Noble Metal Dispersed on Reduced Graphene Oxide and Its Application in PEM Fuel Cells

Metal-dispersed nanoparticles on reduced graphene oxide as catalyst for oxygen reduction reaction (ORR) demonstrate promising applications in the energy sector. The catalyst activity enhancement and stability improvement investigated in this study are mandatory steps in obtaining feasible electrodes for PEMFC. The chapter deals with the synthesis of noble metal catalysts including platinum and gold nanoparticles dispersed on reduced graphene oxide (PtNPs/rGO and AuNPs/rGrO). The understanding of the correlations between the electrochemical activity on one side and the structure, composition and synthesis method on the other side are provided. Facile routes in order to prepare the well dispersed PtNPs/rGO and AuNPs/rGrO are included. The structure and morphology were characterized by different techniques, namely X-ray diffraction (XRD), Scanning Transmission Electron Microscopy (STEM), specific surface area measurements. In this context we report a hybrid derived electrocatalyst with increased electrochemical active area and enhanced mass-transport properties. The electrochemical performances of PtNPs/rGO and AuNPs/rGrO were tested and compared with a standard PEMFC configuration. The performed electrochemical characterization recommends the prepared materials as ORR electrocatalysts for the further fabrication of cathodes for PEM fuel cells. The research directions as well as perspectives on the subsequent development of more active and less expensive electrocatalysts are established

RF Magnetron Sputtering Deposition of TiO2 Thin Films in a Small Continuous Oxygen Flow Rate

Rutile titanium oxide (TiO2) thin films require more energy to crystallize than the anatase phase of TiO2. It is a prime candidate for micro-optoelectronics and is usually obtained either by high substrate temperature, applying a substrate bias, pulsed gas flow to modify the pressure, or ex situ annealing. In the present work, we managed to obtain high enough energy at the substrate in order for the particles to form rutile TiO2 at room temperature without any intentional substrate bias in a continuous gas flow. The rutile TiO2 thin films were deposited by a reactive radiofrequency magnetron sputtering system from a titanium target, in an argon/oxygen gas mixture. Investigations regarding the film’s structure and morphology were performed by X-ray diffraction (XRD), X-ray reflectivity (XRR), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDAX), while the optical properties were investigated by means of ellipsometry

The Mechanical and Physical Properties of 3D-Printed Materials Composed of ABS-ZnO Nanocomposites and ABS-ZnO Microcomposites

In order to expand the mechanical and physical capabilities of 3D-printed structures fabricated via commercially available 3D printers, nanocomposite and microcomposite filaments were produced via melt extrusion, 3D-printed and evaluated. The scope of this work is to fabricate physically and mechanically improved nanocomposites or microcomposites for direct commercial or industrial implementation while enriching the existing literature with the methodology applied. Zinc Oxide nanoparticles (ZnO nano) and Zinc Oxide micro-sized particles (ZnO micro) were dispersed, in various concentrations, in Acrylonitrile Butadiene Styrene (ABS) matrices and printable filament of ~1.75mm was extruded. The composite filaments were employed in a commercial 3D printer for tensile and flexion specimens’ production, according to international standards. Results showed a 14% increase in the tensile strength at 5% wt. concentration in both nanocomposite and microcomposite materials, when compared to pure ABS specimens. Furthermore, a 15.3% increase in the flexural strength was found in 0.5% wt. for ABS/ZnO nano, while an increase of 17% was found on 5% wt. ABS/ZnO micro. Comparing the two composites, it was found that the ABS/ZnO microcomposite structures had higher overall mechanical strength over ABS/ZnO nanostructures

Atopic Dermatitis with Multiple Comorbidities Treated with Dupilumab. A Case Report and Review of the Literature Regarding the Safety of Dupilumab

Dupilumab is the only available biological treatment for moderate-to-severe atopic dermatitis (AD). Even so, limited clinical data regarding its safety profile are available. Interactions with other drugs and the adverse effects of Dupilumab on patients with multiple comorbidities, such as chronic heart disease, diabetes, chronic kidney disease, etc., are not known yet. Moreover, there have been described cases of cutaneous lymphomas induced by Dupilumab. Therefore, the clinician that wants to start treatment for moderate-to-severe atopic dermatitis, which does not respond to conventional drugs, might be reluctant to choose biologic agents such as Dupilumab. In this paper, we reported a case of severe atopic dermatitis with multiple comorbidities in which the patient was successfully treated with Dupilumab despite numerous underlying conditions. We also conducted a review of the current literature on the safety profile of Dupilumab in special categories of patients with comorbidities, such as heart, kidney, and liver disease, oncologic conditions, and during pregnancy

Comparative Study of Graphene Nanoplatelets and Multiwall Carbon Nanotubes-Polypropylene Composite Materials for Electromagnetic Shielding

Graphene nanoplatelets (GNPs) and multiwall carbon nanotubes (CNTs)-polypropylene (PP) composite materials for electromagnetic interference (EMI) shielding applications were fabricated as 1 mm thick panels and their properties were studied. Structural and morphologic characterization indicated that the obtained composite materials are not simple physical mixtures of these components but new materials with particular properties, the filler concentration and nature affecting the nanomaterials’ structure and their conductivity. In the case of GNPs, their characteristics have a dramatic effect of their functionality, since they can lead to composites with lower conductivity and less effective EMI shielding. Regarding CNTs-PP composite panels, these were found to exhibit excellent EMI attenuation of more than 40 dB, for 10% CNTs concentration. The development of PP-based composite materials with added value and particular functionality (i.e., electrical conductivity and EMI shielding) is highly significant since PP is one of the most used polymers, the best for injection molding, and virtually infinitely recyclable

Critical care admission following elective surgery was not associated with survival benefit:prospective analysis of data from 27 countries

Purpose: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. Methods: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests. Results: 44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10–5.21]; p < 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings. Conclusions: We did not identify any survival benefit from critical care admission following surgery

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine