Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.

A simple and precise conductometric method for the determination of losartan in pharmaceutical products

Losartan is an antihypertensive agent that lost its patent protection in 2010, and, consequently, it has been available in generic form. The latter motivated the search for a rapid and precise alternative method. Here, a simple conductometric titration in aqueous medium is described for the losartan analysis in pharmaceutical formulations. The first step of the titration occurs with the protonation of losartan producing a white precipitate and resulting in a slow increase in conductivity. When the protonation stage is complete, a sharp increase in conductivity occurs which was determined to be due to the presence of excess of acid. The titrimetric method was applied to the determination of losartan in pharmaceutical products and the results are comparable with values obtained using a chromatographic method recommended by the United States Pharmacopoeia. The relative standard deviation for successive measurements of a 125 mg L-1 (2.71x10(-4) mol L-1) losartan solution was approximately 2%. Recovery study in tablet samples ranged between 99 and 102.4%. The procedure is fast, simple, and represents an attractive alternative for losartan quantification in routine analysis. In addition, it avoids organic solvents, minimizes the risk of exposure to the operator, and the waste treatment is easier compared to classical chromatographic methods.

Evaluating the performance of polypyrrole nanowires on the electrochemical sensing of ammonia in solution

This work encompasses the direct electrodeposition of polypyrrole nanowires onto Au substrates using different electrochemical techniques: normal pulse voltammetry (NPV) and constant potential method with the aim in applying these films for the first time in ammonia sensing in solution. The performance of these nanowire-based sensors are compared and evaluated in terms of: film morphology (analyzed with scanning electron microscopy); their sensitivity towards ammonia; electrochemical and contact angle measurements. For nanowires prepared by NPV, the sensitivity towards ammonia increases with increasing amount of electrodeposited polypyrrole, as expected due to the role of polypyrrole as electrochemical transducer for ammonia oxidation. On the other hand, nanowires prepared potentiostatically displayed an unexpected opposite behavior, attributed to the lower conductivity of longer polypyrrole nanowires obtained through this technique. These results evidenced that the analytical and physico-chemical features of nanostructured sensors can differ greatly from those of their conventional bulky analogous. (C) 2012 Elsevier B.V. All rights reserved.

Direct ethanol fuel cell: Electrochemical performance at 90 degrees C on Pt and PtSn/C electrocatalysts

Carbon-supported Pt-based electrocatalysts were synthesized by Pechini method for the ethanol oxidation (EOR). Physicochemical characterizations were helpful to estimate the diameters of the obtained materials ranging from 2 nm to 5 nm. Main electrochemical experiments were carried out at 90 degrees C i.e. under the working conditions of performing the single 5 cm(2) direct ethanol fuel cell (DEFC). Pt(80)Sn(20)/C was the anode catalyst which has given the highest power density of 37 mW cm(-2). Importantly, the IR spectroscopy measurements associated with the qualitative analysis done at the output of the anodic compartment of the fuel cell have shown that ethanol oxidation on Pt(80)Sn(20)/C was mainly a two-electron sustainable process. (C) 2011 Elsevier B.V. All rights reserved.

Paper-Based Analytical Device for Electrochemical Flow-Injection Analysis of Glucose in Urine

This article describes a new design for a paper-based electrochemical system for flow injection analysis. Capillary wicking facilitates a gravity-driven flow of buffer solution continuously through paper and nitrocellulose, from a buffer reservoir at one end of the device to a sink at the other. A difference in height between the reservoir and the sink leads to a continuous and constant flow. The nitrocellulose lies horizontally on a working electrode, which consists of a thin platinum layer deposited on a solid support. The counter and reference electrodes are strategically positioned upstream in the buffer reservoir. A simple pipetting device was developed for reliable application of (sub)microliter volumes of sample without the need of commercial micropipets; this device did not damage the nitrocellulose membrane. Demonstration of the system for the determination of the concentration of glucose in urine resulted in a noninvasive, quantitative assay that could be used for diagnosis and monitoring of diabetes. This method does not require disposable test strips, with enzyme and electrodes, that are thrown away after each measurement Because of its low cost, this system could be used in medical environments that are resource-limited.

Application of Electrochemical Degradation of Wastewater Composed of Mixtures of Phenol-Formaldehyde

The industrial wastewater from resin production plants contains as major components phenol and formaldehyde, which are traditionally treated by biological methods. As a possible alternative method, electrochemical treatment was tested using solutions containing a mixture of phenol and formaldehyde simulating an industrial effluent. The anode used was a dimensionally stable anode (DSAA (R)) of nominal composition Ti/Ru0.3Ti0.7O2, and the solution composition during the degradation process was analyzed by liquid chromatography and the removal of total organic carbon. From cyclic voltammetry, it is observed that for formaldehyde, a small offset of the beginning of the oxygen evolution reaction occurs, but for phenol, the reaction is inhibited and the current density decreases. From the electrochemical degradations, it was determined that 40 mA cm(-2) is the most efficient current density and the comparison of different supporting electrolytes (Na2SO4, NaNO3, and NaCl) indicated a higher removal of total organic carbon in NaCl medium.

Influence of Modifications to the Pechini Method on the Electroactivity and Stability of Pt-RuOx/C Catalysts

Since electrode electroactivity and stability depend directly on the nature, morphology, and structure of the material, we have investigated how modifications to the Pechini method during the synthesis of Pt-RuOx/C electrocatalysts affected catalyst activity. The structure and stability of the resulting materials were investigated after their submission to a large number of potential scans and to constant potential for a prolonged time period in sulfuric acid 0.5 mol L-1 and methanol 0.1 mol L-1 solution. DMFC tests were accomplished using membrane electrode assemblies (MEAs) prepared by hot-pressing a pretreated Nafion 117 membrane together with the prepared Pt-RuOx anodes and a Pt cathode (from E-TEK), in order to compare the catalytic activity of the materials prepared by different methods. The stability studies demonstrated that the catalyst whose resin/carbon support mixture was agitated in a balls mill before undergoing heat-treatment was more stable than the other prepared catalysts. The catalysts synthesized with the single resin consisting of Pt and Ru and subjected to ultrasound before heat-treatment furnished the highest power density in the single fuel cell. (C) 2012 The Electrochemical Society. [DOI: 10.1149/2.011208jes]

Carbon nanotubes modified with antimony nanoparticles: A novel material for electrochemical sensing

In this study, a novel material for the electrochemical determination of bisphenol A using a nanocomposite based on multi-walled carbon nanotubes modified with antimony nanoparticles has been investigated. The morphology, structure, and electrochemical performance of the nanocomposite electrodes were characterised by field emission gun scanning electron microscopy, energy-dispersive X-ray spectroscopy, and cyclic voltammetry. A scan rate study and electrochemical impedance spectroscopy showed that the bisphenol A oxidation product is adsorbed on nanocomposite electrode surface. Differential pulse voltammetry in phosphate buffer solution at pH 6, allowed the development of a method to determine bisphenol A levels in the range of 0.5-5.0 mu mol L-1, with a detection limit of 5.24 nmol L-1 (1.19 mu g L-1). (C) 2012 Elsevier Ltd. All rights reserved.

Development of an enzymeless electroanalytical method for the indirect detection of creatinine in urine samples

The aim of this study is to develop a new enzymeless electroanalytical method for the indirect quantification of creatinine from urine sample. This method is based on the electrochemical monitoring of picrate anion reduction at a glassy carbon electrode in an alkaline medium before and after it has reacted with creatinine (Jaffe's reaction). By using the differential pulse voltammetry technique under the optimum experimental conditions (step potential, amplitude potential, reaction time, and temperature), a linear analytical curve was obtained for concentrations of creatinine ranging from 1 to 80 mu mol L-1, with a detection limit of 380 nmol L-1. This proposed method was used to measure creatinine in human urine without the interference of most common organic species normally present in biological fluids (e.g., uric acid, ascorbic acid, glucose, and phosphocreatinine). The results obtained using urine samples were highly similar to the results obtained using the reference spectrophotometric method (at a 95% confidence level). (C) 2012 Elsevier B.V. All rights reserved.

Glass/PDMS hybrid microfluidic device integrating vertically aligned SWCNTs to ultrasensitive electrochemical determinations

This communication reports a promising platform for rapid, simple, direct, and ultrasensitive determination of serotonin. The method is related to integration of vertically aligned single-walled carbon nanotubes (SWCNTs) in electrochemical microfluidic devices. The required microfabrication protocol is simple and fast. In addition, the nanomaterial influenced remarkably the obtained limit-of-detection (LOD) values. Our system achieved a LOD of 0.2 nmol L-1 for serotonin, to the best of our knowledge one of the lowest values reported in the literature.