Exogenous Surfactant Treatment in Children with ARDS

Since the Food and Drug Administration (FDA) approved exogenous surfactant in the early 90s for the treatment of neonates with Hyaline Membrane Disease (HMD), many studies have focused on enlarging its indications for others types of lung injuries and for other age groups. Although in the past 20 years no studies have shown clear results about the efficacy of exogenous surfactant treatment in paediatric Acute Respiratory Distress Syndrome (ARDS), many of them were able to point out and better define very important aspects of this treatment like dosage, timing, ways of administration and usage of different types of surfactant (natural and synthetic). In this review we retrace the development of studies looking at the role of exogenous surfactant treatment in paediatric ARDS

Fluorogenic hyaluronan nanogels for detection of micro- and nanoplastics in water

Environmental pollution from plastics is exponentially increasing due to human activities. While larger microplastics can be detected with various methods, retrieving micron-sized fragments and nanoplastics remains challenging. Yet, these smaller-sized plastics have been raising considerable toxicological concern. Here, we show that a poorly emissive hyaluronan functionalized with rhodamine B (HA–RB) adheres with high affinity to various microplastic surfaces, becoming brightly emissive. Micro- and nanoplastics (MNPs) can be successfully detected with size as small as the diffraction limit of confocal microscopy (ca. 250 nm). FLIM images show that the fluorescence lifetime of the dye moieties changes according to the plastics, making possible a discrimination of the nature of MNPs based on lifetime. HA–RB, compared to previous reports, eliminates false-positive results caused by formation of dye aggregates, resulting in a higher S/N ratio which allows the unequivocal detection of nano-sized fragments

Diluted porcine surfactant lung lavages in children with severe ARDS

Acute respiratory distress syndrome (ARDS) is characterized by damage to the arteriolar-capillary endothelium and alveolar epithelium that leads to surfactant deficiency and atelectasis. Alveolar collapse and pulmonary edema will further induce surfactant inactivation. Surfactant supplementation has been suggested but results are unpredictable. Poor response may be due to inhibition of administered surfactant by plasma components filling the alveolar space, severity of lung injury, time of surfactant application and inadequate dose. We report the course of gas exchange and pulmonary mechanics after instillation of surfactant in 14 children (3 months-7 years) with severe ARDS, defined as an oxygenation index (OI) > 30 and a partial pressure of oxygen/ fraction of Inspired oxygen (PaO2/FiO2) <150 . We used a diluted concentration of Curosurf (8 mg/ml) divided into 4 aliquots, for a total dose of 25 mg/kg. An additional aliquot was used for bronchoalveolar lavage before surfactant treatment. All children showed a dramatic response to surfactant with rapid and progressive increase in compliance and improvement of all respiratory mechanics. Mechanical ventilation settings were rapidly reduced and gas exchange improved with a PaO2/FiO2 >200 for more than 12 hours. Diluted surfactant lung lavages were able to increase blood gas exchange in all our patients despite previously severe gas exchange impairment

The Perception of Ecosystem Services of Mountain Farming and of a Local Cheese: An Analysis for the Touristic Valorization of an Inner Alpine Area

Mountain husbandry systems and their related products may directly or indirectly provide either ecosystem services (ESs) or disservices to humanity. The present study aims to evaluate the perception that a local mountain community has towards animal husbandry in the Lanzo Valleys (Piedmont, Italy) and towards the typical local dairy product, Toma di Lanzo, as well as to investigate the consumers\u2019 habits and preferences, to detect possible positive impacts on mountain tourism. A questionnaire was delivered to 233 respondents. The perception of the impact was scored using a five-point Likert scale. The results show a very positive perception of the product Toma di Lanzo because of its origin and type of processing, with different perceptions of the local society depending on age (p &lt; 0.01), residence (p &lt; 0.01), and education level (p &lt; 0.05). The respondents had a very positive awareness of the impact of mountain livestock farming in the Lanzo Valleys. The most important perceived ESs are cultural identity and maintenance of local breeds. Women, non-residents, and respondents with an intermediate education level generally had a more positive perception of ESs. There was a very low perception of disservices derived from mountain animal farming. The main perceived obstacles to the spread of benefits derived from these farming systems were the scarce presence of specific supporting politics and the low income generated by mountain farming activities. The coexistence of touristic activities and extensive livestock farming systems has to be associated with a better promotion of mountain products like Toma di Lanzo to improve the sustainability of mountain regions

Diluted porcine surfactant lung lavages in children with severe ARDS

Acute respiratory distress syndrome (ARDS) is characterized by damage to the arteriolar-capillary endothelium and alveolar epithelium that leads to surfactant deficiency and atelectasis. Alveolar collapse and pulmonary edema will further induce surfactant inactivation. Surfactant supplementation has been suggested but results are unpredictable. Poor response may be due to inhibition of administered surfactant by plasma components filling the alveolar space, severity of lung injury, time of surfactant application and inadequate dose. We report the course of gas exchange and pulmonary mechanics after instillation of surfactant in 14 children (3 months-7 years) with severe ARDS, defined as an oxygenation index (OI) > 30 and a partial pressure of oxygen/ fraction of Inspired oxygen (PaO2/FiO2) <150 . We used a diluted concentration of Curosurf (8 mg/ml) divided into 4 aliquots, for a total dose of 25 mg/kg. An additional aliquot was used for bronchoalveolar lavage before surfactant treatment. All children showed a dramatic response to surfactant with rapid and progressive increase in compliance and improvement of all respiratory mechanics. Mechanical ventilation settings were rapidly reduced and gas exchange improved with a PaO2/FiO2 >200 for more than 12 hours. Diluted surfactant lung lavages were able to increase blood gas exchange in all our patients despite previously severe gas exchange impairment

Rapid Solvent-Free Microcrystalline Cellulose Melt Functionalization with L-Lactide for the Fabrication of Green Poly-Lactic Acid Biocomposites

A green approach is proposed to achieve a rapid surface functionalization of microcrystalline cellulose (MCC) in 30 min by a solvent-free grafting by the reaction of L-lactide through compression molding without the need for an inert atmosphere. A sufficient hydrophobization of the MCC surface is achieved with an amount of grafted poly(L-lactic acid) (PLLA) oligomers of 7 wt % with respect to MCC. The obtained PLLA-g-MCC is subsequently melt-compounded with poly(lactic acid) (PLA) through extrusion and injection molding. As a result of higher compatibility and interfacial adhesion of the functionalized filler with PLA, PLA/ MCC-g-PLLA biocomposites with a cellulose content ranging from 4 to 20 wt % exhibit an enhancement in important physicochemical properties (i.e., water vapor barrier, crystallinity, stiffness) compared to both pure PLA and formulations containing an equal or higher amount of nonfunctionalized MCC. At the same time, the materials retain the mechanical strength and resistance to thermal degradation of PLA. The physicochemical characteristics, excellent biocompatibility, and biodegradability of PLA and cellulose and the simplicity, rapidity, and cost-effectiveness of the grafting process render these biocomposites suitable for several applications within the plastics domain including packaging, agriculture, automotive, consumer goods, and household appliances

Core–Shell Pluronic-Organosilica Nanoparticles with Controlled Polarity and Oxygen Permeability

Nanostructured systems constitute versatile carriers with multiple functions engineered in a nanometric space. Yet, such multimodality often requires adapting the chemistry of the nanostructure to the properties of the hosted functional molecules. Here, we show the preparation of core-shell Pluronic-organosilica "PluOS" nanoparticles with the use of a library of organosilane precursors. The precursors are obtained via a fast and quantitative click reaction, starting from cost-effective reagents such as diamines and an isocyanate silane derivative, and they condensate in building blocks characterized by a balance between hydrophobic and H-bond-rich domains. As nanoscopic probes for local polarity, oxygen permeability, and solvating properties, we use, respectively, solvatochromic, phosphorescent, and excimer-forming dyes covalently linked to the organosilica matrix during synthesis. The results obtained here clearly show that the use of these organosilane precursors allows for finely tuning polarity, oxygen permeability, and solvating properties of the resulting organosilica core, expanding the toolbox for precise engineering of the particle properties