Continuous flow vortex fluidic-mediated exfoliation and fragmentation of two-dimensional MXene

MXene (Ti₂CT _x ) is exfoliated in a vortex fluidic device (VFD), as a thin film microfluidic platform, under continuous flow conditions, down to ca 3 nm thin multi-layered two-dimensional (2D) material, as determined using AFM. The optimized process, under an inert atmosphere of nitrogen to avoid oxidation of the material, was established by systematically exploring the operating parameters of the VFD, along with the concentration of the dispersed starting material and the choice of solvent, which was a 1 : 1 mixture of isopropyl alcohol and water. There is also some fragmentation of the 2D material into nanoparticles ca 68 nm in diameter.

Chemical Functionalisation of 2D Materials by Batch and Continuous Hydrothermal Flow Synthesis

2D materials are single or few layered materials consisting of one or several elements with a thickness of a few nanometres. Their unique, tuneable physical and chemical properties including ease of chemical functionalisation makes this class of materials useful in a variety of technological applications. The feasibility of 2D materials strongly depends on better synthetic approaches to improve properties, increase performance, durability and reduce costs. As such, in the synthesis of nanomaterials, hydrothermal processes are widely adopted through a precursor-product synthesis route. This method includes batch or continuous flow systems, both employing water at elevated temperatures (above boiling point) and pressures to fine-tune the physical, chemical, optical and electronic properties of the nanomaterial. Both techniques yield particles with different morphology, size and surface area due to different mechanisms of particle formation. In this Minireview, we present batch and continuous hydrothermal flow synthesis of a selection of 2D derivatives (graphene, MXene and molybdenum disulfide), their chemical functionalisation as an advantageous approach in exploring properties of these materials as well as the benefits and challenges of employing these processes, and an outlook for further research.

Continuous hydrothermal flow synthesis of graphene quantum dots

A rapid, continuous hydrothermal flow synthesis route and life cycle assessment was employed for the synthesis of graphene quantum dots in the presence of calixarene.

Prevalence and correlates of inappropriate use of benzodiazepines in Kosovo

BACKGROUND

In post-war Kosovo, the magnitude of inappropriate use of benzodiazepines is unknown to date.

OBJECTIVE

The aim of this study was to assess the prevalence and correlates of continuation of intake of benzodiazepines beyond prescription (referred to as "inappropriate use") in the adult population of Gjilan region in Kosovo.

METHOD

A cross-sectional study was conducted in Gjilan region in 2015 including a representative sample of 780 individuals attending different pharmacies and reporting use of benzodiazepines (385 men and 395 women; age range 18-87 years; response rate: 90%). A structured questionnaire was administered to all participants inquiring about the use of benzodiazepines and socio-demographic characteristics.

RESULTS

Overall, the prevalence of inappropriate use of benzodiazepines was 58%. In multivariable-adjusted models, inappropriate use of benzodiazepines was significantly associated with older age (OR 1.7, 95% CI 1.1-2.7), middle education (OR 1.8, 95% CI 1.2-2.7), daily use (OR 1.4, 95% CI 1.1-2.0) and addiction awareness (OR 2.7, 95% CI 2.0-3.8). Furthermore, there was evidence of a borderline relationship with rural residence (OR 1.2, 95% CI 0.9-1.7).

CONCLUSION

Our study provides novel evidence about the prevalence and selected correlates of inappropriate use of benzodiazepines in Gjilan region of Kosovo. Health professionals and policymakers in Kosovo should be aware of the magnitude and determinants of drug misuse in this transitional society.

Rapid synthesis of graphene quantum dots using a continuous hydrothermal flow synthesis approach

A rapid and environmentally benign synthesis of green fluorescent graphene quantum dots (GQD) with low cytotoxicity via Continuous Hydrothermal Flow Synthesis (CHFS) aided by calix[4]arene tetrasulfonic acid (SCX4) as a particle size limiting agent.

Calixarene Assisted Rapid Synthesis of Silver-Graphene Nanocomposites with Enhanced Antibacterial Activity

Demonstrated herein is a single rapid approach employed for synthesis of Ag-graphene nanocomposites, with excellent antibacterial properties and low cytotoxicity, by utilizing a continuous hydrothermal flow synthesis (CHFS) process in combination with p-hexasulfonic acid calix[6]arene (SCX6) as an effective particle stabilizer. The nanocomposites showed high activity against E. coli (Gram-negative) and S. aureus (Gram-positive) bacteria. The materials were characterized using a range of techniques including transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, UV-vis spectrophotometry, FT-IR, and X-ray powder diffraction (XRD). This rapid, single step synthetic approach not only provides a facile means of enabling and controlling graphene reduction (under alkaline conditions) but also offers an optimal route for homogeneously producing and depositing highly crystalline Ag nanostructures into reduced graphene oxide substrate.

The use of patch testing for the diagnosis of contact dermatitis: an Albanian experience

Introduction: The daily increase of using chemical, aromatic and cosmetic products has been associated with significant increase in frequency of skin diseases such as eczemas and contact dermatitis (CD). The aim of this study was to evaluate the use of patch testing (PT) for the diagnosis of CD and provide current data on the frequency of sensitization to various contact allergens among patients with CD in the Albanian population.Methods: We retrospectively analyzed all consecutive patients clinically suspected for CD during the period February 2010 – February 2011, in the outpatient setting. PT was done using Baseline European Series consisting of 31 allergens. Risk factors (age, gender, occupation and place of residence) and sensitization to various contact allergens were evaluated.  Results: In total, 193 patients clinically suspected for CD were included in the study and underwent PT. The highest prevalence of CD was found in the age-group of 31-40 years (32.6%), with a statistically significant difference between other age-groups (X2 = 141.2, p<0.01). Positive PT results with at least one allergen were seen in 144 (74.6 %) patients suspected for CD. The two most common allergens were nickel and potassium dichromate. Construction worker and hairdresser were the most affected professions. Females had a chance of 1.8 times higher for having a positive patch test result compare to males (OR = 1.8; 95% CI 0.91 – 3.39).Conclusion: Determination of allergens that cause contact dermatitis is a necessity not only to confirm the correct diagnosis, but also for the qualitative treatment and prevention of the disease. Patch testing, even though an old method, still remain a valuable and non-invasive approach to determine the causes of contact dermatitis.

Physicians' Perceptions About the Quality of Primary Health Care Services in Transitional Albania

Aim:

To date, the available information regarding the quality of primary health care services in Albania is scarce. The aim of our study was to assess the quality of primary health care services in Albania based on physicians’ perceptions towards the quality of the services provided to the general population.

Methods:

A cross-sectional study was conducted in January-March 2013 including a representative sample of 132 physicians (59 men aged 41.3±6.9 years and 73 women aged 43.7±4.8 years; overall response rate: 132/150=88%) providing primary health care services in several polyclinics (health centers) of Tirana, the Albanian capital city. A structured self-administered and anonymous questionnaire was applied including physicians’ perceptions regarding different dimensions of the quality of primary health care. Binary logistic regression was used to assess the association of self-perceived quality of health care services with baseline characteristics of physicians.

Results:

Self-perceived adequate quality of health care services was positively related to the age of physicians, their working experience, female gender, a lower population served, and specialization in family medicine.

Conclusion:

Our findings provide useful evidence on the self-perceived quality of health services from primary health care physicians’ perspective in transitional Albania. Health authorities in Albania should implement suitable instruments to measure the quality of health care services at all levels.

A Case of Allergic Dermatitis after Self-Treatment with Propolis: Case Report

Background:  Propolis or bee-glue is used as adjuvant in the therapy because of its antiseptic, anti-inflammatory, anesthetic and antibacterial properties. Propolis is found in a number of products such as cosmetics, shampoos, toothpastes, lip balms, creams and ointments. In dermatology propolis has been used for wound healing, treatment of ulcers and eczema, and regeneration of the skin. The sensitizing properties of propolis have been reported in the literature.Aim: The aim of this study was to present a case of allergic contact dermatitis after self-treatment with propolis.Methods: We report a case of 46 years old man who presented severe vesiculo-bullous elements on the leg after the treatment with bee-glue for the eczematous elements.Results: The diagnosis of allergic contact dermatitis to propolis was confirmed due to patch tests.Conclusions: Here we show that allergic contact dermatitis from propolis should be taken in consideration if an allergic reaction is evident. Dermatologists and general physicians should be aware of propolis as an important allergen that can cause Allergic Contact Dermatitis. The therapeutic use of propolis should be performed under medical advisory.

Actual status of preoperative diagnosis of thyroid cancer in Albania

INTRODUCTION

Thyroid cancer is the most common endocrine malignancy and accounts for almost 1% of human cancer. It is well known that the majority of cases occur in women in the middle decades of life. Thyroid cancer is a relatively rare disease; on the other hand clinically apparent thyroid nodules are present in 4-7% of the adult population. Most thyroid nodules are not malignant, with reported malignancy rates from 3-12%. It is important for the surgeon to know beforehand the diagnosis of malignancy, in order to perform a more radical operation on the thyroid gland.

PATIENTS AND METHODS

In our study we have analyzed the preoperative clinical data of 84 patients operated in the First Clinic of General Surgery, UHC "Mother Theresa" in Tirana; all with a positive histopathologic diagnosis of thyroid cancer. The data comprised age, sex, age distribution, blood group, time-lapse from the first endocrinologic visit, clinical examination, signs and symptoms, imaging, functional tests, preoperative FNA, admission diagnosis, associated diseases and preoperative treatment.

RESULTS

From the study emerged that only 9,3% of these patients were diagnosed preoperatively as thyroid cancer. Another related problem is the low percentage of preoperative FNA - only 22%. Among the signs and symptoms related to thyroid cancer we found that 40 and 33% of these patient presented dyspnea and dysphagia, respectively. The physical examination revealed apparent nodular growth of the thyroid gland in 81% and nodular hard consistency in 79% of cases. The proper endocrinologist consultation lacked in 23% of cases.

CONCLUSION

In our opinion, close collaboration between endocrinologists and surgeons in a multidisciplinary frame is the key to correct preoperative thyroid cancer diagnosis and optimal treatment.

Evaluation of patterns and appropriate gastro protection in Albanian primary health care users

Our aim was to assess the prevalence of gastro protection in the Albanian population using non-steroidal anti-inflammatory drugs (NSAIDs). A cross-sectional study, conducted in November-December 2011 in Albania, included 610 NSAIDs users (236 men and 374 women) who visited pharmacies to receive their NSAID medication. A structured questionnaire was administered to all participants including information on age, sex, educational status, pathology being treated with NSAID, presence of gastrointestinal ulcer or related complications, duration of NSAIDs therapy, type of drug used, and gastro protection therapy. Almost all participants (N=599) received NSAIDs to treat rheumatic and/or musculoskeletal disorders. Of these, 475 individuals were on chronic therapy with high daily doses of NSAIDs. Concomitant gastro protective therapy was found in 184 individuals (30 percent of the overall sample). Women and the more educated individuals received more gastro protection than men and the low educated counterparts, respectively (33.4 percent in women vs 25 percent in men; 47 percent in highly educated vs 18 percent in low educated). Appropriate use of gastro protective therapy for NSAID users needs to be promptly implemented in Albania, as its inappropriate use raises ethical and economic concerns. Prescriptions should follow clear guidelines for prevention of gastrointestinal damage following NSAIDs therapy among persons at high risk.

Postoperative pain management at Tirana university hospital center -Mother Teresa-, Tirana, Albania

There is no or little evidence on postoperative pain assessment and treatment in Albanian hospitals. This study is based on our every day work and aims to highlight our experience. We conducted a descriptive drug utilization study which implied data collection over 6 months. Evidence of the enrolled patients was kept by maintaining records and the completed structured questionnaires. Postoperative pain was assessed through a five-category verbal rating scale (VRS). Metamizole was the most prescribed and administered analgesic drug as single therapy and in combination therapy, and acetaminophen was the least prescribed drug. The compliance between the prescribed dosages and those administered was higher in patients treated with a single analgesic compared to multiple therapies. A few patients reported adverse events (4.2 percent). There is much variability in postoperative pain management methods used by medical staff within the Tirana University Hospital. In Albania to date there is no standard protocol for postoperative pain treatment. This study shows that there are no essential differences in patient outcomes in terms of efficacy of analgesic treatment. This leads to the conclusion that a postoperative protocol/guideline for pain management should be prepared, based on our local study findings and also on international experience. Moreover, the guidelines should consider use of balanced analgesia.

High-throughput continuous hydrothermal flow synthesis of Zn-Ce oxides: unprecedented solubility of Zn in the nanoparticle fluorite lattice

High-throughput continuous hydrothermal flow synthesis has been used as a rapid and efficient synthetic route to produce a range of crystalline nanopowders in the Ce-Zn oxide binary system. High-resolution powder X-ray diffraction data were obtained for both as-prepared and heat-treated (850 degrees C for 10 h in air) samples using the new robotic beamline I11, located at Diamond Light Source. The influence of the sample composition on the crystal structure and on the optical and physical properties was studied. All the nanomaterials were characterized using Raman spectroscopy, UV-visible spectrophotometry, Brunauer-Emmett-Teller surface area and elemental analysis (via energy-dispersive X-ray spectroscopy). Initially, for 'as-prepared' Ce(1-x)Zn(x)O(y), a phase-pure cerium oxide (fluorite) structure was obtained for nominal values of x=0.1 and 0.2. Biphasic mixtures were obtained for nominal values of x in the range of 0.3-0.9 (inclusive). High-resolution transmission electron microscopy images revealed that the phase-pure nano-CeO(2) (x=0) consisted of ca 3.7 nm well-defined nanoparticles. The nanomaterials produced herein generally had high surface areas (greater than 150 m(2) g(-1)) and possessed combinations of particle properties (e.g. bandgap, crystallinity, size, etc.) that were unobtainable or difficult to achieve by other more conventional synthetic methods.

Instant nano-hydroxyapatite: a continuous and rapid hydrothermal synthesis

Nano-particle hydroxyapatite (HA) rods, were rapidly synthesised using a three pump continuous hydrothermal process (using a water feed at up to 400 degrees C and at 24 MPa): the product was obtained as a highly crystalline and phase pure material, without the need for an ageing step or subsequent heat treatment.

Titania nanospheres from supercritical fluids

Surfactant-coated amorphous titania nanospheres have been synthesised using templating 'water-in-supercritical carbon dioxide' emulsion droplets; the process represents a clean and controlled method for the manufacture of high-purity nanoparticles.