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Understanding the adsorption dynamics of nanoparticles at solid–liquid interfaces is of paramount importance to engineer nanoparticles for a variety of applications. The nanoparticle surface chemistry is significant for controlling the adsorption dynamics. This study aimed to experimentally examine the adsorption of surface-modified round-shaped silica nanoparticles (with an average diameter of 12 nm), grafted with hydrophobic (propyl chains) and/or hydrophilic (polyethylene glycol chains) agents, at an aqueous solution–silica interface with spherical soda-lime glass beads (diameter of 3 mm) being used as adsorbents. While no measurable adsorption was observed for solely hydrophobic or hydrophilic nanoparticles, a considerable level of adsorption was detected for nanoparticles comprising both hydrophobic and hydrophilic agents. Various kinetic models were employed to model the adsorption dynamics of the responsive nanoparticles. The results demonstrated that the mixed diffusion-kinetics models could predict the dynamics better than the adsorption diffusion models, indicating that the dynamics is controlled by a combination of liquid film diffusion, intra-particle diffusion, and mass action. Additionally, the adsorption of the surface-modified silica nanoparticles onto a mineral silica surface was examined using molecular dynamics simulations. The interaction energy for nanoparticles comprising both hydrophobic and hydrophilic agents was evaluated to be more favorable than that of solely hydrophobic or hydrophilic nanoparticles.

ABSTRACTSocial media has become a strategic tool for businesses and nonprofit organizations to connect with audiences. However, no comprehensive framework exists to support the continued improvement of social media outcomes. This work draws on prior studies related to social media analytics and user engagement to develop an overarching, analytics-driven process for social content strategy development and improvement. The process provides firms with a set of procedures to regularly assess competitors’ and possibly their own content topic posting activities. It then outlines steps to measure the influence of content topics and post characteristics on engagement outcomes and use the garnered insights to drive future posting activities. A proof-of-concept case in the healthcare context is presented to demonstrate the feasibility of the proposed process.

Aim:Despite the similarities in the pathogenesis of the beta coronaviruses, the precise infective mechanisms of SARS-CoV-2 remain unclear. Objective:In this review, we aim to focus on the proposed theories behind the pathogenesis of SARS-CoV-2 and highlight the clinical complications related to COVID-19. Methods:We conducted a literature search in Pubmed, Scopus and Google Scholar for the relevant articles regarding clinical complications and pathogenesis of COVID-19. Results:Related articles were included and discussed. Conclusion:Respiratory system and the lungs are the most commonly involved sites of COVID-19 infection. Cardiovascular, liver, kidneys, gastrointestinal and central nervous systems are involved with different frequencies and degrees of severity.

•Nearly 7% of the hospitals in the northeastern United States present online physician reviews.•Differences exist between different types of hospitals in terms of offering online physician reviews.•The patient experience measures that hospitals currently use are not consistent.•Standard policies and procedures are needed to make online physician reviews more useful.

Aims: The objective of this survey was to encompass the full scope of international practice, entailing all technical, non-technical, preoperative stratification and functional maturation (FM) of RCAVF.Methods: The survey contained n= 19 questionnaires with n= 46 variables completed by n= 85 providers from n= 21 nations across n= 5 continents. The numerical values were subjected to mean with standard error whereas the nominal data to a non-parametric (Kruskal-Wallis & Spearman correlation test) and analysis of variance (ANOVA). The test of homogeneity, & probability was reported 95% confidence intervals (CI) alongside error plots. Furthermore, a decision and higher attribute tree model was constructed based on current survey for higher FM in RCAVF.Results: FM is independently associated with volume of surgeon per year (procedures performed) (p< 0.01) [High Volume: 73% (95% CI, 68–77%) versus Average volume: 63% (95% CI, 59–66%) vs Low volume: 56% (95% CI, 51–61%)]. FM increased by 8% with every 20 more procedures per group of surgeons on end point of FM. Amongst continents: Australia, America, Asia and South America demonstrated higher FM to Africa & Europe (p< 0.05). UK possessed a lower FM 58% (95% CI, 48–68%) in comparison to the world & Europe respectively [65% (95% CI, 61–70%) vs 61% (95% CI, 58–-65%)]. There was a positive causal link between angle of anastomosis at 30–76° (p< 0.01), longitudinal & S-shaped incision & arteriotomy length of 3 & 4 mm to higher FM (p< 0.05).Conclusion: FM in RCAVF is independently & incrementally associated with the volume of surgeon per year. There is a diverse inclusion, exclusion and technical approach in RCAVF creation. This survey advocates the importance of international collaboration and/or registry in assimilation, consolidate and development of consensus.

According to National Institute of Clinical Excellence guidelines, the ankle‐brachial pressure index coupled with a full clinical evaluation has been the mainstay of detecting peripheral arterial disease on its suspicion. However, this technique is not free of its own limitations in calcified arteries, ulcerative and diabetic patients. We introduce a new, novel, and effective assessment device (BlueDop) with a minimal learning curve that could overcome such barriers and serve as a valid replacement in perihospital settings.

AbstractIntroduction:Oesophagectomy for oesophageal carcinoma carries a high risk of significant morbidity and mortality. Delayed gastric emptying is a relatively common complication following this procedure. A variety of medical, surgical and endoscopic strategies have been described to manage it. The vast majority of cases are related to post-operative pyloric dysfunction and are amenable to conventional management strategies.Patients and methods:We present a new case of a patient with a duodenal hiatus hernia resulting in extrinsic gastroduodenal compression by the massively distended gastric conduit as a cause of gastric outlet obstruction following laparoscopic-assisted Ivor–Lewis oesophagectomy 2 years previously.Results and conclusions:Surgical repair of the hiatus hernia restored the post-oesophagectomy anatomy and resolved this patient’s symptoms where conventional management of post-oesophagectomy gastric outlet obstruction had failed on multiple occasions. Most cases of delayed gastric emptying post-oesophagectomy occur as a result of pyloric dysfunction and can be managed using a combination of prokinetics, surgical intervention or more commonly, endoscopic dilatation. Other potential causes and therefore investigative and management strategies should be considered in patients who repeatedly fail conventional management. We offer an alternative diagnosis that may be considered in these patients and present a novel approach to their investigation and management.

The objective of this study is to test the null hypothesis that an S-shaped surgical incision versus conventional (straight) skin incision in the creation of autogenous radiocephalic arteriovenous fistulas (RCAVFs) have no impact on the primary end-point of primary functional maturation and secondary end points of stenosis and thrombosis.

Introduction The aim of this study is to examine the role of five different operative salvage techniques with their long-term primary patency (PP) in an algorithmic manner in gaining primary functional maturation (FM) in radio cephalic arteriovenous fistulae (RCAVF) formation following their impairment.Methods A prospective consecutive data collection on 195 patients undergoing only autogenous RCAVF formation from July 2013 to December 2015 was conducted. Each non-maturing fistula was then exposed to a salvage technique by an algorithmic methodology and their FM and PP was prospectively recorded.Results Forty-two patients were exposed to five different salvages techniques, with a median age of 67 years (IQR, 27-90), cephalic vein diameter of 2 mm (IQR, 1.5-4 mm) and radial artery diameter of 1.8 mm (IQR, 1.2-2.1 mm), demonstrated 63.1% FM and cumulative primary patency of 15.2 months (95% CI, 12.5-17.9) over a 21-month follow-up period.Conclusions Operative salvage techniques play an important role in achieving assisted functional maturation and long-term patency in RCAVF as an alternative and/or in conjunction with other minimally invasive procedures. These procedures can maximize access outcome, minimize bridging procedures, decrease complications and optimize patient anatomical resources for longer access provisions in an era of aging population.

Purpose The aim of this study is to test the null hypothesis that preoperative albumin along with other preoperative confounders have no impact on the functional maturation of radiocephalic arteriovenous fistulae (RCAVF).Methods A retrospective cohort study of n = 195 individuals undergoing RCAVF formation from July 2013 to December 2015 was conducted. The null hypothesis was assessed through chi squared test. Independent association of each variable was evaluated through univariate and multivariate logistic regression model. Pearson's correlation test was also performed between scale variables to establish their causal link.Results Preoperative hypoalbuminaemic group of individuals demonstrated significant failure of maturation (49.3% vs. 27.2%, p = 0.002). At multivariate analysis, hypoalbuminemia remained an independent marker of fistula failure (OR 0.40, 95% CI 0.21-0.76, p = 0.004) and demonstrated a weak but a positive correlation at the endpoint of maturation (R = 0.223, p = 0.002).Conclusions Preoperative hypoalbuminemia (<35 mg/dL) is independently associated with 40% reduction in the functional maturation of RCAVF. Stratification of this readily available biomarker prior to RCAVF formation may require consideration subjected to further research.

Purpose The aim of this study is to determine the optimal range of cephalic vein and radial artery diameter following preoperative duplex imaging to enhance maturation and primary patency of Brescia-Cimino radiocephalic arteriovenous fistula.Methods A systematic review and meta-aggregation of literature from 1966 to January 2015 in English language and adult subjects in Pubmed, OVID, CINHAL and Cochrane database was conducted.Results This search produced a total of thirty-six (n = 36) articles. Following the application of recruitment criteria, only twelve articles (n = 12) were found eligible. Their quality was assessed by Oxford Critical Appraisal skills Programme (CASP) and their recommendation for practice was examined through National Institute for Health and Care Excellence (NICE).Conclusions The current literature suggests that the optimal range of radial artery for maximum performance (maturation and primary patency) of RCAVF is at least 2 mm (level 2, grade a). The cephalic vein diameter of at least 2 mm (non-augmented) can result in best maturation and primary patency outcomes (level 2, grade a) and threshold below 1.5 mm is not advocated (level 2, grade b).

Purpose The purpose of this study is to investigate the pathogenesis, presentation and diagnosis of donor artery aneurysm formation following arteriovenous fistula (AVF) ligation and reach a consensus on their management.Methods A systematic review of literature in Ovid, MedLine, Embase, Scopus and CINHAL in the English language from 1951 to 2014 was performed. This was accompanied by two case reports. A total of 12 articles with 23 case reports were identified. Variables including patient's demographics, signs, symptoms, fistula type, duration of fistula use, time to aneurysm formation, renal transplantation, diagnostic modality, aneurysm type and size, type of surgery and outcome were reviewed.Results The data demonstrate a male predominance (5:1) and a median age of 47 years (range, 27-75 years). The median duration of access was 54 months (range, 6-300 months). The median time from ligation to aneurysm was 120 months (range, 6-280 months). The commonest aneurysm was of the brachial artery (BA, n = 21, 84%). The commonest type of AVF was radiocephalic (n = 15, 60%) followed by brachiocephalic AVF (n = 9, 36%). The management of choice was aneurysmectomy followed by interposition vein grafting (n = 12, 50%) with a median reported patency of 12 months (range, 1-38 months). This was followed by polytetrafluoroethylene (PTFE) grafting (n = 6, 25%) with a median reported patency of 6 months (range, 1-48 months).Conclusions The pathogenesis of donor artery aneurysms remains contentious. This review suggests that duplex is the investigative modality of choice and aneurysmectomy with interposition grafting is preferred over bypass.

Despite the reduction in mortality incidences of AAA in proportion to increased use of EVAR, the natural history of aneurysms with the presence of an endoleak post EVAR remains unclear. With a cumulative AAA rupture incidence of 2% at six years post EVAR, the lack of an immediate endoleak is not an indicator of success.

Purpose The aim of this study is to examine the efficacy of normal saline (0.9% sodium chloride) as a flush solution on patency of arterial lines in comparison to heparin flush. Data have been examined in various categories of specialty (medical, surgical, cardiac, burns, gynecology), frequency of flushes, strength and volume of flushes, continuous versus bolus, duration of each flush and patency incidence (range, ≤24 to ≥96 hours). The secondary aim focused on the incidences of reported heparin-induced thrombocytopenia (HIT type I and II).Methods A comprehensive review of the literature from 1951 to 2012. An electronic search of OVID, Medline, Embase, Cochrane, Scopus and CINAHL database in English language was conducted. The search was limited to adult subjects only. The following keywords were used: heparin flush, saline flush, 0.9% sodium chloride flush, arterial line and indwelling vascular line. A total of ten papers (n=10) were found eligible.Results The evidence suggests patency is feasible with both solutions but if longer duration of use (arterial line) is advocated, heparin is superior in the long term. Furthermore, heparin flush effects are dose dependent and require fewer numbers of flushes. In addition, no adverse effects were found with heparin flush solution.Conclusion There is level 1 evidence to support heparin as a flush solution once the time frame exceeds 48 hours. In addition, there is level 1 evidence to suggest that heparin at higher doses and in continuous infusion has better patency incidence with no reports of HIT type II or I.

The aim of this study is to describe a case of ruptured cryptogenic mycotic abdominal aortic aneurysm by Salmonella enteritidis(SE) and present a comprehensive review of the literature.

During the past decade, the proliferation of social media has infiltrated various sectors of social and business communications. Of particular interest is the growth of health related websites and the healthcare sector’s adoption of social media. In this paper, we develop a typology of Health 2.0 collaboration platforms and websites. Two major types of actors within Health 2.0 websites are health professionals (P) and health consumers (C). Each actor can serve as either support provider or support recipient. We focus on the six major Health 2.0 collaboration platforms including health blogs, physician-ratings, medicine-ratings, online health social networks, health discussion boards, and ask-a-doctor. We categorize these platforms into four major types including professional-to-professional (P2P), professional-to-consumer (P2C), consumer-to-consumer (C2C), and consumer-to-professional (C2P). Then, based on the combination of collaboration platforms provided by Health 2.0 websites, we categorize these websites into P2P, P2C, C2C, and C2P types. We describe each type and utilize the typology to investigate 20 Health 2.0 websites and the collaboration platforms they provide. Our typology can be used as groundwork for future research on health social media.

AbstractBackground: Hem-o-lok clips are widely deployed in various laparoscopic and robotic operations. Their migration is not very common and majority of reported cases are limited to biliary, prostatic and vesico-urethral cases.Methods:Herein, we would like to report the first case of transmural migration of Hem-o-lok clip from azygous vein stump following totally minimally invasive two-stage oesophagectomy for squamous cell carcinoma of the distal oesophagus, into the gastric conduit 3-months following uneventful discharge. The patient presented with 5-days history of worsening dysphagia.Results:The subsequent gastroscopy revealed normal gastric conduit with two Hem-o-lok clips containing the azygous vein stump within its lumen at the level of the oesophago-gastric anastomosis, propagating a food bolus obstruction. The foreign body was successfully removed and the patient was discharged the same day without any complications at 5 months follow up.Conclusion:Hem-o-lok clip migration trends to be a well-established event. However, their mechanism and exact incidence remains elusive to this date. To the best of our knowledge, their migration in oesophageal cancer surgery has not been reported.