pH- and Electro-Responsive Properties of Poly(acrylic acid) and Poly(acrylic acid)-block-poly(acrylic acid-grad-styrene) Brushes Studied by Quartz Crystal Microbalance with Dissipation Monitoring.

We report on the synthesis of novel pH- and electro-responsive polyelectrolyte brushes from a gold substrate by direct one-step nitroxide-mediated polymerization of acrylic acid (AA) or copolymerization of AA and styrene (S). In the latter case, amphiphilic brushes of block-gradient copolymers PAA-b-(PAA-grad-PS) comprising one PAA block and one block with the gradient sequence of AA and S were obtained. The block-gradient copolymers are initiated from the surface by the start of the PAA block. The brushes were characterized by XPS and ellipsometry. (1)H NMR confirmed the gradient sequence of the PAA-grad-PS copolymer block. The pH- and electro-responsive properties of the brushes were studied by quartz crystal microbalance with dissipation monitoring (QCM-D) in combination with electrochemistry. This method provides evidence of swelling of the PAA brushes proportional to the contour length of the chains at elevated pH, whereas the response functions of the block-gradient copolymers are more complex and point to intermolecular aggregation in the brush at low pH. Monitoring of the changes in resonance frequency and dissipation of the QCM-D also demonstrates that application of negative voltage to the substrate leads to swelling of the brush; application of a positive voltage provokes only a transient collapse of the brush in proportion to the applied voltage.

Bioinspired material based on femtosecond laser machining of cast sheet micromolding as a pattern transfer process.

We present herein a simple, fast, and easy-to-use process to replicate poly(methyl methacrylate) (PMMA) plates generating surface effects. First, a femtosecond laser has been used to fabricate, with sufficient accuracy, a periodic pattern on a glass plate at the microscale. This glass plate, used as a master, can be structured on a large distance with a good control of its roughness. Then, the polymer plates were obtained by bulk polymerization without any solvents with a good replication from the cast sheet process, which has been industrially performed for years. Thus, the modification of this process, environmentally friendly, lets us foresee new applications for commodity polymers by introducing visual iridescent properties and hydrophobicity exaltation.

Photonic properties of hybrid colloidal crystals fabricated by a rapid dip-coating process.

The enhancement of the capillarity fabrication of well-ordered two-dimensional (2D) and three-dimensional (3D) opal photonic crystal is described herein. The quality enhancement and the reduction of the fabrication time are improved by using core@soft adhesive shell (Silica@PolyButylAcrylate) particles dispersed in an organic solvent with a high boiling point. The hybridization by an elastomeric corona polymer, grafted from the SiO(2) surface, has offered adhesive properties naturally tunable by changing the polymer state from a solvated to a dry one. Such properties involve drastic changes of the self-assembly behavior and qualities. Their use, as elementary building blocks, for colloidal crystal fabrication have required a high withdrawal rate (up to 4000 µm s(-1)), i.e. involving a three order of magnitude reduction in time compared to a classic vertical deposition method (1 to 10 µm s(-1)) and a good control/prediction of the coating thickness can be tuned by varying the withdrawal rate and the particle concentration. In addition, an analysis of the 2D synthetic iridescence of the hybrid photonic crystal was performed under white light, revealing the adhesive shell bridge influence on the dissipation energy of cracks linked to the crystal quality and the photonic properties.

Integrating a pharmacist into an anaesthesiology and critical care department: Is this worthwhile?

Background Operating rooms and Intensive Care Units are places where an optimal management of drugs and medical devices is required. Objective To evaluate the impact of a dedicated pharmacist in an academic Anaesthesiology and Critical Care Department. Setting This study was conducted in the Anaesthesiology and Critical Care Department of Grenoble University Hospital. Method Between November 2013 and June 2017, the drug-related problems occurring in three Intensive Care Units and their corrections by a full-time clinical pharmacist were analyzed using a structured order review instrument. Pharmaceutical costs in the Anaesthesiology and Critical Care Department were analyzed over a 7 year period (2010-2016), during which automated dispensing systems and recurrent meetings to review indications of medications and medical devices were implemented in the department. Main outcome measure Analysis of two issues: correcting drug-related problems and containing pharmaceutical costs. Results A total of 324 drug-related problems were identified. The most frequent problem concerned anti-infective agents (45%), and this was mainly due to the over-dosage of drugs (30%). Dosage adjustments were the most frequent interventions performed by the pharmacist (43%). Over the 7 year period, pharmaceutical costs decreased by 9% (€365,469), while the care activity of the department increased by 55% (+ 12,022 surgical procedures and + 1424 admissions in the ICU). Conclusion Integrating a pharmacist into the Anaesthesiology and Critical Care Department was associated with interventions to correct drug-related problems and containing pharmaceutical costs. Pharmacists should play a central role in such medical environments, to optimize the use of drugs and medical devices.

Prospective assessment of patients' knowledge and informational needs and of surgeon-to-patient information transfer before and after knee or hip arthroplasty.

BACKGROUND: Patients are playing an increasingly large role in their own management and must therefore receive clear, complete, and comprehensible information. In the field of hip and knee arthroplasty, little is known about the level of patient knowledge and effectiveness of surgeon-to-patient information transfer. We therefore designed a prospective observational study with the objective of assessing four factors: patient knowledge during management, quality of information transfer, informational needs, and factors associated with the level of knowledge. HYPOTHESIS: The level of patient knowledge changes during the management process. PATIENTS AND METHODS: A prospective single-centre study was conducted between January 2014 and March 2015 during the outpatient visits and inpatient stays of 63 patients who underwent arthroplasty of the hip (n=36) or knee (n=27). A single observer attended all patient visits and recorded the information provided by the surgeon. Each patient completed a self-questionnaire after the outpatient visit (T1), at admission (T2), and at discharge after surgery (T3). Semi-quantitative scores were used to assess knowledge and informational needs. The effectiveness of information transfer was evaluated by comparing the information provided by the surgeon to the replies made by the patients. RESULTS: The mean overall knowledge score (on a 0-42 scale) increased from 17.22±6.33 at T1 to 19.44±6.89 at T3 (P=0.0028). In contrast, knowledge about complications was better at T1 than at T3 (2.67±1.98 vs. 2.19±1.91; P<0.05). Agreement between information given by the surgeon and replies made by patients varied across items from 23% to 100%. The mean informational needs score (on a scale from 0 to 21) ranged from 3.67 to 4.83 and was higher at T3 than at T2 (4.83±3.77 vs. 3.67±4.86; P=0.03). The proportion of patients who wanted written information was higher at T3. Most patients sought information before the outpatient visit. At each step of the management process, the main areas about which the patients wanted information were the surgical procedure, the rehabilitation programme, and the prosthesis. Several socio-demographic or management-related factors influenced the level of knowledge. Thus, older age and lower educational attainment were associated with lower knowledge scores, whereas previous lower-limb orthopaedic surgery and amount of information provided by the surgeon were associated with higher knowledge scores. Knowledge scores were not associated with being employed vs. retired, gender, replacement of a hip vs. a knee, the surgeon, or being accompanied by another person. DISCUSSION: Our study is original in that we assessed changes in patient knowledge during the management process for hip or knee arthroplasty. The level of patient knowledge was fairly low and varied considerably across individuals and time points in the management process. These data highlight the importance of providing patients with information throughout their management and particularly at discharge, when the desire for information seems greatest. LEVEL OF EVIDENCE: IV, prospective observational study with no control group.