Supplementary Respiratory Therapy Improves Pulmonary Function in Pediatric Patients with Cerebral Palsy: A Systematic Review and Meta-Analysis

BACKGROUND

Despite medical advances, individuals with cerebral palsy (CP) face significant respiratory challenges, leading to heightened hospitalization rates and early mortality among this population. We hypothesize that integrating supplementary respiratory therapy into standard rehabilitation will result in significant improvements in pulmonary function, enhanced respiratory muscle strength, and an overall increase in the quality of life among pediatric patients with CP.

METHODS

A systematic search of literature across five databases was conducted, and random-effects meta-analyses were performed to assess the impact of supplementary respiratory therapy on (a) pulmonary function: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio, peak expiratory flow (PEF), and (b) respiratory muscle strength: maximal inspiratory and expiratory pressure (MIP, MEP), and (c) quality of life. Certainty of evidence was determined by the GRADE assessment.

RESULTS

Analysis of data from 11 eligible randomized controlled trials revealed clinically meaningful changes in pulmonary function. We found a relevant mean difference (MD) in absolute PEF of 0.50 L/s (95% confidence interval (CI): 0.19; 0.82 p = 0.0107). The certainty of the evidence ranged from moderate to high.

CONCLUSIONS

This study presents current evidence on the impact of various supplementary respiratory therapies for CP patients classified under gross motor function classification level I-IV, demonstrating clinically meaningful improvements in pulmonary function and respiratory muscle strength. These improvements suggest the potential for an enhanced quality of life. Our findings hold the promise of serving as a foundational reference for potential revisions to conventional rehabilitation care, incorporating supplementary respiratory therapy.

Aqueous heterocoagulation-driven assembly of graphene oxide and polycation-coated sulfur particles for nanocomposite Li-S battery cathodes

HYPOTHESIS

Reduced graphene oxide (rGO/polycation/sulfur) composites are promising cathode materials for Li-S battery applications because homogeneously dispersed sulfur nano/micro clusters in suitable carbon hosts enable remarkable cycle life for Li-S battery cells. New, benign and economic synthesis methods based only on aqueous colloidal dispersions are demanded for achieving high dispersity grade of sulfur within the carbon host. Colloidal interactions leading to heteroaggregation between carbonaceous lamellae and polycation-modified sulphur nanoparticles at ambient conditions in water are foreseen to afford nanocomposite cathodes, which maintain excellent electrochemical performance.

EXPERIMENTS

Hydrophilic sulfur nanoparticles (SNPs) were coated by low doses of polycation (PDDA) until reaching the isoelectric point (IEP), and in high dose to achieve charge reversal. Streaming potential titrations were performed to reveal appropriate mass ratios of PPDA, SNP and GO. Positively charged SNPs formed stable heteroaggregated structures with GO, and were employed to fabricate rGO/polycation/sulphur cathodes.

FINDINGS

Charge reversal characteristics of SNPs, polycation and GO were characterized quantitatively and mass ratios of PDDA to SNP beyond IEP were found to mediate attractive interactions leading to rapid heteroaggregation between SNPs and GO and also alleviate lithium polysulfide migration. The composite cathode showed an initial discharge capacity of 522 mAhg-1 at 0.2C rate with an excellent capacity retention of 91.4 % and coulombic efficiency of 98.5% after 100 charge-discharge cycles.

Association of tumor location with anxiety and depression in childhood brain cancer survivors: a systematic review and meta-analysis

OBJECTIVE

This study aimed to evaluate the association between the location (supratentorial or infratentorial) of brain tumors and the development of depression and anxiety in childhood cancer survivors. Understanding the risk factors for the development of depression and anxiety disordersin these patients is crucial for early diagnosis and successful treatment.

METHODS

The meta-analysis included articles that listed patients diagnosed with an intracranial tumor before the age of 18 years, provided the location of the tumor, had exact data on the prevalence of anxiety and depression, or measured these disorders using different assessment tools. The search was conducted in five different databases (MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library). Risk of bias was assessed using QUIPS-2. Outcome measures used were prevalences and standardized means.

RESULTS

The analysis included 42 eligible articles with a total number of 1071 patients. Relevant articles were cohort studies, cross-sectional studies, and case series. Based on the available data infratentorial brain tumor survivors had significantly higher scores on various assessment tools measuring anxiety (MRAW (raw mean scores): 36.24 [CI (confidence interval): 28.81-43.67]; versus MRAW: 23.21 (CI 0.91-45.51); p = 0.02, and depression (MRAW: 27.57 (CI 14.35-40.78) versus MRAW: 13.84 (CI 11.43-16.26); p < 0.01.

CONCLUSION

Childhood infratentorial cancer survivors have more impairments in terms of depression and anxiety; these children and adults should be monitored more frequently and may require closer follow-up on their mental health. The main limitation of our study originates from the lack of data on follow-up times used by different studies.

Binding of Ca2+ Ions to Alkylbenzene Sulfonates: Micelle Formation, Second Critical Concentration and Precipitation

Anionic surfactants, such as sodium linear alkylbenzene sulfonates (NaLAS), are utilized in various fields, including industry, household, and agriculture. The efficiency of their use in aqueous environments is significantly affected by the presence of cations, Ca²⁺ and Mg²⁺ in particular, as they can decrease the concentration of the surfactant due to precipitation. To understand cation-sulfonate interactions better, we study both NaLAS colloidal solutions in the presence of CaCl₂ and precipitates forming at higher salt concentrations. Upon addition of CaCl₂, we find the surface tension and critical micelle concentration of NaLAS to decrease significantly, in line with earlier findings for alkylbenzylsulfonates in the presence of divalent cations. Strikingly, an increase in the surface tension is discernible above 0.6 g L^-1 NaLAS, accompanied by the decrease of apparent micelle sizes, which in turn gives rise to transparent systems. Thus, there appears to be a second critical concentration indicating another micellar equilibrium. Furthermore, the maximum salt tolerance of the surfactant is 0.1 g L^-1 Ca²⁺, above which rapid precipitation occurs yielding sparingly soluble CaLAS₂∙2H₂O.

M(II)Al4 Type Layered Double Hydroxides-Preparation Using Mechanochemical Route, Structural Characterization and Catalytic Application

The synthesis of the copper-poor and aluminum-rich layered double hydroxides (LDHs) of the CuAl₄ type was optimized in detail in this work, by applying an intense mechanochemical treatment to activate the gibbsite starting reagent. The phase-pure forms of these LDHs were prepared for the first time; using copper nitrate and perchlorate salts during the syntheses turned out to be the key to avoiding the formation of copper hydroxide sideproducts. Based on the use of the optimized syntheses parameters, the preparation of layered triple and multiple hydroxides was also attempted using Ni(II), Co(II), Zn(II) and even Mg(II) ions. These studies let us identify the relative positions of the incorporating cations in the well-known selectivity series as Ni²⁺ >> Cu²⁺ >> Zn²⁺ > Co²⁺ >> Mg²⁺. The solids formed were characterized by using powder X-ray diffractometry, UV–Vis diffuse reflectance spectroscopy, Fourier-transform infrared spectroscopy, thermogravimetric analysis and scanning electron microscopy. The catalytic potential of the samples was investigated in carbon monoxide oxidation reactions at atmospheric pressure, supported by an in situ diffuse reflectance infrared spectroscopy probe. All solids proved to be active and the combination of the nickel and cobalt incorporation (which resulted in a NiCoAl₈ layered triple hydroxide) brought outstanding benefits regarding low-temperature oxidation and increased carbon monoxide conversion values.

Ball Milling of Copper Powder Under Dry and Surfactant-Assisted Conditions-On the Way Towards Cu/Cu₂O Nanocatalyst

Samples of copper powder was milled with varied grinding frequencies in the presence of various organic agents (oleylamine, ethylene glycol or dimethyl sulfoxide) or without additives. The effects of experimental conditions were investigated by X-ray diffractometry, scanning electron microscopy and dynamic light scattering measurements. The aggregation of particles were supressed by added organics. The catalytic activities of the variously treated samples were measured in the Ullmanntype reaction of iodobenzene and 1H-pyrazole.

Exploiting a silver–bismuth hybrid material as heterogeneous noble metal catalyst for decarboxylations and decarboxylative deuterations of carboxylic acids under batch and continuous flow conditions

A silver-containing hybrid material is reported as a heterogeneous noble metal catalyst for protodecarboxylations and decarboxylative deuterations of carboxylic acids.

The Structure and Thermal Properties of Solid Ternary Compounds Forming with Ca2+, Al3+ and Heptagluconate Ions

In the present work, the structure and thermal stability of Ca-Al mixed-metal compounds, relevant in the Bayer process as intermediates, have been investigated. X-ray diffraction (XRD) measurements revealed the amorphous morphology of the compounds, which was corroborated by SEM-EDX measurements. The results of ICP-OES and UV-Vis experiments suggested the formation of three possible ternary calcium aluminum heptagluconate (Ca-Al-Hpgl) compounds, with the formulae of CaAlHpgl(OH)40, Ca2AlHpgl2(OH)50 and Ca3Al2Hpgl3(OH)90. Additional IR and Raman experiments revealed the centrally symmetric arrangement of heptagluconate around the metal ion. The increased thermal stability was demonstrated by thermal analysis of the solids and confirmed our findings.

Ultrasound-Assisted Hydrazine Reduction Method for the Preparation of Nickel Nanoparticles, Physicochemical Characterization and Catalytic Application in Suzuki-Miyaura Cross-Coupling Reaction

In the experimental work leading to this contribution, the parameters of the ultrasound treatment (temperature, output power, emission periodicity) were varied to learn about the effects of the sonication on the crystallization of Ni nanoparticles during the hydrazine reduction technique. The solids were studied in detail by X-ray diffractometry, dynamic light scattering, thermogravimetry, specific surface area, pore size analysis, temperature-programmed CO₂/NH₃ desorption and scanning electron microscopy. It was found that the thermal behaviour, specific surface area, total pore volume and the acid-base character of the solids were mainly determined by the amount of the nickel hydroxide residues. The highest total acidity was recorded over the solid under low-power (30 W) continuous ultrasonic treatment. The catalytic behaviour of the nanoparticles was tested in a Suzuki-Miyaura cross-coupling reaction over five samples prepared in the conventional as well as the ultrasonic ways. The ultrasonically prepared catalysts usually performed better, and the highest catalytic activity was measured over the nanoparticles prepared under low-power (30 W) continuous sonication.

The structure and composition of solid complexes comprising of Nd(III), Ca(II) and D-gluconate isolated from solutions relevant to radioactive waste disposal

Certain complexing agents (such as D-gluconate, D-isosaccharinate, etc.) as well as actinides and lanthanides are simultaneously present in cementitious radioactive waste repositories and (in the presence of water) are capable of forming complex compounds. Such processes may immobilize radionuclides and are of importance in the thermodynamic modelling of the aqueous chemistry of waste repositories. Nd(III) is considered to be a suitable model for trivalent lanthanides and actinides, due to the similarity of their ionic radii. In the current work, solid complexes isolated from aqueous solution containing Nd(III), Ca(II) and D-gluconate (Gluc−) were investigated. In an aqueous solution containing Nd(III) and Gluc−, the formation of a precipitate was observed at pH ≥ 8. This precipitate was found to redissolve around pH ~ 11, but reprecipitated when Ca(II) ions were added to the solution. In order to gain an insight in binary and ternary aqueous systems, in the present work we report the structure of these solid complexes obtained from XRD, FT-IR, Raman, SEM-EDAX and UV-DRS measurements. The structure of these solids, where possible, was compared with those identified in solution. The compositions of these complexes are suggested to be NdGlucH−1(OH) · 2H2O and CaNdGlucH−1(OH)3 · 2H2O, respectively. In these, the chemical environment of the Nd(III) was found to be the same as that in the NdGlucH−1(OH)0(aq) solution species.

Effects of ultrasonic irradiation on the synthesis, crystallization, thermal and dissolution behaviour of chloride-intercalated, co-precipitated CaFe-layered double hydroxide

The output power (30-150 W) and the periodicity (20-100%) of ultrasound emission were varied in a wide range to regulate and improve the crystallization process in the commonly used co-precipitation technique of chloride-intercalated CaFe-layered double hydroxides. The influence of ultrasound irradiation on the as-prepared materials was studied by X-ray diffractometry, dynamic light scattering, UV-Vis-NIR diffuse reflectance spectroscopy, specific surface area measurement, pore size analysis, ion-selective electrode potentiometric investigations and thermogravimetry. Additionally, structural alterations due to heat treatment at various temperatures were followed in detail by Fourier-transform infrared and X-ray absorption spectroscopies as well as scanning electron microscopy. The ultrasonic treatment was capable of controlling the sizes of primarily formed (from 19 nm to 30 nm) as well as the aggregated (secondary) particles (between 450 nm and 700 nm), and thus modifying their textural parameters and enhancing the incorporation of chloride anions into the interlamellar space. For the first time, the optical energy gap of CaFe-LDH was reported here depending on the nature of applied stirring (4.18-4.34 eV). The heat-treatment investigations revealed that the layered structure was stabile until 200 °C, even at the atomic level.

The Synthesis and Use of Nano Nickel Catalysts

The hydrazine reduction method was applied for the synthesis of nickel nanoparticles without using inert atmosphere and added surface active agents. The effect of the preparation temperature and the chemical quality of the metal sources as well as the solvents were studied. The generation of nanoparticles were studied primarily by X-ray diffractometry, but scanning and transmission electron microscopies as well as dynamic light scattering measurements were also used for the better understanding of the nanoparticles behaviour. The elevation of temperature was the key point in transforming Ni(OH)₂ into metallic nickel. By selecting the metal source, the obtained crystallite sizes could be tailored between 7 nm and 15 nm; however, the SEM and DLS measurements revealed significant agglomeration resulting in aggregates with spherical or Ni(OH)2 resembling morphologies depending on the solvent used. The catalytic activities of the nanoparticles prepared were tested and compared in a Suzuki-Miyaura cross-coupling reaction.

Ultrasonically-enhanced preparation, characterization of CaFe-layered double hydroxides with various interlayer halide, azide and oxo anions (CO32-, NO3-, ClO4-)

An ultrasonically-enhanced mechanochemical method was developed to synthesize CaFe-layered double hydroxides (LDHs) with various interlayer anions (CO₃^2-, NO₃^-, ClO₄^-, N₃^-, F^-, Cl^-, Br^- and I^-). The duration of pre-milling and ultrasonic irradiation and the variation of synthesis temperature in the wet chemical step were investigated to obtain the optimal parameters of preparation. The main method to characterize the products was X-ray diffractometry, but infrared and synchrotron-based X-ray absorption spectroscopies as well as thermogravimetric measurements were also used to learn about fine structural details. The synthesis method afforded successful intercalation of the anions, among others the azide anion, a rarely used counter ion providing a system, which enables safe handling the otherwise highly reactive anion. The X-ray absorption spectroscopic measurements revealed that the quality of the interlayered anions could modulate the spatial arrangement of the calcium ions around the iron(III) ions, but only in the second coordination sphere.

Synthesis of high-quality, well-characterized CaAlFe-layered triple hydroxide with the combination of dry-milling and ultrasonic irradiation in aqueous solution at elevated temperature

The combination of mechanochemical and ultrasonic treatment was applied to synthesize CaAlFe-layered triple hydroxides with carbonate or chloride anions in the interlamellar space. The optimal parameters of the preparation were explored by altering the initial ratio of the metal ions and the temperature of ultrasonic irradiation. The resulting triple hydroxides were characterized by X-ray diffractometry, infrared and X-ray absorption spectroscopies, thermogravimetric analysis and scanning electron microscopy. The products were close-to-phase-pure CaAlFe-layered triple hydroxides. Elevation of the temperature transformed the CaAlFe-Cl(-)-layered triple hydroxide to rare oxyhalides (Ca2FeO3Cl and Ca12Al14O32Cl2).

[Long-term treatment with 7S immunoglobulins in myasthenia gravis. Preliminary clinical results]

After initial high-dose intravenous 7S immunoglobulin therapy, six patients with seropositive myasthenia gravis received intermittent low-dose 7S immunoglobulins for at least 4-12 months. This treatment was started in five cases following an acute exacerbation of myasthenic symptoms (Oosterhuis class 3-4) and in one case because of marked clinical fluctuations (Oosterhuis class 3). In five of the six patients, there was a clinical response to the immunoglobulin therapy within 2 weeks, followed by marked long-standing improvement and stability of the clinical outcome. In four cases a decrease in the titer of acetylcholine receptor antibodies was noted in parallel. Our observations suggest an additional positive therapeutic effect of long-term, low-dose intravenous immunoglobulin therapy following the acute management of myasthenic exacerbations.