Can end-tidal CO2 measurement replace arterial partial CO2 in emergency department respiratory distress management?

OBJECTIVE: To assess the feasibility of using end-tidal carbon dioxide (EtCO2) as a non-invasive substitute for partial pressure of arterial carbon dioxide (PaCO2) in emergency department (ED) triage and follow-up, and to explore the potential of partial pressure of venous carbon dioxide (PvCO2) as an alternative to PaCO2. DESIGN: Prospective cross-sectional study. SETTING: Tertiary university hospital. PATIENTS OR PARTICIPANTS: 97 patients presenting with acute respiratory distress to the ED. INTERVENTIONS: EtCO2, arterial blood gases, and venous blood gases measured at admission (0 min), 60 min, and 120 min. MAIN VARIABLES OF INTEREST: CO2 levels. RESULTS: Among 97 patients (mean age: 70.93 ± 9.6 years; 60.8% male), EtCO2 > 45 mmHg at admission showed strong positive correlations with PaCO2 and PvCO2 (r = 0.844, r = 0.803; p < 0.001, respectively). Significant positive correlation was observed between 60-min EtCO2 and PaCO2 (r = 0.729; p < 0.001). Strong correlation between PaCO2 and PvCO2 at 120 min when EtCO2 > 45 mmHg (r = 0.870; p < 0.001). EtCO2 was higher in hospitalized patients compared to discharged ones. CONCLUSIONS: EtCO2 appears promising as a substitute for PaCO2 in ED patients with acute respiratory distress within the initial two hours of treatment. Venous blood gas sampling offers a less invasive alternative to arterial sampling, facilitating simultaneous blood tests.

Comparison of lithotripsy methods during mini-PNL: is there a role for ballistic lithotripsy in the era of high-power lasers.

BACKGROUND: For renal stones > 20 mm, percutaneous nephrolithotomy (PNL) offers the best stone clearance rates with acceptable complication rates. This study aimed to compare the efficiency of high-power holmium YAG laser and ballistic lithotripsy during mini-PNL. METHODS: Data from 880 patients who underwent mini-PNL for renal stones was investigated retrospectively. The study utilized propensity score matching to create two groups: laser lithotripsy (n = 440) and ballistic lithotripsy (n = 440). The groups were matched based on stone size, Guy's stone score, and stone density. The main objectives of the study were to assess the stone-free rate (SFR), duration of surgery, and complication rates. RESULTS: The average age of the population was 51.4 ± 7.1 years, with a mean stone size of 28.6 ± 8.3 mm and a mean stone density of 1205 ± 159 HU. There were no significant differences between the groups. The SFRs of the laser lithotripsy and ballistic lithotripsy were 92.5% and 90.2%, respectively (p = 0.23). The laser lithotripsy group had a notably shorter surgery time (40.1 ± 6.3 min) compared to the ballistic lithotripsy group (55.6 ± 9.9 min) (p = 0.03). Complication rates were similar (p = 0.67). CONCLUSIONS: Our study shows that a high-power holmium YAG laser provides quicker operation time compared to ballistic lithotripsy. However, ballistic lithotripsy is still an effective and safe option for stone fragmentation during mini-PNL. In places where a high-power holmium YAG laser is not available, ballistic lithotripters are still a safe, effective, and affordable option for mini-PNL.

In Situ Design of a Nanostructured Interface between NiMo and CuO Derived from Metal-Organic Framework for Enhanced Hydrogen Evolution in Alkaline Solutions.

Hydrogen shows great promise as a carbon-neutral energy carrier that can significantly mitigate global energy challenges, offering a sustainable solution. Exploring catalysts that are highly efficient, cost-effective, and stable for the hydrogen evolution reaction (HER) holds crucial importance. For this, metal-organic framework (MOF) materials have demonstrated extensive applicability as either a heterogeneous catalyst or catalyst precursor. Herein, a nanostructured interface between NiMo/CuO@C derived from Cu-MOF was designed and developed on nickel foam (NF) as a competent HER electrocatalyst in alkaline media. The catalyst exhibited a low overpotential of 85 mV at 10 mA cm-2 that rivals that of Pt/C (83 mV @ 10 mA cm-2). Moreover, the catalyst's durability was measured through chronopotentiometry at a constant current density of -30, -100, and -200 mA cm-2 for 50 h each in 1.0 M KOH. Such enhanced electrocatalytic performance could be ascribed to the presence of highly conductive C and Cu species, the facilitated electron transfer between the components because of the nanostructured interface, and abundant active sites as a result of multiple oxidation states. The existence of an ionized oxygen vacancy (Ov) signal was confirmed in all heat-treated samples through electron paramagnetic resonance (EPR) analysis. This revelation sheds light on the entrapment of electrons in various environments, primarily associated with the underlying defect structures, particularly vacancies. These trapped electrons play a crucial role in augmenting electron conductivity, thereby contributing to an elevated HER performance.

Tailoring p-Type Behavior in ZnO Quantum Dots through Enhanced Sol-Gel Synthesis: Mechanistic Insights into Zinc Vacancies.

The synthesis and control of properties of p-type ZnO is crucial for a variety of optoelectronic and spintronic applications; however, it remains challenging due to the control of intrinsic midgap (defect) states. In this study, we demonstrate a synthetic route to yield colloidal ZnO quantum dots (QD) via an enhanced sol-gel process that effectively eliminates the residual intermediate reaction molecules, which would otherwise weaken the excitonic emission. This process supports the creation of ZnO with p-type properties or compensation of inherited n-type defects, primarily due to zinc vacancies under oxygen-rich conditions. The in-depth analysis of carrier recombination in the midgap across several time scales reveals microsecond carrier lifetimes at room temperature which are expected to occur via zinc vacancy defects, supporting the promoted p-type character of the synthesized ZnO QDs.

Unlocking the full potential of citric acid-synthesized carbon dots as a supercapacitor electrode material via surface functionalization.

This research paper investigates the effect of functionalizing the surfaces of citric acid-synthesized carbon dots (CDs) with hyperbranched bis(methylol)propionic acid (bis-MPA) polyester hydroxyl polymers (HBPs) on their performance as electrode materials in a supercapacitor. Two types of HBPs with 16 and 64 peripheral hydroxyl groups were used to functionalize the CDs' oxygen-enriched surface. Here, CDs were used as electrode materials for the first time in symmetric supercapacitors without a composite material, and how surface modification affects the capacitance performance of CDs was investigated. Our results showed that the functionalization of green-emitting CDs with HBP resulted in the successful passivation of surface defects, which improved their stability and prevented further oxidation. The CDs with HBP passivation exhibited excellent electrochemical performance, with a high specific capacitance of 32.08 F g-1 at 0.1 A g-1 and good rate capability, indicating a faster ion transport rate at high current densities. Experimental EPR spectra of functionalized and non-functionalized CDs reveal distinct changes in g-factor values and line widths, confirming the impact of dangling bonds and spin-orbit interactions. The observed broader linewidth indicates a wider range of electron spin resonances due to energy-level splitting induced by spin-orbit coupling. The excellent electrochemical performance of CDs with HBP passivation can be attributed to the presence of oxygen-containing surface functional groups such as hydroxyl and carboxyl groups on their surfaces, which enhance the conductivity and charge transfer reactions. These results suggest that functionalization with polar HBPs is a promising strategy to enhance the electrochemical performance of CDs in supercapacitor applications.

Boron Carbide as an Electrode Material: Tailoring Particle Morphology to Control Capacitive Behaviour.

In this study, boron carbide powders consisting mainly of nano/micro fibers or polyhedral-equiaxed particles were synthesized via the sol-gel technique, and the influence of particle morphology on electrochemical performance of boron carbide electrodes was investigated. Thermal decomposition duration of the precursors played a determinant role in the final morphology of the synthesized boron carbide powders. The morphology of boron carbide powders successfully tuned from polyhedral-equiaxed (with ~3 µm average particle size) to nano/micro fibers by adjusting the thermal decomposition duration of precursors. The length and thickness of fibers were in the range of 30 to 200 µm and sub-micron to 5 µm, respectively. The electrochemical performance analysis of boron carbide powders has shown that the particle morphology has a considerable impact on the boron carbide electrodes electrochemical performance. It was found that the synergetic effects of polyhedral-equiaxed and nano/micro fiber morphologies exhibited the best electrochemical performance in supercapacitor devices, resulting in the power and energy density of 34.9 W/kg and 0.016 Wh/kg, respectively.

All-in-One Electric Double Layer Supercapacitors Based on CH3NH3PbI3 Perovskite Electrodes.

Supercapacitors (SCs) are widely used energy storage devices in various applications that require instantaneous power supply and fast response times; however, the challenge for achieving high performance demands the continuous development and tailoring of electrode materials. Organic-inorganic halide perovskites (OIHPs) have recently received significant attention in electrochemical energy storage and conversion applications due to their unique properties including high charge carrier mobility, high mixed (electronic-ionic) conductivity, and presence of large oxygen vacancies. This study presents the fabrication and use of OIHPs based on methyl-ammonium lead iodide (CH3NH3PbI3) and its Co2+- and Bi3+-substituted derivatives (CH3NH3Pb1-x Co x I3 and CH3NH3Pb1-x Bi x I3, respectively, where x = 0.1) as electrodes for SCs. SC devices were constructed symmetrically by sandwiching the synthesized electrode materials in a quasi-solid-state electrolyte between two TiO2-coated FTO glasses. We discussed the optimization parameters (i.e., A-site doping, B-site doping, and controlling the stoichiometry of the anion and cation) to improve the electrochemical performance of the fabricated SCs. Furthermore, the effects of substitution ions (Co2+ and Bi3+) on the charge-discharge performance, energy and power density, defects, crystallinity, and microstructure were demonstrated. Electrochemical performances of the electrodes were analyzed by using CV, EIS, and GCPL techniques. The highest power density of 934.6 W/kg was obtained for Bi-substituted perovskite electrodes. Fabricated SC devices show good cyclability with 97.2, 96.3, and 86.6% retention of the initial capacitances after 50 cycles for pure, Co2+-substituted, and Bi3+-substituted perovskite electrodes, respectively.

Photo-supercapacitors based on nanoscaled ZnO.

In this study, zinc oxide (ZnO) powders in two different morphologies, nanowire (NW) and nanoflower (NF), have been synthesized by the hydrothermal method. The eligibility of the pristine ZnO nanopowders as a photo-active material has been revealed by designing P-SC devices via the facile drop-casting method on both glass and plastic substrates in large-area applications. The impact of physical properties and especially defect structures on photo-supercapacitor (P-SC) performance have been explored. Although the dark Coulombic efficiency (CE%) of both NW and NF-based P-SC were very close to each other, the CE% of NW P-SC increased 3 times, while the CE% of NF P-SC increased 1.7 times under the UV-light. This is because the charge carriers produced under light excitation, extend the discharge time, and as confirmed by electron paramagnetic resonance, photoluminescence, and transmission electron microscopy analyses, the performance of P-SCs made from NF powders was relatively low compared to those produced from NW due to the high core defects in NF powders. The energy density of 78.1 mWh kg-1 obtained for NF-based P-SCs is very promising, and the capacitance retention value of almost 100% for 3000 cycles showed that the P-SCs produced from these materials were entirely stable. Compared to the literature, the P-SCs we propose in this study are essential for new generation energy storage systems, thanks to their ease of design, adaptability to mass production for large-area applications, and their ability to store more energy under illumination.

ZnO and reduced graphene oxide electrodes for all-in-one supercapacitor devices.

Reduced graphene oxide/zinc oxide (rGO/ZnO) hybrid nanocomposites were prepared from synthesized GO and high energy ball milled (HEBM) ZnO for supercapacitor electrodes. Evolution of intrinsic point defects and defect-induced morphological, structural and size-dependent properties of rGO/ZnO hybrid nanocomposites were investigated using electron paramagnetic resonance (EPR) spectroscopy. CV, PEIS and GCPL techniques were employed to investigate the electrochemical behavior of the electrode materials and the effects of defects on the electrochemical performance of the electrodes by using the standard two-electrode cell in a 6 M KOH electrolyte. Analyses of the obtained CV and impedance profiles have shown the pseudocapacitive and EDLC-type contributions in the supercapacitors. Cycling stabilities were evaluated using galvanostatic charge-discharge curves at current densities between 0.10 and 2.40 A g-1. The capacitance retention of all electrodes was found to be 100% after 30 cycles at 0.30 A g-1. The electrochemical analyses revealed that the incorporation of ZnO that is rich in core defects improved the charge transfer performance and ion diffusion of the rGO electrode.

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients.

INTRODUCTION: The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. METHODS: A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin <800 ng/mL, group 2: serum ferritin 800-1,500 ng/mL, and group 3: serum ferritin >1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. RESULTS: Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5-60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, p = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05-0.49]; p = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12-0.88]; p = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23-1.04]; p = 0.063). CONCLUSION: Time-averaged serum ferritin levels >1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

Building an Iron Chromophore Incorporating Prussian Blue Analogue for Photoelectrochemical Water Oxidation.

Invited for the cover of this issue is the Ferdi Karadas and Ekmel Ozbay groups at Bilkent University and co-workers. The image presents an utopic city in Iron Age, which is powered by an iron photosensitizer that bridges semiconductor buildings (TiO2 nanowires) and the catalyst (cobalt site). Read the full text of the article at 10.1002/chem.202100654.

Defect-induced B4C electrodes for high energy density supercapacitor devices.

Boron carbide powders were synthesized by mechanically activated annealing process using anhydrous boron oxide (B2O3) and varying carbon (C) sources such as graphite and activated carbon: The precursors were mechanically activated for different times in a high energy ball mill and reacted in an induction furnace. According to the Raman analyses of the carbon sources, the I(D)/I(G) ratio increased from ~ 0.25 to ~ 0.99, as the carbon material changed from graphite to active carbon, indicating the highly defected and disordered structure of active carbon. Complementary advanced EPR analysis of defect centers in B4C revealed that the intrinsic defects play a major role in the electrochemical performance of the supercapacitor device once they have an electrode component made of bare B4C. Depending on the starting material and synthesis conditions the conductivity, energy, and power density, as well as capacity, can be controlled hence high-performance supercapacitor devices can be produced.

About defect phenomena in ZnO nanocrystals.

ZnO nanocrystals are receiving renewed attraction due to their multifunctional properties. Selective enhancement and tuning of their optical and electrical properties are essential for achieving novel devices with accurate sensing and conducting capabilities. The nature and type of intrinsic defects that occur in ZnO influence these properties. In this work, we investigate the intrinsic defect structure of ZnO via electron paramagnetic resonance (EPR) and photoluminescence (PL) spectroscopy and correlate the results with existing computational works. Mainly, the defects are analysed by taking the microscopic defect structure of the lattice into account. The results manifest the core-shell model of the defect structure in ZnO. By default, specifically for nanocrystals, oxygen vacancies localise on the surface, while zinc vacancies localise in the core. The investigations in this report demonstrate that the concentration of the intrinsic defects and their position can be tuned merely by changing the size of the nanocrystal. Additionally, the UV, green, orange and red emissions can be tuned by nanocrystal's size and post-annealing treatments.

Building an Iron Chromophore Incorporating Prussian Blue Analogue for Photoelectrochemical Water Oxidation.

The replacement of traditional ruthenium-based photosensitizers with low-cost and abundant iron analogs is a key step for the advancement of scalable and sustainable dye-sensitized water splitting cells. In this proof-of-concept study, a pyridinium ligand coordinated pentacyanoferrate(II) chromophore is used to construct a cyanide-based CoFe extended bulk framework, in which the iron photosensitizer units are connected to cobalt water oxidation catalytic sites through cyanide linkers. The iron-sensitized photoanode exhibits exceptional stability for at least 5 h at pH 7 and features its photosensitizing ability with an incident photon-to-current conversion capacity up to 500 nm with nanosecond scale excited state lifetime. Ultrafast transient absorption and computational studies reveal that iron and cobalt sites mutually support each other for charge separation via short bridging cyanide groups and for injection to the semiconductor in our proof-of-concept photoelectrochemical device. The reorganization of the excited states due to the mixing of electronic states of metal-based orbitals subsequently tailor the electron transfer cascade during the photoelectrochemical process. This breakthrough in chromophore-catalyst assemblies will spark interest in dye-sensitization with robust bulk systems for photoconversion applications.

ZnO and MXenes as electrode materials for supercapacitor devices.

Supercapacitor devices are interesting owing to their broad range of applicability from wearable electronics to energy storage in electric vehicles. One of the key parameters that affect the efficiency of supercapacitor devices is selecting the ideal electrode material for a specific application. Regarding this, recently developed metal oxides, specifically nanostructured ZnO, and MXenes with their defect structures, size effects, as well as optical and electronic properties have been presented as electrode material in supercapacitor devices. The discussion of MXenes along with ZnO, although different in chemistry, also highlights the differences in dimensionality when it comes to defect-driven effects, especially in carrier transport. The volume under the influence of the defect centers is expected to be different in bulk and 2D structures, regardless of composition. Hence, analysis and discussion of both materials provide a fundamental understanding regarding the manner in which 2D structures are impacted by defects compared to bulk. Such an approach would therefore serve the scientific community with the material design tools needed to fabricate the next generation of supercapacitor devices.

Tailoring morphology to control defect structures in ZnO electrodes for high-performance supercapacitor devices.

Zinc oxide (ZnO) nanostructures were synthesized in the form of nanoparticles, nanoflowers and nanourchins. Structural, electronic and optical characterization of the samples was performed via standard techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM), photoluminescence, Raman and ultraviolet-visible (UV-Vis) spectroscopy. Point defect structures which are specific to each morphology have been investigated in terms of their concentration and location via state-of-the-art electron paramagnetic resonance (EPR) spectroscopy. According to the core-shell model, all the samples revealed core defects; however, the defects on the surface are smeared out. Finally, all three morphologies have been tested as electrode materials in a real supercapacitor device and the performance of the device, in particular, the specific capacitance and the storage mechanism, has been mediated by the point defects. Morphology-dependent defective ZnO electrodes enable the monitoring of the working principle of the supercapacitor device ranging from electric double-layer capacitors (EDLC) to pseudo-supercapacitors.

Synergy of nano-ZnO and 3D-graphene foam electrodes for asymmetric supercapacitor devices.

Two kinds of electrode materials were produced to fabricate asymmetric supercapacitor devices: (i) Highly defective, n-type wide bandgap semiconductor ZnO nanocrystalline electrodes below 50 nm were synthesized with the aid of the high energy ball milling technique. (ii) Flexible 3D-graphene foams were synthesized via the chemical vapor deposition technique. Extensive defect structure analysis was performed via enhanced characterization techniques mainly the spectroscopy ones: electron paramagnetic resonance (EPR), Raman, and photoluminescence (PL). Compared to bulk ZnO electrodes the nanoscale ZnO electrodes revealed a dramatic increase of defect concentration. The surface defect plays a crucial role in the electrochemical performance of supercapacitor devices. Strong decreases in charge transfer resistance were observed for the smallest crystallite size which is 15 nm. This work also shows that synthesis, controlling the defect structures, electronic and electrical characterization and the device production are extremely important to obtain high performance faradaic asymmetric supercapacitors.

Synthesis and Assembly of Zinc Oxide Microcrystals by a Low-Temperature Dissolution-Reprecipitation Process: Lessons Learned About Twin Formation in Heterogeneous Reactions.

Cobalt-doped zinc oxide single crystals with the shape of hexagonal platelets were synthesized by thermohydrolysis of zinc acetate, cobalt acetate, and hexamethylenetetramine (HMTA) in mixtures of ethanol and water. The mineralization proceeds by a low-temperature dissolution-reprecipitation process from the liquid phase by the formation of basic cobalt zinc salts as intermediates. The crystal shape as well as twin formation of the resulting oxide phase can be influenced by careful choice of the solvent mixture and the amount of doping. An understanding of the course of the reaction was achieved by comprehensive employment of analytical techniques (i.e., SEM, XRD, IR) including an in-depth HRTEM study of precipitates from various reaction stages. In addition, EPR as well as UV/Vis spectroscopic measurements provide information about the insertion of the cobalt dopant into the zincite lattice. The Langmuir-Blodgett (LB) technique is shown to be suitable for depositing coatings of the platelets on glass substrates functionalized with polyelectrolyte multilayers and hence is applied for the formation of monolayers containing domains with ordered tessellation. No major differences are found between deposits on substrates with anionic or cationic surface modification. The adherence to the substrates is sufficient to determine the absolute orientation of the deposited polar single crystals by piezoresponse force microscopy (PFM) and Kelvin probe force microscopy (KPFM) studies.