Professional Documents
Culture Documents
Ada Orlowska JFB Art
Ada Orlowska JFB Art
Ada Orlowska JFB Art
Ada Orłowska1*, Janusz Szewczenko1**, Wojciech Kajzer1, Karolina Goldsztajn1, Marcin Basiaga1, 4
1 Department of Biomaterials and Medical Devices Engineering, Faculty of Biomedical Engineering, Silesian 5
University of Technology, 41-800 Zabrze, Poland; 6
* Ada.orlowska@polsl.pl 7
** Janusz.szewczenko@polsl.pl 8
Abstract: Additive technologies allowed for the development of medicine and implantology, ena- 9
bling the production of personalized and highly porous implants. Although implants of this type 10
are used clinically, they are usually only heat treated. Surface modification using electrochemical 11
methods can significantly improve the biocompatibility of biomaterials used for implants, including 12
printed ones. The study examined the effect of anodizing oxidation on the biocompatibility of a po- 13
rous implant made of Ti6Al4V by the SLM method. The study used a proprietary spinal implant 14
intended for the treatment of discopathy in the c4-c5 section. As part of the work, the manufactured 15
implant was assessed in terms of compliance with the requirements for implants (structure testing 16
- metallography) and the accuracy of the pores produced (pore size and porosity). The samples were 17
subjected to surface modification using anodic oxidation. The research was carried out for 6 weeks 18
in in vitro conditions. Surface topographies and corrosion properties (corrosion potential, ion re- 19
lease) were compared for unmodified and anodically oxidized samples. The tests showed no effect 20
of anodic oxidation on the surface topography and improved corrosion properties. Anodic oxida- 21
tion stabilized the corrosion potential and limited the release of ions to the environment. 22
1. Introduction 25
Titanium and its alloys (including Ti6Al4V) are materials widely used in medicine. 26
Due to their properties, i.e., favorable plastic and strength properties, high corrosion re- 27
sistance and biocompatibility, electromagnetic properties, availability and processing 28
Citation: To be added by editorial ability, they are widely used [1,2]. In orthopedy, they are used to manufacture permanent 29
staff during production. (joint endoprostheses) and temporary (plates and stabilizers) implants, stents, screws, etc. 30
Academic Editor: Firstname Last- [3]. Titanium alloys are also a material that can be surface modified, thus providing the 31
name products with even better properties. The modification methods include acid etching, an- 32
odic oxidation and plasma treatment as well as coating with layers, including inorganic 33
Received: date
layers [4-6]. 34
Revised: date
Thanks to the development of technology, new production methods such as additive 35
Accepted: date
methods are available. 3D printing, including the SLM method, is widely used in all 36
Published: date
branches of science and industry [7]. Elements produced with additive methods are in- 37
creasingly entering operating theaters [8]. Additive methods enable the production of el- 38
ements impossible to obtain with conventional methods [9, 10]. Scaffolds and high poros- 39
Copyright: © 2023 by the authors.
ity implants enable the creation of cell scaffolds that better replace the removed tissues 40
Submitted for possible open access
and enable a more stable connection of the implant with the surrounding tissues [11-13]. 41
publication under the terms and
conditions of the Creative Commons
Additive methods make it possible to produce elements with a strictly defined porosity 42
prevents relocation of the implant [15, 18-20]. In addition, this type of structure is charac- 46
terized by more favorable mechanical properties and allows to avoid stiffening of the sys- 47
tem and degradation of the bone tissue surrounding the implantation site [15, 19, 21, 22]. 48
Good mastery of the technique of producing implants with the use of additive methods 49
also allows for the development of personalized medicine. 3D printing, supported by re- 50
verse engineering and CAD, allows for the production of implants ideally suited to the 51
needs and anatomy of the patient [15, 19, 23, 24]. 52
Degradation of spinal structures is a common phenomenon, and the incidence of 53
changes increases with age [25]. The treatment of spinal lesions depends on the stage of 54
the lesion. In the case of significant degradation of the vertebrae or intervertebral discs, 55
there may be pressure on the nerves, which results in chronic pain, numbness and sensory 56
and locomotor problems. Surgical treatment consists in replacing the damaged tissue frag- 57
ment with a fixed implant (arthrodesis) or a mobile implant (arthroplasty), which is to 58
provide support to the structures and prevent compression [26]. Insertion of a fixed im- 59
plant causes fusion of the vertebrae and a slight decrease in the mobility of the spine, but 60
it is usually well tolerated. For a large group of patients, vertebral fusion provides a better 61
therapeutic effect than treatment with a mobile implant while reducing potential compli- 62
cations [27-30]. Implants intended for spondylodesis are usually made of PEEK, less often 63
of carbon fiber and titanium. Another solution is bone autografts taken from the iliac crest, 64
but this procedure carries a higher risk and involves a wider operating field due to the 65
need to collect material from the patient. One of the main risks when using implants of 66
this type is obtaining an unstable or incorrect mechanical system at the implantation site. 67
While solid implants made of PEEK are more similar in elasticity to bone tissue, studies 68
have shown that the tissue surrounding the implant is very often characterized by high 69
fibrosis, a thick layer of biofilm and an unstable implant-bone connection. This may lead 70
to the relocation of the implant or the formation of a pseudoarthrosis and the need for 71
reoperation [13]. Replacing a solid implant with a scaffold, the porosity of which allows 72
complete overgrowth of the implant with bone, gives hope for a better, more durable fix- 73
ation. Particularly beneficial seem to be implants made of titanium alloy, which is charac- 74
terized by high osteoconductivity. Highly porous titanium implants, despite the fact that 75
the titanium alloys themselves have a higher Young's modulus than bone, can be charac- 76
terized by properties that perfectly imitate healthy bone tissue [15,18, 21, 22]. 77
In clinical practice, there are numerous publications on the use of titanium implants 78
produced in the SLM technology [21, 22, 31]. However, these implants are not subjected 79
to any additional surface modification, and their post-production processing is limited to 80
cleaning, thermal treatment and sterilization. From the research of biomaterials, it is 81
known that there are a number of techniques related to chemical, electrochemical and me- 82
chanical treatment, which can ensure better biocompatibility, stability and corrosion re- 83
sistance of metal implants. Modification of the surface of biomaterials is an important is- 84
sue in biomedical engineering. The top layer in direct contact with the tissues affects the 85
biocompatibility of the implant. The tissue response translates into the dynamics of the 86
response at the cellular level, i.e. adhesion, migration, proliferation, differentiation lead- 87
ing to tissue maturation and bone formation [32, 33]. Properly developed surface and 88
roughness stimulate the differentiation of osteoblasts responsible for bone maturation and 89
the formation of a stable implant-bone connection [34]. 90
Despite all the advantages of SLM high-porosity implants, some caution is required. 91
Although the properties and methods of modification of the Ti6Al4V alloy seem to be well 92
tested, along with the change of the production method, it is necessary to verify. Surface 93
modification, which has been successfully applied to items produced in a conventional 94
manner [5, 6, 35, 36] may not be optimal for the same material processed in the 3D printing 95
process. Therefore, it is necessary to continue research and check whether the methods of 96
modification of biomaterials, well researched by many scientists, still work well in the 97
case of 3D printing [4]. The existing, few works on the modification of implants printed 98
from titanium alloys will not exhaust the subject, and the works on the clinical application 99
J. Funct. Biomater. 2023, 14, x FOR PEER REVIEW 3 of 11
of this type of implants are based on unmodified implants [21, 22, 31, 37-39]. This paper 100
presents the results of the research on the influence of anodic oxidation on the corrosion 101
resistance of the proprietary implant manufactured with the use of additive methods 102
110
Figure 1. Model of the designed implant. 111
The samples (Fig.2) were produced at ChM sp. z o.o. in Białystok on SLM-250 Metal 112
3D Printer (SLM Solutions Group AG) with the use of Ti6Al4V powder (TLS Technik 113
GmbH). Finished samples were annealed at 920°C for 4 h and then cleaned in isopropanol 114
with ultrasound. After receiving the samples, their mechanical strength was verified with 115
the use of a static compression test in order to demonstrate the resistance to physiological 116
mechanical loads occurring in the body area dedicated to the implant [39]. 117
118
Figure 2. Implant produced by the SLM method. 119
J. Funct. Biomater. 2023, 14, x FOR PEER REVIEW 4 of 11
3. Results 167
This section may be divided by subheadings. It should provide a concise and precise 168
description of the experimental results, their interpretation, as well as the experimental 169
conclusions that can be drawn. 170
Figure 3. Microstructure of the material: (a) - for the solid part of the frame in the transverse plane; 186
(b) - for the beams from the porous part in the transverse plane; (c) – for the solid part in the 187
longitudinal plane; SEM. 188
(a) (b)
Figure 4. (a) Sample surface with measured pore size; (b). Sample surface with marked amount of 193
powder deposited on the surface, SEM 194
J. Funct. Biomater. 2023, 14, x FOR PEER REVIEW 2 of 11
The size of the measured pores was reproducible for all samples, both for the outer 195
layers of the sample and in its central part. Although the pores produced differ in size 196
from the intended value (600 µm), their size is within the range of values favoring the 197
growth of bone tissue through the porous implant. 198
Comparing the SEM images of as-is and anodically oxidized samples, the modifica- 199
tion had no effect on the amount of powder deposited on the surface of the sample (Fig.5). 200
Observations on the cut samples showed no significant differences between the top 201
and inner layers of the scaffold. At the intersection site, no material discontinuity was ob- 202
served in the solid beam structures and no closed pores were present. 203
(a) (b)
Figure 5. Surfaces of the implants produced in the (a) initial state, (b) anodically oxidized, SEM 204
215
Figure 6. Transverse scan of the sample taken during micro-CT from the central part of the implant 216
-300
-350
-400
Ekor [mV]
-450
-500
-550
-600
0 30 60 90 120
Time [min]
AO 2 week AO 4 week AO 6 week IS 2 week IS 4 week IS 6 week
222
Figure 7. Sample corrosion potential curves for initial state (red) and anodized samples (blue) 223
Table 1. The average value of the corrosion potential Ecor[mV] for individual groups of samples. 224
241
Figure 8. Graph of the ion density released into the incubation solution over time for initial states 242
and anodized 243
J. Funct. Biomater. 2023, 14, x FOR PEER REVIEW 4 of 11
4. Discussion 244
Comparing the observed structures to the micrographs of the ISO 20160 standard, it was 245
confirmed that the processed material is suitable for medical applications. The disclosed 246
metallographic structure in the transverse and frontal planes is not the same, which can 247
be considered characteristic of elements produced by the SLM technology [43]. Neverthe- 248
less, individual microsections were homogeneous and were characterized by a fine- 249
grained α+β structure. 250
The assessment of the pore surface and structure showed a decrease of the actual pore size 251
in relation to the designed pore size. This discrepancy is a direct result of the production 252
technique., 13-15, 38, 42]. Importantly, the obtained pore size (450-600µ) was within the 253
range of pores, which in the studies of other teams ensure optimal bone tissue growth. 254
Pores <400µm do not provide enough space to obtain a well-vascularized and thus nour- 255
ished tissue. On the other hand, the use of larger pores >900µm delays the maturation of 256
bone tissue and a weaker structure of the extracellular matrix [16, 38, 42]. 257
The observed spheres deposited on the surface, most likely originating from insufficiently 258
melted powder used to produce this type of implants, were also observed in other studies 259
[15, 20, 39]. Smoothing the surface is possible by using a higher annealing temperature 260
(>1300°C), which could be observed, among others, in the studies of N. Taniguchi [16]. 261
However, the use of such high temperatures can significantly affect the structure and thus 262
the properties of Ti6Al4V. In the future, in-depth studies are planned on the effect of the 263
annealing temperature of scaffolds produced from Ti6Al4V on the structure of the mate- 264
rial and the properties of this type of implant The observed structure of the surface carries 265
a certain risk related to the possibility of grain detachment and its relocation in the body. 266
On the other hand, obtaining an unstructured, highly developed surface may well stimu- 267
late osseointegration, constituting a favorable substrate for the migrating cells and the in- 268
tercellular matrix they create. Studies conducted on similar scaffolds have shown that the 269
proposed implants allow for a very stable implant-bone connection, which prevents lick- 270
ing and relocation of the implant. [14, 16, 41]. 271
Due to the reduced size of the actual pores, the actual porosity of the implant was also 272
reduced. The research conducted by G. Li has shown that while the pore size has a signif- 273
icant impact on the way of the growth and maturation of bone tissue, the very ratio of the 274
solid material to the pore volume does not affect the overgrowth of the implant [14]. 275
Anodic oxidation caused the formation of a layer of TiO2 oxide on the surface of the im- 276
plant, which affected the surface properties of the implant. Due to the high stability of the 277
TiO2 passive layer, this process is very beneficial because it increases the bio-compatibility 278
of the material. The modified implants immediately after anodic oxidation showed a pos- 279
itive corrosion potential, which may indicate an improved corrosion resistance of the ma- 280
terial [35, 36]. However, the assessment of the corrosion potential in terms of the beneficial 281
effect on the implant overgrowth with bone is not unambiguous. Bacakov's research 282
shows that the positive corrosion potential of the sample surface pro-motes the aggrega- 283
tion of osteoblasts [40]. Nevertheless, Anaselme research shows that it is beneficial to ob- 284
tain a negative corrosion potential on the surface due to the need to pro-mote protein ag- 285
gregation on the surface of the material. This is beneficial not only in the initial phase of 286
implantation (proteins aggregate on the surface earlier than cells), but also in the later 287
phase, where in order to obtain a permanent implant-bone connection, not only is proper 288
cell profiling on the implant surface necessary, but also tissue maturation, which is asso- 289
ciated with the formation of the extracellular matrix composed mainly of proteins [41]. 290
Comparing the corrosion potential of individual groups of samples after incubation in a 291
liquid imitating the tissue environment, it can be seen that all groups showed a negative 292
J. Funct. Biomater. 2023, 14, x FOR PEER REVIEW 5 of 11
corrosion potential. Samples subjected to anodic oxidation showed higher stability, which 293
should potentially provide better conditions for bone tissue overgrowth. 294
5. Conclusions 295
On the basis of the tests carried out, the designed implant was positively evaluated. 296
Studies have shown that the implant is characterized by features that should translate into 297
good osseointegration and stimulation of bone tissue to overgrow into the implant. 298
The proposed surface modification method using anodic oxidation had a positive 299
effect on the properties of the Ti6Al4V implant produced by the SLM method. Oxidized 300
implants were characterized by a more stable corrosion potential and limited penetration 301
of metal ions into the external environment. 302
Further research is being carried out to optimize the methods of modifying implants 303
made of titanium alloys produced by additive methods. 304
Author Contributions: Conceptualization, A.O. and J.Sz.; methodology, A.O., W.K, K.G., M.B. J.Sz.; 305
software, M.B., validation, J.Sz. and W.K.; formal analysis, A.O.; resources, A.O.; data curation, A.O.; 306
writing—original draft preparation, A.O.; writing—review and editing, K.G. J.Sz..; visualization, 307
A.O.; supervision, J.Sz.; project administration, A.O.; funding acquisition, J.Sz. All authors have read 308
and agreed to the published version of the manuscript. 309
Data Availability Statement: The data presented in this study are available at the request of the 311
appropriate author. The research results are presented in the article and the data obtained during 312
the tests are private. 313
Acknowledgments: Special thanks to ChM sp. z o.o. for the production of the implants used for the 314
research 315
317
J. Funct. Biomater. 2023, 14, x FOR PEER REVIEW 6 of 11
References 318
[1] Peters, M., et al. Structure and properties of titanium and titanium alloys. Titanium and titanium alloys: fundamentals and appli- 319
cations, 2003, 1-36. 320
[2] Niinomi, M.; Narushima, T.; Nakai, M.. Advances in metallic biomaterials. Heidelberg, DE: Springer, 2015, 179-215 321
[3] Tang, H.P., et al. Ti-6Al-4V orthopedic implants made by selective electron beam melting. In: Titanium in medical and dental 322
applications. Woodhead Publishing, 2018. p. 239-249. 323
[4] Kulkarni, M., et al. Biomaterial surface modification of titanium and titanium alloys for medical applications. Nanomedicine, 324
2014, 111.615: 111. 325
[5] Shahali, H.; Jaggessar, A.; Yarlagadda, P. Recent advances in manufacturing and surface modification of titanium orthopaedic 326
applications. Procedia engineering, 2017, 174: 1067-1076. 327
[6] Diamanti, M.V.; Del Curto, B.; Pedeferri, M. Anodic oxidation of titanium: from technical aspects to biomedical applications. 328
Journal of Applied Biomaterials and Biomechanics, 2011, 9.1: 55-69. 329
[7] Łępicka, M.; Grądzka-Dahlke, M. Surface modification of Ti6Al4V titanium alloy for biomedical applications and its effect 330
on tribological performance-a review. Reviews on Advanced Materials Science, 2016, 46.1. 331
[8] Van Der Stok, J., et al. Selective laser melting‐produced porous titanium scaffolds regenerate bone in critical size cortical bone 332
defects. Journal of Orthopaedic Research, 2013, 31.5: 792-799. 333
[9] Moin, D.A., et al. Designing a novel dental root analogue implant using cone beam computed tomography and CAD/CAM 334
technology. Clinical Oral Implants Research, 2013, 24: 25-27. 335
[10] Chen, J., et al. Design and manufacture of customized dental implants by using reverse engineering and selective laser 336
melting technology. The Journal of prosthetic dentistry, 2014, 112.5: 1088-1095. e1. 337
[11] Ghassemi, T., et al. Current concepts in scaffolding for bone tissue engineering. Archives of bone and joint surgery, 2018, 6.2: 338
90. 339
[12] Yadroitsava, I.; Du Plessis, A.; Yadroitsev, I. Bone regeneration on implants of titanium alloys produced by laser powder 340
bed fusion: A review. Titanium for Consumer Applications, 2019, 197-233. 341
[13] Mcgilvray, K.C., et al. Bony ingrowth potential of 3D-printed porous titanium alloy: a direct comparison of interbody cage 342
materials in an in vivo ovine lumbar fusion model. The spine journal, 2018, 18.7: 1250-1260. 343
[14] Li, G., et al. In vitro and in vivo study of additive manufactured porous Ti6Al4V scaffolds for repairing bone defects. Scien- 344
tific reports, 2016, 6.1: 1-11. 345
[15] Nuke, K.C., et al. Interplay between cellular activity and three‐dimensional scaffold‐cell constructs with different foam 346
structure processed by electron beam melting. Journal of Biomedical Materials Research Part A, 2015, 103.5: 1677-1692. 347
[16] Taniguchi, N., et al. Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufactur- 348
ing: An in vivo experiment. Materials Science and Engineering: C, 2016, 59: 690-701. 349
[17] Chen, Z., et al. Influence of the pore size and porosity of selective laser melted Ti6Al4V ELI porous scaffold on cell prolifer- 350
ation, osteogenesis and bone ingrowth. Materials Science and Engineering: C, 2020, 106: 110289. 351
[18] Carter, D.R.; Hayes, W.C. Bone compressive strength: the influence of density and strain rate. Science, 1976, 194.4270: 1174- 352
1176. 353
[19] Gu, Y., et al. 3D-printed porous Ti6Al4V scaffolds for long bone repair in animal models: a systematic review. Journal of 354
Orthopaedic Surgery and Research, 2022, 17.1: 68. 355
[20] Ouyang, P., et al. Hydromechanical mechanism behind the effect of pore size of porous titanium scaffolds on osteoblast 356
response and bone ingrowth. Materials & Design, 2019, 183: 108151. 357
[21] Mobbs, R.J., et al. The utility of 3D printing for surgical planning and patient-specific implant design for complex spinal 358
pathologies: case report. Journal of Neurosurgery: Spine, 2017, 26.4: 513-518. 359
[22] Choy, W.J., et al. Reconstruction of thoracic spine using a personalized 3D-printed vertebral body in adolescent with T9 360
primary bone tumor. World Neurosurgery, 2017, 105: 1032. e13-1032. e17. 361
[23] Bormann, T., et al. Combining micro computed tomography and three-dimensional registration to evaluate local strains in 362
shape memory scaffolds. Acta Biomaterialia, 2014, 10.2: 1024-1034. 363
[24] Pattanayak, D.K., et al. Bioactive Ti metal analogous to human cancellous bone: Fabrication by selective laser melting and 364
chemical treatments. Acta Biomaterialia, 2011, 7.3: 1398-1406. 365
[25] Lee, Y.Ch.; Zotti, M.G.T.; Osti, O. L. Operative management of lumbar degenerative disc disease. Asian spine journal, 2016, 366
10.4: 801. 367
[26] Koszewski, W. Leczenie zespołów bólowych kręgosłupa w przebiegu dyskopatii. Lekarz POZ, 2015, 1.1: 23-33. 368
[27] Resnick, D.K., et al. Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 369
8: lumbar fusion for disc herniation and radiculopathy. Journal of Neurosurgery: Spine, 2005, 2.6: 673-678. 370
[28] Barczewska, M.; Maksymowicz, W.; Beta, J. Protezy dysków jako nowa alternatywa leczenia wybranej grupy chorych z 371
dyskopatią szyjną i lędźwiową. Probl Lek, 2006, 45: 7-10. 372
[29] Park, M.-K., et al. Risk factors for cage migration and cage retropulsion following transforaminal lumbar interbody fusion. 373
The Spine Journal, 2019, 19.3: 437-447. 374
[30] Zarzycki, D. Complications in the surgical treatment of the spinal column, The Journal of orthopaedics trauma syurgery and 375
related research. 2009, 3.15, 44-54. 376
J. Funct. Biomater. 2023, 14, x FOR PEER REVIEW 7 of 11
[31] Wei, R., et al. One-step reconstruction with a 3D-printed, custom-made prosthesis after total en bloc sacrectomy: a technical 377
note. European Spine Journal, 2017, 26: 1902-1909. 378
[32] Tay, Ch.Y., et al. Micro‐/nano‐engineered cellular responses for soft tissue engineering and biomedical applications. Small, 379
2011, 7.10: 1361-1378. 380
[33] Wennerberg, A.; Albrektsson, T.. Effects of titanium surface topography on bone integration: a systematic review. Clinical 381
oral implants research, 2009, 20: 172-184. 382
[34] Schwartz, Z., et al. Mechanisms regulating increased production of osteoprotegerin by osteoblasts cultured on microstruc- 383
tured titanium surfaces. Biomaterials, 2009, 30.20: 3390-3396. 384
[35] Szewczenko, J.; Nowinska, K.; Marciniak, J. Influence of initial surface treatment on corrosion resistance of Ti6Al4V ELI 385
alloy after anodizing. Przegląd Elektrotechniczny, 2011, 87.3: 228-231 386
[36] Marciniak, J.; Szewczenko, J.; Kajzer, W. Surface modification of implants for bone surgery. Archives of Metallurgy and Mate- 387
rials, 2015, 60.3: 2123-2129. 388
[37] Xiu, P, et al. Tailored surface treatment of 3D printed porous Ti6Al4V by microarc oxidation for enhanced osseointegration 389
via optimized bone in-growth patterns and interlocked bone/implant interface. ACS applied materials & interfaces, 2016, 8.28: 390
17964-17975. 391
[38] Li, J., et al. Rational design, bio-functionalization and biological performance of hybrid additive manufactured titanium 392
implants for orthopaedic applications: A review. Journal of the mechanical behavior of biomedical materials, 2020, 105: 103671. 393
[39] Fojt, J., et al. Corrosion behaviour and cell interaction of Ti-6Al-4V alloy prepared by two techniques of 3D printing. Materials 394
Science and Engineering: C, 2018, 93: 911-920. 395
[40] Bacakova, L., et al. Modulation of cell adhesion, proliferation and differentiation on materials designed for body implants. 396
Biotechnology advances, 2011, 29.6: 739-767. 397
[41] Anselme, K.; Ponche, A.; Bigerelle, M. Relative influence of surface topography and surface chemistry on cell response to 398
bone implant materials. Part 2: biological aspects. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of 399
Engineering in Medicine, 2010, 224.12: 1487-1507. 400
[42] Ran, Q., et al. Osteogenesis of 3D printed porous Ti6Al4V implants with different pore sizes. Journal of the Mechanical Behavior 401
of Biomedical Materials, 2018, 84: 1-11. 402
[43] Murr, L. E., et al. Microstructure and mechanical behavior of Ti–6Al–4V produced by rapid-layer manufacturing, for bio- 403
medical applications. Journal of the Mechanical Behavior of Biomedical Materials, 2009, 2.1: 20-32. 404
405
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual au- 406
thor(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to 407
people or property resulting from any ideas, methods, instructions, or products referred to in the content. 408