Electrochemical cell design for the impedance studies of chlorine evolution at DSA® anodes

A new electrochemical cell design suitable for the electrochemical impedance spectroscopy (EIS)studies of chlorine evolution on Dimensionally Stable Anodes (DSA®) has been developed. Despitebeing considered a powerful tool, EIS has rarely been used to study the kinetics of chlorine evolutionat DSA anodes. Cell designs in the open literature are unsuitable for the EIS analysis at high DSAanode current densities for chlorine evolution because they allow gas accumulation at the electrodesurface. Using the new cell, the impedance spectra of the DSA anode during chlorine evolution at highsodium chloride concentration (5 mol dm−3 NaCl) and high current densities (up to 140 mA cm−2)were recorded. Additionally, polarization curves and voltammograms were obtained showing little orno noise. EIS and polarization curves evidence the role of the adsorption step in the chlorine evolutionreaction, compatible with the Volmer-Heyrovsky and Volmer-Tafel mechanisms

The association between body-mass index and patient outcome in septic shock: a retrospective cohort study

Zusammenfassung: HINTERGRUND: Es bestehen keine Daten über die Assoziation zwischen dem Body Mass Index (BMI) bzw. BMI Kategorien und der Mortalität von septischen Schock-patienten. METHODEN: Die Datenbank einer interdisziplinären Intensivstation wurde retrospektiv nach erwachsenen Patienten mit septischem Schock durchsucht. Von allen Patienten wurde der BMI, demographische, klinische und laborchemische Parameter gemeinsam mit Outcomevariabeln dokumentiert. Die Studienpatienten wurden wie folgt anhand des BMI kategorisiert: BMI 30 kg/m2, Fettleibigkeit. Bivariate und multivariate logistische Regressionsmodelle wurden verwendet, um den Zusammenhang zwischen dem BMI und Outcome-variabeln zu untersuchen. RESULTATE: 301 septische Schockpatienten wurden identifiziert. Der BMI war bivariat mit der Mortalität auf der Intensivstation assoziiert (OR, 0,91; 95% CI, 0,86-0,98; p = 0,007). Es gab keine signifikante Assoziation zwischen dem BMI und der Mortalität auf der Intensivstation. Allerdings waren höhere BMI Werte trendmässig mit einer niedrigeren Intensivstations-mortalität assoziiert (OR, 0,93; 95% CI, 0,86-1,01; p = 0,09). Während übergewichtige (OR, 0,43; 95% CI, 0,19-0,98; p = 0,04) und fettleibige (OR, 0,28; 95% CI, 0,08-0,93; p = 0,04) Patienten ein unabhängig niedrigeres Risiko auf der Intensivstation zu versterben hatten als normalgewichtige Patienten, gab es keinen Unterschied im Sterberisiko zwischen normal- und untergewichtigen Patienten (p = 0,22). Ein hoher BMI war unabhängig mit einer geringen Häufigkeit eines akutem Deliriums (p = 0,04) und einer geringeren Intensivwieder-aufnahmerate (p = 0,001), aber mit mehr Harnwegsinfektionen (p = 0,02) assoziiert. SCHLUSSFOLGERUNG: Bis zu einem BMI von 50 kg/m2 scheint keine Assoziation zwischen BMI und schlechterem Überleben auf der Intensivstation oder im Krankenhaus bei septischen Schockpatienten zu bestehen. Im Gegenteil, hohe BMI Werte könnten sogar das Risiko am septischen Schock zu versterben reduziere

The association between body-mass index and patient outcome in septic shock: a retrospective cohort study

It is unknown whether body-mass index (BMI) and commonly defined BMI categories are associated with mortality in patients with septic shock

Stress-related cardiomyopathies

Stress-related cardiomyopathies can be observed in the four following situations: Takotsubo cardiomyopathy or apical ballooning syndrome; acute left ventricular dysfunction associated with subarachnoid hemorrhage; acute left ventricular dysfunction associated with pheochromocytoma and exogenous catecholamine administration; acute left ventricular dysfunction in the critically ill. Cardiac toxicity was mediated more by catecholamines released directly into the heart via neural connection than by those reaching the heart via the bloodstream. The mechanisms underlying the association between this generalized autonomic storm secondary to a life-threatening stress and myocardial toxicity are widely discussed. Takotsubo cardiomyopathy has been reported all over the world and has been acknowledged by the American Heart Association as a form of reversible cardiomyopathy. Four "Mayo Clinic" diagnostic criteria are required for the diagnosis of Takotsubo cardiomyopathy: 1) transient left ventricular wall motion abnormalities involving the apical and/or midventricular myocardial segments with wall motion abnormalities extending beyond a single epicardial coronary artery distribution; 2) absence of obstructive epicardial coronary artery disease that could be responsible for the observed wall motion abnormality; 3) ECG abnormalities, such as transient ST-segment elevation and/or diffuse T wave inversion associated with a slight troponin elevation; and 4) the lack of proven pheochromocytoma and myocarditis. ECG changes and LV dysfunction occur frequently following subarachnoid hemorrhage and ischemic stroke. This entity, referred as neurocardiogenic stunning, was called neurogenic stress-related cardiomyopathy. Stress-related cardiomyopathy has been reported in patients with pheochromocytoma and in patients receiving intravenous exogenous catecholamine administration. The role of a huge increase in endogenous and/or exogenous catecholamine level in critically ill patients (severe sepsis, post cardiac resuscitation, post tachycardia) to explain the onset of myocardial dysfunction was discussed. Further research is needed to understand this complex interaction between heart and brain and to identify risk factors and therapeutic and preventive strategies

Pregled znanstvenih napredaka u učinskoj elektronici usmjerenih ka osiguravanju efikasnog rada i dužeg životnog vijeka PEMgorivih ćelija

This article focuses on the main issues that affect the lifetime and performance of proton-exchange membrane fuel cells. The short lifespans of these fuel cells represent a barrier to their massive commercialization and usage in mobile and stationary applications. As fuel cell is a very complex system, a lot of knowledge of different areas is required, such as chemistry, electricity and mechanics, in order to completely understand its operation and all the problems that can occur during it. It is for this reason that an interdisciplinary approach needs to be taken when designing fuel-cell energy systems. This paper focuses on identifying and solving those issues that negatively affect the lifetime and performance of fuel cells. It is hoped that this article would be a valuable aid for power electronics’ researchers and engineers for better understanding the presented issues and a useful guide for solving them with the use of proper power electronic-devices. Initially, the basic operation and structure of a proton-exchange membrane fuel cell is explained. Three main issues that can occur during operation of a mobile or stationary fuel cell energy system are pointed out and discussed in details, on the basis of the state-of-the-art on fuel cell technology. These issues are poor water management, reactant gas starvation and fuel cell current ripple. This article provides answers as to why they occur, how they affect the fuel cell, how they can be mitigated, and what are the future trends within this research field.Članak se osvrće na ključna pitanja koja utječu na vrijeme rada i performanse gorivih ćelija s polimernom membranom kao elektrolitom. Kratak životni vijek gorivih ćelija takve vrste prepreka je njihovoj komercijalizaciji i masovnoj upotrebi u mobilnim i stacionarnim stanicama. Budući da su gorive ćelije komplicirani sustavi potrebno je znanje iz raznih područja kemije, elektrotehnike i mehanike da bi se u potpunosti mogao razumjeti njihov način rada i problemi koji se događaju. Upravo je zbog toga multidisciplinarni pristup nužnost pri razvoju sustava koji koriste gorive ćelije. Ovaj je članak usmjeren prema identifikaciji i rješavanju onih problema koji negativno utječu na životni vijek i performanse gorivih ćelija. Autori se nadaju da će se članak pokazati kao korisna pomoć i vodič istraživačima i inženjerima u domeni učinske elektronike pri susretu s navedenim problemima. Objašnjen je način rada i struktura gorive ćelije s polimernom membranom kao elektrolitom. Izložena su, i diskutirana do u detalje, tri glavna problema sa stajališta trenutačnih spoznaja u području učinske elektronike. Ti problemi su: loše upravljanje vodom, nestanak reaktantnog plina i strujni trzaji u gorivim ćelijama. Objašnjeno je zašto se ovi problemi događaju, kako utječu na gorivu ćeliju, kako ih se može spriječiti i koje su buduće perspektive istraživanja

The association between early hemodynamic variables and outcome in normothermic comatose patients following cardiac arrest

Currently, few data exist on the association between post-cardiac arrest hemodynamic function and outcome. In this explorative, retrospective analysis, the association between hemodynamic variables during the first 24 h after intensive care unit admission and functional outcome at day 28 was evaluated in 153 normothermic comatose patients following a cardiac arrest

Adverse cardiac events during catecholamine vasopressor therapy: a prospective observational study

PURPOSE: To determine the incidence of and risk factors for adverse cardiac events during catecholamine vasopressor therapy in surgical intensive care unit patients with cardiovascular failure. METHODS: The occurrence of any of seven predefined adverse cardiac events (prolonged elevated heart rate, tachyarrhythmia, myocardial cell damage, acute cardiac arrest or death, pulmonary hypertension-induced right heart dysfunction, reduction of systemic blood flow) was prospectively recorded during catecholamine vasopressor therapy lasting at least 12 h. RESULTS: Fifty-four of 112 study patients developed a total of 114 adverse cardiac events, an incidence of 48.2 % (95 % CI, 38.8-57.6 %). New-onset tachyarrhythmia (49.1 %), prolonged elevated heart rate (23.7 %), and myocardial cell damage (17.5 %) occurred most frequently. Aside from chronic liver diseases, factors independently associated with the occurrence of adverse cardiac events included need for renal replacement therapy, disease severity (assessed by the Simplified Acute Physiology Score II), number of catecholamine vasopressors (OR, 1.73; 95 % CI, 1.08-2.77; p = 0.02) and duration of catecholamine vasopressor therapy (OR, 1.01; 95 % CI, 1-1.01; p = 0.002). Patients developing adverse cardiac events were on catecholamine vasopressors (p < 0.001) and mechanical ventilation (p < 0.001) for longer and had longer intensive care unit stays (p < 0.001) and greater mortality (25.9 vs. 1.7 %; p < 0.001) than patients who did not. CONCLUSIONS: Adverse cardiac events occurred in 48.2 % of surgical intensive care unit patients with cardiovascular failure and were related to morbidity and mortality. The extent and duration of catecholamine vasopressor therapy were independently associated with and may contribute to the pathogenesis of adverse cardiac events