Study of the effect of added bronchoscopic suction to routine treatment of ventilator associated pneumonia patients in surgical ICU.

OBJECTIVE: Comparing BAL and antibiotic therapy with antibiotic therapy itself for treating VAP patients in ICU. METHODS: In this randomized clinical trial, the first group was treated using antibiotics and closed-suction was performed daily, using 50 cc of sterile normal saline. The second group was treated with antibiotics and daily closed-suction with 50 cc of sterile normal saline, plus bronchoscopic suction every other day. Patients of both groups were followed and investigated one, 3, 7, and 10 days after initial diagnosis. RESULTS: Mean blood leukocyte count and body temperature was measured in groups one (no bronchoscopy) and two (with bronchoscopy) in first, 3rd, 7th, and 10th days which was higher in the second group. Mean treatment status was also measured using APACHE II index. There was also a statistically significant difference in 3rd day (p-value < 0.05). There was also no difference in final culture result or mortality rate between two groups. CONCLUSIONS: According to the results of this study like lower body temperature, higher leukocyte count reduction, and lower APACHE II scores in the second group, treated with bronchoscopic suction, adding bronchoscopy seems to be more useful than normal method.

Cold-plasma activation converting conductive agent in spent Li-ion batteries to bifunctional oxygen reduction/evolution electrocatalyst for zinc-air batteries.

Considerable amount of high-value transition metals components can be recycled in spent ternary lithium-ion batteries. In this study, we utilized the conductive agent carbon black, obtained from the leaching waste resulting from the chemical recovery of spent lithium-nickel-manganese-cobalt (NCM) oxide cathode materials. This process allows us to create valuable bifunctional catalysts for the oxygen reduction reaction and oxygen evolution reaction (ORR/OER), facilitated by a facile cold plasma activation method, as a part of lithium batteries circular economy. The activated conductive agent (RCA-30) exhibited an ORR half-wave potential of 0.74 V (vs. RHE) in 0.1 mol/L KOH solution, and an OER overpotential of 360 mV at 10 mA cm-2 in 1 mol/L KOH electrolyte, owing to nitrogen doping of carbon black and activation of surface metal oxides. The complete zinc-air batteries incorporating the activated catalysts at the cathode exhibited an open circuit potential of up to 1.48 V and sustained cycling for 100 h at a current density of 5 mA cm-2. Additionally, the activated catalysts contributed to a power density of 92 mW cm-2 and a full discharge capacity of 640 mAh/g.

The Effect of Intrathecal Bupivacaine Plus Dextrose 5% and Fentanyl Compared with Bupivacaine Alone on the Onset and Duration of Analgesia in Patients Undergoing Lower-Limb Orthopedic Surgery.

Introduction: This study aimed to compare the effect of intrathecal bupivacaine plus dextrose 5% and fentanyl with bupivacaine alone on the onset and duration of analgesia in patients undergoing lower-limb orthopedic surgery. Materials and Methods: A total of 40 patients eligible for lower-limb surgery were divided into two groups by simple randomization: the control group which received only bupivacaine and the intervention group which received bupivacaine plus dextrose 5% and fentanyl. Anesthesia was induced by the spinal method. The visual analog scale (VAS) was used to assess the patients' pain; hemodynamic status (systolic and diastolic blood pressure and the heart rate) and oxygen saturation were also monitored. Results: There was a significant difference between groups in the type of lower-limb movement at the L1 anesthesia level, the sensory block level at time zero after surgery, the type of backward movement at time zero after surgery, and the analgesic dose received (p < 0.05). Fifteen and 30 minutes after the start of surgery, mean systolic blood pressure, and 45 and 60 minutes after the start of surgery, systolic and diastolic blood pressure and the heart rate were significantly lower in the control group than in the intervention group (p < 0.05). The VAS score was significantly lower in the intervention group than in the control group at 6 and 24 hours after surgery (p < 0.05). Systolic and diastolic blood pressure at time zero, systolic blood pressure at hour 6, and diastolic blood pressure at hour 24 after surgery were significantly lower in the control group than in the intervention group (p < 0.05). Conclusion: The mean duration of anesthesia and analgesia was significantly longer in patients receiving bupivacaine plus fentanyl than in those receiving bupivacaine alone. However, concerning hemodynamic parameters, it cannot be concluded that the bupivacaine plus fentanyl receiving group was generally superior to the bupivacaine receiving group.

The enhanced electrocatalytic performance of nanoscopic Cu6Pd12Fe12 heterometallic molecular box encaged cytochrome c.

Designing molecular cages for atomic/molecular scale guests is a special art used by material chemists to harvest the virtues of the otherwise vile idea known as "the cage". In recent years, there has been a notable surge in research investigations focused on the exploration and utilization of the distinct advantages offered by this art in the advancement of efficient and stable bio-electrocatalysts. This usually is achieved through encapsulation of biologically accessible redox proteins within specifically designed molecular cages and matrices. Herein, we present the first successful method for encaging cytochrome c (Cyt-c), a clinically significant enzyme system, inside coordination-driven self-assembled Cu6Pd12Fe12 heterometallic hexagonal molecular boxes (Cu-HMHMB), in order to create a Cyt-c@Cu-HMHMB composite. 1H NMR, FTIR, and UV-Vis spectroscopy, ICP-MS, TGA and voltammetric investigations carried out on the so-crafted Cyt-c@Cu-HMHMB bio-inorganic composite imply that the presented strategy ensures encaging of Cyt-c in a catalytically active, electrochemically stable and redox-accessible state inside the Cu-HMHMB. Cyt-c@Cu-HMHMB is demonstrated to exhibit excellent stability and electrocatalytic activity toward very selective, sensitive electrochemical sensing of nitrite exhibiting a limit of detection as low as 32 nanomolar and a sensitivity of 7.28 µA µM-1 cm-2. Importantly, Cyt-c@Cu-HMHMB is demonstrated to exhibit an excellent electrocatalytic performance toward the 4e pathway oxygen reduction reaction (ORR) with an onset potential of 0.322 V (vs. RHE) and a Tafel slope of 266 mV dec-1. Our findings demonstrate that Cu-HMHMB is an excellent matrix for Cyt-c encapsulation. We anticipate that the entrapment-based technique described here will be applicable to other enzyme systems and Cyt-c for various electrochemical and other applications.

An approach to fabrication of metal nanoring arrays.

Fabrication of tailored nanomaterials with desired structure and properties is the greatest challenge of modern nanotechnology. Herein, we describe a wet chemical method for the preparation of large area metal nanoring arrays. This method is based on self-assembly of polystyrene sphere template on a flat substrate and wicking/reducing metal precursor into the interstices between the template and the substrate. In this article, platinum, gold, and copper nanorings were fabricated by applying 505 nm polystyrene spheres onto highly oriented pyrolytic graphite (HOPG) and Si(100) substrates, followed by reducing the templated metal salt with NaBH(4). AFM images reveal formation of arrays of metal nanorings comprising metal nanoparticles with the average ring height of 5.7 +/- 0.8 nm and diameter of 167.3 +/- 8.9 nm. XPS confirms that these structures are metallic.

Mass transport effects in CO bulk electrooxidation on Pt nanoparticles supported on vertically aligned carbon nanofilaments.

In this work we report on the influence of the catalytic layer architecture on the autocatalytic reaction of CO-bulk oxidation in liquid electrolyte by employing two types of nanomaterials: 2D arrays of Pt particles prepared on the surface of glassy carbon by colloidal lithography and 3D arrays of Pt nanoparticles supported on vertically aligned carbon nanofilaments. Oxidation of dissolved CO is studied experimentally using RDE approach and computationally using finite element method. For the first time, the influence of 3D architecture of the electrode on a complex bistable electrochemical system was investigated. The modelling results are in qualitative agreement with the experiment and explain the influence of nanostructure of the electrodes on such key characteristics of CO electrooxidation as the ignition potential, the width and the shape of the bistability region, and the value of the limiting current. Analysis of the experimental RDE curves suggests spontaneous formation of active and passive reaction zones along the fibre length which is supported by modelling.

Investigating the effect of Integrated Educational Program on the Quality of Life among Cancer Patients: A Clinical Trial Study.

BACKGROUND: cancer is one of the most common causes of death around the world. The process of this disease and the resulting complications reduce the quality of life of cancer patients. Taking the necessary measures for improving the quality of life of these patients seems to be essential. This study was performed to investigate the effect of integrated educational program on the quality of life of cancer patients. METHOD: in this clinical trial study, 64 patients hospitalized in the specialized cancer hospital affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran, were selected according to the inclusion criteria. Then, through blocked randomization method, they were assigned into intervention and control groups. The intervention group received the necessary trainings over four 60-min sessions (one session per week).  The data collection in this study included demographic questionnaire and quality-of-life questionnaire of cancer patients (QLQ-C30). The quality of life was examined before the training as well as one and two months after the training. The data were analyzed by SPSS 20. Independent t-test was used to compare the means of the life quality dimensions of the studied groups. RESULTS: all of the functional dimensions [physical , role function , emotional , cognitive , social(P≤0.05)] and symptomatic [fatigue , nausea and vomiting, pain , dyspnea , sleep disorders, diminished appetite, constipation, and diarrhea (P≤0.05)] of the quality of life of the intervention group increased significantly one and two months after running the integrated educational program. CONCLUSION: integrated training causes improved symptoms and enhanced quality of life in cancer patients. Thus, it is recommended that integrated training be conducted alongside the routine care of cancer patients. This can improve the therapeutic outcomes, and also highlights the important role of nurses as well as nursing cares.

Human T-Lymphotropic Virus Type I (HTLV-1) Infection among Iranian Blood Donors: First Case-Control Study on the Risk Factors.

Human T-cell lymphotropic virus type 1 (HTLV-1) infection is an endemic condition in Northeast Iran and, as such, identification of risk factors associated with the infection in this region seems to be a necessity. All the possible risk factors for HTLV-1 seropositivity among first-time blood donors were evaluated in Mashhad, Iran, during the period of 2011-2012. Blood donation volunteers were interviewed for demographic data, medical history, and behavioral characteristics and the frequencies of risk factors were compared between HTLV-1 positive (case) and HTLV-1 negative (control) donors. The data was analyzed using Chi square and t-tests. Logistic regression analysis was performed to identify independent risk factors for the infection. Assessments were carried out on 246 cases aged 17-60 and 776 controls aged 17-59, who were matched based on their ages, gender, and date and center of donation. Logistic analysis showed low income (OR = 1.53, p = 0.035), low educational level (OR = 1.64, p = 0.049), being born in the cities of either Mashhad (OR = 2.47, p = 0.001) or Neyshabour (OR = 4.30, p < 0001), and a history of blood transfusion (OR = 3.17, p = 0.007) or non-IV drug abuse (OR = 3.77, p < 0.0001) were significant predictors for infection with HTLV-1. Lack of variability or small sample size could be reasons of failure to detect some well-known risk factors for HTLV-1 infection, such as prolonged breastfeeding and sexual promiscuity. Pre-donation screening of possible risk factors for transfusion-transmissible infections should also be considered as an important issue, however, a revision of the screening criteria such as a history of transfusion for more than one year prior to donation is strongly recommended.