Deformation of porous carbons upon adsorption.

N2 and CO2 sorption measurements with in situ dilatometry implemented in a commercial volumetric sorption instrument were performed at 77 and 273 K, respectively. The resolution of the linear deformation was about ±0.2 µm. To separate effects due to microporosity, external surface area and mesopores synthetic porous carbons (xerogels) with different external surface areas and microporosities were applied as a model system. The experimental data show that the relative length change of the monolithic carbon xerogels investigated passes different stages during ad- and desorption, which are connected to micropore-, multilayer- and mesopore-sorption. The length change observed in the range of micropore and surface adsorption was found to be nonmonotonic and to take negative as well as positive values, with the maximum swelling observed being on the order of 4‰. With respect to the length change, the micropore structure seems to have the most significant impact on the overall length change, while the external surface is only of minor importance. Quantiative analysis of the deformation according to the models of Bangham and Scherer for the length change in the range of multilayer- and mesopore-adsorption allows extracting the macrosopic as well as the skeletal Young's modulus.

Reducing the risk of venous thromboembolism following superficial endovenous treatment: A UK and Republic of Ireland consensus study.

OBJECTIVES: Venous thromboembolism is a potentially fatal complication of superficial endovenous treatment. Proper risk assessment and thromboprophylaxis could mitigate this hazard; however, there are currently no evidence-based or consensus guidelines. This study surveyed UK and Republic of Ireland vascular consultants to determine areas of consensus. METHODS: A 32-item survey was sent to vascular consultants via the Vascular and Endovascular Research Network (phase 1). These results generated 10 consensus statements which were redistributed (phase 2). 'Good' and 'very good' consensus were defined as endorsement/rejection of statements by >67% and >85% of respondents, respectively. RESULTS: Forty-two consultants completed phase 1. This generated seven statements regarding risk factors mandating peri-procedural pharmacoprophylaxis and three statements regarding specific pharmacoprophylaxis regimes. Forty-seven consultants completed phase 2. Regarding venous thromboembolism risk factors mandating pharmacoprophylaxis, 'good' and 'very good' consensus was achieved for 5/7 and 2/7 statements, respectively. Regarding specific regimens, 'very good' consensus was achieved for 3/3 statements. CONCLUSIONS: The main findings from this study were that there was 'good' or 'very good' consensus that patients with any of the seven surveyed risk factors should be given pharmacoprophylaxis with low-molecular-weight heparin. High-risk patients should receive one to two weeks of pharmacoprophylaxis rather than a single dose.

Lemierre's syndrome; a rare cause of septic arthritis.

Lemierre's syndrome is a rare condition characterised by pharyngitis leading to septic thrombophlebitis of the internal jugular vein. Complications include pulmonary septic emboli, septic arthritis and disseminated intravascular coagulation. The authors present a case of a healthy woman aged 25 years with septic arthritis of the shoulder due to this unusual cause. This diagnosis was made via a combination of clinical, radiological and microbiological findings. It was successfully treated via surgical and antimicrobial interventions. The patient made a good recovery with minimal associated morbidity or loss of function. This case highlights the importance for awareness and high index of suspicion for rarer causes of septic arthritis in young healthy adults as early appropriate intervention maximises prognosis.

Introducing a post-operative proforma for elective lower limb arthroplasty patients - improving patient care and junior doctor confidence.

The assessment of post-operative patients is vital to identify early complications and ensure patient safety. Good clinical record keeping is essential for effective continuity of care and patient safety in the post-operative period. A group of foundation year 2 (FY2) doctors noted a disparity in levels of confidence and ability in performing this assessment. The aim of the project was to improve documentation and understanding of day one lower limb arthroplasty reviews by FY2 doctors. The Plan-Do-Study-Act model for continuous improvement was adopted from September 2015 to July 2016. A composite score comprising the twelve most important review parameters for documentation was used to score the quality of documentation on an ongoing basis. An electronic survey was completed by every FY2 rotating through the department. Interventions included registrar-led teaching sessions and an integrated review form placed in the medical notes. Further iterations of the proforma and further interventions were coordinated with the ward clerks, sisters, physiotherapists and senior clinicians. The baseline mean composite score was 6.3/12. Following implementation of a standardised proforma this score improved to 10.5 in those who had used the proforma, but 5.7 in those who hadn't. Electronic survey responses showed the proforma and teaching were effective in improving knowledge and understanding of post-operative reviews. The use of an integrated proforma in the medical notes and teaching it's use at induction, improves the documentation and understanding of day one post-operative reviews. Coordinating ward-based change across a cohort of FY2s, with involvement from the multidisciplinary team and management, affects sustained improvements in patient reviews.