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Table 1 Questions compiled during an in-class polling session on the topic of interaction between medical devices and biological systems and classified depending on the discipline

From: Flipping the flipped: the co-creational classroom

Type Question
General How do we classify different types of interaction that might occur? What is the duration of the device integration process?
Materials chemistry Are natural biomaterials more interactive than the synthetic ones? Is it BIOmaterials or bioMATERIALS when it comes to defining this interaction? Does the conformation of adhesion proteins change depending on the crystal face dominantly exposed on the device surface? What surface properties decide if the device will be integrated or rejected? Can topography be designed to repel bacteria and promote adhesion of host cells?
Biophysics Why do hydrophobic surfaces bind more protein than the hydrophilic? Can entropic factors dominate the protein-material interaction energy term? Why is the initial adsorption rate often smaller than expected from diffusion coefficient values?
Cell biology What are the different cell responses depending on whether the cell has the affinity for the surface or not? How do we investigate the effects of substrate surface chemistry on monocyte adhesion, macrophage fusion, and foreign body giant cell development? What are the microenvironmental and the systemic responses to medical devices? What types of cells are most amenable to surface interaction? How can the interaction between cells and the surface of the device affect wound healing? How is hemocompatibility created in a device and how does it differ from other cell type compatibilities?
Medical science When does the interaction between the cell and the medical device result in an inflammatory response? What are the standards, specifically positive controls, used in studying the integration of the device? What are the age and physiological barriers in the interaction of cells and tissues with medical devices? Could a silent, asymptomatic interaction lead to severe problems? Does pyrogenic reaction, i.e., fever, invariably follow the implantation of the device? How can we prevent the infection and granulation tissue complications after the insertion of a medical device? What is the pathobiology of tumorigenesis triggered by medical devices? Which of these toxicity tests provides most valuable information––systemic, acute, subacute, or subchronic?