BackgroundWith growing demand for medical information and health applications in pregnancy, the potential of electronic health (eHealth) and mobile health (mHealth) solutions in clinical care is increasingly unfolding. However, we still do not know how pregnant women engage with mobile apps, how such apps impact routine medical care, and whether benefit expectations are met. Whereas recent research has raised the subject of user distribution and analyzed the content of pregnancy applications, there is still a significant knowledge gap regarding what pregnant women like and dislike about pregnancy tools, along with how such interventions could be improved.ObjectiveThe aim of the study was to examine the perceptions and expectations of mobile and Web-based patient-engagement pregnancy applications. We assessed usability requirements, general acceptance of eHealth, and the impact of eHealth and mHealth pregnancy applications on the doctor-patient interaction and daily clinical routine.MethodsA qualitative study was conducted at the maternity department of a major German university hospital. The sample included 30 women with low- to medium-risk pregnancies. Half of the patients were seen during outpatient care and half were hospitalized for several days. The extent and frequency of Web- and mobile phone app usage were assessed. Semistructured interviews were conducted and analyzed using systematic thematic analysis.ResultsPatients had a high demand for Web-based pregnancy applications. Study findings suggested a strong request for personalization, monitoring, and accessibility for frequent use as main themes derived from the interviews. Fostering patient empowerment in the doctor-patient relationship was also highly valued for a pregnancy app. Participants favored further integration of medical apps in their daily routine and pregnancy care. However, concerns were raised about content quality, trustworthiness of Web sources, and individual data security.ConclusionseHealth and mHealth applications are a highly frequented source of information. Expectations and usability requirements for those applications are also high, thus posing a challenge to interdisciplinary service providers. Patients’ attitude toward integrating apps in routine care settings was positive with a favorable influence on patient empowerment. Health care professionals should guide pregnant women toward a successful integration of these educational tools in pregnancy care.

Highlights• Multicore magnetite nanoparticles (MNPs) were superparamagnetic.• PEG-carboxylate polyelectrolytes coat spontaneously MNPs and stabilize them electrosterically.• Biofunction can be attached to MNPs via carboxylated coating layer.• Multifunctional shell prevents MNPs' internalization into cells.• Superparamagnetic property is sustained after MNP coating. AbstractBiocompatible magnetite nanoparticles (MNPs) were prepared by post-coating the magnetic nanocores with a synthetic polymer designed specifically to shield the particles from nonspecific interaction with cells. Poly(ethylene glycol) methyl ether methacrylate (PEGMA) macromonomers and acrylic acid (AA) small molecular monomers were chemically coupled by quasi-living atom transfer radical polymerization (ATRP) to a comb-like copolymer, P(PEGMA-co-AA) designated here as P(PEGMA-AA). The polymer contains pendant carboxylate moieties near the backbone and PEG side chains. It is able to bind spontaneously to MNPs; stabilize the particles electrostatically via the carboxylate moieties and sterically via the PEG moieties; provide high protein repellency via the structured PEG layer; and anchor bioactive proteins via peptide bond formation with the free carboxylate groups. The presence of the P(PEGMA-AA) coating was verified in XPS experiments. The electrosteric (i.e., combined electrostatic and steric) stabilization is efficient down to pH 4 (at 10 mM ionic strength). Static magnetization and AC susceptibility measurements showed that the P(PEGMA-AA)@MNPs are superparamagnetic with a saturation magnetization value of 55 emu/g and that both single core nanoparticles and multicore structures are present in the samples. The multicore components make our product well suited for magnetic hyperthermia applications (SAR values up to 17.44 W/g). In vitro biocompatibility, cell internalization, and magnetic hyperthermia studies demonstrate the excellent theranostic potential of our product. Graphical abstract

Graphical abstractHighlights  PEG-polymers were adsorbed through surface complexation on magnetite.  Increasing load of functionalized PEGs gradually modifies the MNP's surface.  MNPs coated completely by polyanionic shell can be dispersed in salty media at pH ~6.5.  Carboxylated comb-like PEG copolymer provides the most efficient biocompatible coating. AbstractFabrication of PEG coating on magnetite nanoparticles (MNPs) is one of the most favoured ways to ensure biocompatibility. Surface modification of magnetite by an own-prepared comb-like PEG-copolymer (PEGA-AA) was compared with two commercially available ones (carboxy-PEG (PEG-C) and phosphate-PEG (PEG-P)). ATR FTIR data revealed that all polymers form complexes on the surface of MNPs. Electrophoresis and dynamic light scattering (DLS) experiments showed that both the type and quantity of the polymers' anchoring groups influence the aggregation of coated nanomagnets. PEG-C shell does not provide excess negative charges, so magnetite particles became aggregated. However PEG-P and PEGA-AA gradually modify the surface: neutralizing the originally positively charged MNPs below loading 0.5 mmol/g, while above it a polyanionic layer forms on nanomagnets dispersing them in salty media at pH ~6.5. The PEGA-AA comb-like copolymer is more efficient for MNPs PEGylation due to the uniform distribution of carboxylates and PEG chains along the carbon skeleton.