Elettrofilatura di miscele di cheratina e PLA caricate con ossido di grafene per la produzione di materiali nanofibrosi

In questo elaborato di tesi sperimentale sono state preparate delle nanofibre elettrofilate di cheratina e PLA caricate con differenti percentuali in peso di grafene ossido. In questo particolare sistema, la dimensione del nano-rinforzo è paragonabile alla dimensione delle nanofibre (circa 150 nm), contrariamente alle convenzionali dimensioni dei rinforzi utilizzati per creare materiali compositi. La matrice polimerica utilizzata è una miscela costituita da cheratina e PLA che ha mostrato interazioni positive di interfase tra i due polimeri. Sono stati studiati gli effetti dei parametri di processo di elettrofilatura sulla morfologia delle nanofibre ottenute. Inoltre, è stata studiata l’influenza del grafene ossido sul processo di elettrofilatura, sulla morfologia delle nanofibrose, sulla viscosità delle miscele dei due polimeri e sulle proprietà termiche e meccaniche delle membrane nanofibrose elettrofilate. Tutte le miscele preparate sono state elettrofilate con successo ed i diametri delle nanofibre ottenute variano da 60-400 nm. I dati sperimentali hanno mostrato una diminuzione del diametro delle nanofibre all’aumentare della concentrazione di grafene ossido dovuta alla diminuzione di viscosità e probabile aumento della conducibilità delle soluzioni contenenti. Le analisi termiche hanno messo in evidenza che c’è un effetto nucleante del grafene ossido che induce, probabilmente, l’organizzazione delle catene proteiche. Le analisi meccaniche in trazione hanno mostrato un aumento del modulo di Young e del carico a rottura delle nanofibre elettrofilate caricate con grafene ossido

Home High-Flow Therapy in Patients with Chronic Respiratory Diseases: Physiological Rationale and Clinical Results

High-flow therapy (HFT) is the administration of gas flows above 15 L/min. It is a non-invasive respiratory support that delivers heated (up to 38 °C), humidified (100% Relative Humidity, RH; 44 mg H2O/L Absolute Humidity, AH), oxygen-enriched air when necessary, through a nasal cannula or a tracheostomy interface. Over the last few years, the use of HFT in critically ill hypoxemic adults has increased. Although the clinical benefit of home high-flow therapy (HHFT) remains unclear, some research findings would support the use of HHFT in chronic respiratory diseases. The aim of this review is to describe the HFT physiological principles and summarize the published clinical findings. Finally, we will discuss the differences between hospital and home implementation, as well as the various devices available for HHFT application

Rationalizing the design and implementation of chiral hybrid perovskites

Molecular asymmetry occurs at all scales in nature, spanning organic to inorganic frameworks with consequences of high significance. For this reason, asymmetric organic and inorganic materials are incessantly gaining considerable interest owing to the opportunity of reaching tunable chiral signatures. In recent years, the chiral hybrid organic-inorganic perovskites in which the chiral organic ligands usually induce the symmetry breaking are receiving growing attention. Their circularly polarized emissions without the need for expensive ferromagnets or extremely low temperatures are appealing features for the industry. Until now, there has been no clear relationship between the structure of the chiral perovskites and the generated signal. This review aims at focusing on the supramolecular chiral amplification mechanisms in asymmetric perovskites, rationalizing how to enhance their chiral emission signatures. We conclude by broadening our view toward future challenges in exploring modern simulation protocols to optimize the design of chiral hybrid perovskites

Effects of non-invasive respiratory supports on inspiratory effort in moderate-severe COVID-19 patients. A randomized physiological study

Rationale and objective: Various forms of Non-invasive respiratory support (NRS) have been used during COVID-19, to treat Hypoxemic Acute Respiratory Failure (HARF), but it has been suggested that the occurrence of strenuous inspiratory efforts may cause Self Induced Lung Injury(P-SILI). The aim of this investigation was to record esophageal pressure, when starting NRS application, so as to better understand the potential risk of the patients in terms of P-SILI and ventilator induced lung injury (VILI).Methods and measurements: 21 patients with early de-novo respiratory failure due to COVID-19, underwent three 30 min trials applied in random order: high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), and non-invasive ventilation (NIV). After each trial, standard oxygen therapy was reinstituted using a Venturi mask (VM). 15 patients accepted a nasogastric tube placement. Esophageal Pressure (Delta Pes) and dynamic transpulmonary driving pressure (Delta PLDyn), together with the breathing pattern using a bioelectrical impedance monitor were recorded. Arterial blood gases were collected in all patients.Main results: No statistically significant differences in breathing pattern and PaCO2 were found. PaO2/FiO(2) ratio improved significantly during NIV and CPAP vs VM. NIV was the only NRS to reduce significantly Delta Pes vs. VM (-10,2 +/- 5 cmH20 vs -3,9 +/- 3,4). No differences were found in Delta PLDyn between NRS (10,2 +/- 5; 9,9 +/- 3,8; 7,6 +/- 4,3; 8,8 +/- 3,6 during VM, HFNC, CPAP and NIV respectively). Minute ventilation (Ve) was directly dependent on the patient's inspiratory effort, irrespective of the NRS applied. 14% of patients were intubated, none of them showing a reduction in Delta Pes during NRS.Conclusions: In the early phase of HARF due to COVID-19, the inspiratory effort may not be markedly elevated and the application of NIV and CPAP ameliorates oxygenation vs VM. NIV was superior in reducing Delta Pes, maintaining Delta PLDyn within a range of potential safety

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Cross-polarised optical coherence tomography is a promising technique to reveal certain pathologic conditions in tissue. However, endoscopic devices with flexible small probes to detect diseased areas intraoperatively barely exist. We present an extension of a commercially available swept-source OCT system. Applying a common-path probe, the polarisation of reference and sample arm does not need to be further balanced. Due to a depolariser, the system is independent of the inputpolarisation

Optically activated and interrogated plasmonic hydrogels for applications in wound healing

We disclose the use of hybrid materials featuring Au/Ag core/shell nanorods in porous chitosan/polyvinyl alcohol scaffolds for applications in tissue engineering and wound healing. The combination of Au and Ag in a single construct provides synergistic opportunities for optical activation of functions as near infrared laser tissue bonding, and remote interrogation to return parameters of prognostic relevance in wound healing monitoring. In particular, the bimetallic component ensures optical tunability, enhanced shelf life and photothermal stability, serves as a reservoir of germicidal silver cations, and changes in near-infrared and visible color according to the environmental level of oxidative stress. At the same time, the polymeric blend is ideal to bind connective tissue upon photothermal activation, and to support fabrication processes that provide high porosity, such as electrospinning, thus putting all the premises for cellular repopulation and antimicrobial protection

Chest ultrasonography in health surveillance of asbestos-related lung diseases

Objectives: Exposure to asbestos fibers can lead to different lung diseases, such as pleural thickening and effusion, asbestosis, mesothelioma, and lung cancer. These diseases are expected to peak in the next few years. The aim of the study was to validate ultrasonography (US) as a diagnostic tool in the management of lung diseases in subjects with a history of occupational exposure to asbestos. Methods: Fifty-nine retired male workers previously exposed to asbestos were enrolled in the study. Chest US was performed in all the subjects. The US operator was blinded to earlier performed computed tomography (CT) scan reports and images. The sonographic pathological findings were pleural thickening (with or without calcifications), peripheral lung consolidation, and focal sonographic interstitial syndrome and diffuse pneumogenic sonographic interstitial syndrome (pulmonary asbestosis). Significant US findings were recorded, stored, and subsequently compared with CT scans. Results: With some patients falling into more than one category, on CT scan, pleural thickening was reported in 33 cases (56%, 26 with calcifications), focal interstitial peripheral alterations in 23 (39%), asbestosis in 6 (10%), and peripheral lung consolidation in 13 cases (22%). Comparing each pathological condition to CT scan reports, US findings had high levels of sensitivity, specificity, positive, and negative predictive values. US did not prove effective for the detection of central lung nodules or diaphragmatic pleural thickenings. Chest US was considered to be the best technique to detect minimal pleural effusions (six subjects, 10%). Conclusions: Chest US might be considered an additional tool to follow up subjects occupationally exposed to asbestos who have already undergone CT scan examination and whose pathology is detectable by US as well

Keratin/Polylactic acid/graphene oxide composite nanofibers for drug delivery

In this work keratin/poly(lactic acid) (PLA) 50/50 wt blend nanofibers with different loadings of graphene-oxide (GO) were prepared by electrospinning and tested as delivery systems of Rhodamine Blue (RhB), selected as a model of a drug. The effect of GO on the electrospinnability and drug release mechanism and kinetics was investigated. Rheological measurements carried out on the blend solutions revealed unsatisfactory compatibility between keratin and PLA under quiet condition. Accordingly, poor interfacial adhesion between the two phases was observed by SEM analysis of a film prepared by solution casting. On the contrary, keratin chains seem to rearrange under the flux conditions of the electrospinning process thus promoting better interfacial interactions between the two polymers, thereby enhancing their miscibility, which resulted in homogeneous and defect-free nanofibers. The loading of GO into the keratin/PLA solution contributes to increase its viscosity, its shear thinning behavior, and its conductivity. Accordingly, thinner and more homogeneous nanofibers resulted from solutions with a relatively high conductivity coupled with a pronounced shear thinning behavior. FTIR and DSC analyses have underlined, that while the PLA/GO interfacial interactions significantly compete with the PLA/keratin ones, there are no significant effects of GO on the structural organization of keratin in blend with the PLA. However, GO offers several advantages from the application point of view by slightly improving the mechanical properties of the electrospun mats and by slowing down the release of the model drug through the reduction of the matrix swelling

Optically activated and interrogated plasmonic hydrogels for applications in wound healing

We disclose the use of hybrid materials featuring Au/Ag core/shell nanorods in porous chitosan/polyvinyl alcohol scaffolds for applications in tissue engineering and wound healing. The combination of Au and Ag in a single construct provides synergistic opportunities for optical activation of functions as near infrared laser tissue bonding, and remote interrogation to return parameters of prognostic relevance in wound healing monitoring. In particular, the bimetallic component ensures optical tunability, enhanced shelf life and photothermal stability, serves as a reservoir of germicidal silver cations, and changes in near-infrared and visible color according to the environmental level of oxidative stress. At the same time, the polymeric blend is ideal to bind connective tissue upon photothermal activation, and to support fabrication processes that provide high porosity, such as electrospinning, thus putting all the premises for cellular repopulation and antimicrobial protection

Development of clinical tools to estimate the breathing effort during high-flow oxygen therapy: the BREF models

Introduction and objectives: Quantifying breathing effort in non-intubated patients is important but not easy. We aimed to develop two prediction models to estimate it in patients treated with high-flow oxygen therapy. Patients and Methods: We analyzed the data of 260 patients from previous studies who received high-flow oxygen therapy. Their breathing effort was measured as the maximal deflection of esophageal pressure (ΔPes). We developed a multivariable linear regression model to estimate ΔPes (in cmH2O) and a multivariable logistic regression model to predict the risk of ΔPes being >10 cmH2O. Candidate predictors included age, sex, diagnosis of the novel coronavirus disease (COVID-19), respiratory rate, heart rate, mean arterial pressure, the results of arterial blood gas analysis, including base excess concentration (BEa) and the ratio of arterial tension to the inspiratory fraction of oxygen (PaO2:FiO2), and the product term between COVID-19 and PaO2:FiO2. Results: ΔPes can be estimated from the presence or absence of COVID-19, BEa, respiratory rate, PaO2:FiO2, and the product term between COVID-19 and PaO2:FiO2. The adjusted R2 was 0.39. The risk of ΔPes being >10 cmH2O can be predicted from BEa, respiratory rate, and PaO2:FiO2. The area under the ROC curve was 0.79 (0.73–0.85). We called these two models BREF, where BREF stands for BReathing EFfort and the three common predictors: BEa (B), respiratory rate (RE), and PaO2:FiO2 (F). Conclusions: We developed two models to estimate the breathing effort of patients on high flow oxygen therapy. Our initial findings are promising and suggest that these models merit further evaluation