IMPORTANCE Many inflammatory skin dermatoses mimic cellulitis (pseudocellulitis) and are treated with antibiotics and/or hospitalization, leading to unnecessary patient morbidity and substantial health care spending. OBJECTIVE To evaluate the impact of early dermatology consultation on clinical and economic outcomes associated with misdiagnosed cellulitis. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study enrolled patients with presumed diagnosis of cellulitis in the emergency department, in the emergency department observation unit, or within 24 hours of admission to an inpatient unit of a large urban teaching hospital between February and September 2017. Patients were provided with telephone and clinic follow-up during the 30-day postdischarge period. We screened 165 patients with the primary concern of cellulitis. Of these, we excluded 44 who required antibiotics for cutaneous, soft-tissue, and deeper-tissue and/or bone infections irrespective of cellulitis status, and 5 who were scheduled to be discharged by the emergency department. INTERVENTIONS Early dermatology consultation for presumed cellulitis. MAIN OUTCOMES AND MEASURES Primary outcomes were patient disposition and rates of antibiotic use. RESULTS Of 116 patients (63 [54.3%] women; 91 [78.4%] non-Hispanic white; mean [SD] age, 58.4 [19.1] years), 39 (33.6%) were diagnosed with pseudocellulitis by dermatologists. Of these, 34 (87.2%) had started using antibiotics for presumed cellulitis as prescribed by the primary team at the time of enrollment. The dermatology team recommended antibiotic discontinuation in 28 of 34 patients (82.4%), and antibiotics were stopped in 26 of 28 cases (92.9%). The dermatologists also recommended discharge from planned observation or inpatient admission in 20 of 39 patients with pseudocellulitis (51.3%), and the primary team acted on this recommendation in 17 of 20 cases (85.0%). No patients diagnosed with pseudocellulitis experienced worsening condition after discharge based on phone and clinic follow-up (30 of 39 [76.9%] follow-up rate). Extrapolating the impact of dermatology consultation for presumed cellulitis nationally, we estimate 97 000 to 256 000 avoided hospitalization days, 34 000 to 91 000 patients avoiding unnecessary antibiotic exposure, and $80 million to $210 million in net cost savings annually. CONCLUSIONS AND RELEVANCE Early consultation by dermatologists for patients with presumed cellulitis represents a cost-effective intervention to improve health-related outcomes through the reduction of inappropriate antibiotic use and hospitalization.

Effects of GONP modification and S‐GONPs loading on the mechanical properties of UBF/epoxy composite were investigated. The introduction of the silane organic chains on the surface of GONPs was evaluated by FTIR, STA, and Raman spectroscopy. Out of the specimens, the highest values in mechanical strengths were obtained at 0.4 wt% S‐GONPs. The tensile, flexural, and compressive strengths of this specimen were 16%, 47%, 51% greater, respectively, than that of UBF/epoxy composite. Improvements in the mechanical moduli were also obtained. It was also found that silane modification of GONPs had a significant effect on the mechanical properties of the specimens. Microscopic studies showed a better interfacial bonding between UBF and matrix in nanofiller‐filled specimens. The experimental results for compressive strength and modulus were compared with an Euler–Bernoulli beam‐based model. The model predictions were in very good agreement with experimental results. POLYM. COMPOS., 39:E2472–E2482, 2018. © 2018 Society of Plastics Engineers

In this study, aminopropyl trimethoxysilane as an interfacial modifier was introduced on the surface of graphene (Gr) nanoplatelets. The effects of the silane‐modified graphene (SGr) loading (0, 0.05, 0.1, 0.3, and 0.5 wt %) and silane modification on the tensile, compressive, interlaminar shear stress (ILSS), and tribological properties of the epoxy‐based nanocomposites were investigated. Out of these specimens, the highest values of ILSS and compressive strength were related to the 0.3 wt % SGr–epoxy nanocomposite. The addition of SGr enhanced the tensile strength and strain to failure only at low contents (i.e., 0.05 wt %). Also, the tensile and compressive moduli were improved, and the highest values were observed at a 0.5 wt % SGr loading. In addition, decreases of approximately 40 and 68% in the coefficient of friction and wear rate, respectively, were observed at a 0.3 wt % SGr loading. Enhanced tensile, compressive, ILSS, and wear properties in the SGr–epoxy specimens were observed compared to those in the Gr–epoxy specimens. © 2019 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2019, 136, 47410.

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The main objective of the present work was to study the effects of nano-TiO2 on the dry-sliding wear properties and interlaminar shear strength of jute fiber/epoxy composite. The surface of TiO2 nanoparticles was functionalized by using a amin-terminated silane-coupling agent. Fourier-transform infrared spectroscopy and thermogravimetric analysis were used to characterize the modified TiO2 (M-TiO2). The multiscale composites were fabricated using hand layup technique by dispersing various amounts of the M-TiO2 nanoparticles (0.5, 1, 3, and 5 wt.%) in the matrix. Among these specimens, the 3 wt.% M-TiO2-filled composite showed the best properties. The results of the short-beam shear test demonstrated that the addition of 3 wt.% M-TiO2 increased the interlaminar shear strength of the composite by 43%. The addition of 3 wt.% M-TiO2 significantly decreased the wear rate and coefficient of friction of the jute fiber/epoxy composite by 80% and 48%, respectively. The wear and fracture mechanisam were also examined by scanning electron microscopy. The findings of this work confirmed that the addition M-TiO2 is a suitable choice for the potential applicability as a nanofiller for the fiber-reinforced polymeric composites.