Two-Year Outcomes After Minimally Invasive Surfactant Therapy in Preterm Infants: Follow-Up of the OPTIMIST-A Randomized Clinical Trial

Importance: The long-term effects of surfactant administration via a thin catheter (minimally invasive surfactant therapy [MIST]) in preterm infants with respiratory distress syndrome remain to be definitively clarified. / Objective: To examine the effect of MIST on death or neurodevelopmental disability (NDD) at 2 years' corrected age. / Design, Setting, and Participants: Follow-up study of a randomized clinical trial with blinding of clinicians and outcome assessors conducted in 33 tertiary-level neonatal intensive care units in 11 countries. The trial included 486 infants with a gestational age of 25 to 28 weeks supported with continuous positive airway pressure (CPAP). Collection of follow-up data at 2 years' corrected age was completed on December 9, 2022. / Interventions: Infants assigned to MIST (n = 242) received exogenous surfactant (200 mg/kg poractant alfa) via a thin catheter; those assigned to the control group (n = 244) received sham treatment. / Main Outcomes and Measures: The key secondary outcome of death or moderate to severe NDD was assessed at 2 years' corrected age. Other secondary outcomes included components of this composite outcome, as well as hospitalizations for respiratory illness and parent-reported wheezing or breathing difficulty in the first 2 years. / Results: Among the 486 infants randomized, 453 had follow-up data available (median gestation, 27.3 weeks; 228 females [50.3%]); data on the key secondary outcome were available in 434 infants. Death or NDD occurred in 78 infants (36.3%) in the MIST group and 79 (36.1%) in the control group (risk difference, 0% [95% CI, -7.6% to 7.7%]; relative risk [RR], 1.0 [95% CI, 0.81-1.24]); components of this outcome did not differ significantly between groups. Secondary respiratory outcomes favored the MIST group. Hospitalization with respiratory illness occurred in 49 infants (25.1%) in the MIST group vs 78 (38.2%) in the control group (RR, 0.66 [95% CI, 0.54-0.81]) and parent-reported wheezing or breathing difficulty in 73 (40.6%) vs 104 (53.6%), respectively (RR, 0.76 [95% CI, 0.63-0.90]). / Conclusions and Relevance: In this follow-up study of a randomized clinical trial of preterm infants with respiratory distress syndrome supported with CPAP, MIST compared with sham treatment did not reduce the incidence of death or NDD by 2 years of age. However, infants who received MIST had lower rates of adverse respiratory outcomes during their first 2 years of life. / Trial Registration: anzctr.org.au Identifier: ACTRN12611000916943

Air Toxic Emission Inventory for Mobile Source and Fuel Quality Modeling

Fuel quality and vehicle technologies are linked very intimately and have a combined effect on emission levels. Fuel quality improvement alone can reduce total pollution load from vehicles to a certain extent. A spreadsheet-based model has been developed in this study. The emission factor based on variations in gasoline quality has been derived using “Complex” model of US EPA. The annual emission inventory for gasoline driven vehicles have been estimated with respect to volatile organic compounds (VOCs), toxic air pollutants (TAP) and nitrogen oxides (NOx) using vehicle population data, growth rate of vehicles and usage characteristics in cities from Indian subcontinent. Five pollutants were considered in TAP category: benzene, 1,3-butadiene, policyclic organic matter, formaldehyde, and acetaldehyde. The result of present and projected air toxic emission inventory using planned improvement in gasoline quality reveals that, the emission reduction less than 25% may be achieved. A significant reduction of about 69% in pollutant like benzene justifies the need of gasoline quality improvement in developing countries

A Non-Noble Metal Based Catalytic Converter for Two-Stroke, Two-Wheeler Applications

Two wheelers constitute almost three fourths of the vehicular population in developing countries like India, and consequently they are the major contributors to vehicular pollution. Catalytic converters based on nonnoble metal catalyst have been developed for 2-stroke, 2- wheelers application. In this study a modified and thermally stable alumina washcoat has been developed for application of non-noble metal catalyst. Alumina washcoat has been used on both ceramic and metallic honeycomb substrates and subsequently the perovskite type of catalyst has been synthesized in-situ on alumina washcoated substrates. Extensive characterization was carried out during development of alumina washcoat and synthesis of perovskite catalyst to establish the thermal stability of alumina washcoat and phase formation of catalysts. A number of prototypes based on alumina supported perovskite have been prepared and tested for mass conversion efficiency with respect to CO, HC and NOx. The results reveal the confirmation of performance of converter for EURO-I emission norms, which are presently applicable in India for 2-stroke, 2-wheelers. The optimized design of converter minimizes the pressure drop across the converter and the power loss of the engine is well within tolerable limits

Catalytic Converter Modeling: Artificial Neural Networks for Perovskite Based Catalyst

Two-stroke vehicles including two and three wheelers constitute about 62% of vehicles in India, and about 45-50% in other developing countries in the region. These are the major contributors to vehicular pollution. Catalytic converters based on perovskite have been developed for 2- stroke vehicles. Detailed characterization was carried out during development of alumina washcoat and synthesis of perovskite catalyst to establish the thermal stability of alumina washcoat and phase formation of catalysts. A number of prototypes based on alumina-supported perovskite have been prepared and tested for mass conversion efficiency with respect to CO, HC and NOx using the Indian Driving Cycle (IDC). A catalytic converter model has been developed using the MATLAB artificial neural network toolbox for performance prediction. Experimental data generated during the detailed characterization of catalytic converters and its evaluation on engine dynamometer has been used as training data. The model was used for prediction of conversion efficiencies and mid-bed temperature. Keep-one-out method was used for comparison of predicted and experimental values. The algorithm developed predicts the performance very well and will be able to give prior information on the performance in view of future emission standards

La_(l-x)A_xMn_(l-y)B_yO₃ supported on honeycomb substrate -Characterization and application for catalytic converter

1833-1839Perovskite catalysts are reported as substitute to noble-metal catalysts for automobile catalytic converter. The low surface area and non-compatibility with alumina wash coat had been the major problems for limiting the application of perovskite for auto-exhaust treatment. La0.7Sr0.3Mn0.95Pt0.05O3 supported on alumina washcoated honeycomb substrate has been prepared in this study. The detail characterization, at each step of preparation of catalyst coated substrate, using techniques such as BET SA, porosity, pore size distribution, TGA and XRD have been carried out and discussed. Characterization results reveal the possible use of supported perovskite for automobile exhaust treatment

Nitric oxide absorption by hydrogen peroxide in airlift reactor: a study using response surface methodology

Absorption of nitric oxide from nitric oxide /air mixture in hydrogen peroxide solution has been studied on bench scale internal loop airlift reactor. The objective of this investigation was to study the performance of nitric oxide absorption in hydrogen peroxide solution in the airlift reactor and to explore/determine the optimum conditions using response surface methodology. A Box–Behnken model has been employed as an experimental design. The effect of three independent variables—namely nitric oxide gas velocity, 0.02–0.11 m/s; nitric oxide gas concentration, 300–3,000 ppm and hydrogen peroxide concentration, 0.25–2.5 %—has been studied on the absorption of nitric oxide in aqueous hydrogen peroxide in the semi-batch mode of experiments. The optimal conditions for parameters were found to be nitric oxide gas velocity, 0.02 m/s; nitric oxide gas concentration, 2,246 ppm and hydrogen peroxide concentration, 2.1 %. Under these conditions, the experimental nitric oxide absorption efficiency was observed to be *65 %. The proposed model equation using response surface methodology has shown good agreement with the experimental data, with a correlation coefficient (R2) of 0.983. The results showed that optimised conditions could be used for the efficient absorption of nitric oxide in the flue gas emanating from industries