Synthesis and characterization of TiO2-based supported materials for industrial application and recovery in a pilot photocatalytic plant using chemometric approach.

In this contribution, the performance of powdered titanium dioxide (TiO2)-based photocatalysts was evaluated in a pilot photocatalytic plant for the degradation of different dyes, with an investigated volume of 1 L and solar simulated light as irradiation source. Five different samples, synthesized in our laboratories, were tested in the pilot plant, each consisting of TiO2 nanoparticles (NPs) coupled with a different material (persistent luminescent material and semiconductor material) and treated in different thermal conditions. All synthesized samples have been subjected to X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Brunauer-Emmett-Teller analysis (BET), and transmission electron microscopy (TEM) characterization, to shed light on the influence of introducing other materials on titania characteristics. To study and evaluate the significance of the parameters affecting the process in the pilot plant, a chemometric approach was applied, by selecting a mathematical model (D-Optimal) to simultaneously monitor a large number of variables (i.e., 7), both qualitative and quantitative, over a wide range of levels. At the same time, the recovery of the synthesized photocatalysts was studied following a novel promising recuperation method, i.e., annulling the surface charge of the suspended samples by reaching the isoelectric point (pHPZC) of each sample, for the quantitative precipitation of TiO2 nanoparticles.

Validation of a Cytological Classification System for the Rapid On-Site Evaluation (Rose) of Pulmonary and Mediastinal Needle Aspirates.

Rapid on-site evaluation (ROSE) is a procedure that allows immediate assessment of adequacy of cytological specimens obtained by fine needle aspiration (FNA). The application of ROSE diagnostic categories has been applied in various organs, but not in thoracic pathology. We aimed to retrospectively assess the concordance with the final diagnosis of a categorization from C1 (inadequate) to C5 (neoplastic) during ROSE performed with bronchoscopic or percutaneous sampling procedures of thoracic lesions in a large series of consecutive cases. This retrospective single-center study evaluated 2282 consecutive ROSEs performed on 1827 patients from January 2016 to December 2020 in 994 cases of transbronchial needle aspiration (TBNA) in peripheral pulmonary lesions, in 898 transthoracic FNAs, in 318 ultrasound-guided TBNAs, in 50 conventional TBNAs and in 22 endobronchial TBNAs. False positive and false negative cases of ROSE were 43 (1.88%) and 73 (3.2%), respectively, when compared with the definitive diagnosis. The sensitivity, specificity and the positive and negative prognostic values of ROSE were 94.84%, 95.05%, 96.89% and 91.87%, respectively. Overall concordance between ROSE and the final diagnosis was 0.8960 (Cohen's kappa). No significant differences were observed in terms of sampling procedures and type and location of the lesions. A tiered classification scheme of ROSE from C1 to C5 during bronchoscopic and percutaneous sampling procedures is helpful in effectively guiding clinical management of patients with thoracic lesions.

Red-emissive nanocrystals of Cs4MnxCd1-xSb2Cl12 layered perovskites.

Layered double perovskites are currently being investigated as emerging halide-based materials for optoelectronic applications. Herein, we present the synthesis of Cs4MnxCd1-xSb2Cl12 (0 ≤ x ≤ 1) nanocrystals (NCs). X-ray powder diffraction evidences the retention of the same crystal structure for all the inspected compositions; transmission electron microscopy revealed monodisperse particles with a mean size between 10.7 nm and 12.7 nm. The absorption spectra are mostly determined by transitions related to Sb3+, whereas Mn2+ induced a red emission in the 625-650 nm range. The photoluminescence emission intensity and position vary with the Mn2+ content and reach the maximum for the composition with x = 0.12. Finally, we demonstrate that the photoluminescence quantum yield of the latter NCs was increased from 0.3% to 3.9% through a post-synthesis treatment with ammonium thiocyanate. The present work expands the knowledge of colloidal layered double perovskite nanocrystals, stimulating future investigations of this emerging class of materials.

Effects of distancing and pattern of breathing on the filtering capability of commercial and custom-made facial masks: An in-vitro study.

BACKGROUND: Since the beginning of the COVID-19 pandemics, masking policies have been advocated. While masks are known to prevent transmission towards other individuals, it is unclear if different types of facial masks can protect the user from inhalation. The present study compares in-vitro different commercial and custom-made facial masks at different distances and breathing patterns. METHODS: Masks were placed on a head mannequin connected to a lung simulator, using a collecting filter placed after the mannequin airway. Certified, commercial and custom-made masks were tested at three different distances between the emitter and the mannequin: 40 cm, 80 cm and 120 cm. Two patterns of breathing were used, simulating normal and polypneic respiration. A solution of methylene blue was nebulized with a jet nebulizer and different mask-distance-breathing pattern combinations were tested. The primary endpoint was the inhaled fraction, defined as the amount of methylene blue detected with spectrophotometry expressed as percent of the amount detected in a reference condition of zero distance and no mask. FINDINGS: We observed a significant effect of distance (p < 0.001), pattern of breathing (p = 0.040) and type of mask (p < 0.001) on inhaled fraction. All masks resulted in lower inhaled fraction compared to breathing without mask (p < 0.001 in all comparisons), ranging from 41.1% ± 0.3% obtained with a cotton mask at 40 cm distance with polypneic pattern to <1% for certified FFP3 and the combination of FFP2 + surgical mask at all distances and both breathing pattern conditions. DISCUSSION: Distance, type of device and breathing pattern resulted in highly variable inhaled fraction. While the use of all types of masks resulted relevantly less inhalation compared to distancing alone, only high-grade certified devices (FFP3 and the combination of FFP2 + surgical mask) ensured negligible inhaled fraction in all conditions.

UV-254 degradation of nicotine in natural waters and leachates produced from cigarette butts and heat-not-burn tobacco products.

Nicotine is an important emerging contaminant widely detected in water resources. The main nicotine sources are human excretions from users and leaching from discarded tobacco product waste, which represents the most commonly littered item in urban areas and coasts. In this study, the UV254 photolytical fate of nicotine in natural water and leachates produced from conventional cigarettes (CCs) and the new generation heat-not-burn (HnBs) tobacco products is examined for the first time. The effect of UV254 irradiation on nicotine depletion in ultrapure water was initially studied. The reaction was pseudo first-order with respect to nicotine concentration at low concentrations and shifted to lower order at higher concentrations, an effect associated to absorption saturation. Although nicotine removal was fast, only 9.5% of the total organic carbon was removed after irradiation due to the formation of by-products. The chemical structures of six photo-products were derived by means of liquid and gas chromatography coupled to mass spectrometry. The photodegradation kinetics was found to depend on pH and faster kinetics were recorded when the monoprotonated form of nicotine was dominant (pH = 5-8). The presence of humic acids was found to slightly delay kinetics as they competed with nicotine for lamp irradiance, whereas the presence of salt had no effect on the direct photolysis of nicotine. Direct photolysis studies were also performed using natural waters. Compared to ultra-pure water, photodegradation was found to proceed slightly slower in river water, in similar kinetics in seawater, and relatively faster in rain water. The later was assumed to be due to the lower pH compared to the rest of the natural water tested. Leachates from used HnBs and smoked CCs were also submitted to UV254 irradiation and direct photolysis was found to proceed fast despite the high complexity of these matrices. Nonetheless, the total organic carbon in the system remained the same after irradiation due to the abundance of organics and photo-products formed. We take advantage of the present investigations and report the leaching behavior of nicotine from HnBs and CCs. Among others, we found that in HnBs ~70% of the total and bioavailable nicotine content remains in the tobacco sticks after operation and this percentage drops to 15% in CCs due to the reduction in mass after smoking. This finding demonstrated the importance of properly disposing tobacco product waste to prevent nicotine leaching in water bodies.

Attenuation of oxidative stress and chromosomal aberrations in cultured macrophages and pulmonary cells following self-sustained high temperature synthesis of asbestos.

Inhalation of asbestos fibres can cause lung and pleural diseases in humans and constitutes a severe public health threat worldwide. The aim of the present study was to assess the biological effects induced in both pulmonary cells (A549) and monocyte/macrophage (RAW 264.7) cell lines by combustion slags obtained from asbestos through a self-sustained high-temperature synthesis (SHS) reaction. The SHS reaction involves rapid thermal treatment and displays great ability to neutralise asbestos. Cytotoxicity, redox status imbalance, lipid peroxide production, DNA strand breaks (comet assay) and chromosomal aberrations (cytokinesis block micronucleus test) were evaluated in cells exposed either to untreated asbestos fibres or to grinded SHS-generated slags of different granulometry, tested in cultured cells at varying doses and for varying exposure times. Our results show that asbestos fibres cause redox status imbalance, especially in monocyte/macrophage cell lines. Moreover, they promote lipid peroxidation and trigger genomic alterations. When the cells were exposed to slag powders, which are the products of SHS asbestos treatment, generation of lipid peroxides and induction of DNA strand breaks still persisted, due to the high content in iron and other metals detected in these samples. However, there was an attenuation of redox status imbalance and an absence of chromosomal aberrations, which probably reflects the loss of the asbestos fibrous structure following SHS reaction, as demonstrated by electron microscopy analyses. In conclusions, SHS-treated asbestos wastes can potentially have deleterious health effects due to the oxidative stress induced by inhaled powders but they loose the asbestos ability to induce chromosomal alterations.

TiO2 and N-TiO2 Sepiolite and Zeolite Composites for Photocatalytic Removal of Ofloxacin from Polluted Water.

TiO2 sepiolite and zeolite composites, as well the corresponding N-doped composites, synthesized through a sol-gel method, were tested for the photocatalytic degradation of a widespread fluoroquinolone antibiotic (ofloxacin) under environmental conditions. The catalysts were characterized by X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET), scanning electron microscopy (SEM), and diffuse reflectance spectroscopy (DRS) analyses. A complete drug degradation occurred in 10-15 min in the presence of both TiO2 sepiolite and zeolite catalysts, and in 20-30 min with the N-doped ones. Sepiolite proved to be a better TiO2 support compared to the most common zeolite both in terms of adsorption capacity and photocatalytic efficiency in pollutants degradation. The influence of nitrogen doping (red shift from 3.2 to 3.0 eV) was also investigated. Although it was blurred by a marked increase of the particle dimension and thus a decrease of the specific surface area of the doped catalysts, it allowed a faster drug removal than direct photolysis. The photochemical paths and photoproducts were investigated, too.

Green Synthesis of Silver Nanoparticles by Low-Energy Wet Bead Milling of Metal Spheres.

A low-energy, magnetically-driven milling technique for the synthesis of silver nanoparticles is proposed, where the grinding medium and the metal precursor consisting of silver spheres have the same shape and size, belonging to a millimetric scale. The process is carried out at room temperature in aqueous solvent, where different types of capping agents have been dissolved to damp particle agglomeration. The particle diameters, determined by dynamic light scattering and transmission electron microscopy, have been compared with those typical of conventional wet-chemical bottom-up synthesis processes. The use of milling spheres and metal precursor of the same initial shape and size allows to overcome some drawbacks and limitations distinctive of conventional bead-milling equipment, generally requiring complex operations of separation and recovery of milling media. The milling bead/nanoparticle diameter ratio obtained by this approach is lower than that typical of most previous wet bead milling techniques. The method described here represents a simple, one-pot, cost-effective, and eco-friendly process for the synthesis of metal nanoparticles starting from a bulky solid.

Systematic Study on TiO2 Crystallization via Hydrothermal Synthesis in the Presence of Different Ferrite Nanoparticles as Nucleation Seeds.

In the present work, the crystallization of anatase TiO2 nanoparticles (NPs), using different ferrite nanoparticles with different chemical composition, dimensions and shape as nucleation seeds, was investigated. In particular, CoFe2O4, NiFe2O4 and Fe3O4 NPs with a volume ratio equal to 1:1000 with respect of TiO2 amount, were used in order to investigate the synthesis of nanocrystalline tetragonal anatase TiO2 by a hydrothermal synthesis. In addition, Lu2O3 nanoparticles were also used to detect the effect of a non-magnetic nanoparticle on the synthesis and nanocrystallization of titania. For each sample, a deep physical characterization was performed by XRD (with a Rietveld refinement of the structural data), FE-SEM, STEM, HRTEM, DSC analysis and BET surface area measurement. Furthermore, for some samples, the photocatalytic activity was investigated by degradation of methylene blue in aqueous medium, in the framework of a standard ISO 10678:2010 protocol. The hydrothermal synthesis was performed with a 3 hours' thermal treatment, at a pressure of approximatively 9 bar and a temperature significantly lower (Tmax═150 °C) than the usual temperature necessary to obtain crystalline anatase TiO2 (Tcryst═350 °C). The results give evidence that the mere presence of a nucleation seeds in the hydrothermal reactor, without any particular need for the composition and morphology, leads to crystalline anatase TiO2 nanoparticles with high photocatalytic performances.

Colloidal Synthesis of Double Perovskite Cs2AgInCl6 and Mn-Doped Cs2AgInCl6 Nanocrystals.

We show here the first colloidal synthesis of double perovskite Cs2AgInCl6 nanocrystals (NCs) with a control over their size distribution. In our approach, metal carboxylate precursors and ligands (oleylamine and oleic acid) are dissolved in diphenyl ether and reacted at 105 °C with benzoyl chloride. The resulting Cs2AgInCl6 NCs exhibit the expected double perovskite crystal structure, are stable under air, and show a broad spectrum white photoluminescence (PL) with quantum yield of ∼1.6 ± 1%. The optical properties of these NCs were improved by synthesizing Mn-doped Cs2AgInCl6 NCs through the simple addition of Mn-acetate to the reaction mixture. The NC products were characterized by the same double perovskite crystal structure, and Mn doping levels up to 1.5%, as confirmed by elemental analyses. The effective incorporation of Mn ions inside Cs2AgInCl6 NCs was also proved by means of electron spin resonance spectroscopy. A bright orange emission characterized our Mn-doped Cs2AgInCl6 NCs with a PL quantum yield as high as ∼16 ± 4%.

The Self-sustained High temperature Synthesis (SHS) technology as novel approach in the management of asbestos waste.

The SHS technique was experimented in chrysotile breakdown. By means of two reactions such as Mg3Si2O5(OH)4 + Fe2O3 + 3 Mg and 2Mg3Si2O5(OH)4 + Fe3O4 + 4 Mg the chrysotile was completely converted into forsterite-rich olivine. Different mixtures of hematite + Mg and magnetite + Mg were tested with chrysotile to establish the maximum chrysotile amount in order to allow the reaction. In comparison with conventional thermal treatments, the SHS process is characterized by a fast reaction, needs low activation energy and the apparatus is simple. For these reasons, the asbestos neutralisation is carried out with positive balance of time and costs of the process. Furthermore, the combustion product can be re-used as secondary material.

Postsynthesis Transformation of Insulating Cs4PbBr6 Nanocrystals into Bright Perovskite CsPbBr3 through Physical and Chemical Extraction of CsBr.

Perovskite-related Cs4PbBr6 nanocrystals present a "zero-dimensional" crystalline structure where adjacent [PbBr6]4- octahedra do not share any corners. We show in this work that these nanocrystals can be converted into "three-dimensional" CsPbBr3 perovskites by extraction of CsBr. This conversion drastically changes the optoelectronic properties of the nanocrystals that become highly photoluminescent. The extraction of CsBr can be achieved either by thermal annealing (physical approach) or by chemical reaction with Prussian Blue (chemical approach). The former approach can be simply carried out on a dried film without addition of any chemicals but does not yield a full transformation. Instead, reaction with Prussian Blue in solution achieves a full transformation into the perovskite phase. This transformation was also verified on the iodide counterpart (Cs4PbI6).

Antibacterial activity of standard and N-doped titanium dioxide-coated endotracheal tubes: an in vitro study. / Atividade antibacteriana de tubos endotraqueais revestidos com dióxido de titânio padrão e dopados com nitrogênio: um estudo in vitro.

OBJECTIVE:: The aim of this study was to assess the antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa of two nanoparticle endotracheal tube coatings with visible light-induced photocatalysis. METHODS:: Two types of titanium dioxide nanoparticles were tested: standard anatase (TiO2) and N-doped TiO2 (N-TiO2). Nanoparticles were placed on the internal surface of a segment of commercial endotracheal tubes, which were loaded on a cellulose acetate filter; control endotracheal tubes were left without a nanoparticle coating. A bacterial inoculum of 150 colony forming units was placed in the endotracheal tubes and then exposed to a fluorescent light source (3700 lux, 300-700 nm wavelength) for 5, 10, 20, 40, 60 and 80 minutes. Colony forming units were counted after 24 hours of incubation at 37°C. Bacterial inactivation was calculated as the percentage reduction of bacterial growth compared to endotracheal tubes not exposed to light. RESULTS:: In the absence of light, no relevant antibacterial activity was shown against neither strain. For P. aeruginosa, both coatings had a higher bacterial inactivation than controls at any time point (p < 0.001), and no difference was observed between TiO2 and N-TiO2. For S. aureus, inactivation was higher than for controls starting at 5 minutes for N-TiO2 (p = 0.018) and 10 minutes for TiO2 (p = 0.014); inactivation with N-TiO2 was higher than that with TiO2 at 20 minutes (p < 0.001), 40 minutes (p < 0.001) and 60 minutes (p < 0.001). CONCLUSIONS:: Nanosized commercial and N-doped TiO2 inhibit bacterial growth under visible fluorescent light. N-TiO2 has higher antibacterial activity against S. aureus compared to TiO2.

Atividade antibacteriana de tubos endotraqueais revestidos com dióxido de titânio padrão e dopados com nitrogênio: um estudo in vitro / Antibacterial activity of standard and N-doped titanium dioxide-coated endotracheal tubes: an in vitro study

RESUMO Objetivo: Avaliar a atividade antibacteriana contra Staphylococcus aureus e Pseudomonas aeruginosa de dois revestimentos endotraqueais com nanopartículas e fotocatálise sob luz visível. Métodos: Testaram-se dois tipos de nanopartículas de titânio: anatase padrão (TiO2) e TiO2 nano-dopada (N-TiO2). As nanopartículas foram colocadas em superfície interna de segmentos de tubos endotraqueais comerciais, aplicadas sobre um filtro de acetato de celulose; os tubos endotraqueais controle foram deixados sem revestimento de nanopartículas. Em cada tubo endotraqueal foi inoculado um total de 150 unidades formadoras de colônia e, a seguir, estes foram expostos a uma fonte de luz fluorescente (3700 lux, comprimento de onda de 300 - 700nm) por 5, 10, 20, 40, 60 e 80 minutos. Contaram-se as Unidades Formadoras de Colônia após 24 horas de incubação a 37ºC. A inativação bacteriana foi calculada como a redução porcentual do crescimento bacteriano em comparação a tubos não expostos à luz. Resultados: Na ausência de luz, não se observou qualquer atividade antibacteriana relevante contra qualquer das cepas estudadas. Para P. aeruginosa, ambos os revestimentos tiveram inativação bacteriana mais elevada do que o controle em qualquer dos momentos de avaliação (p < 0,001), sendo que não se observaram diferenças entre o revestimento padrão e nano-dopado. Para S. aureus, a inativação foi maior que os controles, começando a partir de 5 minutos para nano-dopado (p = 0,018) e 10 minutos para o revestimento padrão (p = 0,014); a inativação com a forma nano-dopada foi maior do que com a forma padrão aos 20 minutos (p < 0,001), 40 minutos (p < 0,001) e 60 minutos (p < 0,001). Conclusões: O revestimento com nanopartículas de titânio comercial padrão e nano-dopado inibiu o crescimento bacteriano sob a luz fluorescente visível. o revestimento nano-dopado teve maior atividade antibacteriana contra S. aureus em comparação à atividade observada com o revestimento com anatase padrão.

ABSTRACT Objective: The aim of this study was to assess the antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa of two nanoparticle endotracheal tube coatings with visible light-induced photocatalysis. Methods: Two types of titanium dioxide nanoparticles were tested: standard anatase (TiO2) and N-doped TiO2 (N-TiO2). Nanoparticles were placed on the internal surface of a segment of commercial endotracheal tubes, which were loaded on a cellulose acetate filter; control endotracheal tubes were left without a nanoparticle coating. A bacterial inoculum of 150 colony forming units was placed in the endotracheal tubes and then exposed to a fluorescent light source (3700 lux, 300-700 nm wavelength) for 5, 10, 20, 40, 60 and 80 minutes. Colony forming units were counted after 24 hours of incubation at 37°C. Bacterial inactivation was calculated as the percentage reduction of bacterial growth compared to endotracheal tubes not exposed to light. Results: In the absence of light, no relevant antibacterial activity was shown against neither strain. For P. aeruginosa, both coatings had a higher bacterial inactivation than controls at any time point (p < 0.001), and no difference was observed between TiO2 and N-TiO2. For S. aureus, inactivation was higher than for controls starting at 5 minutes for N-TiO2 (p = 0.018) and 10 minutes for TiO2 (p = 0.014); inactivation with N-TiO2 was higher than that with TiO2 at 20 minutes (p < 0.001), 40 minutes (p < 0.001) and 60 minutes (p < 0.001). Conclusions: Nanosized commercial and N-doped TiO2 inhibit bacterial growth under visible fluorescent light. N-TiO2 has higher antibacterial activity against S. aureus compared to TiO2.

Effects of ventilator settings, nebulizer and exhalation port position on albuterol delivery during non-invasive ventilation: an in-vitro study.

BACKGROUND: Few studies have investigated the factors affecting aerosol delivery during non-invasive ventilation (NIV). Our aim was to investigate, using a bench-top model, the effect of different ventilator settings and positions of the exhalation port and nebulizer on the amount of albuterol delivered to a lung simulator. METHODS: A lung model simulating spontaneous breathing was connected to a single-limb NIV ventilator, set in bi-level positive airway pressure (BIPAP) with inspiratory/expiratory pressures of 10/5, 15/10, 15/5, and 20/10 cmH2O, or continuous positive airway pressure (CPAP) of 5 and 10 cmH2O. Three delivery circuits were tested: a vented mask with the nebulizer directly connected to the mask, and an unvented mask with a leak port placed before and after the nebulizer. Albuterol was collected on a filter placed after the mask and then the delivered amount was measured with infrared spectrophotometry. RESULTS: Albuterol delivery during NIV varied between 6.7 ± 0.4% to 37.0 ± 4.3% of the nominal dose. The amount delivered in CPAP and BIPAP modes was similar (22.1 ± 10.1 vs. 24.0 ± 10.0%, p = 0.070). CPAP level did not affect delivery (p = 0.056); in BIPAP with 15/5 cmH2O pressure the delivery was higher compared to 10/5 cmH2O (p = 0.033) and 20/10 cmH2O (p = 0.014). Leak port position had a major effect on delivery in both CPAP and BIPAP, the best performances were obtained with the unvented mask, and the nebulizer placed between the leak port and the mask (p < 0.001). CONCLUSIONS: In this model, albuterol delivery was marginally affected by ventilatory settings in NIV, while position of the leak port had a major effect. Nebulizers should be placed between an unvented mask and the leak port in order to maximize aerosol delivery.

From CsPbBr3 Nano-Inks to Sintered CsPbBr3-CsPb2Br5 Films via Thermal Annealing: Implications on Optoelectronic Properties.

CsPbBr3 nanocrystals passivated with short molecular ligands and deposited on a substrate were annealed from room temperature to 400 °C in inert atmosphere. Chemical, structural, and morphological transformations were monitored in situ and ex situ by different techniques, while optoelectronic properties of the film were also assessed. Annealing at 100 °C resulted in a 1 order of magnitude increase in photocurrent and photoresponse as a result of partial sintering of the NCs and residual solvent evaporation. Beyond 150 °C the original orthorhombic NCs were partially transformed into tetragonal CsPb2Br5 crystals, due to the desorption of weakly bound propionic acid ligands. The photocurrent increased moderately until 300 °C although the photoresponse became slower as a result of the formation of surface trap states. Eventually, annealing beyond 350 °C removed the strongly bound butylamine ligands and reversed the transition to the original orthorhombic phase, with a loss of photocurrent due to the numerous defects induced by the stripping of the passivating butylamine.

Effects of Nebulizer Position, Gas Flow, and CPAP on Aerosol Bronchodilator Delivery: An In Vitro Study.

BACKGROUND: The aim of this study was to investigate the effects of different delivery circuit configurations, nebulizer positions, CPAP levels, and gas flow on the amount of aerosol bronchodilator delivered during simulated spontaneous breathing in an in vitro model. METHODS: A pneumatic lung simulator was connected to 5 different circuits for aerosol delivery, 2 delivering CPAP through a high-flow generator tested at 30, 60, and 90 L/min supplementary flow and 5, 10, and 15 cm H2O CPAP and 3 with no CPAP: a T-piece configuration with one extremity closed with a cap, a T-piece configuration without cap and nebulizer positioned proximally, and a T-piece configuration without cap and nebulizer positioned distally. Albuterol was collected with a filter, and the percentage amount delivered was measured by infrared spectrophotometry. RESULTS: Configurations with continuous high-flow CPAP delivered higher percentage amounts of albuterol compared with the configurations without CPAP (9.1 ± 6.0% vs 6.2 ± 2.8%, P = .03). Among configurations without CPAP, the best performance was obtained with a T-piece with one extremity closed with a cap. In CPAP configurations, the highest delivery (13.8 ± 4.4%) was obtained with the nebulizer placed proximal to the lung simulator, independent of flow. CPAP at 15 cm H2O resulted in the highest albuterol delivery (P = .02). CONCLUSIONS: Based on our in vitro study, without CPAP, a T-piece with a cap at one extremity maximizes albuterol delivery. During high-flow CPAP, the nebulizer should always be placed proximal to the patient, after the T-piece, using the highest CPAP clinically indicated.

Enhancement of TiO2 NPs Activity by Fe3O4 Nano-Seeds for Removal of Organic Pollutants in Water.

The enhancement of the photocatalytic activity of TiO2 nanoparticles (NPs), synthesized in the presence of a very small amount of magnetite (Fe3O4) nanoparticles, is here presented and discussed. From X-ray diffraction (XRD) and differential scanning calorimetry (DSC) analyses, the crystallinity of TiO2 nanoparticles (NPs) seems to be affected by Fe3O4, acting as nano-seeds to improve the tetragonal TiO2 anatase structure with respect to the amorphous one. Photocatalytic activity data, i.e., the degradation of methylene blue and the Ofloxacin fluoroquinolone emerging pollutant, give evidence that the increased crystalline structure of the NPs, even if correlated to a reduced surface to mass ratio (with respect to commercial TiO2 NPs), enhances the performance of this type of catalyst. The achievement of a relatively well-defined crystal structure at low temperatures (Tmax = 150 °C), preventing the sintering of the TiO2 NPs and, thus, preserving the high density of active sites, seems to be the keystone to understand the obtained results.

Medical teleconsultation to general practitioners reduces the medical error vulnerability of internal medicine patients.

BACKGROUND: e-Health strategies are supposed to improve the performance of national health systems. Medical teleconsultation (MT) is an important component of such e-Health strategies. OBJECTIVES: The outcome of MT was evaluated with regard to the impact on the medical error vulnerability (MEV) of internal medicine patients. METHODS: A team of internal medicine doctors plus a network of forty specialists was set-up in one health district belonging to a unified and universal national health system of a country of Western Europe, in order to provide free-of-charge MT to support general practitioners in solving internal medicine cases. In this observational study, the case series of 2013 is reviewed. RESULTS: a) Only 21% of the MT fell short to the general practitioner's expectations about the case solving focus; b) throughout the medical care process of the patient, 49% of the cases met with one or more of the five MEVs, namely: 1) clinical test mishandling; 2) inaccurate differential diagnosis; 3) inadequate information flow between health providers at different levels of care (transition care); 4) poor coordination between health providers; and 5) poor reconciliation of medications or hazardous therapies. c) MT canceled or prevented MEVs in 56% and mitigate MEVs in 15% of the cases; d) MT canceled or prevented 85% of MEV caused by poor information exchange in transition care, therefore improving patient referral and counter-referral. CONCLUSIONS: MT reduces MEV and therefore, whenever implemented to a large extent, may improve the quality of health care delivery and the performance of national health systems.

PDX-1 mRNA expression in endoscopic ultrasound-guided fine needle cytoaspirate: perspectives in the diagnosis of pancreatic cancer.

BACKGROUND AND AIMS: Endoscopic ultrasound-guided fine needle aspiration is routinely used in the diagnostic work up of pancreatic cancer but has a low sensitivity. Studies showed that Pancreatic Duodenal Homeobox-1 (PDX-1) is expressed in pancreatic cancer, which is associated with a worse prognosis. We aimed to verify whether the assessment of PDX-1 in endoscopic ultrasound-guided fine needle aspiration samples may be helpful for the diagnosis of pancreatic cancer. METHODS: mRNA of 54 pancreatic cancer and 25 cystic lesions was extracted. PDX-1 expression was assessed by Real-Time PCR. RESULTS: In all but two patients with pancreatic cancer, PDX-1 was expressed and was found positive in 7 patients with pancreatic cancer in which cytology was negative. The positivity was associated with a probability of 0.98 (95% CI 0.90-1.00) of having cancer and the negativity with one of 0.08 (95% CI 0.01-0.27). The probability of cancer rose to 1.00 (95% CI 0.97-1.00) for patients positive to both PDX-1 and cytology and fell to 0.0 (95% CI 0.00-0.15) in patients negative for both. CONCLUSIONS: PDX-1mRNA is detectable in samples of pancreatic cancer. Its quantification may be helpful to improve the diagnosis of pancreatic cancer.