Facilely synthesized nitrogen-doped reduced graphene oxide functionalized and/or co-doped with metal ions as electrocatalyst for oxygen reduction reaction

Due to fossil fuels depletion and environmental pollution, clean and sustainable energy technologies, e.g. fuel cells and metal-air batteries, have attracted extensive attention. To push further the research on these electrochemical devices, low-cost, durable and efficient electrocatalysts alternative to platinum are required, to boost the oxygen reduction reaction (ORR). A microwave-assisted method has been optimized, to obtain effective heterogeneous catalyst for ORR, starting from graphene oxide (GO), urea and a transition metal (e.g. Mn and Cu) precursor. We have proved that our synthetic method originates porphyrin-like structures containing pyrrole rings within the reduced GO (rGO) basal plane which coordinate the Mn2+. In the case of copper, however, Cu2+ forms an ionic tetra coordinated structure anchored at the rGO surface via residual oxygen containing functional groups. In both cases, metal complex acts as an ORR highly efficient catalytic reaction center and their identification were strongly supported by several characterization techniques, such as X-ray Photoelectron Spectroscopy (XPS), X-ray absorption spectroscopies (XAS) and Transmission Electron Microscopy (TEM), together with Density Functional Theory (DFT) simulations. All synthesized materials exhibit outstanding catalytic properties toward ORR, as evidenced by electron transfer numbers larger than 3.8 and peroxide percentages lower than 7%, similar to Pt/C reference electrode

Facilely synthesized nitrogen-doped reduced graphene oxide functionalized with copper ions as electrocatalyst for oxygen reduction

Nitrogen-doped reduced graphene oxide is successfully synthesized and functionalized with hydroxylated copper ions via one-pot microwave-assisted route. The presence of cationic Cu coordinated to the graphene layer is fully elucidated through a set of experimental characterizations and theoretical calculations. Thanks to the presence of these hydroxyl-coordinated Cu2+ active sites, the proposed material shows good electrocatalytic performance for the oxygen reduction reaction, as evidenced by an electron transfer number of almost 4 and by high onset and half-wave potentials of 0.91 V and 0.78 V vs. the reversible hydrogen electrode, respectively. In addition, the N-doped Cu-functionalized graphene displays a superior current retention with respect to a commercial Pt/C catalyst during the stability test, implying its potential implementation in high-performance fuel cells and metal-air batteries

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)