Mucosa-Like Conformal Hydrogel Coating for Aqueous Lubrication

Mucus Mimic Hydrogel Coating for Lubricous, Antibiofouling, and Anti-Inflammatory Urinary Catheters

Silicone is a common elastomer used in indwelling urinary catheters, and catheters are widely used in various medical applications due to their exceptional biocompatibility, hypoallergenic properties, and flexibility. However, silicones exhibit hydrophobic characteristics, lack inherent biolubrication, and are susceptible to nonspecific biosubstance adsorption, resulting in complications including but not limited to tissue trauma, postoperative pain, and urinary tract infections (UTIs). The development of effective surface designs for biomedical catheters to mitigate invasive damage and UITs has been a longstanding challenge. Herein, we present a novel approach to prepare a mucus mimic hydrogel coating. A thin layer of hydrogel containing xylitol is fabricated via photopolymerization. The surface modification technique and the interface-initiated hydrogel polymerization method ensure robust interfacial coherence. The resultant coating exhibits a low friction coefficient (CoF ≈ 0.1) for urinary catheter applications. Benefiting from the hydration layer and the antifouling of the xylitol unit, the xylitol hydrogel-coated surfaces (pAAAMXA) demonstrate outstanding antibiofouling properties against proteins (98.9% reduction relative to pristine polydimethylsiloxane (PDMS)). Furthermore, the pAAAMXA shows general adhesion resistance against bacteria primarily responsible for UITs (Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), Methicillin-resistant strains of Staphylococcus aureus (MRSA), and Staphylococcus epidermidis (S. epidermidis)) without compromising biotoxicity (cell viability 98%). In vivo, catheters coated with the mucus mimic hydrogel displayed excellent biocompatibility, resistance to adhesion of bio substance, and anti-inflammatory characteristics. This work describes a promising alternative to conventional silicone catheters, offering potential for clinical interventional procedures with minimized complications.

Functional-hydrogel-based electronic-skin patch for accelerated healing and monitoring of skin wounds

Conductive hydrogels feature reasonable electrical performance as well as tissue-like mechanical softness, thus positioning them as promising material candidates for soft bio-integrated electronics. Despite recent advances in materials and their processing technologies, however, facile patterning and monolithic integration of functional hydrogels (e.g., conductive, low-impedance, adhesive, and insulative hydrogels) for all-hydrogel-based soft bioelectronics still poses significant challenges. Here, we report material design, fabrication, and integration strategies for an electronic-skin (e-skin) patch based on functional hydrogels. The e-skin patch was fabricated by using photolithography-compatible functional hydrogels, such as poly(2-hydroxyethyl acrylate) (PHEA) hydrogel (substrate), Ag flake hydrogel (interconnection; conductivity: ∼571.43 S/cm), poly(3,4-ethylenedioxythiophene:polystyrene) (PEDOT:PSS) hydrogel (working electrode; impedance: ∼69.84 Ω @ 1 Hz), polydopamine (PDA) hydrogel (tissue adhesive; shear strength: ∼725.1 kPa), and poly(vinyl alcohol) (PVA) hydrogel (encapsulation). The properties of these functional hydrogels closely resemble those of human tissues in terms of water content and Young's modulus, enabling stable tissue-device interfacing in dynamically changing physiological environments. We demonstrated the efficacy of the e-skin patch through its application to accelerated healing and monitoring of skin wounds in mouse models - efficient fibroblast migration, proliferation, and differentiation promoted by electric field (EF) stimulation and iontophoretic drug delivery, and monitoring of the accelerated healing process through impedance mapping. The all-hydrogel-based e-skin patch is expected to create new opportunities for various clinically-relevant tissue interfacing applications.

Durable immunomodulatory hierarchical patch for rotator cuff repairing

Degradable rotator cuff patches, followed over five years, have been observed to exhibit high re-tear rates exceeding 50%, which is attributed to the inability of degradable polymers alone to restore the post-rotator cuff tear (RCT) inflammatory niche. Herein, poly(ester-ferulic acid-urethane)urea (PEFUU) was developed, featuring prolonged anti-inflammatory functionality, achieved by the integration of ferulic acid (FA) into the polyurethane repeating units. PEFUU stably releases FA in vitro, reversing the inflammatory niche produced by M1 macrophages and restoring the directed differentiation of stem cells. Utilizing PEFUU, hierarchical composite nanofiber patch (HCNP) was fabricated, simulating the natural microstructure of the tendon-to-bone interface with an aligned-random alignment. The incorporation of enzymatic hydrolysate derived from decellularized Wharton jelly tissue into the random layer could further enhance cartilage regeneration at the tendon-to-bone interface. Via rat RCT repairing model, HCNP possessing prolonged anti-inflammatory properties uniquely facilitated physiological healing at the tendon-to-bone interface's microstructure. The alignment of fibers was restored, and histologically, the characteristic tripartite distribution of collagen I - collagen II - collagen I was achieved. This study offers a universal approach to the functionalization of degradable polymers and provides a foundational reference for their future applications in promoting the in vivo regeneration of musculoskeletal tissues.

Robust and Lubricating Interface Semi-Interpenetrating Network on Inert Polymer Substrates Enabled by Subsurface-Initiated Polymerization

Lubricating hydrogel coatings on inert rubber and plastic surfaces significantly reduce friction and wear, thus enhancing material durability and lifespan. However, achieving optimal hydration lubrication typically requires a porous polymer network, which unfortunately reduces their mechanical strength and limits their applicability where robust durability and wear-resistance are essential. In the research, a hydrogel coating with remarkable wear resistance and surface stability is developed by forming a semi-interpenetrating polymer network with polymer substrate at the interface. By employing a good solvent swelling method, monomers, and photoinitiators are embedded within the substrates' subsurface, followed by in situ polymerization under ultraviolet light, creating a robust semi-interpenetrating and entangled network structure. This approach, offering a thicker energy-dissipating layer, outperforms traditional surface modifications in wear resistance while preserving anti-fatigue, hydrophilicity, oleophobicity, and other properties. Adaptable to various rubber and plastic substrates by using suitable solvents, this method provides an efficient solution for creating durable, lubricating surfaces, broadening the potential applications in multiple industries.

UV-Triggered Hydrogel Coating of the Double Network Polyelectrolytes for Enhanced Endothelialization

The left atrial appendage (LAA) occluder is an important medical device for closing the LAA and preventing stroke. The device-related thrombus (DRT) prevents the implantation of the occluder in exerting the desired therapeutic effect, which is primarily caused by the delayed endothelialization of the occluder. Functional coatings are an effective strategy for accelerating the endothelialization of occluders. However, the occluder surface area is particularly large and structurally complex, and the device is subjected to a large shear friction in the sheath during implantation, which poses a significant challenge to the coating. Herein, a hydrogel coating by the in situ UV-triggered polymerization of double-network polyelectrolytes is reported. The findings reveal that the double network and electrostatic interactions between the networks resulted in excellent mechanical properties of the hydrogel coating. The sulfonate and Arg-Gly-Asp (RGD) groups in the coating promoted hemocompatibility and endothelial growth of the occluder, respectively. The coating significantly accelerated the endothelialization of the LAA occluder in a canine model is further demonstrated. This study has potential clinical benefits in reducing both the incidence of DRT and the postoperative anticoagulant course for LAA closure.

Rapid, Tough, and Trigger-Detachable Hydrogel Adhesion Enabled by Formation of Nanoparticles In Situ

Integrating hydrogel with other materials is always challenging due to the low mass content of hydrogels and the abundance of water at the interfaces. Adhesion through nanoparticles offers characteristics such as ease of use, reversibility, and universality, but still grapples with challenges like weak bonding. Here, a simple yet powerful strategy using the formation of nanoparticles in situ is reported, establishing strong interfacial adhesion between various hydrogels and substrates including elastomers, plastics, and biological tissue, even under wet conditions. The strong interfacial bonding can be formed in a short time (60 s), and gradually strengthened to 902 J m-2 adhesion energy within an hour. The interfacial layer's construction involves chain entanglement and other non-covalent interactions like coordination and hydrogen bonding. Unlike the permanent bonding seen in most synthetic adhesives, these nanoparticle adhesives can be efficiently triggered for removal by acidic solutions. The simplicity of the precursor diffusion and precipitation process in creating the interfacial layer ensures broad applicability to different substrates and nanoparticle adhesives without compromising robustness. The tough adhesion provided by nanoparticles allows the hydrogel-elastomer hybrid to function as a triboelectric nanogenerator (TENG), facilitating reliable electrical signal generation and output performance due to the robust interface.

Structuring and Shaping of Mechanically Robust and Functional Hydrogels toward Wearable and Implantable Applications

Hydrogels possess unique features such as softness, wetness, responsiveness, and biocompatibility, making them highly suitable for biointegrated applications that have close interactions with living organisms. However, conventional man-made hydrogels are usually soft and brittle, making them inferior to the mechanically robust biological hydrogels. To ensure reliable and durable operation of biointegrated wearable and implantable devices, mechanical matching and shape adaptivity of hydrogels to tissues and organs are essential. Recent advances in polymer science and processing technologies have enabled mechanical engineering and shaping of hydrogels for various biointegrated applications. In this review, polymer network structuring strategies at micro/nanoscales for toughening hydrogels are summarized, and representative mechanical functionalities that exist in biological materials but are not easily achieved in synthetic hydrogels are further discussed. Three categories of processing technologies, namely, 3D printing, spinning, and coating for fabrication of tough hydrogel constructs with complex shapes are reviewed, and the corresponding hydrogel toughening strategies are also highlighted. These developments enable adaptive fabrication of mechanically robust and functional hydrogel devices, and promote application of hydrogels in the fields of biomedical engineering, bioelectronics, and soft robotics.

Bioinspired Lubricity from Surface Gel Layers

Surface gel layers on commercially available contact lenses have been shown to reduce frictional shear stresses and mitigate damage during sliding contact with fragile epithelial cell layers in vitro. Spencer and co-workers recently demonstrated that surface gel layers could arise from oxygen-inhibited free-radical polymerization. In this study, polyacrylamide hydrogel shell probes (7.5 wt % acrylamide, 0.3 wt % N,N'-methylenebisacrylamide) were polymerized in three hemispherical molds listed in order of decreasing surface energy and increasing oxygen permeability: borosilicate glass, polyether ether ketone (PEEK), and polytetrafluoroethylene (PTFE). Hydrogel probes polymerized in PEEK and PTFE molds exhibited 100× lower elastic moduli at the surface (E PEEK * = 80 ± 31 and E PTFE * = 106 ± 26 Pa, respectively) than those polymerized in glass molds (E glass * = 31,560 ± 1,570 Pa), in agreement with previous investigations by Spencer and co-workers. Biotribological experiments revealed that hydrogel probes with surface gel layers reduced frictional shear stresses against cells (τPEEK = 35 ± 15 and τPTFE = 22 ± 16 Pa) more than those without (τglass = 68 ± 15 Pa) and offered greater protection against cell damage when sliding against human telomerase-immortalized corneal epithelial (hTCEpi) cell monolayers. Our work demonstrates that the "mold effect" resulting in oxygen-inhibition polymerization creates hydrogels with surface gel layers that reduce shear stresses in sliding contact with cell monolayers, similar to the protection offered by gradient mucin gel networks across epithelial cell layers.

One-Pot Construction of Articular Cartilage-Like Hydrogel Coating for Durable Aqueous Lubrication

Articular cartilage has an appropriate multilayer structure and superior tribological properties and provides a structural paradigm for design of lubricating materials. However, mimicking articular cartilage traits on prosthetic materials with durable lubrication remains a huge challenge. Herein, an ingenious three-in-one strategy is developed for constructing an articular cartilage-like bilayer hydrogel coating on the surface of ultra-high molecular weight polyethylene (BH-UPE), which makes full use of conceptions of interfacial interlinking, high-entanglement crosslinking, and interface-modulated polymerization. The hydrogel coating is tightly interlinked with UPE substrate through hydrogel-UPE interchain entanglement and bonding. The hydrogel chains are highly entangled with each other to form a dense tough layer with negligible hysteresis for load-bearing by reducing the amounts of crosslinker and hydrophilic initiator to p.p.m. levels. Meanwhile, the polymerization of monomers in the top surface region is suppressed via interface-modulated polymerization, thus introducing a porous surface for effective aqueous lubrication. As a result, BH-UPE exhibits an ultralow friction coefficient of 0.0048 during 10 000 cycles under a load of 0.9 MPa, demonstrating great potential as an advanced bearing material for disc prosthesis. This work may provide a new way to build stable bilayer coatings and have important implications for development of biological lubricating materials.

Comparative Study on the Lubrication Mechanism and Performance of Two Representative Ionic and Nonionic Self-Adhesive Polymer Coatings

Surface modification of lubricating coatings on biomedical devices is a pivotal strategy to improve the overall performance and clinical efficacy, significantly reducing friction between devices and human tissues and mitigating tissue damage during intervention and long-term implantation. Recently, various hydrophilic polymeric materials have been used for achieving surface functionalization, endowing the biomedical device with excellent superlubrication performance. N-Vinylpyrrolidone (NVP) and 2-methacryloyloxyethyl phosphorylcholine (MPC) are two typical representatives of nonionic and zwitterionic materials. However, there is still a research gap in a comparative study of the lubrication mechanisms and properties between them. In this study, a bioinspired and dopamine-assisted codeposition technique was used to fabricate biomimetic hydrophilic coatings, including P(DMA-NVP) and P(DMA-MPC), on polyurethane. To achieve a thorough comparative analysis of the self-adhesive coating performance, 3 M ratios of the copolymers were synthesized and comprehensive material evaluations were conducted. Additionally, surface morphology, hydrophilicity, and lubrication at both the microscale and macroscale were performed. It was found that both hydrophilic coatings exhibited good stability. The P(DMA-MPC) coating, due to the ability to attract and bind a large number of water molecules, demonstrated superior lubrication effects compared to the P(DMA-NVP) coating. The study provides an in-depth understanding of the lubrication behavior of the self-adhesive coatings to enhance the functionality and application in biomedical engineering.

Robust, Sprayable, and Multifunctional Hydrogel Coating through a Polycation Reinforced (PCR) Surface Bridging Strategy

The sprayable hydrogel coatings that can establish robust adhesion onto diverse materials and devices hold enormous potential; however, a significant challenge persists due to monomer hydration, which impedes even coverage during spraying and induces inadequate adhesion post-gelation. Herein, a polycation-reinforced (PCR) surface bridging strategy is presented to achieve tough and sprayable hydrogel coatings onto diverse materials. The polycations offer superior wettability and instant electrostatic interactions with plasma-treated substrates, facilitating an effective spraying application. This PCR-based hydrogel coatings demonstrate tough adhesion performance to inert PTFE and silicone, including remarkable shear strength (161 ± 49 kPa for PTFE), interfacial toughness (198 ± 27 J m-2 for PTFE), and notable tolerance to cyclic tension (10 000 cycles, 200% strain, silicone). Meanwhile, this method can be applied to various hydrogel formulations, offering diverse functionalities, including underwater adhesion, lubrication, and drug delivery. Furthermore, the PCR concept enables the conformal construction of durable hydrogel coatings onto sophisticated medical devices like cardiovascular stents. Given its simplicity and adaptability, this approach paves an avenue for incorporating hydrogels onto solid surfaces and potentially promotes untapped applications.

Hydrogen Bonds-Pinned Entanglement Blunting the Interfacial Crack of Hydrogel-Elastomer Hybrids

Anchoring a layer of amorphous hydrogel on an antagonistic elastomer holds potential applications in surface aqueous lubrication. However, the interfacial crack propagation usually occurs under continuous loads for amorphous hydrogel, leading to the failure of hydrogel interface. This work presents a universal strategy to passivate the interfacial cracks by designing a hydrogen bonds-pinned entanglement (Hb-En) structure of amorphous hydrogel on engineering elastomers. The unique Hb-En structure is created by pinning well-tailored entanglements via covalent-like hydrogen bonds, which can amplify the delocalization of interfacial stress concentration and elevate the necessary fracture energy barrier within hydrogel interface. Therefore, the interfacial crack propagation can be suppressed under single and cyclic loads, resulting in a high interfacial toughness over 1650 J m-2 and an excellent interfacial fatigue threshold of 423 J m-2. Such a strategy universally works on blunting the interfacial crack between hydrogel coating and various elastomer materials with arbitrary shapes. The superb fatigue-crack insensitivity at the interface allows for durable aqueous lubrication of hydrogel coating with low friction.

Growth of Double-Network Tough Hydrogel Coatings by Surface-Initiated Polymerization

Hydrogel coatings exhibit versatile applications in biomedicine, flexible electronics, and environmental science. However, current coating methods encounter challenges in simultaneously achieving strong interfacial bonding, robust hydrogel coatings, and the ability to coat substrates with controlled thickness. This paper introduces a novel approach to grow a double-network (DN) tough hydrogel coating on various substrates. The process involves initial substrate modification using a silane coupling agent, followed by the deposition of an initiator layer on its surface. Subsequently, the substrate is immersed in a DN hydrogel precursor, where the coating grows under ultraviolet (UV) illumination. Precise control over the coating thickness is achieved by adjusting the UV illumination duration and the initiator quantity. The experimental measurement of adhesion reveals strong bonding between the DN hydrogel coating and diverse substrates, reaching up to 1012.9 J/m2 between the DN hydrogel coating and a glass substrate. The lubricity performance of the DN hydrogel coating is experimentally characterized, which is dependent on the coating thickness, applied pressure, and sliding velocity. The incorporation of 3D printing technology into the current coating method enables the creation of intricate hydrogel coating patterns on a flat substrate. Moreover, the hydrogel coating's versatility is demonstrated through its effective applications in oil-water separation and antifogging glasses, underscoring its wide-ranging potential. The robust DN hydrogel coating method presented here holds promise for advancing hydrogel applications across diverse fields.

Lubricity, wear prevention, and anti-biofouling properties of macromolecular coatings for endotracheal tubes

Macromolecular coatings can improve the surface properties of many medical devices by enhancing their wetting behavior, tribological performance, and anti-biofouling properties - and covalent coatings produced from mucin glycoproteins have been shown to be very powerful in all those aspects. However, obtaining highly functional mucin glycoproteins is, at the moment, still a time-consuming process, which renders mucins rather expensive compared to other biomacromolecules. Here, we study a set of commercially available macromolecules that have the potential of substituting mucins in coatings for endotracheal tubes (ETTs). We present an overview of the different properties these macromolecular coatings establish on the ETT surface and whether they withstand storage or sterilization processes. Our study pinpoints several strategies of how to enhance the lubricity of ETTs by applying macromolecular coatings but also demonstrates the limited anti-biofouling abilities of well-established macromolecules such as hyaluronic acid, polyethylene glycol, and dextran. Based on the obtained results, we discuss to what extent those coatings can be considered equivalent alternatives to mucin coatings for applications on medical devices - their applicability does not have to be limited to ETTs, but could be broadened to catheters and endoscopes as well.

Robust and self-lubricating polyvinyl alcohol tubes with a mucosa-like hierarchical architecture for endotracheal intubation

Mechanical mismatch between interventional intubation tubes and human tissues often triggers inevitable friction and causes secondary injury to patients during interventional therapy. Herein, we propose a fabrication strategy of a self-lubricating polyvinyl alcohol (PVA) tube by industrial extrusion technology followed by simple infiltration with water. First, biocompatible glycerin was introduced to weaken the intrinsic hydrogen interaction of PVA by new molecular complexation, broadening the gap between the melting and decomposition temperatures and enabling the stable extrusion of the PVA tube. Subsequently, the as-prepared PVA tube was infiltrated with an aqueous solution to construct a strong hydrogen bonding network between PVA and water molecules, forming a soft hydration layer similar to the upper epithelium layer of mucosa. Benefiting from the solid and liquid properties of the hydration layer as well as the small proportion relative to the whole, the infiltrated PVA tube exhibited excellent hydration lubrication behavior and robust mechanical property. The friction coefficient, tensile strength and elongation at break were measured to be 0.05, 26.2 MPa and 654%, respectively, surpassing the values of 0.5, 16.4 MPa and 240% observed in a commercial polyvinyl chloride tube. In vitro, the PVA intubation tube demonstrated significant biocompatibility, and short-term exposure exhibited minimal impacts on the morphology and proliferation of L929 cells. Ultimately, the potential of the infiltrated PVA tube for interventional intubation was demonstrated successfully using an in vivo rabbit model, providing a new idea for the follow-up development of interventional intubation tubes.

Durable hydrogel-based lubricated composite coating with remarkable underwater performances

HYPOTHESIS

Hydrogel coatings have received great attention in the field of such as medical devices, water treatment membranes, flexible electronics, and marine antifouling. However, when it comes to lubrication of hydrogel materials, though it has great potential applications in the field of industrial and medical drag reduction, some restrained properties are urgently needed to overcome for releasing the practical potential.

EXPERIMENTS

Durability of high lubrication was revealed from the sliding test during the long-term storage, as well as the long-distance sliding. Some variables which possibly affect the lubrication performance were examined to demonstrate that excellent lubricity of the coating would not be easily influenced by load, frequency, friction pair and temperature. The microstructure and mechanical characterization of the lubricative coating indicate that the resistance to harsh running conditions is premised on enough hydration extent and robustness. The formulae of Possion ratio and ball-on-disk contact stress which apply to soft matter were used for calculating contact stress values in tribology tests. Anti-swelling and bio-compatibility are also verified.

FINDINGS

This work found a route of achieving superior lubrication and coexisting with stability in lubrication, which can be used for drag reduction in medical devices and shipbuilding industry.

An underwater stable and durable gelatin composite hydrogel coating for biomedical applications

Developing underwater stable and durable hydrogel coatings with drag-reducing, drug release, and antibacterial properties is essential for lots of biomedical applications. However, most hydrogel coatings cannot meet the requirement of underwater stability and versatility, which severely limits their widespread use. In this work, an underwater stable, durable and substrate-independent gelatin composite hydrogel (GMP) coating is developed through covalent crosslinks, where a silane coupling agent with an unsaturated double bond is grafted onto a substrate of co-deposited polydopamine and polyethylenimine. GMP coating can be easily coated onto various medical device surfaces, such as artificial joints, catheters, tracheal tubes and titanium alloys, showing excellent structural stability and mechanical tunability under extreme conditions of ultrasonic treatment for 1 h (400 W of ultrasonic power) or underwater shearing for 14 days (400 rpm). Besides, friction experiment reveals that GMP coating exhibits good lubrication properties (coefficient of friction < 0.003). The drug-loading and bacterial inhibition ring tests show that the GMP coating has a tunable drug release ability with the final releasing ratios of 70-95% by changing the content of poly (ethylene glycol) diacrylate. This work offers a scalable approach of fabricating bio-functional and stable hydrogel coatings, which can be potentially used in biomedical applications.

In Situ Growth of Functional Hydrogel Coatings by a Reactive Polyurethane for Biomedical Devices

Surface modification of thermoplastic polyurethane (TPU) could significantly enhance its suitability for biomedical devices and public health products. Nevertheless, customized modification of polyurethane surfaces with robust interfacial bonding and diverse functions via a simple method remains an enormous challenge. Herein, a novel thermoplastic polyurethane with a photoinitiated benzophenone unit (BPTPU) is designed and synthesized, which can directly grow functional hydrogel coating on polyurethane (PU) in situ by initiating polymerization of diverse monomers under ultraviolet irradiation, without the involvement of organic solvent. The resulting coating not only exhibits tissue-like softness, controllable thickness, lubrication, and robust adhesion strength but also provides customized functions (i.e., antifouling, stimuli-responsive, antibacterial, and fluorescence emission) to the original passive polymer substrates. Importantly, BPTPU can be blended with commercial TPU to produce the BPTPU-based tube by an extruder. Only a trace amount of BPTPU can endow the tube with good photoinitiated capacity. As a proof of concept, the hydrophilic hydrogel-coated BPTPU is shown to mitigate foreign body response in vivo and prevent thrombus formation in rat blood circulation without anticoagulants in vitro. This work offers a new strategy to guide the design of functional polyurethane, an elastomer-hydrogel composite, and holds great prospects for clinical translation.

Molecular Clogging Organogels with Excellent Solvent Maintenance, Adjustable Modulus, and Advanced Mechanics for Impact Protection

Inspired by mechanically interlocking supramolecular materials, exploiting the size difference between the bulky solvent and the cross-linked network mesh, a molecular clogging (MC) effect is developed to effectively inhibit solvent migration in organogels. A bulky solvent (branched citrate ester, BCE) with a molecular size above 1.4 nm is designed and synthesized. Series of MC-Gels are prepared by in situ polymerization of crosslinked polyurea with BCE as the gel solvent. The MC-Gels are colorless, transparent, and highly homogeneous, show significantly improved stability than gels prepared with small molecule solvents. As solvent migration is strongly inhibited by molecular clogging, the solvent content of the gels can be precisely controlled, resulting in a series of MC-Gels with continuously adjustable mechanics. In particular, the modulus of MC-Gel can be regulated from 1.3 GPa to 30 kPa, with a variation of 43 000 times. The molecular clogging effect also provides MC-Gels with unique high damping (maximum damping factor of 1.9), impact resistant mechanics (high impact toughness up to 40.68 MJ m-3 ). By applying shatter protection to items including eggs and ceramic armor plates, the potential of MC-Gels as high strength, high damping soft materials for a wide range of applications is well demonstrated.

[Preparation and Performance Evaluation of Polyacrylamide Hydrogel Coating on the Surface of Silicone Rubber Nasogastric Tube]

Objective

To prepare the hydrogel coating on the surfaces of nasogastric tubes and to evaluate its effect on the insertion of nasogastric tubes in a rabbit model.

Methods

The polyacrylamide (PAAm) hydrogel coating was prepared by UV-induced free radical polymerization. The morphology of the PAAm coating and its interfacial bonding with the silicone rubber substrates of nasogastric tubes were observed with scanning electron microscope. The composition of the coating was analyzed by Fourier transform infrared (FTIR) spectrometer and X-ray photoelectron spectrometer (XPS). The water absorption power and stability of the coating were measured by the weighing method. Water contact angle meter was used to measure the wettability of the coating and tribometer was used to determine the friction coefficient of the silicone rubber substrates before and after the modification. The cytotoxicity of the coating on L929 murine fibroblast cell line was explored with CCK-8 assay after 24-h coculturing of the L929 cell line with silicone rubber substrates before and after modification. An animal model of nasogastric tube insertion in New Zealand rabbits was used to evaluate the effect of the lubrication coating by assessing the insertion time and nasal damage.

Results

In this study, PAAm hydrogel coating was prepared and constructed on the surface of silicone rubber nasogastric tubes. The coating, with a three-dimensional network structure, showed strong interfacial bonding with silicone rubber substrates. The appearance of amino and carbonyl groups indicated that the PAAm hydrogel coating was grafted on the surfaces of nasogastric tubes. Before the modification, the silicone rubber substrate essentially did not absorb much water, whereas, after the modification, the silicone rubber substrate showed significant improvement of as much as 2.9% in water absorption. After sonication for 90 min, the weight loss rate was only 0.15%. Compared with pristine nasogastric tubes, the water contact angle of the modified nasogastric tubes was reduced from 111.9°±2.2° to 58.9°±1.5° ( t=22.59, P<0.05). In addition, the friction coefficient of silicone rubber nasogastric tubes decreased by 69.3% from 0.378±0.05 to 0.116±0.004 ( t=42.80, P<0.05) after modification. Moreover, there was no significant difference in the cytocompatibility between L929 cells cocultured with pristine nasogastric tube and those cocultured with modified nasogastric tube. The animal experiment of nasogastric tube insertion showed that the insertion time of the modified nasogastric tubes was reduced from (41.6±7.8) s to (12.4±2.9) s ( t=8.509, P<0.05). Laryngoscopy revealed that the PAAm hydrogel coating significantly reduced the mucosal damage caused by the insertion of nasogastric tubes.

Conclusion

In this study, PAAm hydrogel coating with strong interfacial bonding was prepared on the surface of silicone rubber nasogastric tubes. The coating has excellent hydrophilic lubrication property and cytocompatibility, effectively shortens the insertion time, and reduces the damage caused by nasogastric tube insertion.

Contact Lens Sensor with Anti-jamming Capability and High Sensitivity for Intraocular Pressure Monitoring

Contact lens sensors provide a noninvasive approach for intraocular pressure (IOP) monitoring in patients with glaucoma. Accurate measurement of this imperceptible pressure variation requires highly sensitive sensors in the absence of simultaneously amplifying IOP signal and blinking-induced noise. However, current noise-reduction methods rely on external filter circuits, which thicken contact lenses and reduce signal quality. Here, we introduce a contact lens strain sensor with an anti-jamming ability by utilizing a self-lubricating layer to reduce the coefficient of friction (COF) to remove the interference from the tangential force. The sensor achieves exceptionally high sensitivity due to the strain concentration layout and the confined occurrence of sympatric microcracks. The animal tests prove our lens can accurately detect IOP safely and reliably.

The role of local inflammation in complications associated with intubation in pediatric patients: A narrative review

Although the most important primary local inflammatory response factor to intubation is not yet clear, it is known that it may be directly attributed to the presence of trauma during intubation or the response of oral bacterial flora present in the trachea. It is known that prolonged intubation is associated with worse outcomes, but other underlying systemic issues, such as sepsis and trauma, are also associated with this result. Likewise, patients who require advanced airway management and excessive manipulation are more likely to experience complications. There are various inflammatory mediators that are generated during orotracheal intubation, many of which can be considered targets for therapies to help reduce inflammation caused by intubation. However, there is little evidence on the management of the inflammatory response induced by orotracheal intubation in pediatric patients. Therefore, the aim of this narrative review is to highlight the intubation associated complications that can arise from poorly controlled inflammation in intubated pediatric patients, review the proposed pathophysiology behind this, and discuss the current treatments that exist. Finally, taking into account the discussion on pathophysiology, we describe the current therapies being developed and future directions that can be taken in order to create more treatment options within this patient population.

Skin-Friendly and Wearable Iontronic Touch Panel for Virtual-Real Handwriting Interaction

Touch panels are deemed as a critical platform for the future of human-computer interaction and metaverse. Recently, stretchable iontronic touch panels have attracted attention due to their superior adhesivity to the human body. However, such adhesion can not be named "real wearable", leading to discomfort for the wearer, such as rashes or itching with long-time wearing. Herein, a skin-friendly and wearable iontronic textile-based touch panel with highly touch-sensing resolution and deformation insensitivity is designed based on an in-suit growing strategy. This textile-based touch panel endows excellent interfacial hydrophilic and biocompatibility with human skin by overcoming the bottlenecks of the hydrogel-based uncomfortable sticky touch interface and low mechanical behavior. The developed touch panel enables handwriting interaction with good mechanical capacity (114 MPa), nearly 4145 times higher than pure hydrogel. More importantly, our touch panel possesses intrinsic insensitivity to wide external loading from the silver fiber (<0.003 g) to even heavy metal block (>10 kg). As proof of concept, the textile-based iontronic touch panel is applied to handwriting interaction, such as a flexible keyboard and wearable sketchpad. This iontronic touch panel with skin-friendly and wearable qualitities is helpful for next-generation wearable interaction electronics.

Tough, Transparent, and Slippery PVA Hydrogel Led by Syneresis

Slippery and transparent polyvinyl alcohol (PVA) hydrogels with mechanical robustness exhibit broad applications in artificial biological soft tissues, flexible wearable electronics, and implantable biomedical devices. Most of the current PVA hydrogels, however, are unable to integrate these features, which compromises its performance in biological and engineering applications. To achieve such purpose, herein, a novel tactic is proposed, salting-out-after-syneresis of PVA, to realize a mechanically robust and highly transparent slippery PVA hydrogel. The syneresis of PVA sol is first conducted to form highly dense and transparent PVA polymer networks, then the salting-out effect tunes the aggregation of the polymer chains to rapidly induce the phase separation and crystallization. The resultant hydrogels show the transparency up to 98% in the visible region, the tribological coefficient down to 0.0081, and the excellent mechanical properties with strength, modulus, and toughness of 26.72 ± 1.05, 6.66 ± 0.29 MPa, and 55.21 ± 1.62 MJ m^-3 , respectively. To reveal the potentials, PVA contact lens that combine remarkable lubrication, anti-protein adhesion, biocompatibility, and drug-loading functions are demonstrated. This strategy provides a simple and new avenue for developing the mechanically robust, transparent, and hydrated hydrogels, showing the potential in biomedicine and wearable devices.

A novel enzyme-free long-lasting chemiluminescence system based on a luminol functionalized β-cyclodextrin hydrogel for sensitive detection of H2O2 in urine and cells

A novel long-lasting chemiluminescent (CL) hydrogel (β-CD@luminol-Co²⁺) was synthesized by embedding luminol and cobalt ions (Co²⁺) into β-cyclodextrin (β-CD) through non-covalent interactions. Due to its porous structure and viscosity, the synthesized β-CD@luminol-Co²⁺ hydrogel exhibited long-lasting CL properties and can emit light for 12 h under both alkaline and neutral conditions. In addition, the CL intensities of β-CD@luminol-Co²⁺ were linear with the logarithm of the hydrogen peroxide (H₂O₂) concentration in the range of 1.0 × 10^-11-1.0 × 10^-7 M, and the limit of detection (LOD) was 0.63 × 10^-11 M and 0.85 × 10^-11 M under alkaline and neutral conditions, respectively. On this basis, an enzyme-free CL sensor based on β-CD@luminol-Co²⁺ was fabricated for the sensitive detection of H₂O₂ in human urine samples under alkaline conditions, and showed good accuracy and recovery. Since β-CD@luminol-Co²⁺ showed good CL properties under neutral conditions, it can be applied to detect H₂O₂ in cells. In order to prolong the emission wavelength of β-CD@luminol-Co²⁺ for better cell imaging, β-CD@luminol-FL-Co²⁺ was prepared by adding fluorescein (FL) to β-CD@luminol-Co²⁺. The as-prepared β-CD@luminol-FL-Co²⁺ also displayed long-lasting CL properties and showed a linear relationship with H₂O₂ concentrations. In addition, the maximum emission wavelength of β-CD@luminol-FL-Co²⁺ was 520 nm, which was red-shifted by 95 nm compared with β-CD@luminol-Co²⁺. The methyl thiazolyl tetrazolium (MTT) assay results and confocal microscopy images illustrated that β-CD@luminol-FL-Co²⁺ had low toxicity and can be taken up by A549 cells. Finally, β-CD@luminol-FL-Co²⁺ was successfully applied for CL imaging and detection of intracellular H₂O₂ in A549 cells under neutral conditions. This enzyme-free long-lasting CL system with high sensitivity can also be extended to real-time monitoring of H₂O₂in vivo.

Versatile Mechanochromic Sensor based on Highly Stretchable Chiral Liquid Crystalline Elastomer

A mechanochromic strain sensor that is capable of distinguishing the orientation, the location, and the degree of deformation based on the highly stretchable membrane of main-chain chiral liquid crystalline elastomer (MCLCE) is proposed. The MCLCE film is designed to exhibit uniform and significant color shift upon the small strain by using step-growth polymerization of liquid crystal (LC) oligomer and its phase-stabilization in solvent mesogen. As conformally placed on the bottom elastomer sheet, the MCLCE film shows multimodal, instantaneous color change for sensing arbitrary in-plane deformation, out-of-plane bending, and nonzero Gaussian deformation. Based on high freedom in the device design, it is also demonstrated that this sensor can display color patterns or encrypted images in response to the localized weight or strain. The simple and straightforward concept proposed here can be applicable in the fields of wearable devices, displays, and soft robotics.

Recent advances in electronic skins: material progress and applications

Electronic skins are currently in huge demand for health monitoring platforms and personalized medicine applications. To ensure safe monitoring for long-term periods, high-performance electronic skins that are softly interfaced with biological tissues are required. Stretchability, self-healing behavior, and biocompatibility of the materials will ensure the future application of electronic skins in biomedical engineering. This mini-review highlights recent advances in mechanically active materials and structural designs for electronic skins, which have been used successfully in these contexts. Firstly, the structural and biomechanical characteristics of biological skins are described and compared with those of artificial electronic skins. Thereafter, a wide variety of processing techniques for stretchable materials are reviewed, including geometric engineering and acquiring intrinsic stretchability. Then, different types of self-healing materials and their applications in electronic skins are critically assessed and compared. Finally, the mini-review is concluded with a discussion on remaining challenges and future opportunities for materials and biomedical research.

Bioinspired Self-Adhesive Lubricated Coating for the Surface Functionalization of Implanted Biomedical Devices

The lubrication property of implanted biomedical devices is of great significance as it affects the clinical performance owing to direct contact with soft tissues. In the present study, a bioinspired copolymer with dual functions of both self-adhesion and lubrication was synthesized with N-(3-aminopropyl) methacrylamide hydrochloride, gallic acid, and 3-[dimethyl-[2-(2-methylprop-2-enoyloxy) ethyl] azaniumyl] propane-1-sulfonate by free radical polymerization and a carbodiimide coupling reaction. The copolymer was further modified on the surface of poly(vinyl chloride) (PVC) samples using a simple dip-coating method and was characterized by different evaluations including Fourier transform infrared spectroscopy, the water contact angle, X-ray photoelectron spectroscopy, optical interferometry, and atomic force microscopy. Additionally, the results of a series of tribological tests at the microscopic level demonstrated that the friction coefficient of the copolymer-coated PVC samples was significantly reduced compared to that of the bare PVC samples. Furthermore, the pull out test at the macroscopic level was performed using copolymer-coated PVC catheters on a poly(dimethylsiloxane)-based test rig, and the result showed that the copolymer-coated PVC catheters were endowed with a greatly decreased and much more stable pull out force compared with that of the bare PVC catheters. In conclusion, the bioinspired self-adhesive lubricated coating developed herein may be applied as a universal and versatile method to enhance the lubrication performance of implanted biomedical devices.

Synergy of Hofmeister effect and ligand crosslinking enabled the facile fabrication of super-strong, pre-stretching-enhanced gelatin-based hydrogels

Hydrogels are becoming increasingly popular in biomedical and soft machine manufacturing, but their practical application is limited by poor mechanical properties. In recent years, Hofmeister effect-enhanced gelatin hydrogels have become popular. However, the synergy of the Hofmeister effect using other toughening methods is still less investigated. We have fabricated an ultra-high strength gelatin-based hydrogel by introducing ligand cross-linking and hydrogen bonds. Unlike conventional double-network hydrogels, the dense physical cross-linking involving sacrificial bonds gives the hydrogel excellent fatigue resistance and self-recovery properties. The enhancement of mechanical properties by the Hofmeister effect is attributed to the disruption of the hydration shell of the gelatin molecular chains, which leads to stronger interactions between the molecular chains. The mechanical properties of the hydrogels are adjustable over a wide range by varying the concentration of the soaked (NH₄)₂SO₄ solution. The fixation of the gelatin molecular chain orientation by the Hofmeister effect and the reorganization of the coordination bonds allow the hydrogels to be self-reinforced by pre-stretching. At the same time, the modulus contraction of hydrogels in high-concentration salt solutions, and relaxation and swelling in dilute solutions exhibit ionic stimulation responses and shape recovery capability, and hybrid hydrogels have great potential as bio-actuators.

Smart Internal Bio-Glues

Although smart bio-glues have been well documented, the development of internal bio-glues for non-invasive or minimally invasive surgery is still met with profound challenges such as safety risk and the lack of deep tissue penetration stimuli for internal usage. Herein, a series of smart internal bio-glues are developed via the integration of o-nitrobenzene modified biopolymers with up-conversion nanoparticles (UCNPs). Upon irradiation by near-infrared (NIR) light, the prepared smart bio-glues can undergo a gelation process, which may further induce strong adhesion between tissues under both dry and wet conditions based on multi-interactions. Moreover, those NIR light-responsive bio-glues with deeper tissue penetration ability demonstrate good biocompatibility, excellent hemostatic performance, and the potent ability to accelerate wound healing for both external and internal wounds. This work provides new opportunities for minimally invasive surgery, especially in internal wound healing using smart and robust bio-glues.

Risk Assessment and Regulatory Exploration of the Lubrication Coating on Intravascular Medical Devices

Lubricious polymer coatings are increasingly used on intravascular devices to facilitate application processes. Although increasing reports about the detachment and subsequent embolism of polymer particles, this iatrogenic polymer embolism has not been paid enough clinical attention for many years. This article reviews the hazard of coating separation and the difficulty to find it. Furthermore, this proposes the scientific evaluation concept and regulatory exploration to solve the problems.