Carbon Monoxide Research Articles

Clinical characteristics of chronic obstructive pulmonary disease according to smoking status.

COPD can be caused by various factors, including lung infections, asthma, air pollution, childhood growth disorders, and genetic factors, although smoking is a predominant risk factor. The main pathological mechanisms in COPD involve small airway disease, emphysema, mucus hypersecretion, and vascular disorders. COPD in non-smokers is characterized by normal FEV1 decline, equal distribution of sex, younger age of onset, fewer comorbidities, milder airflow obstruction, normal diffusing capacity of the lungs for carbon monoxide (DLCO) and radiological features such as more air-trapping and less severe emphysema, compared to COPD in smokers. COPD in non-smokers is still accompanied by a high prevalence of acute exacerbation almost equal to COPD in smokers. Moreover, COPD per se is an independent risk factor for the development of lung cancer, irrespective of smoking status. Considering that COPD coexists with numerous comorbidities, effective management of these comorbidities is essential, and multifaceted efforts are required for the comprehensive treatment of COPD.

Carbon Monoxide Intoxication Leading to Crush Syndrome and Acute Renal Failure: A Case Report

Carbon Monoxide Intoxication Leading to Crush Syndrome and Acute Renal Failure: A Case Report

Redox Gradient Shapes the Chemical Composition of Peatland Microbial Communities.

The response of soil carbon to climate change and anthropogenic forcing depends on the relationship between the physicochemical variables of the environment and microbial communities. In anoxic soils that store large amounts of organic carbon, it can be hypothesized that the low amount of catabolic energy available leads microbial organisms to minimize the energy costs of biosynthesis, which may shape the composition of microbial communities. To test this hypothesis, thermodynamic modeling was used to assess the link between redox gradients in the ombrotrophic peatland of the Marcell Experimental Forest (Minnesota, USA) and the chemical and taxonomic composition of microbial communities. The average amino acid composition of community-level proteins, called hereafter model proteins, was calculated from shotgun metagenomic sequencing. The carbon oxidation state of model proteins decreases linearly from -0.14 at 10 cm depth to -0.17 at 150 cm depth. Calculating equilibrium activities of model proteins for a wide range of chemical conditions allows identification of the redox potential of maximum chemical activity. Consistent with redox measurements across peat soils, this model Eh decreases logarithmically from an average value of 300 mV at 10 cm depth, close to the stability domain of goethite relative to Fe2+, to an average value of -200 mV at 150 cm, within the stability domain of CH4 relative to CO2. The correlation identified between the taxonomic abundance and the carbon oxidation state of model proteins enables predicting the evolution of taxonomic abundance as a function of model Eh. The model taxonomic abundance is consistent with the measured gene and taxonomic abundance, which evolves from aerobic bacteria at the surface including Acidobacteria, Proteobacteria, and Verrumicrobia, to anaerobes at depth dominated by Crenarchaeota. These results indicate that the thermodynamic forcing imposed by redox gradient across peat soils shapes both the chemical and taxonomic composition of microbial communities. By providing a mechanistic understanding of the relationship between microbial community and environmental conditions, this work sheds new light on the mechanisms that govern soil microbial life and opens up prospects for predicting geochemical and microbial evolution in changing environments.

COCCON Measurements of XCO2, XCH4 and XCO over Coal Mine Aggregation Areas in Shanxi, China, and Comparison to TROPOMI and CAMS Datasets

This study presents the first column-averaged dry-air mole fractions of carbon dioxide (XCO2), methane (XCH4) and carbon monoxide (XCO) in the coal mine aggregation area in Shanxi, China, using two portable Fourier transform infrared spectrometers (EM27/SUNs), in the framework of the Collaborative Carbon Column Observing Network (COCCON). The measurements, collected over two months, were analyzed. Significant daily variations were observed, particularly in XCH4, which highlight the impact of coal mining emissions as a major CH4 source in the region. This study also compares COCCON XCO with measurements from the TROPOspheric Monitoring Instrument (TROPOMI) onboard the Sentinel-5P satellite, revealing good agreement, with a mean bias of 7.15 ± 9.49 ppb. Additionally, comparisons were made between COCCON XCO2 and XCH4 data and analytical data from the Copernicus Atmosphere Monitoring Service (CAMS). The mean biases between COCCON and CAMS were −6.43 ± 1.75 ppm for XCO2 and 15.40 ± 31.60 ppb for XCH4. The findings affirm the stability and accuracy of the COCCON instruments for validating satellite observations and detecting local greenhouse gas sources. Operating COCCON spectrometers in coal mining areas offers valuable insights into emissions from these high-impact sources.

Post Mortem Molecular Biomarkers of Asphyxia: A Literature Review

Asphyxia is a critical condition characterized by inadequate oxygen supply to the body. Post mortem diagnostics of asphyxia present significant challenges in forensic pathology, particularly when there are equivocal signs during autopsy or uncertain circumstantial data. The identification of biochemical biomarkers that indicate asphyxia has emerged as a promising area of research, as these markers can provide vital insights into the physiological changes occurring at the cellular level during asphyxiation. We performed a review of the scientific literature on the search engines Pubmed and Scopus in order to assess the state of the art on this topic. The aim of this study is to analyze which are the most promising markers and methods in the post mortem diagnosis of asphyxia. The literature review highlighted the great potential that molecular investigations can have in the analysis of this type of death, especially considering that hypoxia determines strong biochemical alterations in response to cellular stress. These changes are marked by specific biochemical alterations, which can be detected through various advanced technologies and methodologies, including mass spectrometry, immunohistochemistry, and metabolomic profiling. The review evidenced a combination of markers that can be used for diagnostic purposes in various cases, including mechanical asphyxia, carbon monoxide (CO) poisoning, perinatal asphyxia, and drowning analysis. However, we highlight that, to date, there are still no standard protocols for forensic biochemistry in asphyxia. By scrutinizing the reliability of identified biomarkers and their potential to reshape forensic investigative practices, this research aims to elucidate the critical role that post mortem biochemical analysis can play in diagnosing asphyxia, ultimately contributing to a more nuanced understanding of death-related scenarios and the development of standardized protocols in forensic examinations.

The Research on Factors Influencing Air Pollution

The rapid development of urbanization contributes to that the people’ life is more and more beautiful and their quality of life is better and better. There are a lot of complex and diversity influencing of air pollutants. This paper finds a lot of articles and reports of government and focus on four air pollutants: carbon monoxide, ozone, nitrogen oxides, and particulate matter, including ultra-fine particles. Air pollution can cause three major environmental problems, including greenhouse effect, acid rain, and ozone hole, which can cause significant damage to the lungs and respiratory tract of the human body, such as chronic lung disease, neurological damage, and heart disease. The purpose of the article is to find some factors that affect air pollution. Using the method of multiple linear regression turns out that there is a significant linear regression relationship between human activities, exhaust emissions from vehicles, ships, airplanes, industrial pollutant, meteorological conditions, landform and PM2.5, while the speed and direction of wind fail the important test.

Investigating uncertainties in air quality models used in GMAP/SIJAQ 2021 field campaign: General performance of different models and ensemble results

The international field campaign, GMAP/SIJAQ 2021, was conducted in Korea from October 18th to November 25th to enhance the performance and validation of the Geostationary Environment Monitoring Spectrometer (GEMS) products algorithm and obtain a better understanding of the current air pollution status of the Korean Peninsula. Five chemical transport models (CTMs), including CMAQ, CMAQ-GIST, CAMx, WRF-Chem, and WRF GEOS-Chem, were utilized during the campaign to assist in organizing the observation plan and identifying changes in pollutant concentrations and their spatiotemporal distribution in Korea following the Korea–United States Air Quality (KORUS-AQ) 2016. In this study, we evaluated the forecasting performance, strengths, and limitations of these five CTMs and their ensemble in simulating air quality. Intensive measurement data and intercomparisons were employed to explain discrepancies between observed and simulated results. A comparison of the CTM ensemble results for PM2.5 and various gaseous pollutants between the current GMAP/SIJAQ 2021 and previous KORUS-AQ 2016 campaigns showed the R-value for the total mass PM2.5 concentration increased from 0.88 to 0.94. This improvement is related to CTM updates, including the emission inventory and better reproductions of the concentrations of gaseous species. However, the models consistently underestimated carbon monoxide (CO) concentrations, similar to the results from KORUS-AQ. This finding still suggests a further challenge that requires consideration of missing anthropogenic sources. The results of the ensemble model agreed well with the chemical composition of PM2.5 observed at the intensive monitoring station. However, for NO3− and NH4+, discrepancies were primarily due to inaccuracies in the meteorological inputs, such as precipitation, relative humidity (RH), and nighttime planetary boundary layer height (PBLH) in the CTMs. Hence, all models overestimated the concentration of elemental carbon (EC), therefore, it is necessary to revise EC emissions in the SIJAQv2 inventory, as these apply to unusual levels recorded in Seoul during the reference year of 2018.

Разложение аммиака на Co-Al2O3 /SiO2 катализаторах: влияние способов восстановления кобальта

The focus on "green" energy requires the search for environmentally friendly energy storage systems. The reason for choosing ammonia as a potential storage for hydrogen is its high energy capacity and the absence of carbon and nitrogen oxide emissions during decomposition. Herein, we tested Co-Al2O3/SiO2 ammonia decomposition catalysts that had been pre-activated via cyclic hydrogenation-carburization-hydrogenation (RCR) and reduction-oxidation-reduction (ROR) procedures versus the conventional cobalt oxides reduction with hydrogen (R). The samples were characterized by H2-TPR, TEM and synchrotron X-ray diffraction techniques, which revealed that the structural properties of the catalysts were not modified by the reaction. Since the activities of the tested catalysts and the effective reaction barriers appeared to be close, the easiest-to-prepare catalyst R was chosen for the long-term catalytic trial (500 h), and it showed excellent performance stability.

Homogeneous Catalysts of RedOx Processes Based on Heteropolyacid Solutions. VI: Developing a Process for Low-Temperature Oxidation of CO with Oxygen

Research on the development of a homogeneous process for low-temperature oxidation of carbon monoxide in the presence of a “platinum group metal + vanadium-containing heteropolyacid (HPA)” catalytic system has been presented. The optimal reaction conditions, ensuring the maximum rate of CO oxidation to CO2, have been determined; for this reaction the kinetic features have been established, and its mechanism has been proposed. It has been shown that homogeneous systems based on PdII complex exhibit high activity and productivity, but have low stability and operate only at pH below 1,5. The stability of the catalyst can be increased by simultaneous introduction of σ- and π-donor ligands into the system; however, it is more effective to use the PtIV complex in the presence of catalytic amounts of palladium salt at a ratio of 100/1. The transition from HPA solutions with a low content of vanadium atoms (H7PMo8V4O40) to solutions of modified compositions (H10P3Mo18V7O84) ensures an increase in the activity and productivity of the system, with the kinetics of CO oxidation being maintained. The combined homogeneous catalyst PtIV + PdII + H10P3Mo18V7O84 remains stable during multi-cycle use without reducing activity, operates without an induction period and can be used at pH range of 1,7–2,0, which simplifies the process equipment.

Highly sensitive and room-temperature operable carbon dioxide gas sensor based on spin-coated Sn-doped Co3O4 thin films with advanced recovery properties

The urgency to address climate change has highlighted the need for gas sensors capable of monitoring air quality at room temperature (RT) and accurately measuring the concentrations of carbon oxides (CO2 and CO) in the environment. This study details the development of a highly sensitive CO2 gas sensor using spin-coated Sn-doped Co3O4 thin films, operating at a room temperature of 30⁰C and a relative humidity (RH%) of 43 %. Extensive characterization employing XRD, SEM, EDX, FTIR, and UV–Vis optical techniques verified the impact of Sn doping on the surface morphology, phase purity, and a notable reduction in the dual-band gap of the thin films. Gas sensing measurements were conducted at RT using varying CO2 gas concentrations. A sensor response of 796.81 % was obtained for the optimally sensitive film, 10 % Sn-doped Co3O4, at a CO2 concentration of 9990 ppm. Additionally, a range of RH % levels was examined at a constant CO2 gas concentration of 9990 ppm, revealing an optimal humidity level of 43 % at RT. Further analysis revealed that the 10 % Sn-Co3O4 sensor displayed enhanced sensitivity to CO2, surpassing its response to N2, H2, and NH3 gases. The determined limits of detection and quantification underscore the sensor's precision and reliability in quantifying CO2 gas concentrations. Our findings demonstrate the excellent potential of Sn-doped Co₃O₄ thin films as highly sensitive CO₂ gas sensors. These films provide a promising solution for detecting elevated CO₂ levels at room temperature, aiding climate change mitigation efforts.

Characterizing Aircraft Exhaust Emissions and Impact Factors at Tianjin Binhai International Airport via Open-Path Fourier-Transform Infrared Spectrometer

The growth of the civil aviation industry has raised concerns about the impact of airport emissions on human health and the environment. The aim of this study was to quantify the emissions of sulfur dioxide (SO2), nitrogen oxides (NOX), and carbon monoxide (CO) from in-service aircraft via open-path Fourier-transform infrared (OP-FTIR) spectroscopy at Tianjin Binhai International Airport. The results suggest that the CO and NOX emission indices (EIs) for five common aircraft/engine combinations exhibited substantial discrepancies from those reported in the International Civil Aviation Organization (ICAO) databank. Notably, during the idling, approach, and take-off phases, the CO EIs exceeded the ICAO’s standard values by (11.04 ± 10.34)%, (56.37 ± 18.54)%, and roughly 2–5 times, respectively. By contrast, the NOX EIs were below the standard values by (39.15 ± 5.80)%, (13.57 ± 3.67)%, and (21.22 ± 4.03)% in the same phases, respectively. The CO and NOX EIs increased by 31–41% and decreased by 23–24%, respectively, as the ambient temperature decreased from −3 °C to −13 °C. This was attributed to lower temperatures reducing fuel evaporation, leading to inefficient combustion and increased CO emissions and lowering the combustion temperature and pressure, resulting in reduced NOX emissions. The CO EIs had a positive correlation with humidity (adjusted R2: 0.715–0.837), while the NOX EIs were negatively correlated with humidity (adjusted R2: 0.758–0.859). This study’s findings indicate that humidity is a crucial factor impacting aircraft exhaust emissions. Overall, this research will contribute to the development of scientifically informed emission standards and enhanced environmental management practices in the aviation sector.

A Comparative Study of Hydrothermally Leached Al3TM and Al3TM-Rh (TM=Zr, V, Ce) Intermetallic Compounds for Catalytic Oxidation of Carbon Monoxide.

Rise of the mute assassin "carbon monoxide (CO)" levels impact all aerobic life. The elevated rates of CO concentration endure climatic and geographical characteristics that exacerbate air pollution. Herein, a simple approach for hydrothermal leaching (HyTL) of Al3TM-Rh0.5 (Target material (TM)=Zr, V, Ce) and Al3TM (TM=Zr, V, Ce) intermetallic compounds produces leached products of ZrO2, VO2, and CeO2 with Rhodium (Rh) as an active component. The characterization result reveals the HyTL process and the presence of the active Rh element that elevated the performance of HyTL-Al3Zr-Rh0.5 towards CO conversion compared to other samples. Further, the cubic ZrO2 phase selectively forms after HyTL at 130 °C even though the formation of the cubic ZrO2 phase takes place at a high temperature. Moreover, the presence of Rh promotes higher catalytic activity in all the cases with low temperatures. The advancement in the present study towards the catalytic oxidation of CO over the hydrothermally leached ZrO2-Rh nanocatalyst guarantees the perspective of the aggregation-activation process.

Characterising the Chemical Composition of Bushfire Smoke and Implications for Firefighter Exposure in Western Australia

This study evaluates bushfire smoke as a workplace hazard for firefighters by characterising its chemical composition and potential health risks in Western Australia. Portable Fourier Transform Infrared (FTIR) spectrometry was used to measure airborne chemical concentrations at prescribed burns across five regions, including peat (acid sulphate) fire events. Samples were collected during both flaming and smouldering phases, as well as in perceived “clear” air resting zones. Results indicated that carbon monoxide (CO) was the dominant gas, reaching concentrations of 205 ppm at the fire front, followed by nitrogen monoxide (26 ppm) and methane (19 ppm). Peat fires produced distinct profiles, with ammonia (21.5 ppm) and sulphur dioxide (9.5 ppm) concentrations higher than those observed in typical bushfires. Smouldering phases emitted higher chemical concentrations than flaming phases 75% of the time. Even clear air zones contained measurable chemicals, with CO levels averaging 18 ppm, suggesting that firefighters are not free from exposure during rest periods. These findings highlight the need for fit-for-purpose respiratory protective equipment (RPE) and improved rest protocols to minimise exposure. The study underscores the importance of comprehensive health monitoring programs for firefighters to mitigate long-term health risks.

Age and sex differences in the effects of short- and long-term exposure to air pollution on endothelial dysfunction

Abstract Background Endothelial dysfunction is an integrated index of risk factor burden and a marker of atherosclerotic cardiovascular disease. Air pollution is widely acknowledged as a significant non-traditional risk factor for cardiovascular disease. However, the impact of air pollutants at varying concentrations and exposure durations on endothelial function in different populations remains unclear. Purpose We aimed to use brachial artery flow-mediated dilatation (FMD) to identify demographic differences in the effects of short- and long-term exposure to air pollution on endothelial dysfunction. Methods We measured FMD in 850 participants from October 2016 to January 2020. Location-specific concentrations of fine particulate matter <2.5 μm aerodynamic diameter (PM2.5), inhalable particulate matter <10 μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) measured by fixed ambient air monitoring stations were collected for short- and long-term exposure assessment. We used the moving average 7- and 14-day exposures before the date of FMD measurements to estimate the short-term exposure effects and the moving average 12-month exposures before the date of FMD measurements to estimate the long-term exposure effects. Multiple linear regression models and restricted cubic splines were used to assess the associations before and after stratified by age and sex. Results This study eventually included 828 participants [551 (66.5%) younger than 65 years and 553 (66.8%) men]. Each 10 μg/m³ increase in 12-month exposure to PM10 and NO2 was significantly and linearly associated with -0.20% (95% CI: -0.37 to -0.03) and -0.58% (95% CI: -0.99 to -0.18) changes in FMD in all participants. 12-month exposure to gaseous pollutants was also significantly but nonlinearly associated with lower FMD. 7-day exposure to Quartile 4 of SO2 was significantly associated with a 0.70% decrease in FMD compared to Quartile 1 (β = -0.70, 95% CI: -1.40 to -0.008). No relationships were observed between 7- and 14-day exposure to PM2.5, PM10, NO2, CO, and endothelial dysfunction. Although interaction effects were limited to SO2 and sex, significant associations with different air pollutants were only found in men and those younger than 65 years after stratified. Conclusions Long-term exposure to air pollution is strongly associated with decreased endothelial function, and susceptibility to air pollution varies significantly with age and sex. Further identification of different susceptible populations and proactive measures to mitigate air pollution may be beneficial in reducing the burden of cardiovascular disease.

Sources and determinants of exposure to indoor air pollutants in schools and hospitals: a review

Abstract Background Indoor Air Quality (IAQ) is an important determinant of health. This study aimed to review the available scientific evidence about indoor pollutants and determinants of exposure in several settings, in the scope of the K-HEALTHinAIR project. Methods The systematic review was performed for the sources, concentrations, and determinants of pollutants in schools in the European region for 2013-2023. Articles were selected for data extraction if they were epidemiological studies, reported primary data for indoor air and pollutant levels, and, identified sources and determinants of exposure. Results The main pollutants affecting IAQ in schools and hospitals were carbon dioxide, volatile organic compounds (e.g., formaldehyde, terpenes), particulate matter, nitrogen dioxide, radon, ozone, and carbon monoxide. Besides the outdoor environment, several important indoor sources of emissions were identified such as occupancy, resuspension, cleaning products. Ventilation was the main determinant influencing the indoor levels of pollutants, stressing the importance of good planning, installation, and maintenance of mechanical ventilation systems in buildings. Other determinants were the number of occupants and their activities, and the building characteristics (e.g., type of floor, location, etc). Conclusions Results revealed indoor air quality as a public health concern since several pollutants are present in indoor settings. The identification of sources and determinants of exposure is fundamental for determining preventive measures in a public health perspective. Acknowledgments: K-HEALTHinAIR team for screening and data extraction: Mariana Corda, Jose Fermoso, Alicia Aguado, Sandra Rodriguez, Hanns Moshammer, Mireia Ferri, Belén Costa, Leticia Pérez, Wojciech Hanke, Artur Badyda, Piotr Kepa, Katarzyna Affek, Nina Doskocz, Laura Martín, Oguz Mulayim, Cesar Mediavilla Martinez, Alba Gómez, Ruben González, Isaac Cano, Josep Roca, Simon de Leede.

Conditional over-expression of heme-oxygenase 1 in myelomonocytic cells reduces AngII-induced hypertension and vascular inflammation in mice

Abstract Background Systemic arterial Hypertension is one of the most important risk factor responsible for morbidity and mortality world-wide. Angiotensin II (Ang II), a potent vasoconstrictor and key player in the renin-angiotensin-aldosterone system (RAAS) is responsible for vascular dysfunction, inflammation, and tissue damage. Heme oxygenase-1 (HO-1) overexpression may confer antioxidant and anti-inflammatory properties in Ang II-induced hypertension through its action on heme catabolism, generating carbon monoxide (CO), ferritin and biliverdin/bilirubin by the action of biliverdin reductase A (BLVRA). Methods and results Male 9–12-weeks-old HO-1indxLySMCre/wt and LySMCre/wt mice were infused with AngII (1mgAngII/Day/Kg) for 7 days to induce hypertension and compared to sham treatment. Blood pressure monitoring by tail-cuff method, and endothelium-dependent vasodilator studies via organ chamber system using acetylcholine (ACh) in isolated aortic segments (~4 mm), revealed that overexpression of HO-1 in myeloid cells resulted in decreased systolic blood pressure and improved endothelial function in AngII-infused HO-1indxLySMCre/wt mice compared to controls. Concurrently, increased BLVRA expression in liver tissue and elevated plasma bilirubin levels were detected by transcriptome analysis and high-performance liquid chromatography, respectively. These results were supported by a reduction in the expression of inducible cytokines and cell adhesion molecules (CAMs) in the aorta, assessed using qPCR. Bone marrow transplant experiments demonstrated that bone marrow from LysMcre mice in HO-1indxLySMCre/wt mice abrogated the protective effect of HO-1, resulting in endothelial damage and increased blood pressure, potentially due to decreased liver BLVRA expression and the accumulation of bone marrow-derived cells in the vessel wall in response to AngII. Additionally, adeno-associated viral vector (AAV) transfection targeting specifically BLVRA activity in liver lead to an increase in blood pressure values and worse endothelium relaxation, in parallel with higher oxidative stress and the blood neutrophils concentration, as assessed in whole blood by using oxidative burst method and blood count system respectively. Conclusion The overexpression of HO-1 in myeloid cells confers anti-inflammatory protection in AngII-induced arterial hypertension in mice. Myeloid cells bone marrow-derived overexpressing HO-1 regulate the differentiation and infiltration of pro-inflammatory immune cells in the vasculature. BLVRA expression and bilirubin levels downstream of HO-1 play a critical role in protecting against vascular damage by reducing leukocyte infiltration.

An Innovative Fuel Design for HTGRs: Evaluating a 10-Hour High-Temperature Oxidation of the SiC Fuel Matrix During Air Ingress Accident Conditions

Preventing severe corrosion incidents caused by air ingress accidents in high-temperature gas-cooled reactors (HTGRs) while improving heat removal efficiency from the core is of paramount importance. To enhance both safety and efficiency, a sleeveless silicon carbide (SiC)-matrix fuel compact has been proposed. This study evaluates the 10-hour oxidation of reaction-sintered SiC (RS-SiC)-matrix fuel compact under the conditions of an air ingress accident within the temperature range of 1000 to 1400 °C. The oxidation tests were conducted in a stagnant air environment without flow. As a result, it is demonstrated that RS-SiC exhibits exceptional resistance to air oxidation up to 1400 °C, as shown by the thermogravimetric analysis (TGA), with minimal mass loss due to the oxidation of free carbon. Scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM–EDX) analysis reveals that the morphology and thickness of the SiO2 layer formed on the RS-SiC surface vary with temperature. At 1400 °C, uniform oxide layer thickness ranging from 1.59 to 4.10 μm and localized nodule-like oxide formations of approximately 10 μm are observed. In contrast, at 1000–1200 °C, thinner oxide layers are identified, indicating that oxide growth accelerates at higher temperatures. The oxidation rates measured provide insights into the mechanisms of oxide growth.

Beyond Injuries: February 6th Kahramanmaras Earthquakes and Other Patients Transported by Ambulance.

This study evaluates the Emergency Medical Service system and overall emergency preparedness by analyzing ambulance-transported patients during the February 6, 2023 earthquakes, focusing on those without earthquake-related injuries (medical emergencies and traumas not caused by earthquakes). A retrospective, observational case series was conducted, involving patients aged 18 and above transported by ambulance between February 6 and March 6, 2023. Patient demographic characteristics, vital signs, diagnoses, treatments, and outcomes were recorded. Predisposing factors for ambulance transportation including post-earthquake health facility issues, housing problems, hygiene, heating, and smoke exposure were meticulously analyzed. The study included 1872 patients, with a 55.4% hospitalization rate and a 13.7% mortality rate. Cardiovascular emergencies were the primary reason for admission (28.9%). Patients from the hospital in the study's location form Group 1, whereas those from other earthquake-affected provinces constitute Group 2. Significant predisposing factors for ambulance transportation included post-earthquake health facilities (P < 0.001), housing problems (P < 0.001), hygiene (P < 0.001), heating (P = 0.001), and smoke exposure (P < 0.001). In Group 2, pneumonia (P = 0.001), soft tissue infection (P = 0.002), sepsis (P = 0.004), carbon monoxide poisoning (P < 0.001), and diabetic emergencies (P = 0.013) were statistically significantly more frequent. Analyzing post-earthquake ambulance-transported patients is vital to comprehend the demand for emergency health care and address post-disaster health care challenges.

Living with a chronic disease: tertiary prevention tools in asbestos-exposed patients

Abstract Background The main asbestos-related pathology is asbestosis, frequently associated with pleural plaques. The spirometric pattern is mainly restrictive, with reduction in all lung volumes (FEV1, FVC, TLC). Also a reduction in alveolus-capillary diffusion of carbon monoxide (DLCO) may be added, related to the fibrotic process. The aim of the study is to analyze the health surveillance data, correlating the spirometric finding and its variation over time with the clinical and radiological picture. Methods The study is conducted on 372 patients with asbestosis from occupational exposure diagnosed in the period 2017-2023, as part of the Tuscany Region’s program for former asbestos exposures (DGR 396/2016). The investigation is at the second level of surveillance, which includes chest CT and Respiratory Functionality Testing (RFT). Data are obtained from patients’ medical records and processed through a database. Results Out of 372 patients with asbestosis, 213 had pleural plaques (57.25%). Out of those, there is a progressive worsening of RFTs in a restrictive direction (TLC &amp;lt;80%, FEV1/FVC &amp;gt;70%) in 71 patients (33.3%), with a mean TLC loss of 8.7 ± 5.9 mL over subsequent follow-ups on a yearly basis. The FEV1/FVC ratio also declines, with a mean reduction of 5 ± 2.4%. Out of those 71 patients, 14 (19.7%) also show a mean reduction in DLCO of 6.7 ± 5 mL/min/mmHg. The negative trend in RFTs correlates with the worsening clinical and radiological picture attributable to the occurrence of plaques on a fibrotic framework. Conclusions The health surveillance protocol that we adopted has as objective the ascertainment of pulmonary pleura-parenchymal alterations correlated with occupational exposure, investigating their evolution over time through the analysis of spirometric data, and to optimize the management of the functional disability, with a view to the tertiary prevention of patients with asbestos-related disease. Key messages • The negative trend in asbestosis PFRs correlates with the worsening of the clinical and radiological picture attributable to the appearance of pleural plaques on an interstitial fibrosis. • Health surveillance is essential in order to optimize the management of functional disability, with a view to tertiary prevention of patients with asbestos-related disease.

Differential effects of heat-not-burn, electronic cigarettes and conventional cigarettes on endothelial glycocalyx

Abstract Background Heat-not-burn cigarette (HNBC) and electronic cigarette (Ecig) constitute non-combustible smoke products. Their effect on endothelial glycocalyx has not been investigated so far. Patients and Methods: Out of 100 subjects attending smoking cessation clinic: α) 50 smokers were randomized to usage of HNBC (n=25) or Ecig (n=25) and β) 50 smokers were used as control group. Participants randomized to the newer tobacco products had similar clinical and demographic characteristics to the control group. Smoking status was verified by measuring the concentration of exhaled carbon monoxide [(e CO) (ppm), Bedfont Scientific, Maidstone, Kent UK]. Perfused Boundary Region (PBR), which is inversely related to endothelial glycocalyx thickness in sublingual arterioles (range 5–25 μm) and blood levels of cotinine, a stable metabolite of nicotine, was assessed in all participants. Exhaled CO, endothelial glycocalyx, and blood cotinine were assessed at baseline and after 1 month. Results Conventional cigarette smokers were aged: 48 ± 5 years, 53% female and used 27 ± 9 cigarettes/day, 29 ± 9 pack-years. HNBC users were aged: 46 ± 14 years, 55% female and used 26 ± 8 cigarettes/day, 30 ± 8 pack-years. Ecig users were aged: 45 ± 8 years, 51% female and used 27 ± 10 cigarettes/day, 28 ± 10 pack-years. Compared to baseline, switching to HNBC for 1 month improved only PBR20-25 (2.55±0.49 vs 2.34±0.34 μm, p=0.002). Ecig use did not alter endothelial glycocalyx in any range of microvessels throughout the study (p&amp;gt;0.05). In contrast, Tcig smoking for one month further worsened endothelial glycocalyx in all microvessels ranges compared to baseline (p&amp;lt;0.05). Blood cotinine levels were similar at baseline and after 1 month using HNBC (p=0.432), Ecig (p=0.535) or conventional cigarette (p=0.489). Compared to baseline, exhaled CO decreased in HNBC or Ecig users (mean percent change: -55% and -58% respectively p&amp;lt;0.001), while remained unchanged in Tcig smokers (p=0.312) at 1 month. Thus, Tcig smokers had higher CO than those who switched to HNBC or E-cig after one month (p&amp;lt;0.01). Conclusion Conventional cigarette users further worsened endothelial glycocalyx after continuing to smoke for one month. In contrast, smokers who switched to Ecig maintained glycocalyx integrity, while those who switched to HNBC showed modest improvement in glycocalyx integrity in microvessels ranging from 20 to 25 μm. Cotinine levels, which reflect nicotine exposure, were similar between the Tcig, HNBC and Ecig groups. Thus, endothelial glycocalyx impairment in the conventional cigarette group was independent of nicotine consumption and possibly related to greater exposure to toxic emissions, such as CO, after Tcig use than after switching to HNBC or Ecig.