Segmented copolymers with polyesteramide units of uniform length: structure analysis

Segmented poly(ether esteramide) copolymers with short (M = 382) partially aromatic esteramide units of uniform length and segments of poly(tetramethylene oxide) (PTMO) have beem synthesized in the melt. The polymers show phase separation into two or three phases. The influence of the PTMO segment length on the following properties was studied: the Tg of the amorphous phase, the Tm of the crystalline PTMO and the melting and crystallization behaviour of the uniform polyesteramide units. Volume fraction and density of each phase were determined. The polyesteramide units crystallize in lamellar structures; their sizes were studied using WAXD and SAXS. The polymers were melt processed and their mechanical properties were investigated using dynamic mechanical thermal analysis (d.m.t.a.) and tensile tests. Polyesteramide crystallinity, crystalline structure and crystallite size were found to be almost independent of PTMO segment length. The decrease in hard-segment melting temperature with increasing PTMO segment length is explained as being due to a `solvent¿ effect of the soft phase. The copolymers crystallize very fast, and the modulus in the rubber region is essentially independent of temperature. The copolymers with long PTMO segments (M = 2000 and 2900) have a low glass transition temperature (¿65°C); the materials are very soft and have an elongation at break of over 1000%. The copolymer with the shortest PTMO segments (M = 250) has a glass transition temperature of 43°C and the material is hard at room temperature

A comparison between the morphology of semicrystalline polymer blends of poly(ε-caprolactone)/poly(vinyl methyl ether) and poly(ε-caprolactone)/(styrene-acrylonitrile)

The morphology of polymer blends of poly(ε-caprolactone) (PCL) and poly(vinyl methyl ether) (PVME) is compared with that of PCL and a random copolymer of styrene and acrylonitrile (SAN). The main objective is to determine the influence of the glass transition temperature of the amorphous component (Tg,a) on the morphology of the semicrystalline polymer blends. These blends represent the two extreme cases corresponding to Tc < Tg,a and Tc > Tg,a, where Tc is the crystallization temperature. The morphology of these blends, with PVME and SAN representing the amorphous components, have been studied by small angle X-ray scattering. For both blends the long period increases with the addition of amorphous polymer, which is a strong indication for an interlamellar morphology. D.s.c. experiments, including enthalpy relaxation, are used to investigate the crystallinity and the interphases. The overall amount of crystallinity in both blends decreases with increasing content of amorphous polymer. However, the fraction of PCL that crystallizes decreases in PCL/SAN and increases slightly in PCL/PVME. Apparently, the addition of the low Tg,a PVME improves the crystallization of PCL in accordance with a simple Gamblers Ruin Model type argument. The high Tg,a of SAN means this does not occur in PCL/SAN blends. Conventional d.s.c. experiments show an interphase of pure amorphous PCL in PCL/SAN blends and enthalpy relaxation experiments demonstrate its presence in PCL/PVME blends as well.

Heavy menstrual bleeding on direct factor Xa inhibitors: Rationale and design of the MEDEA study

Background: In premenopausal women, treatment with direct oral factor Xa inhibitors is associated with an increased risk of heavy menstrual bleeding (HMB) compared with vitamin K antagonists (VKA). Treatment with the direct oral thrombin inhibitor dabigatran appears to be associated with a reduced risk of HMB compared with VKA. These findings come from small observational studies or post hoc analyses of trials in which HMB was not a primary outcome. Use of tranexamic acid during the menstrual period may be effective in patients with HMB, but prospective data regarding efficacy and safety in patients on anticoagulant treatment are lacking. Rationale and Design: A direct comparison of a factor Xa inhibitor and a thrombin inhibitor with HMB as primary outcome, as well as an evaluation of the effects of adding tranexamic acid in women with anticoagulant-associated HMB is highly relevant for clinical practice. The MEDEA study is a randomized, open-label, pragmatic clinical trial to evaluate management strategies in premenopausal women with HMB associated with factor Xa inhibitor therapy. Outcomes: Women using factor Xa inhibitors with proven HMB, as assessed by a pictorial blood loss assessment chart (PBAC) score of >150, will be randomized to one of three study arms: (i) switch to dabigatran; (ii) continue factor Xa inhibitor with addition of tranexamic acid during the menstrual period; or (iii) continue factor Xa inhibitor without intervention. The primary outcome is the difference in PBAC score before and after randomization. Here, we present the rationale and highlight several unique features in the design of the study