NO Abatement using Microwave Micro Plasma Generated using Granular Activated Carbon

Abatement of NO using microwave micro-plasma is presented in this paper. The micro-plasma is generated using granular activated carbon (GAC) particles of size (size 2-3mm) in loosely fluidised bed in microwave filed operated at 2.45GHz. A single mode microwave cavity reactor (SMMCR) was constructed and microwave was injected through another slotted waveguide in a sandwiched manner. COMSOL Multiphysics software was used to investigate the microwave electric field and the power density within the SMMCR. Gas mixture of air and 500 ppm NO (in N2) at the flow rate of 2 l/min was passed through a quartz tube centered within SMMCR while the supplied microwave power was very low 10-80 W and NO reduction was greater than 98%. The mass of GAC used for generating the plasma was 5g. When air is mixed with NO (in N2), the efficiency of NOx reduction achieved vary greatly with respect to the supplied microwave energy and behavior has become complex and is not predictable. The gas analyzer (testo 350) was used to measure the gas (NO, NO2, CO and O2) concentration and temperature

Involved margins after lumpectomy for breast cancer: Always to be re-excised?

Background: The oncologic benefit of upfront re-excision of involved margins after breast-conserving surgery in the context of current multimodal clinical management of breast cancer is unclear. The aim of the present study was to assess the 5-years locoregional recurrence (LRR)-free and distant metastases (DM)-free survival probabilities in patients not undergoing re-excision of positive margins after lumpectomy for breast cancer. Methods: A cohort of 104 patients with positive margins not undergoing re-excision was matched by propensity score with a cohort of 2006 control patients with clear margins after breast-conserving surgery, treated between 2008 and 2018. A multivariate survival analysis was performed accounting for all variables related to LRR and DM, including adjuvant treatments. Results: After adjusting for potential confounders, avoiding to re-excise a positive margin after lumpectomy had no effect on 5-years LRR-free survival probability (HR 0.98, 95%CI 0.36-2.67, p = 0.96) or 5-years DM-free survival probability (HR 0.37, 95%CI 0.08-1.61, p = 0.18). No correlation was found between occurrence of LRR and number of involved margins (HR 1.28, 95%CI 0.10-12.4, Log-rank p = 0.83), or extension of infiltrating disease (HR 1.21, 95%CI 0.20-7.40, Log-rank p = 0.83), but a trend toward higher LRR probability was found for invasive ductal (HR 6.92, 95%CI 0.7-68.8, Log-rank p = 0.10) and invasive lobular cancer (HR 12.95, 95%CI 0.79-213.6, Log-rank p = 0.07) on positive margins. Conclusions: In the era of multimodal treatment of breast cancer and accurate strategies to reduce the probability of residual disease in the post-lumpectomy cavity, re-excision of positive margins might be omitted in selected patients with low-risk breast cancers

NOx abatement form the exhaust of a diesel engine with non-thermal plasma and Ag/Al2O3 catalys

Air pollutants generated by ships in both gaseous and particulate forms have long term effect on the quality of the environment and cause a significant exposure risk to people living in proximities of harbours or in the neighbouring coastal areas. It has been estimated that ships produce at least 15% of the world’s NOx, ~4% of greenhouse gases, ~5% of black carbon and ~7% of global SO2 output. International shipping traffic presents a major challenge in terms of environment and human health which entails severe economic consequences. During the past decade, the use of non-thermal plasma for the abatement of NOx and SOx has been gaining momentum [1]. Non-thermal plasma selectively transfers input electrical energy to the electrons and to not expend this in heating the entire gas stream, which generates free radicals through collisions and promotes the desired chemical changes in the marine diesel engine exhaust gas. Abatement of NO from the exhaust of a 2 kW diesel engine was experimentally demonstrated in the work reported here. An AC corona based non-thermal plasma (NTP) followed by Ag/Al2O3 catalyst was used to convert NOx (NO+NO2) into harmless N2. A high frequency high voltage source ((~ 4.5 MHz and 30 kV) was used to generate the required NTP. In this set-up, the produced NTP was a streamer plasma [2], where no arc-discharge between the high voltage and ground electrode would be produced due to the fast switching of polarity between plates. Two percent silver (by weight) was impregnated onto the 3 mm Al2O3 beads using a rotary evaporator at 50◦C. Catalyst was heated to 350-400◦c to activate the catalytic effect during the abatement process. In a two-step process, firstly NO would be converted into NO2 in the NTP reactor followed by NO2 conversion into N2 in the catalytic chamber. The flow rate of the exhaust treated was 15 l/min and NOx concentration was 550 ppm. Overall the NOx conversion efficiency was more than 90%. This technique has shown repeatable superior performance than the results reported by McAdams et al [3], whose study was only based on pre-mixed bottles gases, whereas this study was based on real engine exhaust which contained 12% O2 in addition to soot, CO, CO2, HC and other unknown traces of gases

NO Abatement using Microwave Micro Plasma Generated with Granular Activated Carbon

The micro-plasma is generated using granular activated carbon (GAC) particles of size (2-3mm) in loosely fluidized bed in a microwave cavity operated at 2.45GHz. A single mode microwave cavity reactor (SMMCR) was constructed and microwave was injected through another slotted single mode waveguide in a sandwiched manner. COMSOL Multiphysics software was used to investigate the microwave electric field and the power density within the SMMCR. Gas mixture of air and 500 ppm NO (in N2) at the flow rate of 2 l/min was passed through a quartz tube centered within the SMMCR while the supplied microwave power was very low 10-80 W and corresponding NO reduction was greater than 98%. The mass of GAC used for generating the plasma was 5g. The efficiency of NO reduction is found to be 24.84 g(NO2)/kWh. When air is mixed with NO (in N2), the efficiency of NOx reduction achieved vary greatly with respect to the supplied microwave energy and behavior has become complex and is not predictable, which needs further investigation. A gas analyzer (testo 350) was used to measure the gas (NO, NO2, CO and O2) concentration and temperature.Marine Exhaust Gas Treatment System (MAGS) grant reference number 42471-295209

Raman spectroscopy reveals that biochemical composition of breast microcalcifications correlates with histopathologic features

Breast microcalcifications are a common mammographic finding. Microcalcifications are considered suspicious signs of breast cancer and a breast biopsy is required, however, cancer is diagnosed in only a few patients. Reducing unnecessary biopsies and rapid characterization of breast microcalcifications are unmet clinical needs. In this study, 473 microcalcifications detected on breast biopsy specimens from 56 patients were characterized entirely by Raman mapping and confirmed by X-ray scattering. Microcalcifications from malignant samples were generally more homogeneous, more crystalline, and characterized by a less substituted crystal lattice compared with benign samples. There were significant differences in Raman features corresponding to the phosphate and carbonate bands between the benign and malignant groups. In addition to the heterogeneous composition, the presence of whitlockite specifically emerged as marker of benignity in benign microcalcifications. The whole Raman signature of each microcalcification was then used to build a classification model that distinguishes microcalcifications according to their overall biochemical composition. After validation, microcalcifications found in benign and malignant samples were correctly recognized with 93.5% sensitivity and 80.6% specificity. Finally, microcalcifications identified in malignant biopsies, but located outside the lesion, reported malignant features in 65% of in situ and 98% of invasive cancer cases, respectively, suggesting that the local microenvironment influences microcalcification features. This study confirms that the composition and structural features of microcalcifications correlate with breast pathology and indicates new diagnostic potentialities based on microcalcifications assessment. Significance: Raman spectroscopy could be a quick and accurate diagnostic tool to precisely characterize and distinguish benign from malignant breast microcalcifications detected on mammography

Establishment and Morphological Characterization of Patient-Derived Organoids from Breast Cancer

Background: Patient-derived organoids (PDO) technology represents an emerging tool for the study of tumor biology and drug responsiveness, thus being useful to design personalized medicine approaches. Despite several studies and clinical trials are ongoing using PDO from colorectal and pancreatic cancer, only few research papers have been published exploiting PDO from breast cancer. Here, we have developed a new protocol to establish PDO from surgical and biopsy samples. Furthermore, we have set up also the methodologies adopted for culture and morphological evaluations. Results: Surgical and core biopsy specimens collected from 33 patients with diagnosis of breast cancer have been processed using the protocols here described obtaining PDO from cancerous and healthy mammary tissue (when available) in a quick and easy way with good yields. The more critical aspects influencing the yield were the characteristic of the tissue of origin (healthy vs tumor tissue) and the amount of material obtained after enzymatic digestion process. Success rate from healthy samples was about 20,83%, while this percentage was higher in samples from cancer tissue (i.e. 87,5%). Also the morphological characterization of breast cancer PDO by brightfield and transmission electron microscopy has been reported. Conclusions: Despite obtaining some organoids from a surgical or biopsy specimen is not a difficult procedure, the establishment of a stable organoid line able to grow and replicate, suitable for long-term biobank storage, is not so obvious. A novel, simple and quick procedure to obtain PDO from surgical and biopsy samples is here proposed to achieve high success rate

Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

Background: During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods: A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results: Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0–6]%, 0 [0–4]% and 11 [2–25]%, respectively, p < 0.001). Habits of pediatric ICUs were less affected by the pandemic. Conclusions: Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted

Adherence issues related to sublingual immunotherapy as perceived by allergists

Objectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence. Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10. Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists. Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers. © 2010 Scurati et al, publisher and licensee Dove Medical Press Ltd

Endocrinologic, neurologic, and visual morbidity after treatment for craniopharyngioma

Craniopharyngiomas are locally aggressive tumors which typically are focused in the sellar and suprasellar region near a number of critical neural and vascular structures mediating endocrinologic, behavioral, and visual functions. The present study aims to summarize and compare the published literature regarding morbidity resulting from treatment of craniopharyngioma. We performed a comprehensive search of the published English language literature to identify studies publishing outcome data of patients undergoing surgery for craniopharyngioma. Comparisons of the rates of endocrine, vascular, neurological, and visual complications were performed using Pearson’s chi-squared test, and covariates of interest were fitted into a multivariate logistic regression model. In our data set, 540 patients underwent surgical resection of their tumor. 138 patients received biopsy alone followed by some form of radiotherapy. Mean overall follow-up for all patients in these studies was 54 ± 1.8 months. The overall rate of new endocrinopathy for all patients undergoing surgical resection of their mass was 37% (95% CI = 33–41). Patients receiving GTR had over 2.5 times the rate of developing at least one endocrinopathy compared to patients receiving STR alone or STR + XRT (52 vs. 19 vs. 20%, χ2P < 0.00001). On multivariate analysis, GTR conferred a significant increase in the risk of endocrinopathy compared to STR + XRT (OR = 3.45, 95% CI = 2.05–5.81, P < 0.00001), after controlling for study size and the presence of significant hypothalamic involvement. There was a statistical trend towards worse visual outcomes in patients receiving XRT after STR compared to GTR or STR alone (GTR = 3.5% vs. STR 2.1% vs. STR + XRT 6.4%, P = 0.11). Given the difficulty in obtaining class 1 data regarding the treatment of this tumor, this study can serve as an estimate of expected outcomes for these patients, and guide decision making until these data are available