Filtering facepieces (FFP), mainly class FFP2 particle half masks (EN 149:2001#x02009;+ A1:2009), are commonly used in European mines to protect workers from respirable dust, especially from particulate matter (PM) with a diameter of 4 µm or less (PM4). The aerosol associated with diesel exhaust (DE) is dominated by submicrometer particles (with a diameter of less than 1 µm) and nanoparticles (size in the range between 10 and 500 nm). In the European Union (EU), the occupational exposure level (OEL) for DE has been defined in terms of elemental carbon (EC) concentration. Based on measurements in underground mines, on average, 60% of EC associated with PM4 was contained in PM with a diameter of 1 µm or less (PM1). Particle number size distribution (PNSD) of PM1 showed that the most numerous were particles in the size range of 20 to 300 nm. Four popular types of certified FFP2 half masks were tested for penetration. Brand new and thermally conditioned masks of each type were included in the study. NaCl aerosol in the particle size range of 7 to 270 nm was used for tests. Filtration efficiencies of 98.5% (median) or higher were achieved. Aerosol penetration was a function of particle size. Maximum penetration was observed between 20 and 60 nm, depending on the type of mask. During filtration, aerosol characteristics changed. Nanoparticles ranging in size from 7 to about 60 nm were removed to a very limited extent. The change was more noticeable for brand-new masks compared to the thermally conditioned ones. Usually, aerosol penetration through thermally conditioned masks was lower and more consistent. It was confirmed that the half masks of the FFP2 class are capable of filtering submicrometer aerosol in particle size range 7 to 270 nm with an efficiency exceeding 96% and can contribute to achieving compliance with the OEL for DE in the mining sector.

BACKGROUND: Transfusion-related acute lung injury (TRALI) is a severe complication of plasma transfusion, though the use of solvent/detergent pooled plasma (SDP) has nearly eliminated reported TRALI cases. The goal of this study was to investigate the incidence of TRALI in intensive care units (ICU) following the replacement of quarantined fresh frozen plasma (qFFP) by SDP.
METHODS: A retrospective multicenter observational before-after cohort study was performed during two 6-month periods, before (April-October 2014) and after the introduction of SDP (April-October 2015), accounting for a washout period. A full chart review was performed for patients who received ≥1 plasma units and developed hypoxemia within 24 h.
RESULTS: During the study period, 8944 patients were admitted to the ICU. Exactly 1171 quarantine fresh frozen plasma (qFFP) units were transfused in 376 patients, and respectively, 2008 SDP units to 396 patients after implementation. Ten TRALI cases occurred during the qFFP and nine cases occurred during the SDP period, in which plasma was transfused. The incidence was 0.85% (CI95%: 0.33%-1.4%) per unit qFFP and 0.45% (CI95%: 0.21%-0.79%, p = 0.221) per SDP unit. One instance of TRALI occurred after a single SDP unit. Mortality was 70% for patients developing TRALI in the ICU compared with 22% in patients receiving at least one plasma transfusion.
CONCLUSIONS: Implementation of SDP lowered the incidence of TRALI in which plasma products were implicated, though not significantly. Clinically diagnosed TRALI can still occur following SDP transfusion. Developing TRALI in the ICU was associated with high mortality rates, therefore, clinicians should remain vigilant.

There is equipoise regarding the use of prothrombin complex concentrate vs. fresh frozen plasma in bleeding patients undergoing cardiac surgery. We performed a pilot randomised controlled trial to determine the recruitment rate for a large trial, comparing the impact of prothrombin complex concentrate vs. fresh frozen plasma on haemostasis (1 h and 24 h post-intervention), and assessing safety. Adult patients who developed bleeding within 24 h of cardiac surgery that required coagulation factor replacement were randomly allocated to receive prothrombin complex concentrate (15 IU.kg-1 based on factor IX) or fresh frozen plasma (15 ml.kg-1 ). If bleeding continued after the first administration of prothrombin complex concentrate or fresh frozen plasma administration, standard care was administered. From February 2019 to October 2019, 180 patients were screened, of which 134 (74.4% (95%CI 67-81%)) consented, 59 bled excessively and 50 were randomly allocated; 25 in each arm, recruitment rate 35% (95%CI 27-44%). There were 23 trial protocol deviations, 137 adverse events (75 prothrombin complex concentrate vs. 62 fresh frozen plasma) and 18 serious adverse events (5 prothrombin complex concentrate vs. 13 fresh frozen plasma). There was no increase in thromboembolic events with prothrombin complex concentrate. No patient withdrew from the study, four were lost to follow-up and two died. At 1 h after administration of the intervention there was a significant increase in fibrinogen, Factor V, Factor XII, Factor XIII, α2 -antiplasmin and antithrombin levels in the fresh frozen plasma arm, while Factor II and Factor X were significantly higher in the prothrombin complex concentrate group. At 24 h, there were no significant differences in clotting factor levels. We conclude that recruitment to a larger study is feasible. Haemostatic tests have provided useful insight into the haemostatic changes following prothrombin complex concentrate or fresh frozen plasma administration. A definitive trial is needed to ascertain the benefits and safety for each.

In Italy, as well as in almost all countries, the use of masks in public with several other measures has been an important health measure during the ongoing COVID-19 pandemic. The correct use of masks is essential, as a wrong use and disposal may increase the rate of contagious. Herein, we report a descriptive study evaluating the knowledge and use, reuse and disposal of masks in community settings. An anonymous questionnaire called MaSK (Mask uSe and Knowledge) questionnaire was developed and offered to patients referring at our dermatologic outpatient clinic. A total of 2562 full complete patients\' questionnaires were considered for the study. Our results showed that awareness and information campaigns aimed at the general population are urgently needed in order to implement a correct use of masks and limit as much as possible the infection rate.

China has achieved a dramatic development in scientific research over the last few decades. However, just like many other countries, it has also seen a surge of scientific misconducts. With its expansion of international publications, retractions due to suspected research misconduct are also on the rise. A transcultural case study was conducted by investigating the perception of research misbehaviors by Chinese researchers compared to their Belgian Flemish colleagues. The study was designed to find out variation in research practices in different countries and to see how research was shaped and influenced by cultural contexts. An online questionnaire was sent to 3,236 researchers by e-mails and it received a response rate of 13.09%. They were asked to score 32 research misbehaviors on a 5-point scale. The findings suggested that compared to Flemish respondents, the Chinese had a significantly higher acceptance toward most research misbehaviors. To be more specific, the Chinese respondents felt less unacceptable toward behaviors violating such values as honesty, fairness, and verifiability than the Flemish, while their perceptions of behaviors that violated such values as responsibility, objectivity, and truth were not different compared to the Flemish. This case study implies that the Chinese research community is in an urgent need of training in responsible conduct of research and strong as well as sound guidelines for responsible research practices in place.

OBJECTIVE: Early-stage non-small cell lung cancer (NSCLC) has a high recurrence rate and poor 5-year survival, particularly if lymph nodes are involved. Our objective was to perform a dose-escalation study to assess safety and feasibility of intraoperative near-infrared (NIR) fluorescence imaging to identify the first tumor-draining lymph nodes (ie, sentinel lymph nodes [SLNs] in patients with NSCLC).
METHODS: A-dose escalation phase 1 clinical trial assessing real-time NIR imaging after peritumoral injection of 3.8 to 2500 μg indocyanine green (ICG) was initiated in patients with suspected stage I/II NSCLC. Visualization of lymphatic migration, SLN identification, and adverse events were recorded.
RESULTS: Thirty-eight patients underwent ICG injection and NIR imaging via thoracotomy (n = 18) or thoracoscopic imaging (n = 20). SLN identification increased with ICG dose, with fewer than 25% SLNs detected in dose cohorts of 600 μg or less versus 89% success at 1000 μg or greater. Twenty-six NIR(+) SLNs were identified in 15 patients, with 7 NIR(+) SLNs (6 patients) harboring metastatic disease on histologic analysis. Metastatic nodal disease was never identified in patients with a histologically negative NIR(+) SLN. No adverse reactions were noted.
CONCLUSIONS: NIR-guided SLN identification with ICG was safe and feasible in this initial dose-escalation trial. ICG doses greater than 1000 μg yielded nearly 90% intrathoracic SLN visualization, with the presence or absence of metastatic disease in the SLN directly correlating with final nodal status of the lymphadenectomy specimen. Further studies are needed to optimize imaging parameters and confirm sensitivity and specificity of SLN mapping in NSCLC using this promising imaging technique.