Pain treatment in neonates : a Polish multicentre survey conducted in 2014

Introduction: Preventing pain before and during medical procedures is a basic human right, regardless of age. Painful invasive procedures are frequently performed on infants admitted to neonatal units. Aim of the study: The aim of this study was to describe current neonatal pain management in Polish neonatal units according to the opinions of physicians. Material and methods: A survey of 100 Polish neonatal units was performed. Physicians were asked to complete a researcher-developed questionnaire. The survey comprised 40 questions. The frequency of use of selected pain medicines and pain treatment according to guidelines was assessed using Likert-scale questions.Results: Seventy-six units agreed to participate in the study. Data were available from 235 physicians. Most neonatal units did not have guidelines for the treatment of pain in newborns. There was no significant correlation between theoretical knowledge and pain treatment in accordance with the guidelines (r = -0.04, p = 0.6). Pain treatment before selected procedures seems to be insufficient. The study revealed the frequent use of paracetamol before painful procedures. Before central line insertion 42% of physicians from level III units very often or often administered paracetamol. About 40% of physicians used paracetamol before chest tube insertion. Phenobarbital intravenous/per os/per rectum was the most frequently used drug (76% of respondents from level III NICU). Almost 60% of physicians did not use written guidelines for pain management, but they followed their experience. Conclusions: Despite changes in the approach to pain management in neonates and the widespread availability of recommendations, pain treatment in Polish neonatal units is still insufficient. There is a need for the education of health professionals on neonatal pain management. This study suggests that Polish neonatal units need national guidelines for pain management

Na-P1 zeolite synthesis and its crystalline structure ripening through hydrothermal process using coal combustion by-products as substrates

Energy industry sector is one of the major environment pollutants. This branch also generates significant amounts of by-products such as slugs, slug-ash mixtures, ashes and microspheres, which can be very harmful for the earth ecosystems. Statistically the microspheres (MIC) constitute from 0.6% to 2.5% of the total amount of post combustion wastes. MIC occurs mainly in fly ashes (less often in slugs) as the smallest, hollow, spherical particles. MIC is composed mainly of crystalline and amorphous aluminosilicate phases. The combustion conditions have strong influence on MIC composition. Mineral and chemical composition of MIC is very similar to F type of fly ashes; consequently there is a possibility to use them as substrates for zeolite synthesis. Zeolites are minerals from microporous, aluminosilicate group (Szala et al. 2015). Among others, they are characterized by specific channels and chambers occurrence in their structure, which results in a number of important features like: ion exchange, sorption, molecular sieve or catalytic properties. This is the reason for wide use of zeolites in numerous industrial sectors (Ahmaruzzaman 2010). The aim of this study is a synthesis of Na-P1 zeolite at semi-technical scale by conversion of microspheres under hydrothermal conditions in an alkaline medium. This study involves also research of Na-P1 zeolite structure ripening in order to optimize the synthesis conditions. Microspheres from Stalowa Wola Power Plant (Poland) were used as a substrate. For the synthesis of Na-P1 phase the following conditions were applied: 90 dm 3 of water, 15 kg of microsphere, 11 kg of sodium hydroxide (3 mol/dm 3 ), temperature: 80°C, and reaction time up to 26 h (Franus et al. 2014). The zeolite conversion was performed on semi-technical scale installation (Wdowin et al. 2014). During the conversion, samples were collected from the reactor after 2, 4, 6, 10, 14, 26 hours. To investigate the influence of time for zeolitization process efficiency these samples were analyzed in terms of chemical and mineral composition, structural and textural properties. The main attention was paid to the evolution of the Na-P1 unit cell parameters observed as a function of time (calculations and models were performed for every sample). The phase’s composition was determined with powder X-ray diffraction (XRD) method using a PANalytical X’pert MPD diffractometer (with a PW 3050/60 goniometer), Cu lamp, and a graphite monochromator. The analysis was performed within the angle range of 5–65 2θ. PANalytical X’Pert Highscore software was used to process the diffraction data. The identification of mineral phases was based on the PDF-2 release 2010 database formalized by the ICD and IZA-SC Database of Zeolite Structures. The experimental calculations of the unit cell parameters were performed using UnitCell software. The spatial model of Na-P1 zeolite cell was prepared using Mercury 3.7 Windows software. The morphological forms and the chemical composition of the main mineral components were determined with scanning electron microscope (SEM) FEI Quanta 250 FEG equipped with the SE detector and a system of chemical composition analysis based on energy dispersive X-ray-EDS of EDAX company. N 2 adsorption-desorption measurements were carried out at 77 K using ASAP 2020 volumetric adsorption analyzer (Micromeritics). The specific surface areas (S BET ) of the samples were evaluated using the standard Brunauer–Emmett–Teller (BET) method for nitrogen adsorption data in the range of relative pressure p / p 0 from 0.06 to 0.3. The total pore volumes were estimated from single-point adsorption at a relative pressure of 0.98. XRD data indicates that main phases in microsphere are amorphous aluminosilicate glass, mullite and quartz. The obtained product is dominated by Na-P1 phase. Experimental calculations of cell parameters and fabricated models confirm crystallographic similarity to Na-P1 pattern. Noteworthy is the fact that the unit cell parameters depend on reaction time. Calculations indicate that the cell parameters (walls length: a , b , c and cell volume) increase with time towards to pattern values. This phenomenon may be interpreted as a ripening of crystalline structure. An in-depth look at this matter can lead to better estimation of synthesis conditions, which have a significant impact to the total cost of zeolites production – especially at a larger scale. SEM shows progressive dissolution (also as a function of time) of aluminosilicate glass in favor of crystallization of zeolite phase. EDS analysis confirms similarity of chemical composition of the obtained samples to a standard Na-P1 zeolite. Calculated textural properties indicate increase of S BET with the reaction time. Simultaneously, the average pore diameters decrease. The S BET of synthetized Na-P1 was 4.62 m 2 /g after 2 h but it increased to 47.92 m 2 /g after 26 h. This is an effect of growing contribution of zeolite phase in relation to the initial substrates in the sample during the reaction time. The experimental conditions allowed synthesizing Na-P1 zeolite from microsphere particles in the prototype installation. Zeolitization process strongly influences the textural properties by increasing S BET and improving pore structure. The microsphere from Stalowa Wola Power Plant is a promising material for the synthesis of Na-P1 zeolite in the prototype installation. Still, the reaction parameters should be reconsidered, basing on the obtained results, in order to reduce the cost of the zeolite production as much as possible. This is required before proceeding to the full technical production scale. To observe increase of zeolite amount in entirety synthesis batch (and to link it with cell behavior) the Rietveld analysis will be provided

Neutrophil-to-lymphocyte ratio predicts long-term all-cause mortality in patients with chronic kidney disease stage 5

Introduction: A high neutrophil-to-lymphocyte ratio (NLR) has been reported to be a strong biomarker of infl ammation. Aim: We sought to evaluate the impact of NLR on long-term all-cause and cardio-vascular (CV) mortality in hemodialysis (HD) patients. Material and Methods: A total of 84 chronic kidney disease (CKD) stage 5 patients with 54 of them on HD, with a median age of 61.5 (51.3-74.8) years were enrolled. The association between NLR and clinical biomarkers was investigated. Multivariable Cox regression analysis was used to find significant predictors of all-cause and CV mortality at follow-up. Results: The median NLR (interquartile range) was 3.0 (2.1-4.1). Patients with NLR ≥3.9 (the highest tertile) had higher fi ve-year all-cause mortality then remaining patients (53.6% vs. 30.4%; p = 0.039). On the contrary, only a trend towards increased CV mortality was observed (25.0% vs. 42.9%; p = 0.10). NLR ≥3.9 was a significant predictor of all-cause mortality at five years [hazard ratio (95%CI): 2.23 (1.10- 4.50); p = 0.025] in Cox regression model adjusted for age, gender, and diabetes status. Similarly, while using NLR as continuous variable a significant association between NLR and all-cause mortality was confirmed even after adjustment for covariates [hazard ratio per 1 unit increase (95%CI): 1.26 (1.06–1.51); p = 0.009] with the area under the receiver operating characteristic (ROC) curve of 0.64. Correlations between NLR and WBC, concentration of fi brinogen, albumin were observed. Conclusions: Asymptomatic inflammation measured by NLR showed an association with long-term all-cause mortality in stage 5 CKD patients, even while white blood cell count was in the normal range

Fungal X-Intrinsic Protein Aquaporin from Trichoderma atroviride: Structural and Functional Considerations

The major intrinsic protein (MIP) superfamily is a key part of the fungal transmembrane transport network. It facilitates the transport of water and low molecular weight solutes across biomembranes. The fungal uncharacterized X-Intrinsic Protein (XIP) subfamily includes the full protein diversity of MIP. Their biological functions still remain fully hypothetical. The aim of this study is still to deepen the diversity and the structure of the XIP subfamily in light of the MIP counterparts-the aquaporins (AQPs) and aquaglyceroporins (AQGPs)-and to describe for the first time their function in the development, biomass accumulation, and mycoparasitic aptitudes of the fungal bioagent Trichoderma atroviride. The fungus-XIP Glade, with one member (TriatXIP), is one of the three clades of MIPs that make up the diversity of T. atroviride MIPs, along with the AQPs (three members) and the AQGPs (three members). TriatXIP resembles those of strict aquaporins, predicting water diffusion and possibly other small polar solutes due to particularly wider ar/R constriction with a Lysine substitution at the LE2 position. The XIP loss of function in Delta TriatXIP mutants slightly delays biomass accumulation but does not impact mycoparasitic activities. Delta TriatMIP forms colonies similar to wild type; however, the hyphae are slightly thinner and colonies produce rare chlamydospores in PDA and specific media, most of which are relatively small and exhibit abnormal morphologies. To better understand the molecular causes of these deviant phenotypes, a wide-metabolic survey of the ATriatXIPs demonstrates that the delayed growth kinetic, correlated to a decrease in respiration rate, is caused by perturbations in the pentose phosphate pathway. Furthermore, the null expression of the XIP gene strongly impacts the expression of four expressed MIP-encoding genes of T. atroviride, a plausible compensating effect which safeguards the physiological integrity and life cycle of the fungus. This paper offers an overview of the fungal XIP family in the biocontrol agent T. atroviride which will be useful for further functional analysis of this particular MIP subfamily in vegetative growth and the environmental stress response in fungi. Ultimately, these findings have implications for the ecophysiology of Trichoderma spp. in natural, agronomic, and industrial systems

Experimental study of mercury removal from exhaust gases

An initial study has been made of the use of synthetic zeolites for mercury capture from exhaust gases. Synthetic zeolites (Na-X and Na-P1), and for comparison a natural zeolite (clinoptilolite) and activated carbon with bromine (AC/Br) were tested for mercury uptake from a gaseous stream. The materials were subjected to mercury adsorption tests and their thermal stability was evaluated. The untreated synthetic zeolites had negligible mercury uptake, but after impregnation with silver, the adsorption of mercury was markedly improved. The synthetic zeolite Na-X impregnated with silver adsorbed significantly more mercury before breakthrough than the activated carbon impregnated with bromine, indicating the potential of zeolite derived from coal fly ash as a new sorbent for capture of mercury from flue gases

"Stare" media w obliczu "nowych", "nowe" w obliczu "starych"

Praca recenzowana / peer-reviewed pape

Realistic Total-Body J-PET Geometry Optimization -- Monte Carlo Study

Total-Body PET is one of the most promising medical diagnostics modalities. The high sensitivity provided by Total-Body technology can be advantageous for novel tomography methods like positronium imaging. Several efforts are ongoing to lower the price of the TB-PET systems. Among the alternatives, the Jagiellonian PET (J-PET) technology, based on plastic scintillator strips, offers a low-cost alternative. The work aimed to compare five Total-Body J-PET geometries as a possible next generation J-PET scanner design. We present comparative studies of performance characteristics of the cost-effective Total-Body PET scanners using J-PET technology. We investigated in silico five Total-Body scanner geometries. Monte Carlo simulations of the XCAT phantom, the 2-meter sensitivity line source and positronium sensitivity phantoms were performed. We compared the sensitivity profiles for 2-gamma and 3-gamma tomography, relative cost of the setups and performed quantitative analysis of the reconstructed images. The analysis of the reconstructed XCAT images reveals the superiority of the seven-ring scanners over the three-ring setups. However, the three-ring scanners would be approximately 2-3 times cheaper. The peak sensitivity values for two-gamma vary from 20 to 34 cps/kBq. The sensitivity curves for the positronium tomography have a similar shape to the two-gamma sensitivity profiles. The peak values are lower compared to the two-gamma cases, from about 20-28 times, with a maximum of 1.66 cps/kBq. The results show the feasibility of multi-organ imaging of all the systems to be considered for the next generation of TB J-PET designs. The relative cost for all the scanners is about 10-4 times lower compared to the cost of the uExplorer. These properties coupled together with J-PET cost-effectiveness, make the J-PET technology an attractive solution for broad application in clinics

From tests of discrete symmetries to medical imaging with J-PET detector

We present results on CPT symmetry tests in decays of positronium performed with the precision at the level of 10$^{-4}$, and positronium images determined with the prototype of the J-PET tomograph. The first full-scale prototype apparatus consists of 192 plastic scintillator strips readout from both ends with vacuum tube photomultipliers. Signals produced by photomultipliers are probed in the amplitude domain and are digitized by FPGA-based readout boards in triggerless mode. In this contribution we report on the first two- and three-photon positronium images and tests of CPT symmetry in positronium decays

ProTheRaMon : a GATE simulation framework for proton therapy range monitoring using PET imaging

Objective. This paper reports on the implementation and shows examples of the use of the ProTheRaMon framework for simulating the delivery of proton therapy treatment plans and range monitoring using positron emission tomography (PET). ProTheRaMon offers complete processing of proton therapy treatment plans, patient CT geometries, and intra-treatment PET imaging, taking into account therapy and imaging coordinate systems and activity decay during the PET imaging protocol specific to a given proton therapy facility. We present the ProTheRaMon framework and illustrate its potential use case and data processing steps for a patient treated at the Cyclotron Centre Bronowice (CCB) proton therapy center in Krakow, Poland. Approach. The ProTheRaMon framework is based on GATE Monte Carlo software, the CASToR reconstruction package and in-house developed Python and bash scripts. The framework consists of five separated simulation and data processing steps, that can be further optimized according to the user’s needs and specific settings of a given proton therapy facility and PET scanner design. Main results. ProTheRaMon is presented using example data from a patient treated at CCB and the J-PET scanner to demonstrate the application of the framework for proton therapy range monitoring. The output of each simulation and data processing stage is described and visualized. Significance. We demonstrate that the ProTheRaMon simulation platform is a high-performance tool, capable of running on a computational cluster and suitable for multi-parameter studies, with databases consisting of large number of patients, as well as different PET scanner geometries and settings for range monitoring in a clinical environment. Due to its modular structure, the ProTheRaMon framework can be adjusted for different proton therapy centers and/or different PET detector geometries. It is available to the community via github (Borys et al 2022)