Continuous Oxygen Research Articles

Understanding patient experience of chronic cough in interstitial lung disease

Chronic cough is a common symptom in patients with interstitial lung disease (ILD), negatively contributing to health-related quality of life. Despite this, there is limited information and understanding on the experience of this group of patients with chronic cough. This study aimed to explore the symptom experiences for chronic cough in patients with ILD to identify its characteristics and impacts. A qualitative study using semi-structured telephone interviews was undertaken in 16 adults with a diagnosis of ILD of any type and severity. Patients were recruited from a quaternary referral centre in Melbourne, Australia. Interviews were transcribed verbatim and coded by two researchers using thematic analysis. Patients (age range: 39-87 years, forced vital capacity: 53-107% predicted and diffusing capacity of the lung for carbon monoxide: 28-89% predicted) experienced a spectrum of cough severity and characteristics, including both dry and productive coughs. The impact of chronic cough included physical symptoms, social and emotional difficulties, and interference with work and vocational participation. Management strategies used to relieve cough included mucolytics, opiates, throat lozenges, warm drinks, pacing, breath control, relaxation exercises, movement, continuous positive airways pressure and supplemental oxygen. Patients expressed a need for further information and education regarding chronic cough, including its triggers and management. This study highlights the experience and significance of chronic cough in patients with ILD. The nature and severity of chronic cough in patients with ILD appears to be more heterogeneous than previously described, with physical, social and emotional impacts contributing to symptom burden.

High-Flow Nasal Oxygen versus Continuous Positive Airway Pressure in patients with hypoxemic acute respiratory failure due to pneumonia

PurposeNo study has ever compared Continuous Positive Airway Pressure (CPAP) and High Flow Nasal Oxygen (HFNO) in adult patients with hypoxemic acute respiratory failure (h-ARF) due to pneumonia. For this reason, our study used a retrospective analysis to assess patients admitted to an IMCU with a diagnosis of hypoxemic acute respiratory failure secondary to pneumonia. The aim was to determine whether CPAP, as compared with HFNO, could reduce the rate of intubation and improve some outcomes. Materials and methodsA retrospective analysis reviewing all patients admitted in our IMCU with a diagnosis of h-ARF and oxygenated by CPAP or HFNO was carried out. The inclusion criteria were: a PaO2/FiO2 ratio of 300 mmHg or less; a PaCO2 not higher than 45 mmHg; and a diagnosis of pneumonia as the only cause of h-ARF. The study analyzed two groups of patients (CPAP and HFNO), matched for age, SAPS II score, SOFA score, and PaO2/FiO2 ratio before the start of oxygenation by CPAP or HFNO. Main outcomesThe primary outcome was the proportion of patients who required intubation secondary to a failure of treatment by CPAP or HFNO at 28 days. Secondary outcomes were mortality in the IMCU, mortality at 90 days, the length of IMCU and hospital stay, and the duration of HFNO/CPAP treatment. ResultsIn total, 45 patients were eligible for inclusion in the study, and all were included in the analysis — 18 patients in the CPAP group and 27 in the HFNO group. There was no significant difference in intubation rates between the two groups (OR 0.57, 0.13–2.58, p = 0.47). The rate of IMCU mortality was 17% in the CPAP group and 7% in the HFNO group (OR 2.5, 0.37–16.72, p = 0.34), and the rate of mortality at 90 days was 28% in the CPAP group and 22% in the HFNO group (OR 1.34, 0.34–5.32, p = 0.67). ConclusionsOur analysis showed that CPAP, when compared with HFNO, did not reduce intubation and mortality rates in patients affected by hypoxemic acute respiratory failure due to pneumonia.

Molecular Cluster Complex of High-Valence Chromium Selenide Carbonyl as Effective Electrocatalyst for Water Oxidation

Developing simple, affordable, and environmentally friendly water oxidation electrocatalysts with high intrinsic activity and low overpotential continues to be an area of intense research. In this article, a trichromium diselenide carbonyl cluster complex (Et4N)2[Se2Cr3(CO)10], with a unique bonding structure comprising bridging Se groups, has been identified as a promising electrocatalyst for oxygen evolution reaction (OER). This carbonyl cluster exhibits a promising overpotential of 310 mV and a low Tafel slope of 82.0 mV dec−1 at 10 mAcm−2, with superior durability in an alkaline medium, for a prolonged period of continuous oxygen evolution. The mass activity and turnover frequency of 62.2 Ag−1 and 0.0174 s−1 was achieved, respectively at 0.390 V vs. RHE. The Cr-complex reported here shows distinctly different catalytic activity based on subtle changes in the ligand chemistry around the catalytically active Cr site. Such dependence further corroborates the critical influence of ligand coordination on the electron density distribution which further affects the electrochemical activation and catalytic efficiency of the active site. Specifically, even partial substitution with more electronegative substituents leads to the weakening of the catalytic efficiency. This report further demonstrates that metal carbonyl chalcogenides cluster-type materials which exhibit partially occupied sites and high valence in their metal sites can serve as catalytically active centers to catalyze OER exhibiting high intrinsic activity. The insight generated from this report can be directly extrapolated to 3-dimensional solids containing similar structural motifs, thereby aiding in optimal catalyst design.

Blood Pressure Responses to Postexercise Circulatory Occlusion Are Attenuated After Exercise-Induced Muscle Weakness.

Exercise blood pressure (BP) responses are thought to be determined by relative exercise intensity (percent maximal voluntary contraction (MVC) strength). However, cross-sectional studies report that during a static contraction, higher absolute force is associated with greater BP responses to relative intensity exercise and subsequent muscle metaboreflex activation with postexercise circulatory occlusion (PECO). We hypothesized that a bout of unaccustomed eccentric exercise would reduce knee extensor MVC and subsequently attenuate BP responses to PECO. Continuous BP, heart rate, muscle oxygenation, and knee extensor electromyography were recorded in 21 young healthy individuals (female, n = 10) during 2 min of 20% MVC static knee extension exercise and 2 min of PECO, performed before and 24 h after 300 maximal knee extensor eccentric contractions to cause exercise-induced muscle weakness. As a control, 14 participants repeated the eccentric exercise 4 wks later to test whether BP responses were altered when exercise-induced muscle weakness was attenuated via the protective effects of the repeated bout effect. Eccentric exercise reduced MVC in all participants (144 ± 43 vs 110 ± 34 N·m, P < 0.0001). BP responses to matched relative intensity static exercise (lower absolute force) were unchanged after eccentric exercise ( P > 0.99) but were attenuated during PECO (systolic BP: 18 ± 10 vs 12 ± 9 mm Hg, P = 0.02). Exercise-induced muscle weakness modulated the deoxygenated hemoglobin response to static exercise (64% ± 22% vs 46% ± 22%, P = 0.04). When repeated after 4 wks, exercise-induced weakness after eccentric exercise was attenuated (-21.6% ± 14.3% vs -9.3 ± 9.7, P = 0.0002) and BP responses to PECO were not different from control values (all, P > 0.96). BP responses to muscle metaboreflex activation, but not exercise, are attenuated by exercise-induced muscle weakness, indicating a contribution of absolute exercise intensity on muscle metaboreflex activation.

Modeling and tuning of glucose oxidase‐catalase system incorporating dissolved oxygen concentration

AbstractBACKGROUNDGluconic acid production by a glucose oxidase (GOx) and catalase (CAT) system has been proposed. However, the bioprocess optimal design and operation are limited by the lack of kinetic models of GOx involving oxygen as substrate. Herein, the GOx‐CAT system is modeled considering a continuous oxygen supply at a bioreactor lab scale. Initially, experiments and modeling for parameter estimations of and the individual enzymes were conducted. Then, experiments and modeling for the GOx‐CAT system were performed for final model tuning. Additionally, the model quality was evaluated, allowing for a deeper understanding of the system phenomenology.RESULTSFrom the oxygen transport model tuning, a highly accurate estimation was obtained (&gt;0.98 and confidence interval &lt;2%). The highest oxygen transport rate was obtained for the combined system Buffer‐antifoam‐GOx‐CAT that was 2.5 times larger than that obtained for DI water. Kinetic models for the individual enzymes were very accurate and the parameters were fully identifiable. For the integrated system, the gluconic acid evolution was properly predicted and there was a loss of predictive power for the oxygen model. Parameter identifiability analysis showed that and interpretability was compromised. However, the sensitivity analysis indicated that the model must not be simplified.CONCLUSIONHerein its has been demonstrated that is a complex parameter to be estimated for multi‐enzymatic systems due to its dependency on medium composition, particularly with GOx. Nonetheless, based on the acceptable model predictive power, the calculated parameters could be used for studies on the process design phase. © 2023 The Authors. Journal of Chemical Technology and Biotechnology published by John Wiley &amp; Sons Ltd on behalf of Society of Chemical Industry (SCI).

Awake Fiberoptic Intubation

We may have many devices in this 21st century, which can be used to secure the airway in patients who have been predicted to have a difficult airway. There are many studies about difficult airways and suggested various devices such as flexible fiberoptic scope, video laryngoscope, and the specialized intubating laryngeal mask airway and they ended up concluding one device better than another. Furthermore, ET intubation requires continued practice and carries with it its own set of complications. Technical problems with the placement of endotracheal tubes have been the most frequent cause of anesthetic deaths in published analyses from all over the world. The basic responsibility of an anesthesiologist is to maintain adequate gas exchange in patients by securing a patent airway through a proper device. Fiberoptic bronchoscopy and intubation have the advantage of being easier, with shorter intubation time and continuous oxygenation and ventilation throughout the procedure, especially in the case of children. We report two such cases, where “Awake flexible fiberoptic-guided intubation” was considered the only desirable choice.

Rational Synthesis of Core-Shell-Structured Nickel Sulfide-Based Nanostructures for Efficient Seawater Electrolysis.

Versatile electrocatalysis at higher current densities for natural seawater splitting to produce hydrogen demands active and robust catalysts to overcome the severe chloride corrosion, competing chlorine evolution, and catalyst poisoning. Hereto, the core-shell-structured heterostructures composed of amorphous NiFe hydroxide layer capped Ni3 S2 nanopyramids which are directly grown on nickel foam skeleton (NiS@LDH/NF) are rationally prepared to regulate cooperatively electronic structure and mass transport for boosting oxygen evolution reaction (OER) performance at larger current densities. The prepared NiS@LDH/NF delivers the anodic current density of 1000mA cm-2 at the overpotential of 341mV in 1.0m KOH seawater. The feasible surface reconstruction of Ni3 S2 -FeNi LDH interfaces improves the chemical stability and corrosion resistance, ensuring the robust electrocatalytic activity in seawater electrolytes for continuous and stable oxygen evolution without any hypochlorite production. Meanwhile, the designed Ni3 S2 nanopyramids coated with FeNi2 P layer (NiS@FeNiP/NF) still exhibit the improved hydrogen evolution reaction (HER) activity in 1.0m KOH seawater. Furthermore, the NiS@FeNiP/NF||NiS@LDH/NF pair requires cell voltage of 1.636V to attain 100mA cm-2 with a 100% Faradaic efficiency, exhibiting tremendous potential for hydrogen production from seawater.

Oxygen Nanobubble-Loaded Biochars Mitigate Copper Transfer from Copper-Contaminated Soil to Rice and Improve Rice Growth

Copper (Cu)-contaminated paddy soil has caused substantial concerns for human health through biomagnification in the soil–rice–human chain. In this study, oxygen nanobubble-loaded biochars (ONBC), including pyrochars (NPC) and hydrochars (NHC), were used to amend Cu-contaminated paddy soils and reduce rice Cu toxicity. The ONBC amendment improved the rhizospheric redox potential and dissolved oxygen concentration via slow, continuous oxygen release, promoting root iron plaque formation and effectively inhibiting root Cu influx. Moreover, the ONBC amendment improved soil microbial diversity. The abundance of bacterial genes involved in cytosolic Cu complexation and Cu export to the periplasm space for Cu stabilization markedly improved. The sequestered Cu in root iron plaque and soil bacteria inhibited Cu influx into the shoots to avoid Cu overaccumulation in the edible parts. This was reflected by the Cu content decreasing by 1.91-fold and 2.38-fold in shoots under NPC and NHC treatments, respectively. Furthermore, the improved oxygen-enriched rhizosphere environment via the ONBC amendment promoted root activity and the abundance of bacterial genes involved in nutrients mineralization, further promoting shoot biomass by 1.46-fold and 2.29-fold under NPC and NHC treatments, respectively. This study proposes an environmentally friendly strategy to mitigate Cu transfer from soil to crops and improve crop productivity.

Early Skin-to-Skin Contact in Preterm Infants: Is It Safe? An Italian Experience.

Skin-to-skin contact (SSC) is one of the four components of kangaroo care (KC) and is also a valued alternative to incubators in low-income countries. SSC has also become a standard of care in high-income countries because of its short- and long-term benefits and its positive effect on infant growth and neurodevelopmental outcome. However, barriers in the implementation of SSC, especially with preterm infants, are common in NICUs because parents and health care professionals can perceive it as potentially risky for the clinical stability of preterm infants. Previous studies have assessed safety before and during SSC by monitoring vital parameters during short-time intervals. To demonstrate the safety of early SSC in preterm infants during at least 90 min intervals. Prospective observational monocentric study. Preterm infants born between June 2018 and June 2020 with a gestational age of ≤33 weeks and a birth weight of <2000 g were monitored while performing an SSC session during the first three weeks of life. Infants with necrotizing enterocolitis, sepsis, and congenital malformations on mechanical ventilation or with more than five apneas in the hour before SSC were excluded. Continuous oxygen saturation (SaO2), heart rate (HR), and respiratory rate (RR) were registered during an SSC session and in the hour before. The minimum duration of an SSC session was 90 min. Information regarding postmenstrual age (PMA), body weight, respiratory support, presence of a central venous catheter and the onset of sepsis within 72 h after a session was collected. Two physicians, blinded to infant conditions and the period of analysis (before or during SSC), evaluated desaturation episodes (SaO2 < 85%, >15 s), bradycardia (HR < 100, >15 s) and apneas (pause in breathing > 20 s associated with desaturation and/or bradycardia). A Wilcoxon rank sum test was used for the statistical analysis. In total, 83 episodes of SSC were analyzed for a total of 38 infants. The mean gestational age at birth was 29 weeks (range 23-33 weeks). Median PMA, days of life, and body weight at SSC were 31 weeks (range 25-34 weeks), 10 days (range 1-20 days), and 1131 g (range 631-2206 g), respectively. We found that 77% of infants were on respiratory support and 47% of them had a central venous catheter (umbilical or peripherally inserted central catheter) during SSC. The total duration of desaturation, bradycardia, and the number of apneas were not statistically different during the SSC session and the hour before. No catheter dislocation or ruptures were reported. These findings highlighted the safety of early SSC in preterm infants and the possibility of performing it in an intensive care setting in the first weeks of life. In addition, these findings should reassure health care professionals offering this practice as a standard of care. SSC plays a key role in the care of preterm infants due to its short- and long-term positive benefits, and it deserves to be increasingly offered to infants and their parents.

Methodical control of the difficult pediatric airway: two case reports

BackgroundManagement of children who present with a history of impossible mask ventilation or difficult tracheal intubation is fraught with challenges. Despite this, the “airway stress test” of an inhalational induction is frequently employed risking airway obstruction, breath holding, apnea, and laryngospasm.Case presentationsWe present two cases of children with anticipated difficult airway management. The first child (14-year-old African American boy) had severe mucopolysaccharidosis with a history of failed anesthetic induction and failed airway management. The second child (3-year-old African American girl) had progressive lymphatic infiltration of the tongue, resulting in severe macroglossia. We describe a technique that forgoes inhalational induction, incorporates recent pediatric airway guidelines, and provides a greater margin of safety. The technique encompasses the use of drugs that facilitate sedation for intravenous access, without respiratory depression or airway obstruction, titrated use of medications to achieve anesthetic depth while preserving ventilatory drive and airway tone, and the continuous provision of directed oxygen flow during airway manipulation. Propofol and volatile gases were avoided to preserve airway tone and respiratory drive.ConclusionsWe emphasize that an intravenous induction technique utilizing medications that preserve airway tone and ventilatory drive, and the use of continuous oxygen flow throughout airway manipulation, allows for successful management of children with a difficult airway. The common practice of volatile inhalational induction should be avoided in anticipated difficult pediatric airways.

Perfusion Air Culture of Precision-Cut Tumor Slices: An Ex Vivo System to Evaluate Individual Drug Response under Controlled Culture Conditions

Precision-cut tumor slices (PCTS) maintain tissue heterogeneity concerning different cell types and preserve the tumor microenvironment (TME). Typically, PCTS are cultured statically on a filter support at an air-liquid interface, which gives rise to intra-slice gradients during culture. To overcome this problem, we developed a perfusion air culture (PAC) system that can provide a continuous and controlled oxygen medium, and drug supply. This makes it an adaptable ex vivo system for evaluating drug responses in a tissue-specific microenvironment. PCTS from mouse xenografts (MCF-7, H1437) and primary human ovarian tumors (primary OV) cultured in the PAC system maintained the morphology, proliferation, and TME for more than 7 days, and no intra-slice gradients were observed. Cultured PCTS were analyzed for DNA damage, apoptosis, and transcriptional biomarkers for the cellular stress response. For the primary OV slices, cisplatin treatment induced a diverse increase in the cleavage of caspase-3 and PD-L1 expression, indicating a heterogeneous response to drug treatment between patients. Immune cells were preserved throughout the culturing period, indicating that immune therapy can be analyzed. The novel PAC system is suitable for assessing individual drug responses and can thus be used as a preclinical model to predict in vivo therapy responses.

Realizing discrepant oxygen-redox chemistry in honeycomb superlattice cathode via manipulating oxygen-stacking sequences

Anion redox chemistry in honeycomb-superlattice transition metal layer oxides plays a profound role on improving energy density in Na-defect P-type layer structure with pure cationic redox for sodium-ion batteries (SIBs). The correlation regarding variant oxygen-stacking sequences, discrepant oxygen-redox chemistry and electrochemical oxygen-layer sliding is vital, but is not established. Driving from controlling oxygen stacking sequences, the discrepant anionic redox chemistry is realized within Mg-Mn honeycomb-superlattice layer structure. Specifically, the P3-ABBCCA structure exhibits lower oxygen-redox trigger potential and higher oxygen-redox activity, resulting in a higher initial discharge capacity 202.0 mAh g−1 than 152.9 mAh g−1 of P2-ABBA structure. However, P3-ABBCCA stacking structure easily suffers grievous oxygen-sliding coupled with continuous oxygen activation at high cutting-off operation voltage 4.5 V, and finally transforms into O3-ABCABC structure. Compared with oxygen-stacking configuration of P2-ABBA structure, the oxygen-sliding of P3-ABBCCA structure is more irreversible, resulting in sluggish kinetics, rapid capacity degradation and discharge voltage fade during cycling. This study provides a new perspective and guidance on facilitating oxygen-redox chemistry reform in superlattice Na-defective layer cathode of SIBs.

The Same Day on Repeat: A Unique Case of Persistent Déjà Vu Phenomenon as a Long COVID Symptom in an Older Adult

IntroductionDéjà vu is a condition characterized by the experience of recognizing a current situation as familiar with the awareness that the recognition is inappropriate (Pasic et al. Psychiatria Danubina; 30, 21–25). This phenomenon has been well described in temporal lobe epilepsy, and is thought to be caused by abnormal synchronization in the corticolimbic network. While the etiology of neuropsychiatric symptoms in long COVID is still not well demarcated, studies have found that the virus attacks the temporal lobe and limbic system; therefore, we suggest that the ongoing symptoms of déjà vu, in this case, may be a manifestation of long COVID.ObjectivesTo illustrate a unique case of persistent déjà vu after severe infection with COVID-19 virus.MethodsThe patient is a 79-year-old female with a pertinent past medical history of generalized anxiety disorder, major depressive disorder, and prior hospitalization for delirium who presented with a chief complaint of being tired of living the same day. The patient was hospitalized eight months prior for a severe COVID-19 infection that now requires continuous oxygen therapy. Since leaving the hospital, the patient began to develop episodic confusion, memory impairment, and tinnitus which gradually improved. However, the patient developed severe distress due to a constant feeling of déjà vu characterized by a sense of familiarity with events in her daily life. There was no history of loss of consciousness, abnormal involuntary movements, or other semiology related to seizures. Due to distress caused by the déjà vu symptoms, the patient also endorsed depression, anxiety, and insomnia, with deterioration of quality of life.ResultsMRI showed mild volume loss and multifocal regions, including bilateral temporal lobes, of subcortical and periventricular high T2/FLAIR signal abnormality consistent with chronic white matter microangiopathy. MOCA score was 24/30, and the dissociative experiences scale score was 15.36/100. The patient continues to be treated for her depression, insomnia and anxiety with escitalopram 10mg daily and mirtazapine 7.5mg at night as a neuropsychological assessment and electroencephalogram are done.ConclusionsThe incidence of neurological symptoms is more than 80% in severe cases of COVID-19 (Douaud et al. Nature; 604,697–707). This patient was likely predisposed to developing these symptoms due to her age and psychiatric history. Déjà vu occurs in temporal lobe epilepsy, schizophrenia, and depersonalization disorders, all of which affect the limbic-temporal lobe networks (Pasic et al. Psychiatria Danubina; 30, 21–25). Signal abnormalities in the medial temporal lobe are one of the findings seen on MRI in patients with neuropsychiatric symptoms after severe COVID-19 infection. We propose that the persistent déjà vu phenomenon along with cognitive impairments described in this case are manifestations of long COVID.Disclosure of InterestNone Declared

Clinical practice of emergency department-initiated extracorporeal cardiopulmonary resuscitation for cardiac arrest in adults.

Clinical practice of emergency department-initiated extracorporeal cardiopulmonary resuscitation for cardiac arrest in adults.

Fully Oxygen-Tolerant Visible-Light-Induced ATRP of Acrylates in Water: Toward Synthesis of Protein-Polymer Hybrids.

Over the last decade, photoinduced ATRP techniques have been developed to harness the energy of light to generate radicals. Most of these methods require the use of UV light to initiate polymerization. However, UV light has several disadvantages: it can degrade proteins, damage DNA, cause undesirable side reactions, and has low penetration depth in reaction media. Recently, we demonstrated green-light-induced ATRP with dual catalysis, where eosin Y (EYH2) was used as an organic photoredox catalyst in conjunction with a copper complex. This dual catalysis proved to be highly efficient, allowing rapid and well-controlled aqueous polymerization of oligo(ethylene oxide) methyl ether methacrylate without the need for deoxygenation. Herein, we expanded this system to synthesize polyacrylates under biologically relevant conditions using CuII/Me6TREN (Me6TREN = tris[2-(dimethylamino)ethyl]amine) and EYH2 at ppm levels. Water-soluble oligo(ethylene oxide) methyl ether acrylate (average M n = 480, OEOA480) was polymerized in open reaction vessels under green light irradiation (520 nm). Despite continuous oxygen diffusion, high monomer conversions were achieved within 40 min, yielding polymers with narrow molecular weight distributions (1.17 ≤ D̵ ≤ 1.23) for a wide targeted DP range (50-800). In situ chain extension and block copolymerization confirmed the preserved chain end functionality. In addition, polymerization was triggered/halted by turning on/off a green light, showing temporal control. The optimized conditions also enabled controlled polymerization of various hydrophilic acrylate monomers, such as 2-hydroxyethyl acrylate, 2-(methylsulfinyl)ethyl acrylate), and zwitterionic carboxy betaine acrylate. Notably, the method allowed the synthesis of well-defined acrylate-based protein-polymer hybrids using a straightforward reaction setup without rigorous deoxygenation.

Mechanism of coupling corrosion caused by flue gas and deposits in municipal solid waste incinerator: Resistance of HVOF-NiCr coating

Municipal solid waste (MSW) incineration technology have developed rapidly for the achievement of waste disposal and energy conversion. However, the contents of alkali salts especially chlorides are much higher than traditional solid fuels such as coal and biomass, resulting in severe high-temperature corrosion. High-velocity oxy-fuel spray (HVOF) coating is a promising method, while the complex corrosion process involving flue gas and deposits was still unclear. In this study, the in-service performance and coupling corrosion mechanism was investigated. After the 2700 h of in-situ experiments in a 400 t/d MSW incinerator, thickness loss of bare high temperature superheater was 1.9 times that of bare low temperature superheater. For coated superheater by HVOF-NiCr coating, the layered Cr, Mo and Ni oxides was successively formed during the corrosion process, contributing to an 80 % reduction in the thinning rate. In order to further investigate the corrosion mechanism induced by deposits and flue gas, the decoupling analysis of corrosion kinetics and in-stage characterization was conducted based on the lab-scale experiments. Results showed that a two-stage linear fitting was appropriate, theoretically confirming that the coupling corrosion reaction is dominated by deposits. HCl and SO2 can significantly accelerate the deposits-induced corrosion by about 10 times, through promoting the inward penetration of chlorine and oxidation. The resistance of HVOF-NiCr coating against corrosion can be divided into two stages. In the first 10 h, the growth of spherical nickel oxide with continuous oxygen intake resulted in a quick mass gain rate of 1.18 mg·cm−2·h−1. Subsequently, the corrosion rate significantly decreased to 0.086 mg·cm−2·h−1 due to the formed oxide layer. This study provided a new insight into the coupling corrosion caused by flue gas and deposits through kinetic analysis, and the resistance of HVOF-NiCr coating was clarified through the staged characterization.

Pressure-Driven Fabrication of Zn-Doped Co3C@Carbon Nano-Onions for Robust Oxygen Evolution Reaction

Despite being an essential half-reaction for splitting water, the oxygen evolution reaction (OER) is rarely used in the industry because it is slow and requires expensive catalysts. Here, in the present study, the nanosheet of Co3C and carbon nano-onions (CNOs) have been prepared using an annealing process under high pressure, and Zn-doped Co3C was additionally prepared to investigate the impact of doping on Co3C nanosheet as an OER electrocatalyst. The synthesized electrocatalyst is portrayed by X-ray diffraction (XRD), scanning electron microscopy (SEM), Brunauer–Emmet–Teller (BET), and Fourier transform infrared (FTIR). The standing nanoflakes are shaped on the nanosheets of Co3C in the wake of the doping effect. The mesoporous nanoflakes Zn-Co3C@CNO have shown striking OER activity requiring 1.45 V vs RHE as the beginning potential for the OER and required a 276 mV overpotential (η) at 10 mA cm–2. Indeed, even the higher current densities of 50 and 78 mA cm–2 were achieved individually at lower η of 301 and 345 mV, respectively. The prepared electrocatalyst has shown unusual activity fit for continuous oxygen gas evolution for more than 50 h. Such excellent OER performance can be credited to doping Zn particles into the lattice structure of Co3C, along with nanoflakes like standing construction are shaped on the nanosheet of Co3C and microporosity of arranged terminals are considered as efficient for higher OER activity.

Cerebral Oxygenation during Neonatal Intubation with Nasal High Flow: A Sub-Study of the SHINE Randomized Trial

Introduction: Nasal high flow (nHF) improves the likelihood of successful neonatal intubation on the first attempt without physiological instability. The effect of nHF on cerebral oxygenation is unknown. The aim of this study was to compare cerebral oxygenation during endotracheal intubation in neonates receiving nHF and those receiving standard care. Methods: A sub-study of a multicentre randomized trial of nHF during neonatal endotracheal intubation. A subset of infants had near-infrared spectroscopy (NIRS) monitoring. Eligible infants were randomly assigned to nHF or standard care during the first intubation attempt. NIRS sensors provided continuous regional cerebral oxygen saturation (rScO₂) monitoring. The procedure was video recorded, and peripheral oxygen saturation and rScO₂ data were extracted at 2-second intervals. The primary outcome was the average difference in rScO₂ from baseline during the first intubation attempt. Secondary outcomes included average rScO₂ and rate of change of rScO₂. Results: Nineteen intubations were analyzed (11 nHF; 8 standard care). Median (interquartile range [IQR]) postmenstrual age was 27 (26.5–29) weeks, and weight was 828 (716–1,135) g. Median change in rScO₂ from baseline was −1.5% (−5.3 to 0.0) in the nHF group and −9.4% (−19.6 to −4.5) in the standard care group. rScO₂ fell more slowly in infants managed with nHF compared with standard care: median (IQR) rScO₂ change −0.08 (−0.13 to 0.00) % per second and −0.36 (−0.66 to −0.22) % per second, respectively. Conclusions: In this small sub-study, regional cerebral oxygen saturation was more stable in neonates who received nHF during intubation compared with standard care.

Management of Late Radiation Tissue Injury Ulcers With Continuous Topical Oxygen Therapy Supports Wound Healing in Patients of Advanced Age Following Mohs Surgery: A Case Series

Background. The long-term chronic effect of radiotherapy is commonly referred to as LRTI. Clinical complications such as skin atrophy, tissue fibrosis, endothelial damage, ulcer formation, and compromised wound healing are common sequela. Despite advances in medicine over the past decade, there remains a need for effective treatments for LRTI skin necrosis and ulcerations. Materials and Methods. This case series discusses cTOT in 3 patients of advanced age with LRTI wounds having undergone Mohs surgery. All wounds had been recalcitrant to multiple wound care treatments. All patients suffered with significant wound pain as well. Results. cTOT resulted in complete wound healing in all 3 patient cases. Additionally, all 3 patients reported a significant reduction in wound pain during the course of therapy. Conclusions. The positive outcomes exhibited in this case series suggest that cTOT is an effective treatment in the management of Mohs surgery patients with compromised wound healing due to radiation, advanced age, and comorbidities.

Efficacy of Apnoeic Oxygenation by Nasal Prongs in Preventing Desaturation during Airway Management in Infants Undergoing General Anaesthesia: A Randomised Controlled Study

Introduction: Neonates and infants are more prone to desaturation during the apnoeic period of laryngoscopy and intubation. Various options exist to reduce this risk beyond conventional preoxygenation. Aim: To assess whether continuous apnoeic oxygenation via nasal prongs during intubation can extend the safe apnoea period compared to standard management with preoxygenation alone. Materials and Methods: A randomised controlled, two-group parallel clinical study was conducted at the Department of Anaesthesiology, Vijayanagar Institute of Medical Sciences, Ballari, Karnataka, India, from July 2019 to November 2020. The study involved 63 infants aged one day to six months undergoing elective or emergency surgeries under general anaesthesia. Preoxygenation via a mask was followed by sevoflurane induction and vecuronium-induced muscle relaxation. Conventional laryngoscopy and intubation were performed in 32 infants in Group-C (Control group), while 31 infants in Group-O (Apnoeic Oxygenation group) also received oxygen (O2 ) via nasal prongs at 4 L/min in addition to preoxygenation. The primary outcome parameter was the time taken for desaturation by 1%. The time taken to desaturate by 2%, 3%, 4%, and 5%, as well as their incidences, lowest observed saturation, safe apnoea period, and Heart Rate (HR) trends, were also noted. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0 and OpenEpi version 3.01. Results: Demographic and clinical parameters were comparable between the groups. The mean time for 1% desaturation was 18.33±4.3 seconds in Group-C, while all Group-O cases maintained 100% saturation during the study period. No significant difference was found in the safe apnoea period between the groups (p=0.503). The average lowest O2 saturation observed in Group-C was 98.81±1.28%, while it was 100% in Group-O. Only one infant in Group-C showed desaturation down to 95%. Both groups exhibited similar HR trends. Conclusion: Apnoeic oxygenation by nasal prongs in healthy infants helps prolong the time to desaturation and can be beneficial for those at risk of desaturation and hypoxia.