Quantitative Comparison of the Hydration Capacity of Surface-Bound Dextran and Polyethylene Glycol.

We have quantified and compared the hydration capacity (i.e., capability to incorporate water molecules) of the two surface-bound hydrophilic polymer chains, dextran (dex) and poly(ethylene glycol) (PEG), in the form of poly(l-lysine)-graft-dextran (PLL-g-dex) and poly(l-lysine)-graft-poly(ethylene glycol) (PLL-g-PEG), respectively. The copolymers were attached to a negatively charged silica-titania surface through the electrostatic interaction between the PLL backbone and the surface in neutral aqueous media. While the molecular weights of PLL and PEG were fixed, that of dex and the grafting density of PEG or dex on the PLL were varied. The hydration capacity of the polymer chains was quantified through the combined experimental approach of optical waveguide lightmode spectroscopy (OWLS) and quartz crystal microbalance with dissipation monitoring (QCM-D) to yield a value for areal solvation (Ψ), i.e., mass of associated solvent molecules within the polymer chains per unit substrate area. For the two series of copolymers with comparable stretched chain lengths of hydrophilic polymers, namely, PLL(20)-g-PEG(5) and PLL(20)-g-dex(10), the Ψ values gradually increased as the initial grafting density on the PLL backbone increased or as g decreased. However, the rate of increase in Ψ was higher for PEG than dextran chains, which was attributed to higher stiffness of the dextran chains. More importantly, the number of water molecules per hydrophilic group was clearly higher for PEG chains. Given that the -CH2CH2O- units that make up the PEG chains form a cage-like structure with 2-3 water molecules, these "strongly bound" water molecules can account for the slightly more favorable behavior of PEG compared to dextran in both aqueous lubrication and antifouling behavior of the copolymers.

Measuring Rolling Friction at the Nanoscale.

Colloidal probe microscopy, a technique whereby a microparticle is affixed at the end of an atomic force microscopy (AFM) cantilever, plays a pivotal role in enabling the measurement of friction at the nanoscale and is of high relevance for applications and fundamental studies alike. However, in conventional experiments, the probe particle is immobilized onto the cantilever, thereby restricting its relative motion against a countersurface to pure sliding. Nonetheless, under many conditions of interest, such as during the processing of particle-based materials, particles are free to roll and slide past each other, calling for the development of techniques capable of measuring rolling friction alongside sliding friction. Here, we present a new methodology to measure lateral forces during rolling contacts based on the adaptation of colloidal probe microscopy. Using two-photon polymerization direct laser writing, we microfabricate holders that can capture microparticles, but allow for their free rotation. Once attached to an AFM cantilever, upon lateral scanning, the holders enable both sliding and rolling contacts between the captured particles and the substrate, depending on the interactions, while simultaneously giving access to normal and lateral force signals. Crucially, by producing particles with optically heterogeneous surfaces, we can accurately detect the presence of rotation during scanning. After introducing the workflow for the fabrication and use of the probes, we provide details on their calibration, investigate the effect of the materials used to fabricate them, and report data on rolling friction as a function of the surface roughness of the probe particles. We firmly believe that our methodology opens up new avenues for the characterization of rolling contacts at the nanoscale, aimed, for instance, at engineering particle surface properties and characterizing functional coatings in terms of their rolling friction.

Renewing our commitment to protect children experiencing armed conflict.

Civilian casualties from armed conflicts have increased, such that 90% of deaths from armed conflicts in the first decade of the 21st century have been civilians, a significant number of whom are children. The acute and chronic effects of armed conflict on child health and well-being are among the most significant children's rights violations of the 21st century. Children are increasingly exposed to armed conflict and targeted by governmental and non-governmental combatants. Despite International Human Rights and Humanitarian laws and multiple international declarations, conventions, treaties and courts, injury and death of children due to armed conflicts have worsened over the decades. It is critically important that a concerted effort be undertaken to address and rectify this issue. Toward this end, the Internal Society of Social Pediatrics and Chid Health (ISSOP) and others have called for a renewed commitment to children experiencing armed conflict with an immediate call to implement a new UN Humanitarian Response on Child Casualties in Armed Conflict.

Management of Diabetic Ketoacidosis in Pregnancy.

Diabetic ketoacidosis (DKA) is a rare, but potentially life-threatening complication of diabetes. Certain physiological changes during pregnancy predispose pregnant individuals to developing DKA. Early recognition and aggressive treatment are essential to avoid maternal and fetal morbidity and mortality. Although laboratory values can help to support, pregnant patients with DKA may not meet the usual criteria and the diagnosis can be made clinically. The key components to treatment include volume replacement, insulin infusion, correction of serum potassium, and fetal monitoring. With appropriate treatment, maternal mortality is low. After recovery, steps should be taken to avoid recurrence.

Household income and maternal education in early childhood and risk of overweight and obesity in late childhood: Findings from seven birth cohort studies in six high-income countries.

BACKGROUND/OBJECTIVES: This study analysed the relationship between early childhood socioeconomic status (SES) measured by maternal education and household income and the subsequent development of childhood overweight and obesity. SUBJECTS/METHODS: Data from seven population-representative prospective child cohorts in six high-income countries: United Kingdom, Australia, the Netherlands, Canada (one national cohort and one from the province of Quebec), USA, Sweden. Children were included at birth or within the first 2 years of life. Pooled estimates relate to a total of N = 26,565 included children. Overweight and obesity were defined using International Obesity Task Force (IOTF) cut-offs and measured in late childhood (8-11 years). Risk ratios (RRs) and pooled risk estimates were adjusted for potential confounders (maternal age, ethnicity, child sex). Slope Indexes of Inequality (SII) were estimated to quantify absolute inequality for maternal education and household income. RESULTS: Prevalence ranged from 15.0% overweight and 2.4% obese in the Swedish cohort to 37.6% overweight and 15.8% obese in the US cohort. Overall, across cohorts, social gradients were observed for risk of obesity for both low maternal education (pooled RR: 2.99, 95% CI: 2.07, 4.31) and low household income (pooled RR: 2.69, 95% CI: 1.68, 4.30); between-cohort heterogeneity ranged from negligible to moderate (p: 0.300 to < 0.001). The association between RRs of obesity by income was lowest in Sweden than in other cohorts. CONCLUSIONS: There was a social gradient by maternal education on the risk of childhood obesity in all included cohorts. The SES associations measured by income were more heterogeneous and differed between Sweden versus the other national cohorts; these findings may be attributable to policy differences, including preschool policies, maternity leave, a ban on advertising to children, and universal free school meals.

Polymeric Friction Modifiers: Influence of Anchoring Chemistry on Their Adsorption and Effectiveness.

Correlated adsorption and lubricity have been investigated using polymeric friction modifiers, specifically designed with an oleophilic brush-forming block and an anchoring block of comparable length. Through adsorption, rheology, and friction measurements, we have highlighted the existence of boundary layers, whose molecular organization and mechanical properties govern the frictional behavior. We have demonstrated that changing the anchoring chemistry controls the final ordering in the boundary layer. The stability of the surface anchoring governs the onset of repulsion between the polymer layers and the capacity of the layer to withstand shear. The higher degree of molecular order provided by the most firmly anchored polymer to the surface was thereby responsible for the significant friction reduction observed.

Dispersity within Brushes Plays a Major Role in Determining Their Interfacial Properties: The Case of Oligoxazoline-Based Graft Polymers.

Many synthetic polymers used to form polymer-brush films feature a main backbone with functional, oligomeric side chains. While the structure of such graft polymers mimics biomacromolecules to an extent, it lacks the monodispersity and structural purity present in nature. Here we demonstrate that side-chain heterogeneity within graft polymers significantly influences hydration and the occurrence of hydrophobic interactions in the subsequently formed brushes and consequently impacts fundamental interfacial properties. This is demonstrated for the case of poly(methacrylate)s (PMAs) presenting oligomeric side chains of different length (n) and dispersity. A precise tuning of brush structure was achieved by first synthesizing oligo(2-ethyl-2-oxazoline) methacrylates (OEOXMAs) by cationic ring-opening polymerization (CROP), subsequently purifying them into discrete macromonomers with distinct values of n by column chromatography, and finally obtaining poly[oligo(2-ethyl-2-oxazoline) methacrylate]s (POEOXMAs) by reversible addition-fragmentation chain-transfer (RAFT) polymerization. Assembly of POEOXMA on Au surfaces yielded graft polymer brushes with different side-chain dispersities and lengths, whose properties were thoroughly investigated by a combination of variable angle spectroscopic ellipsometry (VASE), quartz crystal microbalance with dissipation (QCMD), and atomic force microscopy (AFM) methods. Side-chain dispersity, or dispersity within brushes, leads to assemblies that are more hydrated, less adhesive, and more lubricious and biopassive compared to analogous films obtained from graft polymers characterized by a homogeneous structure.

Applying an Oleophobic/Hydrophobic Fluorinated Polymer Monolayer Coating from Aqueous Solutions.

Despite major advancements in the fabrication of low-surface-energy surfaces, the environmental consequences of their fabrication can be a serious issue, particularly in an industrial context. This is especially the case for fluorine-based coatings, which often require fluorinated solvents for their processing and applications. These solvents are not only detrimental to the ozone layer but also represent a potential workplace hazard because they tend to bioaccumulate. We describe the design, synthesis, and characterization of a new fluorinated-polymer coating that can be simply applied to surfaces from an aqueous environment using a dip-coating technique. This was made possible by copolymerizing three different methacrylate monomers, each serving a specific function. Namely, fluorinated methacrylate providing oleo/hydrophobicity, photocleavable polyethylene glycol (PEG) methacrylate promoting water solubility of the copolymer, and thioether-based methacrylate serving as an anchoring unit to a number of different substrates. This copolymer is initially grafted to the surface as a monolayer from an aqueous solvent, after which the system is treated with ultraviolet (UV) light, cleaving away the protecting PEG moieties to yield an oleo/hydrophobic surface.

Oxygen inhibition of free-radical polymerization is the dominant mechanism behind the "mold effect" on hydrogels.

Hydrogel surfaces are of great importance in numerous applications ranging from cell-growth studies and hydrogel-patch adhesion to catheter coatings and contact lenses. A common method to control the structure and mechanical/tribological properties of hydrogel surfaces is by synthesizing them in various mold materials, whose influence has been widely ascribed to their hydrophobicity. In this work, we examine possible mechanisms for this "mold effect" on the surface of hydrogels during polymerization. Our results for polyacrylamide gels clearly rule out the effect of mold hydrophobicity as well as any thermal-gradient effects during synthesis. We show unequivocally that oxygen diffuses out of certain molding materials and into the reaction mixture, thereby inhibiting free-radical polymerization in the vicinity of the molding interface. Removal of oxygen from the system results in homogeneously cross-linked hydrogel surfaces, irrespective of the substrate material used. Moreover, by varying the amount of oxygen at the surface of the polymerizing solutions using a permeable membrane we are able to tailor the surface structures and mechanical properties of PAAm, PEGDA and HEMA hydrogels in a controlled manner.

Magnetic propulsion of colloidal microrollers controlled by electrically modulated friction.

Precise control over the motion of magnetically responsive particles in fluidic chambers is important for probing and manipulating tasks in prospective microrobotic and bio-analytical platforms. We have previously exploited such colloids as shuttles for the microscale manipulation of objects. Here, we study the rolling motion of magnetically driven Janus colloids on solid substrates under the influence of an orthogonal external electric field. Electrically induced attractive interactions were used to tune the load on the Janus colloid and thereby the friction with the underlying substrate, leading to control over the forward velocity of the particle. Our experimental data suggest that the frictional coupling required to achieve translation, transitions from a hydrodynamic regime to one of mixed contact coupling with increasing load force. Based on this insight, we show that our colloidal microrobots can probe the local friction coefficient of various solid surfaces, which makes them potentially useful as tribological microsensors. Lastly, we precisely manipulate porous cargos using our colloidal rollers, a feat that holds promise for bio-analytical applications.

Roughness-dependent tribology effects on discontinuous shear thickening.

Surface roughness affects many properties of colloids, from depletion and capillary interactions to their dispersibility and use as emulsion stabilizers. It also impacts particle-particle frictional contacts, which have recently emerged as being responsible for the discontinuous shear thickening (DST) of dense suspensions. Tribological properties of these contacts have been rarely experimentally accessed, especially for nonspherical particles. Here, we systematically tackle the effect of nanoscale surface roughness by producing a library of all-silica, raspberry-like colloids and linking their rheology to their tribology. Rougher surfaces lead to a significant anticipation of DST onset, in terms of both shear rate and solid loading. Strikingly, they also eliminate continuous thickening. DST is here due to the interlocking of asperities, which we have identified as "stick-slip" frictional contacts by measuring the sliding of the same particles via lateral force microscopy (LFM). Direct measurements of particle-particle friction therefore highlight the value of an engineering-tribology approach to tuning the thickening of suspensions.

Oxygen Tolerant and Cytocompatible Iron(0)-Mediated ATRP Enables the Controlled Growth of Polymer Brushes from Mammalian Cell Cultures.

The use of zerovalent iron (Fe0)-coated plates, which act both as a source of catalyst and as a reducing agent during surface-initiated atom transfer radical polymerization (SI-ATRP), enables the controlled growth of a wide range of polymer brushes under ambient conditions utilizing either organic or aqueous reaction media. Thanks to its cytocompatibility, Fe0 SI-ATRP can be applied within cell cultures, providing a tool that can broadly and dynamically modify the substrate's affinity toward cells, without influencing their viability. Upon systematically assessing the application of Fe-based catalytic systems in the controlled grafting of polymers, Fe0 SI-ATRP emerges as an extremely versatile technique that could be applied to tune the physicochemical properties of a cell's microenvironments on biomaterials or within tissue engineering constructs.

The hierarchical bulk molecular structure of poly(acrylamide) hydrogels: beyond the fishing net.

The polymeric structure of hydrogels is commonly presented in the literature as resembling a fishing net. However, this simple view cannot fully capture all the unique properties of these materials. Crucial for a detailed description of the bulk structure in free-radical polymerized vinylic hydrogels is a thorough understanding of the cross-linker distribution. This work focuses on the precise role of the tetra-functional cross-linker in the hydrogel system: acrylamide-N,N'-methylenebis(acrylamide). Clusters of crosslinker smaller than 4 nm and their agglomerates, as well as polymer domains with sizes from the 100 nm to the µm-range, have been identified by means of both X-ray and visible-light scattering. Placed in the context of the extensive literature on this system, these observations demonstrate the heterogeneous organisation of the polymer within the hydrogel network structure, and can be accounted for by the different polymerization behavior of the monomer and crosslinker. Together with polymer-network chain-length approximations based on swelling experiments and structural observations with scanning electron microscopy, these results indicate a hierarchical structure of the polymer network surrounding pockets of water.

The impact of low-dose versus high-dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery.

OBJECTIVE: The objective of this study was to determine if high-dose antibiotic prophylaxis with cefazolin decreases the risk of surgical site infection (SSI) after a cesarean delivery. METHODS: We performed a retrospective cohort study of women who underwent a cesarean section. Two preoperative antibiotic regimens were compared: low dose versus high dose. The primary outcome was SSI. A sample size of 343 patients per group was calculated for a 50% reduction in risk for SSI. RESULTS: Seven hundred and thirty women were included with an incidence of SSI of 5%. Women who received the high-dose antibiotic regimen had lower rates of risk factors for SSI. The only exception was skin incision closure with staples. The rate of SSI did not differ between the low-dose and high-dose groups, even after adjusting for confounding variables [aOR 1.78, 95% CI (0.82-3.9)]. CONCLUSIONS: Higher doses of antibiotic prophylaxis did not decrease the rates of SSI after cesarean delivery.

Synthesis of Polymers Containing Potassium Acyltrifluoroborates (KATs) and Post-polymerization Ligation and Conjugation.

We report the synthesis of monomers for atom-transfer radical polymerization (ATRP) and a reversible addition-fragmentation chain transfer (RAFT) agent bearing trifluoroborate iminiums (TIMs), which are quantitatively converted into potassium acyltrifluoroborates (KATs) after polymerization. The resulting KAT-containing polymers are suitable for rapid amide-forming ligations for both post-polymerization modification and polymer conjugation. The polymer conjugation occurs rapidly, even under dilute (micromolar) aqueous conditions at ambient temperatures, thereby enabling the synthesis of a variety of linear and star-shaped block copolymers. In addition, we applied post-polymerization modification to the covalent linking of a photocaged cyclic antibiotic (gramicidin S) to the side chains of the KAT-containing copolymer. Cellular assays revealed that the polymer-antibiotic conjugate is biocompatible and provides efficient light-controlled release of the antibiotic on demand.

Load and Velocity Dependence of Friction Mediated by Dynamics of Interfacial Contacts.

Studying the frictional properties of interfaces with dynamic chemical bonds advances understanding of the mechanism underlying rate and state laws, and offers new pathways for the rational control of frictional response. In this work, we revisit the load dependence of interfacial chemical-bond-induced (ICBI) friction experimentally and find that the velocity dependence of friction can be reversed by changing the normal load. We propose a theoretical model, whose analytical solution allows us to interpret the experimental data on timescales and length scales that are relevant to experimental conditions. Our work provides a promising avenue for exploring the dynamics of ICBI friction.

Brushes, Graft Copolymers, or Bottlebrushes? The Effect of Polymer Architecture on the Nanotribological Properties of Grafted-from Assemblies.

Surface-grafted polyzwitterions (PZW) have gained a foothold in the design of synthetic materials that closely mimic the lubricious properties of articular joints in mammals. Besides their chemical composition, the architecture of PZW brushes strongly determines their morphological, nanomechanical, and nanotribological characteristics. This emerges while comparing the properties of linear poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) brushes with those displayed by graft copolymer and bottlebrush brushes, either featuring a low or a high content of PMPC side chains. Surface-initiated atom transfer radical polymerization (SI-ATRP) enabled the synthesis of different branched-brush architectures from multifunctional macroinitiators via multiple grafting steps, and allowed us to modulate their structure by tuning the polymerization conditions. At relatively low grafting densities (σ), long PMPC side segments extend at the interface of bottlebrush and graft copolymer brushes, providing both morphology and lubrication properties comparable to those shown by loosely grafted, linear PMPC brushes. When σ > 0.1 chains nm-2 the effect of the branched-brush architecture on the nanotribological properties of the films became evident. Linear PMPC brushes showed the lowest friction among the studied brush structures, with a coefficient of friction (µ) that reached 1 × 10-4, as measured by atomic force microscopy (AFM). Bottlebrush brushes showed comparatively higher friction, although the high content of hydrophilic PMPC side chains along their backbone substantially improved lubrication compared to that displayed by the more sparsely substituted graft copolymer brushes.

Linking Friction and Surface Properties of Hydrogels Molded Against Materials of Different Surface Energies.

Biological tissues subjected to rubbing, such as the cornea and eyelid or articular cartilage, are covered in brushy, hydrated mucous structures in order to reduce the shear stress on the tissue. To mimic such biological tissues, we have prepared polyacrylamide (PAAm) hydrogels with various concentrations of un-cross-linked chains on their surfaces by synthesizing them in molds of different surface energies. The selected molding materials included hydrophilic glass, polyoxymethylene (POM), polystyrene (PS), polyethylene (PE), polypropylene (PP), and polytetrafluoroethylene (PTFE). After synthesis, demolding, and equilibration in water, the elastic modulus at the hydrogel surface decreased with increasing water contact angle of the mold. The softer, brushier surfaces did not completely collapse under compressive pressures up to 10 kPa, remaining better hydrated compared to their denser, cross-linked analogs. The hydrogels with brushier surfaces displayed an order of magnitude lower coefficient of friction than the cross-linked ones, which is attributed to the ability of their near-surface regions to retain larger amounts of liquid at the interface. The characteristic speed-dependent friction of the denser, cross-linked hydrogel surface is compared to the speed-independent friction of the brushy hydrogels and discussed from the perspectives of (elasto)hydrodynamic lubrication, permeability, and shear-induced hydrodynamic penetration depth.

A randomized controlled trial of Dilapan-S vs Foley balloon for preinduction cervical ripening (DILAFOL trial).

OBJECTIVE: The objective of the study was to test the hypothesis that Dilapan-S is not inferior to the Foley balloon for preinduction cervical ripening at term. STUDY DESIGN: Pregnant women ≥37 weeks scheduled for induction with unfavorable cervix (≤3 cm dilated and ≤60% effaced) were randomly assigned to 12 hours of either Foley balloon inflated with 60 mL saline or Dilapan-S for cervical ripening. If the cervix remained unfavorable, then 1 more round of the assigned dilator was used. Management following ripening was left up to the clinical providers. The primary outcome was vaginal delivery. A satisfaction survey was also obtained after the preinduction period. Sample size was based on a noninferiority margin of 10%, 90% power, and an estimated frequency of vaginal delivery of 71% in Foley balloon and 76% in Dilapan-S. RESULTS: From November 2016 through February 2018, 419 women were randomized (209 to Foley balloon; 210 to Dilapan-S). In the intent-to-treat analysis, vaginal delivery was more common in Dilapan-S vs Foley balloon (81.3% vs 76.1%), with an absolute difference with respect to the Foley balloon of 5.2% (95% confidence interval, -2.7% to 13.0%) indicating noninferiority for the prespecified margin. The difference was not large enough to show superiority. Noninferiority was confirmed in the per-protocol population (n = 204 in the Foley balloon, n = 188 in Dilapan-S), supporting the robustness of the results. Secondary outcomes were not different between groups, except for a longer time the device remained in place in Dilapan-S compared with the Foley balloon. Maternal and neonatal adverse events were not significantly different between groups. A priori interaction analyses showed no difference in the effect on vaginal delivery by cervical dilation at randomization, parity, or body mass index >30 kg/m2. Patients with Dilapan-S were more satisfied than patients with the Foley balloon as far as sleep (P = .01), relaxing time (P = .001), and performance of desired daily activities (P = .001). CONCLUSION: Dilapan-S is not inferior to the Foley balloon for preinduction cervical ripening at term. Advantages of Dilapan-S over Foley include Food and Drug Administration approval, safe profile, no protrusion from the introitus, no need to keep under tension, and better patient satisfaction.