Variable definitions: implications for the prediction of pulmonary complications after adult cardiac surgery

Aim: The aim of this paper was to review the implications that variable definitions have for the prediction of post-operative pulmonary complications after cardiac surgery.

Method: A review of the literature from 1980 to 2002. Selected studies demonstrated an original attempt to examine multivariate associations between pre, intra or post-operative antecedents and pulmonary outcomes in patients undergoing coronary artery bypass grafting (CABG). Reports that described the validation of established clinical prediction rules, testing interventions or research conducted in non-human cohorts were excluded from this review.

Results: Consistently, variable factor and outcome definitions are combined for the development of multivariate prediction models that subsequently have limited clinical value. Despite being prevalent there are very few attempts to examine post-operative pulmonary complications (PPC) as endpoints in isolation. The trajectory of pulmonary dysfunction that precedes complications in the post-operative context is not clear. As such there is little knowledge of post-operative antecedents to PPC that are invariably excluded from model development.

Conclusion: Multivariate clinical prediction rules that incorporate antecedent patient and process factors from the continuum of cardiovascular care for specific pulmonary outcomes are recommended. Models such as these would be useful for practice, policy and quality improvement.

One-step coating of fluoro-containing silica nanoparticles for universal generation of surface superhydrophobicity

Stable superhydrophobic surfaces with water contact angles over 170 degrees and sliding angles below 7 degrees were produced by simply coating a particulate silica sol solution of co-hydrolysed TEOS/fluorinated alkyl silane with NH₃^.H₂O on various substrates, including textile fabrics (e.g. polyester, wool and cotton), electrospun nanofibre mats, filter papers, glass slides, and silicon wafers.

Photochromic wool fabrics with enhanced durability and photochromic performance

In our previous work, we have produced a photochromic wool fabric by applying a thin layer of hybrid silica-photochromic dye onto the wool surface. The coating showed a very fast optical response, but had little influence on the fabric handle, however durability was low. In this context, we reported that durability of the hybrid layer can be improved by introducing epoxy groups into the silica matrix via co-hydrolysis and co-condensation of an alkyl trialkoxysilane (ATAS) and 3-glycidoxypropyltrimethoxysilane (GPTMS). The presence of epoxy groups in the silica enhanced both washing and abrasion durabilities. Also, the optical response speed was slightly increased as well. Effects of the type of alkyl silane and the GPTMS:alkyl silane ratio on the coating durability, fabric handle and optical response were examined.

Fast response photochromic textiles from hybrid silica surface coating

In this study, a hybrid silica sol-gel embedded with a photochromic dye has been applied to wool fabric to form a photochromic coating. The treated wool fabrics showed very quick photochromic response. Five different silanes have been used as the silica precursor, and the resultant coating showed slight differences in photochromic performance, fabric washing fastness, and surface hydrophilicity. However, the silica type had a considerable influence on fabric handle property. The silica matrix from the silane containing a long alkyl chain had a very little influence on the fabric handle and better photochromic performance than those from other different silane precursors.

Superhydrophobic fabrics prepared by silica coating

In this work, a silica sol prepared by co-hydrolysis and co-condensation of TEGS (Tetraethylrthosilicate) and alkyl silane under alkaline condition was applied to polyester, wool, and cotton fabrics. The water contact angle measurement indicated considerable increase in the surface hydrophobicity of the sol-treated fabrics. Five different alky silanes were used, namely methyltritthoxysilane (MTES), pheryl triethoxysilane (PTES), n-octyltricthoxysilane (OTES), hexadecyl trimethoxysilan (HDTMS), and tridecafluorooctyl triethoxysilane (FAS), and the water contact anglc (CA) for the coated fabrics ranged between 1300 and 174°. The alkyl silane used influenced the CA valuc, and the silica coating from FAS, HDTMS and PTES snowed CA value greater than ISO', indicating the formation of superhydrophobicity. The fabric coated by the fluorinated silica (TEOS/FAS) has a water contact angle as high as 174°. The treated polyester fabric showed a slightly higher CA value than the wool and cotton fabrics, under the same coating condition.
The coating surface was characterized by SEM, EDX, TEM, FTlR, XPS and AFM. The results showed that silica nanoparticles with thc sizc in the range of 50-ISOnm werc formed in the cohydrolyzed silica sol, and these particles had a core-shell structure with many alkyl groups gathering on the surface region. The formation of superhydrophobic surface was attributed to the nano-structured surface coating with a low surface energy.

Super water repellent fabrics produced by silica nanoparticle-containing coating

In this paper, we report on superhydrophobic fabrics (polyester, wool and cotton) produced by a wet-chemical coating technique. The coating solutions were synthesized by the co-hydrolysis of two silane precursors, tetraethyl orthosilicate (TEOS) and an alkylsilane, in an alkaline condition. Without any purification, the as-hydrolyzed solutions were directly used to treat fabrics, and the treated fabrics had water contact angles (CA) as high as 170º and sliding angles (SA) as low as 5º. Three alkylsilanes have been used for the synthesis of the coating solutions, and all contain three hydrolysable alkoxyl groups and one non-hydrolysable alkyl, but with different chain lengths (C1, C8 and C16). It was found that the CA value increased with an increase in the alkyl chain length, while the SA showed a reverse trend. When the functional group had a C16 alkyl, the treated fabric surfaces were highly superhydrophobic, with the CA not being affected much by the fabric type, while the SA values were slightly affected by the original wettability of the fabric substrates. The superhydrophobic feature was attributed to a highly rough surface formed by the particulate coating. Aside from the superhydrophobicity, the influence of the coating on the fabric softness was also examined.

Photochromic textiles from hybrid silica coating with improved photostability

Photochromic surface coating on textiles may create new fashion opportunities. It also enhances the ultraviolet (UV) protection ability of the coated products. In this study, a spirooxazine dye and a silane that bears a long alkyl chain have been used to produce hybrid photochromic silica coatings on wool fabrics. Four stabilisers are added separately to the photochromic silica coatings to examine their influence on photostability and photochromic behaviour. It is found that the addition of UV stabilisers slightly reduces the photochromic response speed and photochromic absorption. However, the addition of UV stabilisers to the photochromic coating considerably improves the photochromic lifetime. Among the four UV stabilisers studied, the quencher results in the best improvement to photostability with the lowest reduction in photochromic absorption.

Superhydrophobic fabrics from hybrid silica sol-gel coatings: Structural effect of precursors on wettability and washing durability

Particle-containing silica sol was synthesized by co-hydrolysis and co-condensation of two silane precursors, tetraethylorthosilicate (TEOS) and an organic silane composed of a non-hydrolyzable functional group (e.g., alkyl, flourinated alkyl, and phenyl), and used to produce superhydrophobic coatings on fabrics. it has been revealed that the non-hydrolyzable functional groups in the organic silanes have a considerable influence on the fabric surface wettability. When the functional group was long chain alkyl (C16), phenyl, or flourinated alkyl (C8), the treated surfaces were highly superhydrophobic with a water contact angle (CA) greater than 170°, and the CA value was little affected by the fabric type. The washing durability of the superhydrophobic coating was improved by introducing the third silane containg epoxide group, 3-glycidoxypropyltrimethoxsilane (GPTMS), for synthesis. Although the presence of epoxide groups in the coating slightly reduced the fabrics' superhydrophobicity, the washing durability was considerably improved when polyester and cotton fabrics were used as substrates.

Magnet-induced temporary superhydrophobic coatings from one-pot synthesized hydrophobic magnetic nanoparticles.

In this paper, we report on the production of superhydrophobic coatings on various substrates (e.g., glass slide, silicon wafer, aluminum foil, plastic film, nanofiber mat, textile fabrics) using hydrophobic magnetic nanoparticles and a magnet-assembly technique. Fe3O4 magnetic nanoparticles functionalized with a thin layer of fluoroalkyl silica on the surface were synthesized by one-step coprecipitation of Fe2+/Fe3+ under an alkaline condition in the presence of a fluorinated alkyl silane. Under a magnetic field, the magnetic nanoparticles can be easily deposited on any solid substrate to form a thin superhydrophobic coating with water contact angle as high as 172°, and the surface superhydrophobicity showed very little dependence on the substrate type. The particulate coating showed reasonable durability because of strong aggregation effect of nanoparticles, but the coating layer can be removed (e.g., by ultrasonication) to restore the original surface feature of the substrates. By comparison, the thin particle layer deposited under no magnetic field showed much lower hydrophobicity. The main reason for magnet-induced superhydrophobic surfaces is theformation of nano- and microstructured surface features. Such a magnet-induced temporary superhydrophobic coating may have wide applications in electronic, biomedical, and defense-related areas.

Contact electrification induced by monolayer modification of a surface and relation to acid-base interactions

Electrical charge separation following contact between two materials (contact electrification or the triboelectric effect) is well known to occur between different materials as a consequence of their different electronic structures. Here we show that the phenomenon occurs between two surfaces of the same material if one is coated with a single chemisorbed monolayer. We use the surface force apparatus to study contact electrification and adhesion between two silica surfaces, one coated with an amino-silane. The presence of this monolayer results in significantly enhanced adhesion between the surfaces, owing to electrostatic attraction following contact electrification, in accord with Derjaguin's electrostatic theory of adhesion. At the same time, the observed increase in adhesion is consistent with Fowkes' acid-base model (in which acid-base interactions between surface groups are considered to be the predominant factor determining adhesion), as the monolayer converts the originally acidic silica surface to a basic (amine-terminated) one. These observations demonstrate a link between acid- base interactions and contact electrification.

Electrical charge separation following contact between two materials (contact electrification or the triboelectric effect) is well known to occur between different materials as a consequence of their different electronic structures. Here we show that the phenomenon occurs between two surfaces of the same material if one is coated with a single chemisorbed monolayer. We use the surface force apparatus to study contact electrification and adhesion between two silica surfaces, one coated with an amino-silane. The presence of this monolayer results in significantly enhanced adhesion between the surfaces, owing to electrostatic attraction following contact electrification, in accord with Derjaguin's electrostatic theory of adhesion. At the same time, the observed increase in adhesion is consistent with Fowkes' acid-base model (in which acid-base interactions between surface groups are considered to be the predominant factor determining adhesion), as the monolayer converts the originally acidic silica surface to a basic (amine-terminated) one. These observations demonstrate a link between acid-base interactions and contact electrification.

One-step vapour-phase formation of patternable, electrically conductive, superamphiphobic coatings on fibrous materials

Patternable, electrically conductive coatings having a superhydrophobic and superoleophobic surface have been prepared by one-step vapour-phase polymerisation of polypyrrole in the presence of a fluorinated alkyl silane directly on fibrous substrates. The coated fabrics showed a surface resistance of 0.5-0.8 kΩ □^-1 with water and hexadecane contact angles of 165° and 154°, respectively.

Superhydrophobic nanofibre membranes : effects of particulate coating on hydrophobicity and surface properties

Superhydrophobic electrospun polyacrylonitrile nanofibre membranes have been prepared by surface coating of silica nanoparticles and fluorinated alkyl silane. The coated membranes were characterised by scanning electron microscopy, water contact angle, thermogravimetry analysis, Brunauer–Emmett–Teller, Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy and atomic force microscopy. It was shown that the loading of nanoparticle on the nanofibre membrane was controlled by the particle concentration in the coating solution, which played a critical role in the formation of superhydrophobic surface. Increased particle loading led to higher surface roughness and WCA. The nanoparticle coating had little influence on the porosity of the nanofibre membranes. However, overloading of the particles would affect the specific surface area of the nanofibre membrane.

Vascular access surveillance : the role of the access nurse in the renal dialysis unit.

Introduction
In January 2006, the Renal Dialysis Unit at Geelong Hospital appointed a Vascular Access Nurse. A Transonic Flow Qc HDO2 Ultrasound Dilution Monitor was purchased to monitor access flow and recirculation in arteriovenous fistulae in an attempt to predict AVF stenoses requiring early surgical correction.

Methods
A bi-monthly monitoring program tested all facility-based patients. 82 patients were assessed for access flow and recirculation between February and December 2006.

Results
18 (22%) had poor AVF function; 13 with access flows <500ml/minute on initial testing and 5 with an access flow decreasing >25% over a four month period. Of the 18 patients shown to have poor access flow, 2 died within one month of measurement while 5 were too frail to attempt corrective surgery. The remaining 11 proceeded to ultrasound or fistulography. A >50% stenosis was detected in all 11 cases. Of these, 4 had successful vein patch surgery and one had PTFE grafting, each with marked improvement in access flow. One had failed vein patch surgery requiring creation of a femoral AVF, one patient required cvc insertion to await AVF creation, and one had failed stenting requiring a permanent cvc. 3 died before planned surgery.

Conclusion
5 of the 82 patients that had access flow assessment, and needed further evaluation, proceeded to successful pre-emptive surgical intervention. We believe the Transonic is a useful adjunct to routine clinical AVF surveillance, in providing early evidence of AVF failure that can be avoided by pre-emptive surgery.

Biofunctionalization of 3D nylon 6,6 scaffolds using a two-step surface modification

Nylon is a relatively inert polymer. The ability to easily functionalize nylon with biomolecules will improve the utilization of nylon in biological systems. A potential use of the biofunctionalized nylon scaffolds is in devices for cell therapeutics that can specifically select cells present in small numbers, such as hematopoietic stem cells. This study developed a versatile and simple two-step technique combining oxygen plasma treatment with wet silanization to graft biomolecules onto nylon 6,6 3D porous scaffolds. Scaffolds that were exposed to oxygen plasma exhibited up to 13-fold increase in silane attachment ((3-mercaptopropyl)trimethoxysilane/(3-aminopropyl)trimethoxysilane) compared to untreated scaffolds. To address the limitation of nondestructive characterization of the surface chemistry of 3D scaffolds, fluorescent CdSe/ZnS nanoparticles were used as a reporting tool for -NH(2) functionalized surfaces. Scaffolds that were covalently bound with neutravidin protein remained stable in phosphate buffered saline up to four months. Functionality of the neutravidin-grafted scaffolds was demonstrated by the specific binding of CD4 cells to the scaffold via CD4-specific antibody. Ultimately, these neutravidin-functionalized 3D nylon scaffolds could be easily customized on demand utilizing a plethora of biotinylated biomolecules (antibodies, enzymes and proteins) to select for specific cell of interest. This technique can be extended to other applications, including the enhancement of cell-scaffold interactions.

The boundary lubrication of chemically grafted and cross-linked hyaluronic acid in phosphate buffered saline and lipid solutions measured by the surface forces apparatus

High molecular weight hyaluronic acid (HA) is present in articular joints and synovial fluid at high concentrations; yet despite numerous studies, the role of HA in joint lubrication is still not clear. Free HA in solution does not appear to be a good lubricant, being negatively charged and therefore repelled from most biological, including cartilage, surfaces. Recent enzymatic experiments suggested that mechanically or physically (rather than chemically) trapped HA could function as an “adaptive” or “emergency” boundary lubricant to eliminate wear damage in shearing cartilage surfaces. In this work, HA was chemically grafted to a layer of self-assembled amino-propyl-triethoxy-silane (APTES) on mica and then cross-linked. The boundary lubrication behavior of APTES and of chemically grafted and cross-linked HA in both electrolyte and lipid 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) solutions was tested with a surface forces apparatus (SFA). Despite the high coefficient of friction (COF) of μ ≈ 0.50, the chemically grafted HA gel significantly improved the lubrication behavior of HA, particularly the wear resistance, in comparison to free HA. Adding more DOPC lipid to the solution did not improve the lubrication of the chemically grafted and cross-linked HA layer. Damage of the underlying mica surface became visible at higher loads (pressure >2 MPa) after prolonged sliding times. It has generally been assumed that damage caused by or during sliding, also known as “abrasive friction”, which is the main biomedical/clinical/morphological manifestation of arthritis, is due to a high friction force and, therefore, a large COF, and that to prevent surface damage or wear (abrasion) one should therefore aim to reduce the COF, which has been the traditional focus of basic research in biolubrication, particularly in cartilage and joint lubrication. Here we combine our results with previous ones on grafted and cross-linked HA on lipid bilayers, and lubricin-mediated lubrication, and conclude that for cartilage surfaces, a high COF can be associated with good wear protection, while a low COF can have poor wear resistance. Both of these properties depend on how the lubricating molecules are attached to and organized at the surfaces, as well as the structure and mechanical, viscoelastic, elastic, and physical properties of the surfaces, but the two phenomena are not directly or simply related. We also conclude that to provide both the low COF and good wear protection of joints under physiological conditions, some or all of the four major components of joints—HA, lubricin, lipids, and the cartilage fibrils—must act synergistically in ways (physisorbed, chemisorbed, grafted and/or cross-linked) that are still to be determined.