Defect sites on bone minerals play a critical role in bone remodeling processes. We investigated single crystal hydroxyapatite (100) surfaces bearing crystal defects under acidic dissolution conditions using real-time in situ atomic force microscopy. At defect sites, surface structure-dependent asymmetric hexagonal etch pits were formed, which dominated the overall dissolution rate. Meanwhile, dissolution from the flat terraces proceeded by stochastic formation of flat bottom etch pits. The resulting pit shapes were intrinsically dictated by the HAP crystal structure. Computational modeling also predicted different step energies associated with different facets of the asymmetric etch pits. Our microscopic observations of HAP dissolution are significant for understanding the effects of local surface structure on the bone mineral remodeling process and provide useful insights for the design of novel therapies for treating osteoporosis and dental caries.

We consider the attributes of a successful engineered material, acknowledging the contributions of composition and processing to properties and performance. We recognize the potential for relevant lessons to be learned from nature, at the same time conceding both the limitations of such lessons and our need to be selective. We then give some detailed attention to the molecular biomimicry of filamentous phage, the process biomimicry of silk and the structure biomimicry of hippopotamus 'sweat', in each case noting that the type of lesson now being learned is not the same as the potential lesson that originally motivated the study.

Objective: To assess the attitudinal impact of patients living with T1D in the United States. Methods: Between Sep 10th-Oct 21st, 2018, a representative sample of United States patients (n=600, 56% male, mean age 40.6 years, managing their T1D with multiple daily injections (MDI) or insulin pump therapy completed a 102-question online survey (5- or 7-point Likert scale) designed by Inspired Insight (Boston, Massachusetts, U.S.) in partnership with Medtronic. Respondent sample was identified and screened with standard methods. Analyses were conducted using Pearson’s correlation and quadratic equation modeling. Results: Of the respondents, 47% agreed that T1D is a burden, 65% agreed that they wished they could escape their disease, 60% felt they were in control of their diabetes, and 57% agreed that their diabetes did not define them. Additionally, 60% of the respondents felt they were very knowledgeable about their disease, 71% were very motivated to manage their disease, and 72% were very interested in learning more about managing their disease. The longer that respondents had been living with diabetes, the less likely they felt in control of managing diabetes (Pearsons’ r=-0.108, p=0.008). While at the same time, motivation to manage their disease tended to increase (p=0.073, non-linear regression) and the overall level of knowledge tended to increase (r=0.071, p=0.067). Conclusions: Not surprisingly, T1D is being perceived as a burdensome disease that many patients wish to escape from. Although patients who have been living with T1D longer feel that they lose control of diabetes management, they tend to become motivated to increase their knowledge toward better management of their diabetes. Disclosure J. Alford: Employee; Self; Medtronic. M. Koobatian: Employee; Self; Medtronic. B. Daigle: Research Support; Self; Medtronic MiniMed, Inc. K. Mathews: Other Relationship; Self; Medtronic. L. Dias: Employee; Self; Medtronic.

Objective: To assess patient attitudes, reactions, and motivations resulting from living with T1D. Methods: Between Sep 10th-Oct 21st, 2018, a representative sample of United States patients (n=600, 56% male, mean age 40.6 years, managing their T1D with multiple daily injections (MDI) or insulin pump therapy completed a 102-question online survey (5- or 7-point Likert scale) designed by Inspired Insight (Boston, Massachusetts, U.S.) in partnership with Medtronic. Respondent sample was identified and screened with standard methods. Analyses were conducted using Pearson’s correlation and quadratic equation modeling. Results: The survey showed that 58% of the respondents reported their disease as severe. Since the time of diagnosis, 44% of the individuals reported that living with diabetes has had a positive impact on their life, while 41% reported that it has had a negative impact on their life. Those respondents who felt that living with the disease negatively impacted their life, reported that the negative aspects were related to self-confidence (59%), achieving emotional wellbeing (58%), and the ability to be happy/optimistic (57%). Interestingly, those respondents who felt that living with the disease has positively impacted their life, reported that the positive aspects were related to having self-confidence (81%), being physically fit/active (80%), and achieving emotional wellbeing (80%). Conclusions: Though the majority of patients who were assessed recognized the severity of their disease, they were polarized when it came to reporting how living with diabetes has impacted their life. Some found that their self-confidence and emotional wellbeing were positively impacted, while a proportionate number felt the opposite. Disclosure J. Alford: Employee; Self; Medtronic. M. Koobatian: Employee; Self; Medtronic. B. Daigle: Research Support; Self; Medtronic MiniMed, Inc. K. Mathews: Other Relationship; Self; Medtronic. L. Dias: Employee; Self; Medtronic.