Network of cyano-p-aramid nanofibres creates ultrastiff and water-rich hydrospongels.

The structure-property paradox of biological tissues, in which water-rich porous structures efficiently transfer mass while remaining highly mechanically stiff, remains unsolved. Although hydrogel/sponge hybridization is the key to understanding this phenomenon, material incompatibility makes this a challenging task. Here we describe hydrogel/sponge hybrids (hydrospongels) that behave as both ultrastiff water-rich gels and reversibly squeezable sponges. The self-organizing network of cyano-p-aramid nanofibres holds approximately 5,000 times more water than its solid content. Hydrospongels, even at a water concentration exceeding 90 wt%, are hard as cartilage with an elastic modulus of 50-80 MPa, and are 10-1,000 times stiffer than typical hydrogels. They endure a compressive strain above 85% through poroelastic relaxation and hydrothermal pressure at 120 °C. This performance is produced by amphiphilic surfaces, high rigidity and an interfibrillar, interaction-driven percolating network of nanofibres. These features can inspire the development of future biofunctional materials.

Percolation-induced gel-gel phase separation in a dilute polymer network.

Cosmic large-scale structures, animal flocks and living tissues can be considered non-equilibrium organized systems created by dissipative processes. Replicating such properties in artificial systems is still difficult. Herein we report a dissipative network formation process in a dilute polymer-water mixture that leads to percolation-induced gel-gel phase separation. The dilute system, which forms a monophase structure at the percolation threshold, spontaneously separates into two co-continuous gel phases with a submillimetre scale (a dilute-percolated gel) during the deswelling process after the completion of the gelation reaction. The dilute-percolated gel, which contains 99% water, exhibits unexpected hydrophobicity and induces the development of adipose-like tissues in subcutaneous tissues. These findings support the development of dissipative structures with advanced functionalities for distinct applications, ranging from physical chemistry to tissue engineering.

Effects of network junctions and defects on the crystallization of model poly(ethylene glycol) networks.

Polymer crystallization drastically changes the physical properties of polymeric materials. However, the crystallization in polymer networks has been little explored. This study investigated the crystallization behavior of a series of poly(ethylene glycol) (PEG) networks consisting of well-defined branched precursors. The PEG networks were prepared by drying gels synthesized at various conditions. The PEG networks showed slower crystallization with lower final crystallinity than uncrosslinked PEGs with amine end groups. Surprisingly, the effect of network formation was not as significant as that of the relatively bulky end-groups introduced in the uncrosslinked polymer. The molecular weight of the precursor PEG, or equivalently the chain length between neighboring junctions, was the primary parameter that affected the crystallization of the PEG networks. Shorter network chains led to lower crystallization rates and final crystallinity. This effect became less significant as the network chain length increased. On the other hand, the spatial and topological defects formed in the gel synthesis process did not affect the crystallization in the polymer networks at all. The crystallization in the polymer networks seems insensitive to these mesoscopic defects and can be solely controlled by the chain length between junctions.

Analysis of the sustained release ability of bevacizumab-loaded tetra-PEG gel.

Multiple intravitreal injections, which are painful and costly, are often required in the treatment of retinal disorders. Therefore, a novel drug delivery system using hydrogels is currently being evaluated as an alternative. This study aimed to evaluate the ability of tetra-armed polyethylene glycol (tetra-PEG) gel for sustained release in vitro. Bevacizumab-loaded tetra-PEG gel and 5-Carboxyfluorescein N-succinimidyl ester (FAM-NHS)-labeled IgG-loaded tetra-PEG gel were prepared by mixing tetra-PEG with thiol termini (tetra-PEG-SH) solution, maleimide termini (tetra-PEG-MA) solution, and bevacizumab or FAM-NHS labeled IgG. The gels were prepared with three different polymer concentrations of 1.5%, 5%, and 10%, then an in vitro release study performed to assess the sustained release ability of the drug-loaded tetra-PEG gels. High performance liquid chromatography (HPLC) was used to test the structural stability of the bevacizumab released from the tetra-PEG gel. The binding of bevacizumab to tetra-PEG-SH or MA was assessed using SDS-polyacrylamide gel electrophoresis (PAGE). The bioactivity of released bevacizumab was tested using KDR/NFAT-RE HEK293 cells. In addition, in vitro degradation and swelling studies were also performed. The in vitro release analysis showed that the release of bevacizumab was slower in the 5% and 10% tetra-PEG gels than that of 1.5% tetra-PEG gels. Similarly, the release of FAM-NHS-labeled IgG was slowest in the 1.5%, 5%, and 10% tetra-PEG gels, in that order. The 5% and 10% tetra-PEG gels released bevacizumab and FAM-NHS-labeled IgG over a period of 1-2 weeks. Both bevacizumab and FAM-NHS-labeled IgG were not fully released in 2 weeks. HPLC analysis showed that the retention time of the samples released from the bevacizumab-loaded tetra-PEG gel was similar to that of the bevacizumab standard. The SDS-PAGE analysis showed that bevacizumab binds to tetra-PEG-MA. The bioactivity assay test revealed no decrease in the bioactivity of the released bevacizumab. In vitro degradation and swelling studies revealed that 1.5%, 5%, and 10% tetra-PEG gels expanded by approximately 1.4-, 2-, and 3-fold, respectively. Based on the results of the release and swelling tests, 5% tetra-PEG gels are considered good candidates for controlled release systems for therapeutic antibodies such as bevacizumab. The binding of PEG to the therapeutic antibodies may reduce the availability of therapeutic antibodies that can be released.

Brownian simulations for tetra-gel-type phantom networks composed of prepolymers with bidisperse arm length.

We studied the effect of arm length contrast of prepolymers on the mechanical properties of tetra-branched networks via Brownian dynamics simulations. We employed a bead-spring model without the excluded volume interactions, and we did not consider the solvent explicitly. Each examined 4-arm star branch prepolymer has uneven arm lengths to attain two-against-two (2a2) or one-against-three (1a3) configurations. The arm length contrast was varied from 38-2 to 20-20 for 2a2, and from 5-25 to 65-5 for 1a3, with the fixed total bead number of 81, including the single bead located at the branch point for prepolymers. We distributed 400 molecules in the simulation box with periodic boundary conditions, and the bead number density was fixed at 4. We created polymer networks by cross-end-coupling of equilibrated tetra-branched prepolymers. To mimic the experiments of tetra gels, we discriminated the molecules into two types and allowed the reaction only between different types of molecules at their end beads. The final conversion ratio was more than 99%, at which unreacted dangling ends are negligible. We found that the fraction of double linkage, in which two of the four arms connect a pair of branch points, increases from 3% to 15% by increasing the arm length contrast. We stretched the resultant tetra-type networks to obtain the ratio of mechanically effective strands. We found that the ratio is 96% for the monodisperse system, decreasing to 90% for high arm length contrast. We introduced bond scission according to the bond stretching to observe the network fracture under sufficiently slow elongation. The fracture behavior was not correlated with the fraction of double linkage because the scission occurs at single linkages.

Quasi-elastic neutron scattering study on dynamics of polymer gels with controlled inhomogeneity under uniaxial deformation.

We study the segmental and monomer dynamics of polymer gels with controlled inhomogeneity under uniaxial deformation by means of quasi-elastic neutron scattering (QENS). In order to clarify the effect of the homogeneity of a network structure on the polymer dynamics in gels, we compare two types of polymer gels with controlled homogeneity: a homogeneous tetra-PEG gel (homo-gel) prepared from uniform tetra-arm pre-polymers and a heterogeneous tetra-PEG gel (hetero-gel) with a small amount of shorter tetra-PEG pre-polymer. The different inhomogeneity in the homo-gel and the hetero-gel has little effect on the average relaxation time of the chain dynamics in the undeformed state. The difference in the local dynamics in the gels is emphasized under uniaxial deformation: while the homo-gel shows a single relaxation mode, the hetero-gel exhibits a bimodal distribution of relaxation times with a slow dynamic mode ascribed to highly stretched short strands, which causes a more brittle macroscopic fracture compared with that in the case of the homo-gel.

Dually-dynamic covalent tetraPEG hydrogels end-linked with boronate ester and acylhydrazone groups.

Well-defined dually dynamic hydrogels were prepared by end-linking four-armed poly(ethylene glycol) stars (tetraPEG stars) through two different types of dynamic covalent cross-links, boronates and acylhydrazones, leading to robust, self-healable materials. This required the prior end-functionalization of tetraPEG stars, originally bearing four hydroxyl terminal groups, with glucoronate, acylhydrazide and benzaldehyde groups, resulting in three differently end-functional star polymers. A first type of dually dynamic hydrogel resulted from the combination of the first two differently end-functionalized tetraPEG stars, cross-linked by 4-formylphenyl boronic acid, a small molecule bearing both an aldehyde and a boronic acid group, respectively complementary to the acylhydrazide and glucoronate end-groups of the two above-mentioned tetraPEG stars. For comparison, a singly-dynamic hydrogel cross-linked with only acylhydrazone groups was also prepared, as well as a double-like hydrogel combining the constituents of both of the above-mentioned hydrogels. All three types of hydrogels were prepared at three different pH values, 8.5, 10.5 and 12.5, leading to a total number of nine samples. All nine samples were investigated for their self-healing, mechanical, viscoelastic and aqueous swelling/degradation properties. This study sets the basis for the development of well-defined polymeric dynamic covalent hydrogels where their self-healing and stability can be readily tuned.

Hemostatic Capability of a Novel Tetra-Polyethylene Glycol Hydrogel.

BACKGROUND: TetraStat is a tetra-armed polyethylene glycol (PEG) hydrogel. It is a synthetic sealant that solidifies instantly in response to pH changes. This study aimed to evaluate the hemostatic effect of TetraStat through experiments evaluating future clinical applications. METHODS: We used TetraStat, oxidized regenerated cellulose (SURGICEL®), and fibrinogen and thrombin sealant patch (TachoSil®) using in vitro and in vivo experiments. For the in vitro experiment, a closed circulatory system filled with phosphate-buffered saline under high pressure was used. Needle punctures were created and closed using the various sealants. For the in vivo experiment, rat venae cavae were punctured with 18- and 20-gauge (G) needles, and hemorrhage was allowed to occur for several seconds. A porous PEG sponge soaked with TetraStat was applied as a hemostatic system. Hemostasis outcomes were compared among the various concentrations (40-100 g/L) of TetraStat, SURGICEL, and TachoSil. RESULTS: The punctured holes in the prosthetic graft were successfully sealed with TetraStat in 1 min. The success rate of hemostasis with TetraStat for the punctured holes in the rat vena cava was dose-dependent. TetraStat was effective in sealing the holes created with a 20 G needle at all concentrations; however, the holes created with an 18 G needle could be sealed only when the concentration ≥60 g/L. Hemostasis using SURGICEL or TachoSil was less successful and sometimes required up to 5 min. CONCLUSIONS: TetraStat has a high hemostatic ability. A porous PEG sponge soaked with TetraStat is a useful choice for effective hemostasis during massive hemorrhage.

Analysis of factors contributing to medication errors during self-management of medication in the rehabilitation ward: a case control study.

BACKGROUND: In the rehabilitation ward, many elderly patients require continuous use of medication after a stroke or bone fracture, even after discharge. They are encouraged to self-manage their medications from the time of admission. Medication errors, such as a missed dose or incorrect administered medication can worsen conditions, resulting in recurrent strokes, fractures, or adverse effects. The study was aimed to identify risk factors, such as medication and prescription, contributing to errors in self-management of medication. METHODS: This study was conducted on patients who self-managed their medication in the rehabilitation ward of Higashinagoya National Hospital from April 2018 to March 2020. The patient background including age and sex were investigated. The medication factors examined include the number of medications and administrations per day, dosing frequency on indicated days, prescription and start date are the same, medications from multiple prescriptions, and one package or one tablet at each dosage. The group of medication error cases were defined as the medication error group and that of control cases as the no-medication error group. A logistic regression analysis was performed for factors related to medication errors. RESULTS: A total of 348 patients were included in the study, of which 154 patients made medication errors, with 374 total medication error cases. The median number of medications in the medication error group was six, and that in the no-medication error group was five. Statistically significant factors correlated with errors made during self-management of medication were the number of medications, number of administrations per day, dosing frequency on indicated days, and medication from multiple prescriptions. CONCLUSIONS: When a patient is self-managing their medications, errors are likely to occur due to a high number of medicines they are taking and the complexity of the dosage regimen. Therefore, to prevent medication errors, reviewing the prescribed medications and devise ways to simplify the dosage regimens is crucial.

Temperature Dependence of Polymer Network Diffusion.

The swelling dynamics of polymer gels are characterized by the (collective) diffusion coefficient D of the polymer network. Here, we measure the temperature dependence of D of polymer gels with controlled homogeneous network structures using dynamic light scattering. An evaluation of the diffusion coefficient at the gelation point D_{gel} and the increase therein as the gelation proceeds ΔD≡D-D_{gel} indicates that ΔD is a linear function of the absolute temperature with a significantly large negative constant term. This feature is formally identical to the recently discovered "negative energy elasticity" [Y. Yoshikawa et al. Phys. Rev. X 11, 011045 (2021)PRXHAE2160-330810.1103/PhysRevX.11.011045], demonstrating a nontrivial similarity between the statics and dynamics of polymer networks.

The impact of regulation changes in the spontaneous reporting system for vaccines on reporting trends and signal detection in Japan.

PURPOSE: Spontaneous reporting constitutes one of the most fundamental and important systems for pharmacovigilance. In Japan, important regulation changes in the vaccine spontaneous reporting were implemented between 2009 and 2013; however, no studies had yet assessed the impact of the changes. The objective of this study was to assess the impact on the reporting trends in vaccine reports and on signal detection for vaccines. METHODS: For assessment of the impact on the reporting trends, we performed the joinpoint trend analysis and descriptively considered number of vaccine reports grouped by the timing of the regulation change. For assessment of the impact on signal detection, we performed signal detection using dataset during the pre or postperiod of the regulation changes, and compared their agreement rates, which was calculated with a reference set for vaccines, created by the Global Research in Paediatrics project. RESULTS: We retrieved 467 635 spontaneous reports, including 12 287 vaccine reports from April 2004 to March 2019. The average number of vaccine reports per year increased from 231 reports during the preperiod to 1227 during the postperiod. The joinpoint trend analysis found two joinpoints and differentiated three trends, significant increased trend of which was observed when regulations had changed. For signal detection, the agreement rate was improved when using data during the postperiod. CONCLUSION: We concluded that the regulation changes increased the number of vaccine reports, and could have improved signal detection performance for vaccines by accelerating accumulation of reports, while more spontaneous reports are necessary to optimize signal detection.

Disproportionality Analysis of Safety Signals for a Wide Variety of Opioid-Related Adverse Events in Elderly Patients Using the Japanese Adverse Drug Event Report (JADER) Database.

Opioids are widely used for the treatment of moderate/severe pain in cancer and noncancer patients. In this study, we searched for safety signals for a wide variety of opioid-related adverse events (AEs) in elderly patients by disproportionality analysis using the Japanese Adverse Drug Event Report (JADER) database. Data from the JADER database from April 2004 to May 2018 were obtained from the Pharmaceuticals and Medical Devices Agency website. Safety signal detection of opioid-related AEs in elderly patients was defined using the relative elderly reporting odds ratio (ROR). Among the analyzed AEs, opioid-induced neurotoxicity (OIN) was assessed based on the time to onset using the Weibull shape parameter. The following safety signals were detected in elderly patients: respiratory depression, somnolence, hallucinations, akathisia and OIN. Fentanyl, tramadol, oxycodone and morphine exhibited a large relative elderly ROR for OIN. The median time to onset of OIN of transdermal fentanyl, oral tramadol, oral oxycodone and oral morphine was 13.5, 6, 9, and 6 d, respectively. These opioids were classified as early failure types using the Weibull distribution. Our results showed that elderly patients who are administered opioids should be closely monitored for AEs, such as respiratory depression, OIN and akathisia.

Identification of target small molecule tyrosine kinase inhibitors that need monitoring and clinical application of protocol for early detection of cancer therapeutics-related cardiac dysfunction using signal detection: An investigation of real world data.

PURPOSE: In order to detect cancer therapeutics-related cardiac dysfunction (CTRCD) early, we identified which drugs were to be monitored using signal detection and the package insert, and created and applied a protocol to address this. METHODS: Adverse event data recorded in the Japanese Adverse Drug Event Report (JADER) database between April 2004 and January 2018 were used. Among small molecule tyrosine kinase inhibitors that are not described in the serious side-effects section of the package insert despite signal detection, tyrosine kinase inhibitors with severe side-effects in the background of cases reported by JADER database were selected to be monitored in clinical practice. We applied our findings clinically by creating a protocol to detect CTRCD early. All cases at Tosei General Hospital where the target tyrosine kinase inhibitors were administered from when they were first released in November 2019 were included. We compared the results from before and after we began the protocol to clarify its effects. RESULTS: We found that CTRCD was not described in the serious side-effect section of the package inserts for Bosutinib, Alectinib, and Osimertinib even though CTRCD signals were detected for them. Therefore, it is possible that we may have previously overlooked CTRCD. When we applied our protocol using Osimertinib as the target drug, we were able to detect CTRCD early in 5/21 (24%) patients. CONCLUSIONS: It was clarified that the drug identification method used in this study for early detection of adverse events leads to early detection of adverse events when applied clinically.

Universal Equation of State Describes Osmotic Pressure throughout Gelation Process.

The equation of state of the osmotic pressure for linear-polymer solutions in good solvents is universally described by a scaling function. We experimentally measure the osmotic pressure of the gelation process via osmotic deswelling. We find that the same scaling function for linear-polymer solutions also describes the osmotic pressure throughout the gelation process involving both the sol and gel states. Furthermore, we reveal that the osmotic pressure of polymer gels is universally governed by the semidilute scaling law of linear-polymer solutions.

Relationship between Bulk Physicochemical Properties and Surface Wettability of Hydrogels with Homogeneous Network Structure.

Controlling hydrogel surface wettability is of great importance in the viewpoint of engineering biomaterials that are in contact with cells and tissues. However, studies reporting how the hydrogel bulk properties would affect the surface is scarce, and thus it has been difficult to fabricate hydrogels with the desired properties. Also, there has been no effective method to elucidate this, due to the inhomogeneity introduced in the network structure of conventional hydrogels. Here we report our approach in elucidating the relationship between hydrogel physicochemical parameters and surface wettability by using Tetra-PEG gels, which are known to have homogeneous network structure. Specifically, the polymer volume fraction (φ) and the molecular weight (MW) between the cross-links were controlled. The number of anions, cations, and ionic pairs introduced within the hydrogel, were also individually controlled. The surface wettability of the resulting hydrogels was then evaluated. Results showed that surface wettability is largely dependent on the concentration of charged groups that are introduced in the hydrogel bulk, especially those that are not paired and ionically stabilized. Our findings strongly support the fact that with conventional hydrogels, the correlation between surface wettability and its physicochemical properties had not been evaluated appropriately, and thus our insights will contribute significantly to accumulating further knowledge on controlling hydrogel surface wettability.

Quality evaluation of the Japanese Adverse Drug Event Report database (JADER).

INTRODUCTION: The spontaneous adverse drug reaction (ADR) reporting system plays an important role in pharmacovigilance by providing information from clinical settings in the postmarketing environment. The Japanese Adverse Drug Event Report (JADER) database contains a portion of Japanese ADR reports, and no previous study has described the quality or characteristics of ADR reports in the JADER. OBJECTIVE: The aim of this study was to identify the characteristics of the JADER database and to evaluate the quality of ADR reports contained in the JADER using the documentation-grading scheme developed by the World Health Organization. METHODS: Of 478 508 ADR reports in the JADER, the analysis set consisted of 395 091 reports meeting inclusion criteria. An analysis was carried out to evaluate the quality of the reports according to the type of report, the type of sender, and the qualification of the reporter. Annual changes in the number of reports from medical institutions submitted by pharmacists were compared with changes in the number submitted by physicians. RESULTS: The distribution of documentation grade differed according to the type of report, the type of sender, and the qualification of the reporter. Regarding "medical institution reports", the quality of reports was similar among qualification types, while the quality of reports submitted by physicians was higher for "company reports" and "study reports" (P < .0001, respectively). CONCLUSION: Our study showed that the quality of the ADR reports in the JADER differed among the type of report, the sender of the report, and the qualification of the reporter.

Connectivity dependence of gelation and elasticity in AB-type polymerization: an experimental comparison of the dynamic process and stoichiometrically imbalanced mixing.

To control various physical properties of polymer gels, it is important to control the connection probability between functional groups of network structures (connectivity). In this study, we compare two methodologies tuning the connectivity in AB-type polymerization: one is stopping the reaction intentionally at a certain conversion, and the other is mixing two prepolymers in a stoichiometrically imbalanced ratio. By experimentally examining the relationships between elastic modulus and connectivity, we find that the relationships are almost the same for these two methodologies. However, the critical connectivity for gelation is different. These results are well reproduced by a kind of phantom network model whose structural parameters are estimated by using a mean-field approximation.

Structure-property relationship of a model network containing solvent.

For the application of polymer gels, it is necessary to control independently and precisely their various physical properties. However, the heterogeneity of polymer gels hinders the precise control over the structure, as well as the verification of theories. To understand the structure-property relationship of polymer gels, many researchers have tried to develop a homogeneous model network. Most of the model networks were made from polymer melts that did not have a solvent and had many entanglements in the structure. Because the contribution of entanglements is much larger than that of chemical crosslinking, it was difficult to focus on the crosslinking structure, which is the structure considered in conventional theories. To overcome such a situation, we have developed a new model network system that contains much solvent. Specifically, we fabricated the polymer gel (Tetra-PEG gel) by mixing two types of solutions of tetra-armed poly(ethylene glycol) (Tetra-PEG) with mutually reactive end groups (amine (-PA) and activated ester (-HS)). Because the existence of a solvent strongly reduces the effect of entanglements, the effect of the crosslinking structure on the physical properties can be extracted. In this review, we present the structure-property relationship of Tetra-PEG gel. First, we show the structural homogeneity of Tetra-PEG gels. Then, we explain gelation reaction, elastic modulus, fracture energy and kinetics of swelling and shrinking of Tetra-PEG gels by comparing the theories and experimental results.

Enzyme-Catalyzed Bottom-Up Synthesis of Mechanically and Physicochemically Stable Cellulose Hydrogels for Spatial Immobilization of Functional Colloidal Particles.

The dispersion stabilization of colloidal particles and subsequent construction of functional materials are of great interest in areas ranging from colloid chemistry to materials science. A promising strategy is the spatial immobilization of colloidal particles within gel scaffolds. However, conventional gels readily deform and even collapse when changes in environmental conditions occur. Herein, we describe the enzyme-catalyzed bottom-up synthesis of mechanically and physicochemically stable nanoribbon network hydrogels composed of crystalline cellulose oligomers in which cellulose nanocrystals (CNCs) as model colloidal particles are immobilized spatially. The stiffness of the hydrogels increased with the amount of CNCs incorporated. Filling the void space of the hydrogels with hydrophobic polymers resulted in polymer nanocomposites with excellent mechanical properties. The nanoribbon networks will be useful for demonstrating the potential functions of colloidal particles.

Network elasticity of a model hydrogel as a function of swelling ratio: from shrinking to extreme swelling states.

In this work, we intended to investigate the relationship between the swelling ratio Q and Young's modulus E of hydrogels from their contracted state to extreme swelling state and elucidate the underlining molecular mechanism. For this purpose, we used tetra-poly(ethylene glycol) (tetra-PEG) gel, whose network parameters are well known, as the polymer backbone, and we succeeded in tuning the swelling of the gel by a factor of 1500 times while maintaining the topological structure of the network unchanged, using an approach combining a molecular stent method and a PEG dehydration method. A master curve of Q-E, independent of the method of obtaining Q, was obtained. Using the worm-like chain model, the experimentally determined master curve can be well reproduced. We also observed that the uniaxial stress-strain curve of the hydrogel can be well predicted by the worm-like chain model using the structure parameters determined from the fitting of the Q-E experimental curve.