Hydrogels with dual sensitivity to temperature and pH in physiologically relevant ranges as supports for versatile controlled cell detachment

Thermosensitive hydrogels based on the N-vinyl caprolactam (VCL), capable of allowing for cell adhesion and proliferation, as well as non-aggressive detachment by controlled temperature drop, were functionalized with 23 % or lower molar percentages of the cationizable hydrophobic unit 2-(diisopropylamino) ethyl methacrylate (DPAEMA), to obtain networks with dual sensitivity to temperature and pH. The swelling analysis of the systems has shown a transition pK (pKb) close to physiological values, dependent on the temperature of the medium (pKb of 6.6 and 6.9 when the temperature of the medium is above and below the transition temperature VPTT, respectively) and little dependence on the degree of functionalization of DPAEMA. In addition, at temperatures below the transition temperature (VPTT), the systems have shown large swelling variations as a function of the pH (i.e. below and above the pKb), exhibiting greater absorption capacity at pHs below pKb, where the DPAEMA units are cationized. Cytocompatibility and transplant capacity have been evaluated using the C166-GFP endothelial cell line. None of the thermosensitive hydrogels with variable DPAEMA content showed a delay with respect to the control without DPAEMA neither in terms of adhesion nor in proliferation. However, by increasing the percentage of DPAEMA functionalization -and decreasing thermosensitivity-, a correlative decrease in mitochondrial activity was obtained in the transplant, with significant differences for the hydrogels with DPAEMA molar percentage of 3 % or higher. Taking advantage of the proximity of the pKb to the physiological value, we have evaluated the cellular response and the capacity for transplantation after lowering the pH to 6.5, below pKb. A direct relationship of the DPAEMA functionalization degree on the detachment efficiency was observed, since the hydrogels with the highest molar load of DPAEMA showed higher mitochondrial metabolic activity after cell detachment.

Vat Photopolymerization 3D Printing of Hydrogels with Re-Adjustable Swelling

Vat photopolymerization typically prints highly crosslinked networks. Printing hydrogels, which are also networks but with a high swelling capacity in water and therefore with low crosslinking density, is a challenge for this technique. However, it may be of interest in medicine and in other areas, since it would allow for the preparation of this type of 3D-shaped material. In this work, an approach for printing hydrogels via vat photopolymerization that uses a mixture of stable and hydrolysable crosslinkers has been evaluated so that an initial highly crosslinked network can be printed, although after hydrolysis it becomes a network with low crosslinking. This approach has been studied with PEO/PEG-related formulations, that is, with a PEG-dimethacrylate as a stable crosslinker, a PEO-related derivative carrying β-aminoesters as a degradable crosslinker, and PEG-methyl ether acrylate and hydroxyethyl acrylate as monofunctional monomers. A wide family of formulations has been studied, maintaining the weight percentage of the crosslinkers at 15%. Resins have been studied in terms of viscosity, and the printing process has been evaluated through the generation of Jacobs working curves. It has been shown that this approach allows for the printing of pieces of different shapes and sizes via vat photopolymerization, and that these pieces can re-ajust their water content in a tailored fashion through treatments in different media (PBS or pH 10 buffer).

Evaluation of Poly(N-Ethyl Pyrrolidine Methacrylamide) (EPA) and Derivatives as Polymeric Vehicles for miRNA Delivery to Neural Cells

MicroRNAs (miRNAs) are endogenous, short RNA oligonucleotides that regulate the expression of hundreds of proteins to control cells' function in physiological and pathological conditions. miRNA therapeutics are highly specific, reducing the toxicity associated with off-target effects, and require low doses to achieve therapeutic effects. Despite their potential, applying miRNA-based therapies is limited by difficulties in delivery due to their poor stability, fast clearance, poor efficiency, and off-target effects. To overcome these challenges, polymeric vehicles have attracted a lot of attention due to their ease of production with low costs, large payload, safety profiles, and minimal induction of the immune response. Poly(N-ethyl pyrrolidine methacrylamide) (EPA) copolymers have shown optimal DNA transfection efficiencies in fibroblasts. The present study aims to evaluate the potential of EPA polymers as miRNA carriers for neural cell lines and primary neuron cultures when they are copolymerized with different compounds. To achieve this aim, we synthesized and characterized different copolymers and evaluated their miRNA condensation ability, size, charge, cytotoxicity, cell binding and internalization ability, and endosomal escape capacity. Finally, we evaluated their miRNA transfection capability and efficacy in Neuro-2a cells and rat primary hippocampal neurons. The results indicate that EPA and its copolymers, incorporating β-cyclodextrins with or without polyethylene glycol acrylate derivatives, can be promising vehicles for miRNA administration to neural cells when all experiments on Neuro-2a cells and primary hippocampal neurons are considered together.

Polycaprolactone with multiscale porosity and patterned surface topography prepared using sacrificial 3D printed moulds: Towards tailor-made scaffolds

Biocompatible three-dimensional porous scaffolds are widely used in multiple biomedical applications. However, the fabrication of tailor-made 3D structures with controlled and combined multiscale macroscopic-microscopic, surface and inner porosities in a straightforward manner is still a current challenge. Herein, we use multimaterial fused deposition modeling (FDM) to generate poly (vinyl alcohol) (PVA) sacrificial moulds filled with poly (Ɛ-caprolactone) (PCL) to generate well defined PCL 3D objects. Further on, the supercritical CO₂ (SCCO₂) technique, as well as the breath figures mechanism (BFs), were additionally employed to fabricate specific porous structures at the core and surfaces of the 3D PCL object, respectively. The biocompatibility of the resulting multiporous 3D structures was tested in vitro and in vivo, and the versatility of the approach was assessed by generating a vertebra model fully tunable at multiple pore size levels. In sum, the combinatorial strategy to generate porous scaffolds offers unique possibilities to fabricate intricate structures by combining the advantages of additive manufacturing (AM), which provides flexibility and versatility to generate large sized 3D structures, with advantages of the SCCO₂ and BFs techniques, which allow to finely tune the macro and micro porosity at material surface and material core levels.

Technological advances in fibrin for tissue engineering

Fibrin is a promising natural polymer that is widely used for diverse applications, such as hemostatic glue, carrier for drug and cell delivery, and matrix for tissue engineering. Despite the significant advances in the use of fibrin for bioengineering and biomedical applications, some of its characteristics must be improved for suitability for general use. For example, fibrin hydrogels tend to shrink and degrade quickly after polymerization, particularly when they contain embedded cells. In addition, their poor mechanical properties and batch-to-batch variability affect their handling, long-term stability, standardization, and reliability. One of the most widely used approaches to improve their properties has been modification of the structure and composition of fibrin hydrogels. In this review, recent advances in composite fibrin scaffolds, chemically modified fibrin hydrogels, interpenetrated polymer network (IPN) hydrogels composed of fibrin and other synthetic or natural polymers are critically reviewed, focusing on their use for tissue engineering.

Fabrication of 3D cylindrical thermosensitive hydrogels as supports for cell culture and detachment of tubular cell sheets

Pseudo interpenetrating vinyl-caprolactam (VCL) based thermosensitive tubular hydrogels with a volume phase transition temperature, VPTT, around 35 °C, have been prepared by combining two different crosslinkers, a di-methacrylate (C1) and a di-vinyl urea (C2). The molar ratio between the two crosslinkers (for a global crosslinker molar percentage of 1.9) has shown to play a key role on the properties of the hydrogel. Increasing the amount of di-vinyl urea, leads to transparent but rather fragile materials and to a lower extent of thermosensitivity, that is, to a lower variation in the hydrogel swelling upon temperature change. However, tubes prepared with a selected crosslinker molar ratio C1/C2 of 65/35 provided a compromise between transparency, thermosensitivity and maneuverability and were, thus, evaluated as supports for cell culture using premyoblastic cells. These hydrogels, used as supports, allow for surface adhesion and cell proliferation until confluence, and eventually an efficient monolayer detachment (and transplant to a 3D-printed polylactic acid (PLA) support) through a controlled drop in temperature. As a result, this method permits to obtain tubular tissue constructs with potential applications in tissue engineering such as in the elaboration of vascular grafts.

Hyaluronic acid-fibrin hydrogels show improved mechanical stability in dermo-epidermal skin substitutes

Human plasma-derived bilayered skin substitutes have been successfully used by our group in different skin tissue engineering applications. However, several issues associated with their poor mechanical properties were observed, and they often resulted in rapid contraction and degradation. In this sense, hydrogels composed of plasma-derived fibrin and thiolated-hyaluronic acid (HA-SH, 0.05-0.2% w/v) crosslinked with poly(ethylene glycol) diacrylate (PEGDA, 2:1, 6:1, 10:1 and 14:1 mol of thiol to moles of acrylate) were developed to reduce the shrinking rates and enhance the mechanical properties of the plasma-derived matrices. Plasma/HA-SH-PEGDA hydrogels showed a decrease in the contraction behaviour ranging from 5% to 25% and an increase in Young's modulus. Furthermore, the results showed that a minimal amount of the added HA-SH was able to escape the plasma/HA-SH-PEGDA hydrogels after incubation in PBS. The results showed that the increase in rigidity of the matrices as well as the absence of adhesion cellular moieties in the second network of HA-SH/PEGDA, resulted in a decrease in contraction in the presence of the encapsulated primary human fibroblasts (hFBs), which may have been related to an overall decrease in proliferation of hFBs found for all hydrogels after 7 days with respect to the plasma control. The metabolic activity of hFB returned to the control levels at 14 days except for the 2:1 PEGDA crosslinking ratio. The metabolic activity of primary human keratinocytes (hKCs) seeded on the hydrogels showed a decrease when high amounts of HA-SH and PEGDA crosslinker were incorporated. Organotypic skins formed in vitro after 21 days with plasma/HA-SH-PEGDA hydrogels with an HA content of 0.05% w/v and a 2:1 crosslinking ratio were up to three times thicker than the plasma controls, evidencing a reduction in contraction, while they also showed better and more homogeneous keratin 10 (K10) expression in the supra-basal layer of the epidermis. Furthermore, filaggrin expression showed the formation of an enhanced stratum corneum for the constructs containing HA. These promising results indicate the potential of using these biomimetic hydrogels as in vitro skin models for pharmaceutical products and cosmetics and future work will elucidate their potential functionality for clinical treatment.

Design of novel small molecule base-pair recognizers of toxic CUG RNA transcripts characteristics of DM1

Myotonic Dystrophy type 1 (DM1) is an incurable neuromuscular disorder caused by toxic DMPK transcripts that carry CUG repeat expansions in the 3' untranslated region (3'UTR). The intrinsic complexity and lack of crystallographic data makes noncoding RNA regions challenging targets to study in the field of drug discovery. In DM1, toxic transcripts tend to stall in the nuclei forming complex inclusion bodies called foci and sequester many essential alternative splicing factors such as Muscleblind-like 1 (MBNL1). Most DM1 phenotypic features stem from the reduced availability of free MBNL1 and therefore many therapeutic efforts are focused on recovering its normal activity. For that purpose, herein we present pyrido[2,3-d]pyrimidin-7-(8H)-ones, a privileged scaffold showing remarkable biological activity against many targets involved in human disorders including cancer and viral diseases. Their combination with a flexible linker meets the requirements to stabilise DM1 toxic transcripts, and therefore, enabling the release of MBNL1. Therefore, a set of novel pyrido[2,3-d]pyrimidin-7-(8H)-ones derivatives (1a-e) were obtained using click chemistry. 1a exerted over 20% MBNL1 recovery on DM1 toxic RNA activity in primary cell biology studies using patient-derived myoblasts. 1a promising anti DM1 activity may lead to subsequent generations of ligands, highlighting a new affordable treatment against DM1.

Diagnostic groups and short-term outcomes in suspected COVID-19 cases treated in an emergency department

OBJECTIVES

The primary objective was to describe the clinical characteristics and 30-day mortality rates in emergency department patients with coronavirus disease 2019 (COVID-19) in different diagnostic groupings.

MATERIAL AND METHODS

Secondary analysis of the COVID-19 registry compiled by the emergency department of Hospital Clínico San Carlos in Madrid, Spain. We selected suspected COVID-19 cases treated in the emergency department between February 28 and March 31, 2020. The cases were grouped as follows: 1) suspected, no polymerase chain reaction (PCR) test (S/no-PCR); 2) suspected, negative PCR (S/PCR-); 3) suspected, positive PCR (S/PCR+); 4) highly suspected, no PCR, or negative PCR (HS/no or PCR-); and 5) highly suspected, positive PCR (HS/PCR+). We collected clinical, radiologic, and microbiologic data related to the emergency visit. The main outcome was 30-day all-cause mortality. Secondary outcomes were hospitalization and clinical severity of the episode.

RESULTS

A total of 1993 cases (90.9%) were included as follows: S/no-PCR, 17.2%; S/PCR-, 11.4%; S/PCR+, 22.1%; HS/no PCR or PCR-, 11.7%; and HS/PCR+, 37.6%. Short-term outcomes differed significantly in the different groups according to demographic characteristics; comorbidity and clinical, radiographic, analytical, and therapeutic variables. Thirty-day mortality was 11.5% (56.5% in hospitalized cases and 19.6% in cases classified as severe). The 2 HS categories and the S/PCR+ category had a greater adjusted risk for 30-day mortality and for having a clinically severe episode during hospitalization in comparison with S/PCR- cases. Only the 2 HS categories showed greater risk for hospitalization than the S/PCR- cases.

CONCLUSION

COVID-19 diagnostic groups differ according to clinical and laboratory characteristics, and the differences are associated with the 30-day prognosis.

Contraction of fibrin-derived matrices and its implications for in vitro human skin bioengineering

It is well-known that fibroblasts play a fundamental role in the contraction of collagen and fibrin hydrogels when used in the production of in vitro bilayered skin substitutes. However, little is known about the contribution of other factors, such as the hydrogel matrix itself, on this contraction. In this work, we studied the contraction of plasma-derived fibrin hydrogels at different temperatures (4, 23, and 37°C) in an isotonic buffer (phosphate-buffered saline). These types of hydrogels presented a contraction of approximately 30% during the first 24 hr, following a similar kinetics irrespectively of the temperature. This kinetics continued in a slowed down manner to reach a plateau value of 40% contraction after 10-15 days. Contraction of commercial fibrinogen hydrogels was studied under similar conditions and the kinetics was completed after 8 hr, reaching values between 20 and 70% depending on the temperature. We attribute these substantial differences to a modulatory effect on the contraction due to plasma proteins which are initially embedded in, and progressively released from, the plasma-based hydrogels. The elastic modulus of hydrogels measured at a constant frequency decreased with increasing temperature in 7-day gels. Rheological measurements showed the absence of a strain-hardening behavior in the plasma-derived fibrin hydrogels. Finally, plasma-derived fibrin hydrogels with and without human primary fibroblast and keratinocytes were prepared in transwell inserts and their height measured over time. Both cellular and acellular gels showed a height reduction of 30% during the first 24 hr likely due to the above-mentioned intrinsic fibrin matrix contraction.

Fabrication of 3D-Printed Biodegradable Porous Scaffolds Combining Multi-Material Fused Deposition Modeling and Supercritical CO2 Techniques

The fabrication of porous materials for tissue engineering applications in a straightforward manner is still a current challenge. Herein, by combining the advantages of two conventional methodologies with additive manufacturing, well-defined objects with internal and external porosity were produced. First of all, multi-material fused deposition modeling (FDM) allowed us to prepare structures combining poly (ε-caprolactone) (PCL) and poly (lactic acid) (PLA), thus enabling to finely tune the final mechanical properties of the printed part with modulus and strain at break varying from values observed for pure PCL (modulus 200 MPa, strain at break 1700%) and PLA (modulus 1.2 GPa and strain at break 5-7%). More interestingly, supercritical CO2 (SCCO2) as well as the breath figures mechanism (BFs) were additionally employed to produce internal (pore diameters 80-300 µm) and external pores (with sizes ranging between 2 and 12 μm) exclusively in those areas where PCL is present. This strategy will offer unique possibilities to fabricate intricate structures combining the advantages of additive manufacturing (AM) in terms of flexibility and versatility and those provided by the SCCO2 and BFs to finely tune the formation of porous structures.

General approach to prepare polymers bearing pendant isocyanate groups

A versatile synthetic approach for the easy preparation, under smooth reaction conditions, of diverse classes of linear polymers bearing aliphatic or aromatic isocyanate groups in the side chains is described.

Combining Breath Figures and Supercritical Fluids To Obtain Porous Polymer Scaffolds

Supercritical fluids technology is a clean methodology to foam polymeric materials. However, this technique provides only the formation of inner porosity, whereas the so-called skin layer is commonly observed at the polymer surface. This article describes a new method for the preparation of outer and inner porous poly(ε-caprolactone) (PCL) scaffolds by combination of supercritical CO2 (SCCO2) foaming and the breath figures technique. In the first step, experiments with a SCCO2 reactor were performed at 35-45 °C, 100-250 bar, and 1-20 min depressurization time. The effect of these parameters in the formation of inner porosity was investigated for an adequate optimization. In a late stage, to provide also surface porosity to the polymeric samples and remove the skin layer, the breath figures technique was employed. The evaluation of porosity was determined by scanning electronic microscopy, mercury porosimetry, and micro X-ray computerized tomography scanning processing the images obtained with the ImageJ software. The results of this study using these two complementary techniques showed the existence of interconnectivity between inner and outer porosity of the samples. Furthermore, thermal transitions and crystallinity of the PCL samples have been analyzed by differential scanning calorimetry. Finally, a preliminary biological evaluation of the resulting scaffolds with mouse endothelial cells (C166-GFP) was performed to assess their biocompatibility and cellular viability.

Stereoselectivity of Proline/Cyclobutane Amino Acid-Containing Peptide Organocatalysts for Asymmetric Aldol Additions: A Rationale

Several α,β,α- or α,γ,α-tripeptides, consisting of a central cyclobutane β- or γ-amino acid being flanked by two d- or l-proline residues, have been synthesized and tested as organocatalysts in asymmetric aldol additions. High yields and enantioselectivities have been achieved with α,γ,α-tripeptides, being superior to peptides containing a cyclobutane β-amino acid residue. This is probably due to their high rigidity, which hinders some of the peptide catalysts to adopt the proper active conformation. This reasoning correlates with the major conformation of the peptides in the ground state, as suggested by ¹H NMR and computational calculations. The configuration of the aldol products is controlled by the proline chirality, and consequently, the R/S configuration of aldol products can be tuned by the use of either commercially available d- or l-proline. The enantioselectivity in the aldol reactions is reversed if the reactions are carried out in the presence of water or other protic solvents such as methanol. Spectroscopic and theoretical investigations revealed that this effect is not the consequence of conformational changes in the catalyst but rather caused by the participation of a water molecule in the rate determining transition state, in such a way that the preferential nucleophilic attack is oriented to the opposite enantiotopic aldehyde face.

Hydroxyl versus permethylated glycopolymers as gene carriers

The main parameters that contribute to non-viral gene delivery are chemical structure and charge distribution. Indeed, saccharide units have been reported to have specific interactions with proteins located in the outer leaflet of the plasma cell membrane that facilitate the cellular internalization of plasmid-DNA vector complexes. In this work, glycopolymers based on statistical copolymers were synthesized through radical copolymerization of a cationic unit, N-ethyl pyrrolidine methacrylamide (EPA), with two styrenic monomers derived from the hydroxylated and permethylated forms of α-glucose. These copolymers were evaluated as possible non-viral gene carriers, and their ability to complex DNA was evaluated. The transfection efficiency and cytocompatibility of the polyplexes, in both fibroblastic and tumoral murine cell lines, was evaluated. Systems derived from α-glucose (GLCSt), over a monomer concentration range of 5-70mol%, exhibited high toxicity and low transfection efficiency, and were not able to significantly improve on results obtained from positive poly-EPA (PEPA) and polyethyleneimine (PEI) controls. However, systems derived from the permethylated form of α-glucose (MGLCSt), formed stable complexes with DNA or polyplexes, which showed improved transfection efficiency and cytocompatibility in comparison to positive controls. The high transfection efficiency can be clearly attributed to their cytocompatibility, which was notably found to be different for Swiss fibroblasts and B16 melanoma cells, high for Swiss and low for B16. As such, we present permethylated MCLCSt copolymers as good candidates for the possible development of therapies against melanoma.

Nonmigrating Equivalent Substitutes for PVC/DOP Formulations as Shown by a TG Study of PVC with Covalently Bound PEO-PPO Oligomers

Monoamino functionalized ethylenoxide (EO)/propylenoxide oligomers (Jeffamine) are linked chemically to poly(vinyl chloride) (PVC) using trichlorotriazine chemistry in order to prepare nonmigrating internally plasticized materials. The dependence of the plasticizer efficiency on both the number of anchoring points to the chains and the PVC/plasticizer compatibility is investigated using oligomers of different molecular weight and hydrophilic-hydrophobic balance. Hydrophilic oligomers (containing predominantly EO) of molecular weights between 2000 and 5000 g mol^-1 exhibit excellent plasticizer efficiency, nearly identical to di-2-ethylhexylphthalate (DOP) in conventional PVC/DOP mixtures and may therefore be used as nonmigrating equivalents for DOP.

Opening New Gates for the Modification of PVC or Other PVC Derivatives: Synthetic Strategies for the Covalent Binding of Molecules to PVC

Several synthetic strategies based on the use of substituted aromatic and hetero-aromatic thiols for the covalent binding of modifier compounds to PVC are described. A variety of aliphatic alcohols and amines are linked to the aromatic or heteroaromatic rings via highly active functionalities as the isocyanate, acidchloride, or chlorosulfonyl group, and the three chlorine atoms of trichlorotriazine. The first three pathways lead to protected aromatic disulfides obtaining the substituted aromatic thiols by reduction as a final step of an unprecedented synthetic route. The second approach, in a novel, extremely efficient, and scalable process, uses the particular selectivity of trichlorotriazine to connect aliphatic amines, alcohols, and thiols to the ring and creates the thiol via nucleophilic substitution of a heteroaromatic halogen by thiourea and subsequent hydrolysis. Most of the modifier compounds were linked to the polymer chains with high degrees of anchorage. The presented approaches are highly versatile as different activations of aromatic and heteroaromatic rings are used. Therefore, many types of tailored functional nucleophiles may be anchored to PVC providing non-migrating materials with a broad range of applications and properties.

Polymeric Gene Carriers Bearing Pendant β-Cyclodextrin: The Relevance of Glycoside Permethylation on the "In Vitro" Cell Response

The incorporation of cyclodextrins (CDs) to nonviral cationic polymer vectors is very attractive due to recent studies that report a clear improvement of their cytocompatibility and transfection efficiency. However, a systematic study on the influence of the CD derivatization is still lacking. In this work, the relevance of β-CD permethylation has been addressed by preparing and evaluating two series of copolymers of the cationic N-ethyl pyrrolidine methacrylamide (EPA) and styrenic units bearing pendant hydroxylated and permethylated β-CDs (HCDSt and MeCDSt, respectively). For both cell lines, CDs permethylation shows a strong influence on plasmid DNA complexation, "in vitro" cytocompatibility and transfection efficiency of the resulting copolymers over two murine cell lines. While the incorporation of the hydroxylated CD moiety increased the cytotoxicity of the copolymers in comparison with their homopolycationic counterpart, the permethylated copolymers have shown full cytocompatibility as well as superior transfection efficiency than the controls. This behavior has been related to the different chemical nature of both units and tentatively to a different distribution of units along the polymeric chains. Cellular internalization analysis with fluorescent copo-lymers supports this behavior.

Effect on in vitro cell response of the statistical insertion of N-(2-hydroxypropyl) methacrylamide on linear pro-dendronic polyamine's gene carriers

Statistical copolymers of N-(2-hydroxypropyl) methacrylamide (HPMA) and the dendronic methacrylic monomer 2-(3-(Bis(2-(diethylamino)ethyl)amino)propanamido)ethyl methacrylate (TEDETAMA, derived from N,N,N',N'-tetraethyldiethylenetriamine, TEDETA), were synthesized through radical copolymerization and evaluated in vitro as non-viral gene carriers. Three copolymers with nominal molar percentages of HPMA of 25%, 50% and 75% were prepared and studied comparatively to the positive controls poly-TEDETAMA and hyperbranched polyethyleneimine (PEI, 25kDa). Their ability to complex DNA at different N/P molar ratios, from 1/1 up to 8/1, was determined through agarose gel electrophoresis and Dynamic Light Scattering. The resulting complexes (polyplexes) were characterized and evaluated in vitro as possible non-viral gene carriers for Swiss-3T3 fibroblasts, using luciferase as reporter gene and a calcein cytocompatibility assay. All the copolymers, except the one with highest HPMA proportion (75 molar %) at the lowest N/P ratio, condensed DNA to a particle size between 100 and 300 nm. The copolymers with 25 and 50 molar % of HPMA displayed higher transfection efficiency and cytocompatibility than the positive controls poly-TEDETAMA and PEI. A higher proportion of HPMA (75 molar %) led to copolymers that displayed very low transfection efficiency, despite their full cytocompatibility even at the highest N/P ratio. These results indicate that the statistical combination of TEDETAMA and HPMA and its fine compositional tuning in the copolymers may fulfill the fine balance of transfection efficiency and cytocompatibility in a superior way to the control poly-TEDETAMA and PEI.

Study of outpatient neurological care in the Region of Madrid: The impact of implementing free choice of hospital

INTRODUCTION

A new model permitting free choice of hospital has been introduced in the Region of Madrid. This may result in changes in how outpatient neurological care is provided and managed. The purpose of this study is to analyse initial visits to a general neurology department in the Region of Madrid and record the health district corresponding to each patient's residence.

METHODS

Observational and prospective study of a cohort of patients making initial outpatient visits to a neurology department between 16 September 2013 and 16 January 2014.

RESULTS

The study included 1109 patients (63.8% women, mean age 55.2±20.5). The most frequent diagnostic groups were periodic headache, cognitive disorders, and neuromuscular diseases. Non-neurological diseases were diagnosed in 1.1% of the cases. The mean time of delay was 7.2±5.1 days. Residents within the hospital's health district made up 73.8% of the total, while 26.2% chose a hospital outside of the health district corresponding to their residences. In the latter group, 59.5% made the choice based on the level of care offered, while 39.7% changed hospitals due to shorter times to consultation. The patients who came from another health district were younger (50.7 vs 57.3, P<.0001) and had a lower rate of discharges on the first visit (16.4% vs 30.1%, P<.0001).

CONCLUSION

The model of free choice of hospital delivers significant changes in healthcare management and organisation. Reasons given for choosing another hospital are more ample experience and shorter delays with respect to the home district hospital. Management of patients from outside the health district is associated with greater complexity.

Pseudo-double network hydrogels with unique properties as supports for cell manipulation

Introducing new hydrogels for the support of confluent cell growth and from which cell sheets can be easily detached or transplanted.

Synthesis of randomly aminated polyvinylpyrrolidone and its use in the preparation of hydrolyzable conjugates

Preparation of side-aminated polyvinylpyrrolidones and their potential application as pH-sensitive drug-conjugate carriers.

Chemical guiding of magnetic nanoparticles in dispersed media containing poly-(methylmethacrylate-co-vinylpyrrolidone)

The differential reactivity of methylmethacrylate (MMA) and vinylpyrrolidone (VP) in free radical copolymerization, with stirring in methanol, renders an emulsified two phase system. The dispersed and continuous liquid phases contain copolymers rich in MMA and VP, respectively. When Fe(3)O(4) magnetic nanoparticles (mNPs) stabilized with tetramethylammonium hydroxide are added to this emulsion, the mNPs are located in the continuous phase. Very small chemical changes in the methacrylic or vinylic chains are able to guide the mNP toward the interface or to the inside of the dispersed phase since quite a selective functionalization of each phase may be achieved separately. Thus, a small addition of methacrylic acid as comonomer (0.5% molar) guides all of the mNPs to the interface while a 0.5% molar of sulfopropyl methacrylate induces the migration of all mNPs to the dispersed phase. When 0.5% molar of a VP derivative bearing sulfonate functionality is added, the mNPs are found both in the interface and in the continuous phase. The addition of water allows solid MMA-based microspheres to be obtained incorporating the mNPs selectively either at the surface or in the core.

End functionalized polymeric system derived from pyrrolidine provide high transfection efficiency

Chemical architecture and functionality play an important role in the physico-chemical properties of cationic polymers with applications as gene vectors. In this study, linear homopolymers of N-ethyl pyrrolidine methacrylamide (EPA), copolymers of EPA with N,N-dimethylacrylamide (DMA) and oligomers of EPA were synthesized, and the resulting structures were evaluated for their transfection efficiency as non-viral gene vectors. Specifically, polymer species with high and low molecular weights (120-2.6 kDa) and different functionalities (tertiary amines as side chains and primary amine as chain end) were prepared as non-crosslinked, linear homopolymers, copolymers and oligomers, respectively. Polymer/DNA complexes (polyplexes) formation was evaluated by agarose gel electrophoresis, showing that all systems complexed with DNA in all P/N ratios with the exception of the EPA homopolymer. Furthermore, light scattering measurements and transmission electronic microscopy (TEM) showed different size (50-450 nm) and morphology depending on the composition and concentration of the polyplex systems. Cell viability and proliferation after contact with polymer and polyplexes were studied using 3T3 fibroblasts, and the systems showed an excellent biocompatibility at 2 and 4 days. Transfection studies were performed with plasmid Gaussian luciferase kit and were found that the highest transfection efficiency in serum free was obtained with oligomers from the P/N ratio of 1/6 to 1/10. Transfection values of the functionalized oligomers with respect to the control linear poly (dimethylaminoethyl methacrylate) [poly (DMAEMA)] are very interesting in the presence of serum. Haemolysis for these polymers values below 1%, which provide attractive potential applications in gene therapy with these non-toxic readsorbable polymers.

Poly(N,N-dimethylacrylamide-co-4-(ethyl)-morpholine methacrylamide) copolymer as coating for CE

In this work, a new physically adsorbed coating for CE is presented. This coating is based on a poly(N,N-dimethylacrylamide-co-4-(ethyl)-morpholine methacrylamide) (DMA/MAEM) copolymer synthesized in our laboratory. It is demonstrated that the direction and magnitude of the EOF in CE can be modulated by varying the composition of the DMA/MAEM copolymer and the type and pH of the BGE. Moreover, the DMA/MAEM coating provides %RSD(n) = 5 values for migration times lower than 0.9% for the same capillary and day, whereas the %RSD(n) = 25 obtained for the interday assay was lower than 2.9%. The stability of the coating procedure is also tested between capillaries obtaining %RSD(n) = 15 values lower than 2.9%, demonstrating that this physically adsorbed copolymer gives rise to a stable and reproducible coating in CE. Finally, the usefulness of this new cationic copolymer as CE coating is demonstrated through different applications. Namely, it is demonstrated that the CE separation of basic proteins, nucleotides and organic acids is achieved in a fast and easy way by using the DMA/MAEM coated capillary. The use of fused bare silica capillaries did not allow the separation of these compounds under the same analytical conditions. These results demonstrate that this type of coating in CE provides the option of using BGEs that are useless when utilized together with bare silica capillaries making wider the application and possibilities of this analytical technique.

New stimuli-responsive polymers derived from morpholine and pyrrolidine

The preparation of three new ionizable monomers: N-ethyl morpholine metacrylate (EMM), N-ethyl morpholine methacrylamide (EMA) and N-ethyl pyrrolidine metacrylamide (EPA) and their respective homopolymers poly-EMM, poly-EMA and poly-EPA prepared by radical polymerization in solution, is described. The systems have been characterized by NMR and FTIR spectroscopic techniques, determined their glass transition temperatures by DSC and their respective pKs. Moreover, crosslinked samples were prepared by bulk polymerization using N,N-methylene bisacrylamide (BAam) and the trifunctional 1,3,5-triacryloylhexa-hydro-1,3,5-triazine (135-T) as crosslinkers. The studies of swelling kinetics were carried out in different pH buffer solutions (2, 7.4 and 10) in a thermostatic bath at 37 degrees C showing hydration degrees that go from 2,600% to about 200% depending on the pH and on the crosslinker used. The systems seem to be suitable for the preparation of smart hydrogels for drug delivery and Tissue Engineering.

Self-curing acrylic formulations with applications in intervertebral disk restoration: drug release and biological behaviour

New injectable acrylic formulations have been prepared to be applied in restoration processes for intervertebral disks (IVDs). The solid phase of the formulations is composed of poly(methyl methacrylate) (PMMA), incorporating in some cases chondroitin sulphate (CS) as a regenerative bioactive molecule, whereas the liquid phase is constituted by an amphiphilic macromonomer (MT), 2-hydroxyethyl methacrylate (HEMA) and, in some formulations, acrylic acid (AA). The curing parameters and the mechanical properties of the IVD formulations make them excellent candidates for intervertebral application. In vitro and in vivo evaluation of the prepared IVD formulations is described in terms of CS release, surface analysis after immersion in SBF solutions, and biocompatibility studies based on MTT assay and Alamar blue test, as well as in vivo implantation in female Wistar rats, by injection of the IVD formulations followed by histological evaluations to assess tissue response.