The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS

Background The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality. Methods and analysis Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the "PROVENT-C19 Registry", endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care. . .'(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice. Conclusions This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed observation-based registries could be effective tools aimed at identifying specific clusters of patients within a large study population with widely heterogeneous clinical characteristics. Copyright

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Development of a novel SiO2 based composite anode material for Li-ion batteries

Abstract Research interest towards Li-ion batteries (LIBs) has been significantly increased over decades as high power energy storage systems for renewable energy generators and electrical vehicles emerged. One of the most representative anode materials for LIBs is silica (SiO2) thanks to its high theoretical capacity of 1965 mAh·g-1. However, low coulombic efficiency and irreversible capacity losses during cycling of silica-based anodes are critical issues that need to be addressed nowadays. In this work, a novel three-dimensional SiO2/carbon nanotube/graphene ternary composite was developed as an anode material for LIBs to improve electrochemical performances and to make significant advances as a potential candidate for high-energy applications. The novel ternary composite with weight ratio of 50:25:25 exhibited initial discharge and charge capacities of 732 mAh·g-1 and 260 mAh·g-1 respectively, with initial coulombic efficiency of 82%. Nevertheless, further investigations are necessary for attaining higher specific capacities, enhanced cyclic stability and better rate capability

NMR evidence of the diamagnetic interaction between carbon nanotubes functionalized with polymer chains

, DOI = 10.1063/1.3157205Carbon nanotubes functionalized with sulfonated polyether-ether-ketone are investigated using solid state nuclear magnetic resonance. Carbon and proton NMR experiments of the sulfonated polymer chains covalently grafted on the nanotube surface reveal a distribution of diamagnetic shifted lines. These experimental results can be interpreted at the molecular level in terms of magnetic ring currents originating from the surface of the graphitized wall of the nanotubes in agreement with recent theoretical investigations. These features can potentially be used to track the structural modifications, which take place during the functionalization of carbon nanotubes. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.3157205

Sulfonated poly (ether ether ketone) chains grafted on carbon nanotubes surface

http://www.iwepnm.org/2008/International audienceAmong many extraordinary properties, Carbon nanotubes (CNTs) have a very high Young modulus, generally reported with a value of ~ 1 TPa, making this kind of material even stronger than diamond and carbon fiber. Moreover their very light weight makes them first choice materials for mechanical reinforcement of polymer matrices. Most of previous studies using CNTs deal with so-called physical mixing, meaning that there is no strong link between polymer and nanotube surface, resulting in a relatively poor enhancement of the composite Young's modulus. In our study, we first investigated the functionalization of multi-walled carbon nanotubes (MWNTs) surface by sulfonated poly (ether ether ketone) (SPEEK) chains using a direct attachment reaction, PEEK being known as a very promising polymer especially in aerospace field for its particularly high glass transition and melting temperature, compared with most of polymer material. MWNTs were oxidized by a nitric acid treatment to generate carboxyl groups on their surface, which then react with sulfonated groups of SPEEK using hexane diamine as an interlinking molecule. Characterization of covalent functionalization of MWNTs by SPEEK macromolecules was obtained by electron microscopy, infra-red spectroscopy and near-edge X-ray absorption fine structure spectroscopy (NEXAFS) at O K-edge. Mechanical properties of the MWNT-SPEEK composite material have to be tested to quantify the enhancement of Young's modulu

Carbon nanotubes functionalization with sulfonated poly (ether ether ketone) chains

http://www.icb.csic.es/fileadmin/grupos/G-CNN/CHEMONTUBES2008/chemontubes.htmlInternational audienceAmong many extraordinary properties, CNTs have a very high Young modulus, generally reported with a value of ~ 1 TPa, making this kind of material even stronger than diamond and carbon fiber. Moreover their very light weight makes them first choice materials for mechanical reinforcement of polymer matrices. Most of previous studies using CNTs deal with so-called physical mixing, meaning that there is no strong link between polymer and nanotube surface, resulting in a relatively poor enhancement of the composite Young's modulus. In our study, we first investigated the functionalization of multi-walled carbon nanotubes (MWNTs) surface by sulfonated poly (ether ether ketone) SPEEK chains using a direct attachment reaction, PEEK being known as a very promising polymer especially in aerospace field for its particularly high glass transition and melting temperature, compared with most of polymer material.[1] MWNTs were oxidized by a nitric acid treatment to generate carboxyl groups on their surface, which then react with sulfonated groups of SPEEK using hexane diamine as an interlinking molecule.[2,3] Evidence of covalent functionalization of MWNTs by SPEEK macromolecules was given by near-edge X-ray absorption fine structure spectroscopy (NEXAFS) at the C K-edge, O K-edge, and N K-edge and X-ray photoelectron spectroscopy (XPS). Mechanical properties of the MWNT-SPEEK composite material were then tested to quantify the enhancement of Young's modulus

Development of nanohybrid material for antibiotics removal and degradation

This project is about a technique to accelerate the degradation of antibiotics (for example Doxycycline) using a severe confined environment and a physical agent. The confining medium is carbon nanotubes (CNTs) because of their low internal diameter (of the order of 1 to 10 nanometers), high physicochemical stability, high mechanical strength, and presence of strong intermolecular forces at their inner surface that contribute to the degradation effect. This new technique will find a niche in pharmaceutical industries where many processes are not sufficiently clean to eliminate a significant amount of antibiotic residues from waste streams