Engineering of mono-dispersed mesoporous TiO2 over 1-D nanorods for water purification under visible light irradiation.

Herein we synthesized a novel structure of mesoporous TiO2 decorated on 1D ZnO nanorods for environmental remediation. The effect of mesoporous TiO2 over 1D nanorods were investigated. The phase transitions of nanocomposite were confirmed by powder diffraction analysis. The morphological investigation of synthesized TiO2/ZnO catalyst revealed that the TiO2 are in porous in nature which covered the surface of 1D nanorods. The size of mesoporous TiO2 nanoparticles was about 10-15 nm. The chemical composition and elemental mapping results clearly evident that the presence of ZnO and TiO2 is distributed uniformly on ZnO nanorods. TiO2/ZnO nanocomposite shows enhanced activity which degrades in 14 min under visible light irradiation. TiO2/ZnO catalyst with 5 wt % exhibited the high photocatalytic activity (0.1882 min-1). It is proposed that a synergistic interaction between ZnO and TiO2 leads to a charge separation which leads to the enhanced activity.

Evaluation of a Comprehensive Delivery Room Neonatal Resuscitation and Adaptation Score (NRAS) Compared to the Apgar Score: A Pilot Study.

This study evaluated the interrater reliability and perceived importance of components of a developed neonatal adaption score, Neonatal Resuscitation Adaptation Score (NRAS), for evaluation of resuscitation need in the delivery room for extremely premature to term infants. Similar to the Apgar, the NRAS highest score was 10, but greater weight was given to respiratory and cardiovascular parameters. Evaluation of provider (N = 17) perception and scoring pattern was recorded for 5 clinical scenarios of gestational ages 23 to 40 weeks at 1 and 5 minutes and documenting NRAS and Apgar score. Providers assessed the tool twice within a 1-month interval. NRAS showed superior interrater reliability (P < .001) and respiratory component reliability (P < .001) for all gestational ages compared to the Apgar score. These findings identify an objective tool in resuscitation assessment of infants, especially those of smaller gestation age, allowing for greater discrimination of postbirth transition in the delivery room.

T-piece resuscitator versus self-inflating bag for preterm resuscitation: an institutional experience.

BACKGROUND: Manual ventilation in the delivery room is provided with devices such as self-inflating bags (SIBs), flow-inflating bags, and T-piece resuscitators. OBJECTIVE: To compare the effect of type of manual ventilation device on overall response to resuscitation among preterm neonates born at < 35 weeks gestation. METHODS: Retrospective data were collected in 2 time periods. Primary outcome was overall response to resuscitation, as measured by Apgar score. Secondary outcomes were incidence of air leaks, need for chest compressions/epinephrine, need for intubation, and surfactant use. RESULTS: We identified 294 resuscitations requiring ventilation. SIB was used for 135 neonates, and T-piece was used for 159 neonates. There was no significant difference between the 1-min and 5-min Apgar scores between SIB and T-piece (P = .77 and P = .11, respectively), nor were there significant differences in secondary outcomes. The rate of rise of Apgar score was higher, by 0.47, with T-piece, compared to SIB (95% CI 0.08-0.87, P = .02). CONCLUSIONS: Although some manikin studies favor T-piece for providing reliable and consistent pressures, our experience did not indicate significant differences in effectiveness of resuscitation between the T-piece and SIB in preterm resuscitations.

Impact of clinical pathway on quality of care in sickle cell patients.

Clinical pathways are disease specific and are designed to standardize care. They are intended to serve the purpose of improving quality of care and decreasing healthcare and societal costs. A retrospective cross-sectional study was conducted comparing sickle cell patients admitted to Mercy Children's Hospital (MCH) from June 1999 to November 2001 before the implementation of the clinical care pathway (n=66), to a similar group of patients admitted from December 2001 to July 2004 after pathway (n=121) implementation. The χ2 tests were used to compare categoric variables and independent t-tests for continuous variables. The results indicate improvement in compliance postpathway with specific care elements: incentive spirometry, pulse oximetry, ordering comfort measures, right dosage of pain medications, and achieving excellent nursing compliance in documenting pain scores. There was a significant decrease in the number of blood transfusions in postpathway patients. Though limited by sample size, the results suggest that clinical pathways are good tools for standardization of care in certain care elements and help to improve quality of care in sickle cell patients.

Immune response of young children using ATP-based Cylex assay: a brief report.

Data on immune responses of young children using ATP release-based Cylex assay are insufficient. This study measured the immune response of healthy children less than three years of age to mitogens, PHA and Con-A. Blood was obtained from children attending routine health care visits. The Cylex assay was used to measure ATP production by CD4+ and CD3+ cells in response to PHA and Con-A, respectively. Samples from 20 children less than three years (range 10-27 months) were evaluated. The mean ATP production by CD4+ lymphocytes following PHA stimulation was 376 ng/mL (95% CI 17.1-735), which was similar to the response of older children in Hooper et al.'s (Clin Transplant 2005;19:834) study (p-value 0.28). The mean and median ATP production by CD3+ cells following Con-A stimulation were 114 ng/mL and 93.3 ng/mL, respectively (95% CI for median 45.2,148.6). The data suggest that although the immune system of young infants and toddlers is evolving, they are still able to respond to mitogen stimulation similar to older children.

Successful management of rhabdoid tumor of the liver.

A 3-year-old male was referred because of fever, abdominal pain, and enlarged abdomen. Magnetic resonance imaging showed a very large lobulated mass involving predominantly the right lobe of liver. Tumor histology was consistent with rhabdoid tumor of the liver. The patient received 3 cycles of chemotherapy consisting of ifosfamide, carboplatin, and etoposide alternating with vincristine, adriamycin, and cyclophosphamide, at 3-week intervals. Follow-up magnetic resonance imaging revealed approximately 84% decrease in size of tumor after 2 cycles of chemotherapy. Patient underwent liver transplantation, as the tumor was unresectable. Six weeks posttransplant, the patient received 4 more cycles of chemotherapy. The patient is free of disease at evaluation 3 years posttransplant.