies adhesive substance on the powder sticking powder particles together layer by layer which allows fabrication of solid objects in accordance with developed 3D model. Nevertheless, additive approach takes a lot of time and has other limitations such as limited tool resolution and necessity of additional material.
Forming technology which arisen recently as an alternative to additive approach includes assembly in the whole volume of a working chamber. In forming approach, scaffold shape and microstructure are defined by physical forces such as acoustic waves, magnetic and electric fields. Desired geometry of 3D scaffold in accordance with preliminary 3D model is achieved by calculation and modeling of certain physical fields distribution in 3D space. Therefore, magnetic field is most commonly used for levitation and modification of different objects (magnetic levitation (MagLev)). In order to provide conditions for diamagnetic objects levitation for magnetic assembly, paramagnetic medium, for example, with gadolinium salts, may be added. Gadolinium (Gd3+) based pharmaceutical preparations usually used by MagLev approach are approved by the FDA for clinical use as contrast agents for MRI and, therefore, contain non-toxic agents. Magnetic levitation assembly was recently suggested as a new fabrication method for biomaterials and scaffolds for tissue engineering [15-18]. In other research magnetic fabrication of viable scaffolds based on chondrospheres using levitation was demonstrated [19].
The objective of the present invention is to develop fast and reliable production method of material for restoration of bone tissue defects based on magnetic levitation assembly in non-homogeneous magnetic field allowing generation of biocompatible three-dimensional material based on calcium phosphate for restoration and regeneration of bone defects.
The technical result of the invention is the development of fast and reliable material generation method for restoration of bone tissue defects based on magnetic levitation assembly in non-homogeneous magnetic field allowing generation of biocompatible three-dimensional material based on calcium phosphate for restoration and regeneration of bone defects. This method allows to create 3D scaffolds based on octacalcium phosphate (OCP) quickly, in particular, within 40 hours, in levitation conditions, excluding the use of temporary foundation, caps and magnetic marks. Furthermore, according to SEM (scanning electron microscopy) data and X-ray structural analysis, paramagnetic salts, in particular, gadolinium salts do not remain in the structure and on the surface of CP particles. Furthermore, 3D scaffold generated using the method according to the invention has sufficient porosity level which can provide cellular migration within porous channels. Alternatively, cells or tissue spheroids can be placed in granular space of 3D scaffold. It makes the resulting 3D material a promising candidate for application in tissue-engineered approaches to bone regeneration. Therefore, the method according to the invention offers an opportunity for fast assembly and fabrication of material (or scaffold) based on CP. Design and development in this field can play an important role in the field of bone tissue engineering.
The said technical result is achieved by realization of the method of fabrication of 3D material based on octacalcium phosphate by magnetic levitation assembly in non-homogeneous magnetic field including the following phases:
1) α-tricalcium phosphate particles assembly in 3D structures,
2) recrystallization of obtained structures.
In particular embodiments of the invention magnetic levitation assembly is performed in the central area on non-homogeneous magnetic field with lowest field density parameters from 3D material randomly distributed within fabrication chamber volume.
In particular embodiments of the invention non-homogeneous magnetic field is created using magnetic system consisting of at least two circular neodymium magnets with analogous poles facing each other.
In particular embodiments of the invention non-homogeneous magnetic field is created using Bitter magnets.
In particular embodiments of the invention the size of α-tricalcium phosphate particles is 250 to 500 μm.
In particular embodiments of the invention α-tricalcium phosphate particles assembly is performed by levitation forming method using non-homogeneous magnetic field in paramagnetic medium. In particular embodiments of the invention paramagnetic medium contains Gd3+ gadolinium salts.
In particular embodiments of the invention α-tricalcium phosphate particles assembly is performed at temperature of 0 to 80° C. In other embodiments of the invention α-tricalcium phosphate particles assembly is performed at room temperature.
In particular embodiments of the invention α-tricalcium phosphate particles are placed in magnetic field in buffer No. 1 with mass ratio of α-tricalcium phosphate particles to buffer No. 1 equal to 1:100 to 1:400, where buffer No. 1 is an aqueous solution of 1.5±0.1 M of sodium acetate and 1.0±0.01 M of phosphoric acid with pH 5.2±0.2 and also contains 3M of Gd3+.
In particular embodiments of the invention mass ratio of α-tricalcium phosphate particles to buffer No. 1 is 1:400.
In particular embodiments of the invention recrystallization of obtained structures is performed in two stages: in the first stage obtained 3D structures are held in magnetic field during 12 to 48 hours, then buffer No. 1 is replaced by buffer No. 2 and held in magnetic field during more 12 to 48 hours, where buffer No. 2 represents an aqueous solution of 1.5±0.1 M of sodium acetate with pH 8.2±0.2 and also contains 3M of Gd3+. In more specific embodiments of the invention obtained 3D structures are held in magnetic field during 20 hours in the first stage. In other embodiments of the invention 3D structures are held in magnetic field during 20 hours after buffer No. 1 replacement by buffer No. 2.
In particular embodiments of the invention α-tricalcium phosphate particles are placed in magnetic field in buffer No. 1 in transparent syringe and preliminarily shaken.
The present invention also contains 3D material based on octacalcium phosphate for restoration and regeneration of bone defect obtained using the method according to the invention.
In theory, magnetic levitation approach may be used for assembly of spatial 3D scaffolds from single CP granules. But, in order to compensate for gravitation, CP levitation requires magnetic force greater than the force required for living cells levitation by several fold due to the difference in material density. This problem may be solved by the use of higher magnetic field gradient which may be achieved by the use of superconducting electromagnets (of Bitter electromagnets) or higher concentrations of paramagnetic salts in the medium. The basic concept of the present invention is based on assembly of 3D scaffolds (frameworks) from octacalcium phosphate (OCP) in levitation conditions excluding the use of any temporary foundation, caps, and magnetic marks. Authors of the present invention believe that as a result of realization of the present invention more advanced biodegradable scaffolds may be fabricated with enhanced properties in magnetic levitation conditions. Authors of the present invention newly present successful fabrication of biocompatible framework using forming technology for restoration and regeneration of bone defect, namely, the method of CP particles assembly by means of magnetic levitation using gadolinium salts in special buffer solution with subsequent recrystallization in levitation conditions. This approach allows to create 3D scaffolds based on OCP phases quickly, in particular, within 40 hours.
In additions to recrystallization rate, another important property of scaffold (material) according to the invention is its porosity. Scaffold assembly involves the most dense packing of spherical particles. The space between granules is called interpenetrating pores and there is a linear correlation between interpenetrating porosity with the most dense hexagonal packing of spherical particles and their diameters. Therefore, application of porous particles additionally provides osteoconductive properties and use of ceramics with bimodal distribution of pores by size seems preferable. 3D scaffolds generated using the method according to the invention have sufficient porosity level which can provide stem cells migration within porous channels. Alternatively, cells or tissue spheroids can be placed in granular space of 3D scaffold. This document contains research results obtained on primary adherent cultures mesenchymal stem cells (MSCs) from primary teeth pulp samples collected after normal peeling-off—SHED (stem cells of peeled-off human primary teeth). These cells are naturally involved in physiologic regeneration processes and may be subjected to in vitro osteogenic differentiation. It makes them promising candidates for application in tissue-engineered approaches to bone regeneration. Therefore, the method according to the invention may be used for fabrication of scaffolds for tissue engineering based on OCP and MSC intended for bone defect regeneration and bone tissue restoration.
(a) Schematic image of α-TCP particles fabrication process;
(b) SEM image of α-TCP particles (bar 200 μm and 20 μm);
(c) α-TCP particles diameter distribution;
(d) X-ray phase analysis of α-TCP particles.
(a) Schematic image of the device and fabrication of scaffold (framework);
(b) Horizontal section of magnetic field (arrows show magnetic well);
(c) Vertical section of magnetic field;
(d) Dependence of the distance between levitation unit and magnetic field center on the ratio between magnetophoretic and gravitation forces acting on the particles;
(e) Magnetic printer model.
(a) Modeling of α-TCP particles assemble and scaffold shape.
(b) α-TCP particles assemble dynamics.
(c) Assembly time area curves in modeling and in experiment, highlighted in red and blue, respectively.
(a) Schematic image of recrystallization phases.
(b) SEM image shows the surface of primary α-TCP particles (bar 10 μm).
(c) SEM image shows dicalcium phosphate dihydrate (DCPD) phase (intermediate product) (bar 10 μm).
(d) SEM image shows the surface of obtained scaffold (OCP phase) (bar 10 μm).
(a) Impact of medium after 4 days of incubation with 3D scaffold based on CP on cell viability (Alamar Blue analysis, 72 hours).
(b) SHED tissue spheroid made of 27,000 cells in spheroidal microplate (bar 100 μm).
(c) 3D scaffold based on CP immediately after fabrication (bar 2,000 μm).
(d) Schematic image of adherence and migration of SHED cells on the surface and within 3D scaffold.
(e) 3D scaffold based on CP incubated with SHED spheroids (0 hours).
(f) 3D scaffold based on CP incubated with SHED spheroids during 7 days.
(g) Images of fluorescent and light microscopy of 3D scaffold incubated with SHED spheroids during 7 days.
(h) SEM image of 3D scaffold with SHED spheroids on the surface after 7 days of incubation (bar 50, 100 μm).
(a) X-ray phase analysis of 3D scaffold fabricated by magnetic levitation after step 1 (20 hours in buffer No. 1);
(b) X-ray phase analysis of 3D scaffold fabricated by magnetic levitation after step 1 (20 hours in buffer No. 1) and step 2 (20 hours in buffer No. 2).
(a) after the first passage
(b) in the passage.
(a) Osteogenic differentiation was detected by coloration with alizarin red for calcium deposits visualization;
(b) Osteogenic differentiation was detected by coloration analysis of alkaline phosphatase;
(c) Chondrogenic differentiation was detected by coloration with Alcian Blue for visualization of glycosaminoglycan reach matrix products;
(d) Adipogenic differentiation was detected by coloration with oil red for visualization of intracellular lipidic vacuoles.
Different terms related to the objects of present invention are used above and in description and claims of the invention. Unless otherwise specified, all technical and scientific terms used herein have the same meaning which is understood by professionals in the given field. References to methods used in description of this invention are related to well known methods including changes to these methods and substitution thereof with equivalent ones well known to professionals.
In description of this invention, the terms “includes” and “including” are interpreted as meaning “includes among other things”. The said terms are not intended to be understood as “only consists of”.
In this context, the term “medium” is related to any medium intended for cultivation and/or crystallization or recrystallization.
In description of this invention the terms “three-dimensional (3D) material based on calcium phosphate” or “framework” or “scaffold” are related to bone tissue engineering. These materials shall be porous for favorable intergrowth of biological bone during bone defect restoration.
α-TCP Particles Fabrication
SEM micrographs of primary α-TCP ceramic particles intended for fabrication of 3D scaffold based on CP in magnetic field are shown in
Computer-Aided Simulation of Magnetic Field and Particles Assembly
Authors of the present invention used magnetic device for assembly (
Scaffolds (Frameworks) Fabrication Using Magnetic Levitation Assembly
While computer-aided simulation predicted spherical shape of final scaffold (
In order to ease recrystallization during assembly the scaffold levitated in magnetic field during 40 hours at room temperature. Process of α-TCP conversion to OCP is shown in
2Ca3(PO4)2+2NaH2PO4+2CH3COOH+12H2O=6CaHPO4.2H2O+2CH3COONa
At the end of step 2 the whole structure was fully converted to OCP (
8CaHPO4.2H2O+8NaOH+4CH3COOH→Ca8(HPO4)2(PO4)4.5H2O+2Na2HPO4+4CH3COONa+19H2O
Gibbs energies were calculated based on standard activity of ions presented in solutions. ΔG of DCPD generation is equal to −7 kJ/mole, and ΔG of OCP generation is equal to −663 kJ/mole. It confirms the possibility of these reaction.
SEM image of 3D scaffold which was obtained in similar buffer conditions but without magnetic field application (considered as a reference sample) is shown in
Biocompatibility of 3D Scaffolds
In order to evaluate cytotoxicity of 3D scaffolds extract-based cytotoxicity analysis was used which evaluates cytotoxicity of any secondary products extracted from material.
Surface properties of 3D scaffold in relation to cellular colonization were evaluated using fluorescent microscopy and SEM. Schematic image of SHED cells migration from tissue spheroids and their adherence to the surface of 3D scaffold is shown in
It should be understood, that these and all examples given in application materials are not limiting and are given only for illustration of the present invention.
Tools and Methods
Chemicals and Reagents
Dulbecco's Minimal Essential Medium (DMEM, cat. No.: 12491-015), Fetal Bovine Serum (FBS, cat. No.: 16000-044), antibiotic/antimycotic agent (cat. No.: 15240-062), trypsin/EDTA (cat. No.: 25200-114) were received from Gibco (USA). EDTA (cat. No.: R080), L-glutamine (cat. No.: F032) was received from PANECO (Russia). High-purity calcium nitrate (cat. No.: 13477-34-4), ammonium carbonates (cat. No.: 506-87-6), diammonium phosphate (cat. No.: 7722-76-1), sodium acetate (cat. No.: 127-09-3), glutaraldehyde (cat. No.: G5882) and resazurin sodium salt (cat. No.: R7017-5G) were received from Sigma-Aldrich (USA).
α-TCP powder was synthesized in aqueous medium by slow addition of diammonium phosphate solution ((NH4)2HPO4) to calcium nitrate solution (Ca(NO3)2.4H2O) containing ammonia solution (NH4OH) with constant stirring. Mixture pH was about 7 with molar Ca/P ratio of 1.5/1. After full addition of reagents the suspension was filtered, dried at 80° C. and sintered at 900° C. during 2 hours.
In order to obtain α-TCP particles the method was used which is based on spheroidization of liquid drops under surface tension forces using a mixed suspension of α-TCP, binding agent (gelatin) and oil (
Two solutions were prepared to obtain magnetic levitation assembly and recrystallization of α-TCP particles. One buffer solution (called buffer No. 1 herein) was prepared by dissolution of 1.5±0.1 M of sodium acetate and 0.0±0.01 M of phosphoric acid in water (pH 5.2±0.2). The second buffer solution (called buffer No. 2 herein) was prepared by dissolution of CH3COONa (95.2 g) in 700 ml of distilled water (which corresponds to 1.66 mole I−1) with pH 8.2±0.2. Buffer No. 1 and buffer No. 2 both contained 3M of Gd3+. In order to obtain concentration of 3M, 3 ml of 1M Gadovist (BAYER PHARMA AG, Germany) were lyophilized using Heto PowerDry LL3000 (Thermo Fisher Scientific, USA) and dissolved in 1 ml of buffer No. 1 and buffer No. 2.
The Magnetic Device
Fabrication process was performed in two steps—α-TCP particles assembly in magnetic levitation conditions and their subsequent recrystallization. 3D scaffolds have been assembled by levitation forming using non-homogeneous magnetic field in the presence of Gd3+ salts at room temperature (RT). Magnetic device (
In order to start fabrication process, transparent syringe of 2 ml in volume (SMF, Germany) was filled with buffer No. 1 containing α-TCP particles (ratio between particles weight and liquid weight was 1:400). After intensive shaking particles distributed evenly in the whole liquid volume in syringe. When this syringe was inserted in the opening of magnet system, α-TCP particles began to accumulate in the center of working area. As a results, particles gathered in three-dimensional levitating scaffold under the action of magnetic forces. Once α-TCP particles are gathered in the scaffold, recrystallization process begins. It can be subdivided in two steps. During the first step, α-TCP particles remained levitating in buffer No. 1 during 20 hours. During the second step, syringe with 3D scaffold in buffer No. 1 was withdrawn from the printer, buffer No. 1 in the syringe was replaced by buffer No. 2 and then the syringe was placed in magnetic device again. After that the scaffold was subjected to further recrystallization in levitation conditions during additional 20 hours. Principle of operation of experimental device involves creation of local microgravitation zone where all forces acting on objects are compensated. Magnetophoretic force appears only if magnetic field is not homogeneous. It causes particles movement from areas where magnetic field is strong. Magnetophoretic force is applicable for neutrally charged particles whose relative permeability differs from that of background liquid. In such case, effective magnetophoretic force F acting on the object in non-homogeneous magnetic field will be defined as follows:
F=2πr3μ0μfK∇(H2),
where H is magnetic field, μr is relative liquid permeability, μp is relative particle(s) permeability, μ0 is magnetic constant and K is defined as:
In this experiment relative permeability of liquid and particles is very close to 1, therefore, magnetophoretic force acting on particles is approximately linear in relation to the difference between them. Since μ1 for paramagnetic materials and μ<1 for diamagnetic materials, the difference μp−μr refines magnetic force direction. As a result, objects will be ejected to the area with the lowest field density (magnetic trap) under the action of magnetophoretic force. In Earth gravitation conditions, equilibration of objects occurs at a certain distance from local minimum of magnetic field.
Computer-Aided Simulation of Magnetic Field and Particles Assembly
Simulation of three-dimensional non-homogeneous static magnetic field in paramagnetic medium made of two permanent magnets was performed using COMSOL Multiphysics modeling software by finite elements method. Characteristics used during magnetic field simulation were as follows: relative permeability of paramagnetic medium was μr=1.00027; and magnet N38 made of NdFeB class material (VG=1.21 TL) was used. Magnetic field was calculated and then inserted in field particles trajectory equation. Intermediate calculation of particles trajectories was performed using COMSOL “Particles monitoring module”. The following forces were taken into account during calculation: magnetophoretic force based on the difference between magnetic permeability of particle and medium, resistance force affecting assembly time, particle-to-particle interaction elastic force and gravity force. Due to low particles' velocities Stokes resistance law was used to describe viscous resistance. Physical characteristics of particles were similar to those of CP particles: diameter was equal to 0.5 mm, density was taken equal to 2,000 kg m−3, particles' shape was supposed to be spherical, and total number of simulated particles was 400. Notwithstanding that solid CP density is equal to 2,800 kg m−3, particles contained air bubbles which decreased effective density. Specific properties of paramagnetic liquid were defined by experiment and had the following values: density was equal to 1,550 kg m−3, dynamic viscosity was equal to 0.01 Pa·s. Calculated particle velocities corresponded closely to experimental data.
Material Characteristics
Phase composition was analyzed using usual X-ray diffraction method (XRD) [Shimadzu XRD-6000 (Japan), Ni-filtered target CuKα1, λ=1,54183 Å]. Samples were scanned at 2θ=3°−60° with pitch of 0.02° during preset time of 5 seconds.
Scanning electron microscopy (SEM) apparatus (Tescan Vega II, Czech Republic) operating in secondary and backward scattering of electrons was used to research materials.
3D scaffolds based on CP with SHED cells were fixed with 2.% v/v glutaraldehyde PBS, dewatered in ethanol series and then dried in drier with critical point (HCP-2, Hitachi Koki Co. Ltd., Japan), and observation was performed using JSM-6510 LV microscope (JEOL, Japan).
All samples were coated with 25 nm thick gold layer by spraying using ion coating device (IB-3, EIKO, Japan) prior to visualization in order to add electrical conductivity to surfaces.
Cell Culture In this study, primary MSC adhesive cultures from primary teeth pulp collected after normal peeling-off—SHED (stem cells of peeled-off human primary teeth) were used (
Primary SHED culture was analyzed by immunophenotyping method using flow cytometry for presence and absence of certain markers as recommended by International Society for Cellular Therapy (ISCT) [20]. It was found that cells were strongly positive (over 95%) for CD29, CD44, CD49b, CD73 and CD90 and negative (less than 2% positive) for CD34, CD45 and HLA-DR.
Authors of the present invention also checked cell cultures for multipotent ability for differentiation in osteogenetic, adipogenic and chondrogenic lines since the ability for differentiation in three different lines is another obligatory ISCT criterion for MSC (
Tissue Spheroids Generation Using Corning Spheroidal Microplates
Tissue spheroids were generated using Corning spheroid microplates (Corning, cat. No.: 4520) according to manufacturer's protocol. Cells in monolayer with 95% fusion were rinsed with EDTA solution, gathered from substrate using 0.25% trypsin/0.53 mM EDTA and then resuspended in cell culture medium. Cells concentration was 2.7×105 per milliliter. 100 μl of cell substrate were added in wells of Corning spheroidal microplates. Corning spheroidal were incubated at 37° C. in humid atmosphere with 5% of CO2 over 24 hours.
Cytotoxicity Assay of 3D Scaffold Based on Calcium Phosphate
Extract was tested to evaluate cytotoxicity. The extract had the form of 3D scaffolds based on CP saturated in culture medium at 37° C. over 4 days. SHED cells were seeded in 96-well cultural plate in concentration of 1×104 cells per well. Each well contained 100 μl of cell-rich fluid and the plate was incubated during 24 hours at 37° C. in humidified atmosphere with 5% of CO2 to obtain the culture in front of monolayer. Then 200 μl of culture medium preliminarily incubated with 3D scaffold was inserted in experimental wells and 200 μl of fresh culture medium were inserted in reference wells. The plate was incubated during additional 72 hours at 37° C. in humidified atmosphere with 5% of CO2, then 200 μl of supernatant were aspirated and 10 μl of 0.02% resazurin solution in culture medium were added to each plate well. Plate was returned to CO2 incubator for 6 hours and then fluorescence was recorded at excitation wavelength of 555 nm with emission recorded at 580 nm using multibeam plate reader VICTOR X3 (Perkin Elmer, USA). Wells contained cell culture medium without any cells and were used for background signal evaluation.
Biocompatibility of 3D Scaffolds
Biocompatibility of 3D scaffolds was studied in relation to SHED tissue spheroids using fluorescent microscopy (NIKON SMZ18, USA) and SEM (JSM-6510 LV, JEOL, Japan). One-day tissue spheroids made of SHED cells were incubated in close contact with 3D scaffold based on CP during 7 days. Cells viability was controlled using a live/dead assay staining kit (Sigma-Aldrich, USA) according to manufacturer's protocol. This analysis was used to determine visually whether cells in tissue spheroids remain viable after cultivation using 3D scaffold based on CP. After 7 days of cultivation 3D scaffold with one-day tissue spheroids made of SHED cells was incubated with solution containing calcein-AM and propidium iodide (PI) at 37° C. during 30 minutes. After rinsing with PBS tissue spheroids were visualized using fluorescent microscopy (NIKON SMZ18, USA).
Data Analysis
Statistical data were analyzed using GraphPad Prism software (GraphPad Software, Inc., La Jolla, Calif.) and presented as average value±S.E.M. Analysis of variance (ANOVA) was used to determine significant differences between average values of three groups with P<0.0001.
Notwithstanding that the invention is described with reference to embodiments disclosed, it should be obvious for professionals in the given field that specific experiments detailed herein are only given for illustration of the present invention and they should not be considered as limiting the scope of invention in any way. It should be understood that realization of different modifications is possible without departing from the spirit and scope of the present invention.
List of literature sources included in this disclosure of the invention as references:
Number | Date | Country | |
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62923809 | Oct 2019 | US |