Steering Self-Assembly of Three-Dimensional Iptycenes on Au(111) by Tuning Molecule-Surface Interactions.

Self-assembly of three-dimensional molecules is scarcely studied on surfaces. Their modes of adsorption can exhibit far greater variability compared to (nearly) planar molecules that adsorb mostly flat on surfaces. This additional degree of freedom can have decisive consequences for the expression of intermolecular binding motifs, hence the formation of supramolecular structures. The determining molecule-surface interactions can be widely tuned, thereby providing a new powerful lever for crystal engineering in two dimensions. Here, we study the self-assembly of triptycene derivatives with anthracene blades on Au(111) by Scanning Tunneling Microscopy, Near Edge X-ray Absorption Fine Structure and Density Functional Theory. The impact of molecule-surface interactions was experimentally tested by comparing pristine with iodine-passivated Au(111) surfaces. Thereby, we observed a fundamental change of the adsorption mode that triggered self-assembly of an entirely different structure.

On-surface photopolymerization of two-dimensional polymers ordered on the mesoscale.

The use of solid supports and ultra-high vacuum conditions for the synthesis of two-dimensional polymers is attractive, as it can enable thorough characterization, often with submolecular resolution, and prevent contamination. However, most on-surface polymerizations are thermally activated, which often leads to high defect densities and relatively small domain sizes. Here, we have obtained a porous two-dimensional polymer that is ordered on the mesoscale by the two-staged topochemical photopolymerization of fluorinated anthracene triptycene (fantrip) monomers on alkane-passivated graphite surfaces under ultra-high vacuum. First, the fantrip monomers self-assemble into highly ordered monolayer structures, where all anthracene moieties adopt a suitable arrangement for photopolymerization. Irradiation with violet light then induces complete covalent crosslinking by [4+4] photocycloaddition to form a two-dimensional polymer, while fully preserving the long-range order of the self-assembled structure. The extent of the polymerization is confirmed by local infrared spectroscopy and scanning tunnelling microscopy characterization, in agreement with density functional theory calculations, which also gives mechanistic insights.

Alternative clinical trial designs.

High-quality clinical trials are needed to advance the care of injured patients. Traditional randomized clinical trials in trauma have challenges in generating new knowledge due to many issues, including logistical difficulties performing individual randomization, unclear pretrial estimates of treatment effect leading to often unpowered studies, and difficulty assessing the generalizability of an intervention given the heterogeneity of both patients and trauma centers. In this review, we discuss alternative clinical trial designs that can address some of these difficulties. These include pragmatic trials, cluster randomization, cluster randomized stepped wedge designs, factorial trials, and adaptive designs. Additionally, we discuss how Bayesian methods of inference may provide more knowledge to trauma and acute care surgeons compared with traditional, frequentist methods.

Optimal delay time to initiate anticoagulation after ischemic stroke in atrial fibrillation (START): Methodology of a pragmatic, response-adaptive, prospective randomized clinical trial.

RATIONALE: An estimated 15% of all strokes are associated with untreated atrial fibrillation. Long-term secondary stroke prevention in atrial fibrillation is anticoagulation, increasingly with non-vitamin K oral anticoagulants. The optimal time to initiate anticoagulation following an atrial fibrillation-related stroke that balances hemorrhagic conversion with recurrent stroke is not yet known. AIMS: To determine if there is an optimal delay time to initiate anticoagulation after atrial fibrillation-related stroke that optimizes the composite outcome of hemorrhagic conversion and recurrent ischemic stroke. SAMPLE SIZE ESTIMATES: The study will enroll 1500 total subjects split between a mild to moderate stroke cohort (1000) and a severe stroke cohort (500). METHODS AND DESIGN: This study is a multi-center, prospective, randomized, pragmatic, adaptive trial that randomizes subjects to four arms of time to start of anticoagulation. The four arms for mild to moderate stroke are: Day 3, Day 6, Day 10, and Day 14. The time intervals for severe stroke are: Day 6, Day 10, Day 14, and Day 21. Allocation involves a response adaptive randomization via interim analyses to favor the arms that have a better risk-benefit profile. STUDY OUTCOMES: The primary outcome event is the composite occurrence of an ischemic or hemorrhagic event within 30 days of the index stroke. Secondary outcomes are also collected at 30 and 90 days. DISCUSSION: The optimal timing of direct oral anticoagulants post-ischemic stroke requires prospective randomized testing. A pragmatically designed trial with adaptive allocation and randomization to multiple time intervals such as the START trial is best suited to answer this question in order to directly inform current practice on this question.

A Two-Dimensional Polymer Synthesized at the Air/Water Interface.

A trifunctional, partially fluorinated anthracene-substituted triptycene monomer was spread at an air/water interface into a monolayer, which was transformed into a long-range-ordered 2D polymer by irradiation with a standard UV lamp. The polymer was analyzed by Brewster angle microscopy, scanning tunneling microscopy measurements, and non-contact atomic force microscopy, which confirmed the generation of a network structure with lattice parameters that are virtually identical to a structural model network based on X-ray diffractometry of a closely related 2D polymer. The nc-AFM images highlight the long-range order over areas of at least 300×300 nm2 . As required for a 2D polymer, the pore sizes are monodisperse, except for the regions where the network is somewhat stretched because it spans over protrusions. Together with a previous report on the nature of the cross-links in this network, the structural information provided herein leaves no doubt that a 2D polymer has been synthesized under ambient conditions at an air/water interface.

Structural Characterization of a Covalent Monolayer Sheet Obtained by Two-Dimensional Polymerization at an Air/Water Interface.

This work describes a two-dimensional polymerization at an air/water interface and provides, for the first time, direct spectroscopic evidence for the kind of crosslinks formed and for the conversion reached in a covalently bonded monolayer sheet. This evidence was obtained through a combination of a variety of monolayer characterization techniques before and after transfer onto solid substrates, in particular by tip-enhanced Raman spectroscopy (TERS) and TERS mapping after transfer of both the monomer and polymer monolayer onto Au(111). This work is a major advance for the field of 2D polymers synthesized at the air/water interface as it, in principle, allows estimation of the crystallinity by percolation theory and the location of regions with defects.

Kekulenes, cycloarenes, and heterocycloarenes: addressing electronic structure and aromaticity through experiments and calculations.

Kekulenes, cycloarenes, and heterocycloarenes have attracted much attention though the years, largely due to their electronic structure. The synthesis and characterization of these interesting molecules showed that their π electrons remained delocalized in individual benzenoid-type rings rather than globally delocalized in an annulenoid fashion. This discovery further suggested that the Clar bonding model, not the Kekulé model, is the best representation for depicting the bonding of large macrocyclic aromatic compounds. A plethora of computational studies suggest that cycloarenes gain little, if any, energetic stabilization from global delocalization, obviating the need for the concept of superaromaticity. More recently, cycloarenes have been suggested to serve as models for defects in graphene. Further study into this interesting set of compounds will continue to provide insights into fundamental questions about how aromatic compounds behave.

Two-dimensional polymers: concepts and perspectives.

Creation of polymers comprised of repeat units that can create topologically planar macromolecules (rather than linear) has been the topic of several recent studies in the field of synthetic polymer chemistry. Such novel macromolecules, known as 2D polymers, are the result of advanced synthetic methodology which allows creation of monolayer sheets with a periodic internal structure and functional groups placed at predetermined sites under mild conditions. Given the promising potentials of 2D polymers, this feature paper aims at discussing the concept of these novel macromolecules from a topological viewpoint in Section 1. This is followed by spotlighting the expected behavior of 2D polymers in the context of polymer physics (entropy elasticity, strength, percolation, and persistence) and polymer chemistry (copolymers and growth kinetics) in Section 2. Section 3 delineates synthetic and analytical matters associated with 2D polymers followed by a brief final section highlighting the potential of these sheet-like macromolecules for application purposes. We hope this article will trigger the interest of chemists, physicists and engineers to help develop this encouraging new class of materials further such that societally relevant applications will be accessible in the market soon.

Large area synthesis of a nanoporous two-dimensional polymer at the air/water interface.

We present the synthesis of a two-dimensional polymer at the air/water interface and its nm-resolution imaging. Trigonal star, amphiphilic monomers bearing three anthraceno groups on a central triptycene core are confined at the air/water interface. Compression followed by photopolymerization on the interface provides the two-dimensional polymer. Analysis by scanning tunneling microscopy suggests that the polymer is periodic with ultrahigh pore density.

A nanoporous two-dimensional polymer by single-crystal-to-single-crystal photopolymerization.

In contrast to the wide number and variety of available synthetic routes to conventional linear polymers, the synthesis of two-dimensional polymers and unambiguous proof of their structure remains a challenge. Two-dimensional polymers-single-layered polymers that form a tiling network in exactly two dimensions-have potential for use in nanoporous membranes and other applications. Here, we report the preparation of a fluorinated hydrocarbon two-dimensional polymer that can be exfoliated into single sheets, and its characterization by high-resolution single-crystal X-ray diffraction analysis. The procedure involves three steps: preorganization in a lamellar crystal of a rigid monomer bearing three photoreactive arms, photopolymerization of the crystalline monomers by [4 + 4] cycloaddition, and isolation of individual two-dimensional polymer sheets. This polymer is a molecularly thin (~1 nm) material that combines precisely defined monodisperse pores of ~9 Šwith a high pore density of 3.3 × 10(13) pores cm(-2). Atomic-resolution single-crystal X-ray structures of the monomer, an intermediate dimer and the final crystalline two-dimensional polymer were obtained and prove the single-crystal-to-single-crystal nature and molecular precision of the two-dimensional photopolymerization.

Synthesis of a covalent monolayer sheet by photochemical anthracene dimerization at the air/water interface and its mechanical characterization by AFM indentation.

Covalent monolayer sheets in 2 hours: spreading of threefold anthracene-equipped shape-persistent and amphiphilic monomers at the air/water interface followed by a short photochemical treatment provides access to infinitely sized, strictly monolayered, covalent sheets with in-plane elastic modulus in the range of 19 N/m.

A two-dimensional polymer from the anthracene dimer and triptycene motifs.

A two-dimensional polymer (2DP) based on the dimerization of anthraceno groups arranged in a triptycene motif is reported. A photoinduced polymerization is performed in the crystalline state and gives a lamellar 2DP via a crystal-to-crystal (but not single-crystal to single-crystal) transformation. Solvent-induced exfoliation provides monolayer sheets of the 2DP. The 2DP is considered to be a tiling, a mathematical approach that facilitates structural elucidation.

Synthesis of 1,8,9,16-tetrakis(trimethylsilyl)tetra-cata-tetrabenzoquadrannulene.

The synthetic efforts that yielded the first stable [4]circulene, 1,8,9,16-tetrakis(trimethylsilyl)tetra-cata-tetrabenzoquadrannulene (TMS(4)-TBQ, 1), are reported. The synthesis and characterization of different intermediates are described. The cyclotrimerization of the key precursor tetraalkyne was explored using Rh(I), Ni(0), and Co(I) catalysts. The ultimate product 1 was isolated only after oxidative demetalation of cobalt complexes.

Molecular nesting in co-crystals of tetrabenzoquadrannulene and C60: application of the sphere in a cone model.

We report the X-ray crystal structure of TMS(4)-TBQ with C(60) and analyse their interaction using a sphere in a cone model.

A two-dimensional polymer prepared by organic synthesis.

Synthetic polymers are widely used materials, as attested by a production of more than 200 millions of tons per year, and are typically composed of linear repeat units. They may also be branched or irregularly crosslinked. Here, we introduce a two-dimensional polymer with internal periodicity composed of areal repeat units. This is an extension of Staudinger's polymerization concept (to form macromolecules by covalently linking repeat units together), but in two dimensions. A well-known example of such a two-dimensional polymer is graphene, but its thermolytic synthesis precludes molecular design on demand. Here, we have rationally synthesized an ordered, non-equilibrium two-dimensional polymer far beyond molecular dimensions. The procedure includes the crystallization of a specifically designed photoreactive monomer into a layered structure, a photo-polymerization step within the crystal and a solvent-induced delamination step that isolates individual two-dimensional polymers as free-standing, monolayered molecular sheets.

Comprehensive pain management protocol reduces children's memory of pain at discharge from the pediatric ED.

BACKGROUND: Historically, pain has been poorly managed in the pediatric emergency department (ED) (PED), resulting in measurable psychosocial issues both acute and delayed. OBJECTIVE: The aim of the study was to measure the impact of protocolized pain management on patients with painful conditions or undergoing painful procedures in the PED. METHODS: We performed an analysis before and after the implementation of the protocol, dubbed the "Comfort Zone." Validated, age-appropriate pain scales were performed. Validation (using Cronbach α, confirmatory factor analysis) was followed by comparison of responses between the pre- and posttests collected (χ(2) and Wilcoxon rank sum tests). Pain scores were collected at triage and at discharge. At triage, patients were asked to report pain levels. At discharge, they were asked to report their current pain and recall the level of pain during their stay. At triage, parents were asked to report about their perception of the child's pain. At discharge, they were asked to report about their perception of the child's current pain and recall the level of pain during the stay and during procedures, if done. RESULTS: Five hundred thirty-one patients were enrolled in the preprotocol group; 47% were women with a median age of 5 years (range, 30 days-18 years). Two hundred sixty-three patients were enrolled in the protocol group; 39% were women with a median age of 6 years (range, 30 days-18 years). Patient-recalled pain scores of the ED visit in the protocol group were significantly lower than those of the preprotocol group (Wong-Baker Faces Pain Scale, 5.07-4.01; P < .001); yet parent estimates of pain did not show a significant change at any point. Patient assessment of pain at ED discharge did not show a significant change either (Wong-Baker Faces Pain Scale, 1.99-1.56; P = .09). The Faces scale is not well validated for patients younger than 4, so that group had only parental assessment of pain and, consistent with the larger data set, showed no significant pain scale reduction at any point. CONCLUSION: Protocolized pain management reduces patients' memory of pain during PED visits but may not affect parental memory of perceived pain or parent- and patient-reported pain at discharge.

t-Butyl biphenylation of o-dibromoarenes: a route to soluble polycyclic aromatic hydrocarbons.

Large, soluble polycyclic aromatic hydrocarbons (PAHs) have been synthesized using Zr-mediated and Stille-type biphenylation reactions. Both the Zr and Stille methodologies have been adopted to incorporate tert-butyl substituents, permitting the direct synthesis of alkylated PAHs that are much more soluble than their unsubstituted analogues. To demonstrate the utility of these methods and the importance of solubilizing functionality, several large PAHs were synthesized and crystallographically characterized. The scope of the Zr-mediated and Stille methodologies is shown to be complementary. The Stille methodology often gives higher yields but is ineffective for the introduction of strain and failed with some polybrominated arenes. In these difficult cases, the zirconium methodology is effective, albeit in low yields.