We herein describe our use of a water-ethylene method to prepare a composite material consisting of platinum nanoparticles and graphene. Results obtained using XPS and XRD show that the degree of reduction of graphene was increased by the incorporation of Pt, and in addition, the increased concentration of defects was confirmed by the D/G ratio of the Raman spectra obtained. In comparison with Pt films, results obtained using CV and EIS showed that the electrocatalytic ability of the composite material was greater, and afforded a higher charge transfer rate, an improved exchange current density, and a decreased internal resistance. SEM images showed that the morphology of PtNP/ GR counter electrodes is characterized by a smooth surface, however, resulting in a lower resistance to diffusion, thereby improving the total redox reaction rate that occurs at the counter electrode. PtNP/ GR electrodes have a number of advantages over other electrodes that consist solely of graphene or Pt films, including a high rate of charge transfer, a low internal resistance, and a low resistance to diffusion. In our study, we showed that DSSCs that incorporate platinum-grafted graphene had a conversion efficiency of 6.35%, which is 20% higher than that of devices with platinized FTO.

Dinitrosyl iron complex [(-SC(7)H(4)SN)(2)Fe(NO)(2)](-) (1) was prepared by reaction of [S(5)Fe(NO)(2)](-) and bis(2-benzothiozolyl) disulfide. In synthesis of the analogous dinitrosyl iron compounds (DNICs), the stronger electron-donating thiolates [RS](-) (R = C(6)H(4)-o-NHCOCH(3), C(4)H(3)S, C(6)H(4)NH(2), Ph), compared to [-SC(7)H(4)SN](-) of complex 1, trigger thiolate-ligand substitution to yield [(-SC(6)H(4)-o-NHCOCH(3))(2)Fe(NO)(2)](-) (2), [(-SC(4)H(3)S)(2)Fe(NO)(2)](-) (3), and [(SPh)(2)Fe(NO)(2)](-) (4), respectively. At 298 K, complexes 2 and 3 exhibit a well-resolved five-line EPR signal at g = 2.038 and 2.027, respectively, the characteristic g value of DNICs. The magnetic susceptibility fit indicates that the resonance hybrid of {Fe(+)((*)NO)(2)}(9) and {Fe(-)((+)NO)(2)}(9) in 2 is dynamic by temperature. The IR nu(NO) stretching frequencies (ranging from (1766, 1716) to (1737, 1693) cm(-)(1) (THF)) of complexes 1-4 signal the entire window of possible electronic configurations for such stable and isolable {Fe(NO)(2)}(9) [(RS)(2)Fe(NO)(2)](-). The NO-releasing ability of {Fe(NO)(2)}(9) [(RS)(2)Fe(NO)(2)](-) is finely tuned by the coordinated thiolate ligands. The less electron-donating thiolate ligands coordinated to {Fe(NO)(2)}(9) motif act as better NO-donor DNICs in the presence of NO-trapping agent [Fe(S,S-C(6)H(4))(2)](2)(2-). Interconversion between {Fe(NO)(2)}(9) [(RS)(2)Fe(NO)(2)](-) and {Fe(NO)(2)}(10) [(Ph(3)P)(2)Fe(NO)(2)] was verified in the reaction of (a) [(RS)(2)Fe(NO)(2)](-), 10 equiv of PPh(3) and sodium-biphenyl, and (b) 2 equiv of thiol, [RS](-), and [(Ph(3)P)(2)Fe(NO)(2)], respectively. The biomimetic reaction cycle, transformation between {Fe(NO)(2)}(9) [(RS)(2)Fe(NO)(2)](-) and {Fe(NO)(2)}(9) [(R'S)(2)Fe(NO)(2)](-), reversible interconversion of {Fe(NO)(2)}(9) and {Fe(NO)(2)}(10) DNICs, and degradation/reassembly of [2Fe-2S] clusters may decipher and predict the biological cycle of interconversion of {Fe(NO)(2)}(9) DNICs, {Fe(NO)(2)}(10) DNICs, and the [Fe-S] clusters in proteins.

The synthesis, characterization, and transformation of the anionic {Fe(NO)(2)}(9) dinitrosyl iron complexes (DNICs) [(NO)(2)Fe(ONO)(2)](-) (1), [(NO)(2)Fe(OPh)(2)](-) (2), [(NO)(2)Fe(OPh)(C(3)H(3)N(2))](-) (3) (C(3)H(3)N(2) = imidazolate), [(NO)(2)Fe(OPh)(-SC(4)H(3)S)](-) (4), [(NO)(2)Fe(p-OPhF)(2)](-) (5), and [(NO)(2)Fe(SPh)(ONO)](-) (6) were investigated. The binding affinity of ligands ([SPh](-), [-SC(4)H(3)S](-), [C(3)H(3)N(2)](-), [OPh](-), and [NO(2)](-)) toward the {Fe(NO)(2)}(9) motif follows the ligand-displacement series [SPh](-) approximately [-SC(4)H(3)S](-) > [C(3)H(3)N(2)](-) > [OPh](-) > [NO(2)](-). The findings, the pre-edge energy derived from the 1s --> 3d transition in a distorted T(d) environment of the Fe center falling within the range of 7113.4-7113.8 eV for the anionic {Fe(NO)(2)}(9) DNICs, implicate that the iron metal center of DNICs is tailored to minimize the electronic changes accompanying changes in coordinated ligands. Our results bridging the ligand-substitution reaction study and X-ray absorption spectroscopy study of the electronic richness of the {Fe(NO)(2)}(9) core may point the way to understanding the reasons for nature's choice of combinations of cysteine, histidine, and tyrosine in protein-bound DNICs and rationalize that most DNICs characterized/proposed nowadays are bound to the proteins almost through the thiolate groups of cysteinate/glutathione side chains in biological systems.

Purpose:To investigate the use of laryngeal mask (LM) in Prehospital Emergency Medicine, to document the experiences with the device, and to develop a staff-training program. Materials: From 01 January 2000 through 31 December 2002, doctors and paramedics placed the LM in victims of respiratory or cardio-respiratory arrests or victims of multiple traumatic injuries. Paramedics were trained in LM placement for a total of 12 hours (video, manikin). Methods: The following information was recorded for each patient: (1) Vital signs (systolic and diastolic arterial blood pressures (SAP, DAP), heart rate (HR); ventilatory rate (RR), pulse oximetry readings (SpO 2 ); Glasgow Coma Scale score, (GCS)), Rapid Acute Physiology Score (RAPS) on-site and at the Emergency Department, Hector Emergency Scale (HES), and therapeutic interventions. Results:The LM was placed in 221 cases (140 cardio-respiratory, 70 respiratory arrests, 9 multi-trauma patients, and 2 burn episodes). In 147 episodes, it was placed by paramedics without a doctor present, and in 77 cases with a doctor present. In 94% of the cases, the LM was placed in the first attempt.For the 140 victims of cardio-respiratory arrests, 47 patients had return of spontaneous circulation (ROSC, heart rhythm and arterial pressure). In these cases, the mean SpO 2 and GCS on-site and at hospital arrival were: SpO 2 = 31.8% -> 87% ; and GCS = 3 -» 13 respectively. In those patients with respiratory arrests: SpO 2 = 61% -» 96.5% and GCS = 7 -» 14. In victims of multi-trauma, the intubation was impossible in four patients. For another four patients, the LM was a temporary airway, and in three cases, the patient was intubated via the LM with handle after general Anesthesia (SpO 2 = 65% -> 97% and GCS = 6 -> 12). No aspiration was observed in patients who recovered from respiratory and cardio-respiratory arrests as well as in multi-trauma patients. Conclusions:This 3-year experience shows that crew training is easy and practice using the device indicates that only rarely are there sides effects. The LM is a valuable tool during the recovery process and for establishing a temporary airway in the prehospital setting. Objectives: The aim of the study was to use a visual analogue scale (VAS) to measure pain severity in the prehospital setting, and to compare changes in pain score with a clinically significant benchmark reduction of 20 mm. Methods: This prospective, observational study used a VAS to record pain severity for patients requiring ambulance transport. Patients used a VAS to score pain severity during the initial patient assessment process (T Q ), and again at the hospital of destination (T end ). This study reports mean changes in score, and the percentage of cases in which the difference between T Q and Tend in the study population achieves or exceeds the 20 mm benchmark. A survey also was administered to ambulance officers participating in this study to identify attitudes, values, and beliefs that may influence their use of the VAS.Results: A total of 262 patients were enr...

Introduction:This article characterizes the epidemiological outcomes, resource utilization, and time course of emergency needs in mass-casualty, terrorist bombings producing 30 or more casualties.Methods:Eligible bombings were identified using a MEDLINE search of articles published between 1996 and October 2002 and a manual search of published references. Mortality, injury frequency, injury severity, emergency department (ED) utilization, hospital admission, and time interval data were abstracted and relevant rates were determined for each bombing. Median values for the rates and the inter-quartile ranges (IQR) were determined for bombing subgroups associated with: (1) vehicle delivery; (2) terrorist suicide; (3) confined-space setting; (4) open-air setting; (5) structural collapse sequela; and (6) structural fire sequela.Results:Inclusion criteria were met by 44 mass-casualty, terrorist bombings reported in 61 articles. Median values for the immediate mortality rates and IQRs were: vehicle-delivery, 4% (1–25%); terrorist-suicide, 19% (7–44%); confined-space 4% (1–11%); open-air, 1% (0–5%); structural-collapse, 18% (5–26%); structural fire 17% (1–17%); and overall, 3% (1–14%). A biphasic pattern of mortality and unique patterns of injury frequency were noted in all subgroups. Median values for the hospital admission rates and IQRs were: vehicle-delivery, 19% (14–50%); terrorist-suicide, 58% (38–77%); confined-space, 52% (36–71%); open-air, 13% (11–27%); structural-collapse, 41% (23–74%); structural-fire, 34% (25–44%); and overall, 34% (14–53%). The shortest reported time interval from detonation to the arrival of the first patient at an ED was five minutes. The shortest reported time interval from detonation to the arrival of the last patient at an ED was 15 minutes. The longest reported time interval from detonation to extrication of a live victim from a structural collapse was 36 hours.Conclusion:Epidemiological outcomes and resource utilization in mass-casualty, terrorist bombings vary with the characteristics of the event.

Reaction of Fe(CO)2(NO)2 and sparteine/tetramethylethylenediamine (TMEDA) in tetrahydrofuran afforded the electron paramagnetic resonance (EPR)-silent, neutral {Fe(NO)2}10 dinitrosyliron complexes (DNICs) [(sparteine)Fe(NO)2] (1) and [(TMEDA)Fe(NO)2] (2), respectively. The stable and isolable anionic {Fe(NO)2}9 DNIC [(S(CH2)3S)Fe(NO)2]- (4), with a bidentate alkylthiolate coordinated to a {Fe(NO)(2)} motif, was prepared by the reaction of [S(CH2)3S]2- and the cationic {Fe(NO)2}9 [(sparteine)Fe(NO)2]+ (3) obtained from the reaction of complex 1 and [NO][BF4] in CH(3)CN. Transformation from the neutral complex 1 to the anionic complex 4 was verified via the cationic complex 3. Here complex 3 acts as an {Fe(NO)2}-donor reagent in the presence of thiolates. The EPR spectra of complexes 3 and 4 exhibit an isotropic signal with g = 2.032 and 2.031 at 298 K, respectively, the characteristic g value of {Fe(NO)2}9 DNICs. On the basis of N-O/Fe-N(O) bond lengths of the single-crystal X-ray structures of the {Fe(NO)2}9/{Fe(NO)2}10 DNICs, the oxidation level of the {Fe(NO)2} core of DNICs can be unambiguously assigned. The mean N-O distances falling in the range of 1.214(6)-1.189(4) A and the Fe-N(O) bond distances in the range of 1.650(7)-1.638(3) A are assigned as the neutral {Fe(NO)(2)}(10) DNICs. In contrast, the mean N-O bond distances ranging from 1.178(3) to 1.160(6) A and the mean Fe-N(O) bond distances ranging from 1.695(3) to 1.661(4) A are assigned as the anionic/neutral/cationic {Fe(NO)2}9 DNICs. In addition, an EPR spectrum in combination with the IR nu(NO) (the relative position of the nu(NO) stretching frequencies and their difference Deltanu(NO)) spectrum may serve as an efficient tool for discrimination of the existence of the anionic/cationic/neutral {Fe(NO)2}9 DNICs and the neutral {Fe(NO)2}10 DNICs.

This article reviews the implications of mass-casualty, terrorist bombings for emergency department (ED) and hospital emergency responses. Several practical issues are considered, including the performance of a preliminary needs assessment, the mobilization of human and material resources, the use of personal protective equipment, the organization and performance of triage, the management of explosion-specific injuries, the organization of patient flow through the ED, and the efficient determination of patient disposition. As long as terrorists use explosions to achieve their goals, mass-casualty, terrorist bombings remain a required focus for hospital emergency planning and preparedness.

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