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Background: A bronchopleural fistula (BPF) occurs when an abnormal connection forms between the bronchial tubes and pleural cavity, often due to surgery, infection, trauma, radiation, or chemotherapy. The outcomes of both surgical and bronchoscopic treatments frequently prove to be unsatisfactory. Case presentation: Here, we report a case of successful bronchoscopic free fat pad transplantation combined with platelet-rich plasma, effectively addressing a post-lobectomy BPF. Contrast-enhanced chest tomography revealed pleural thickening with heterogeneous consolidations over the right upper and middle lobes, indicative of destructive lung damage and bronchiectasis. The patient underwent thoracoscopic bilobectomy of the lungs. During surgery, severe adhesions and calcification of the chest wall and lung parenchyma were observed. The entire hilar structure was calcified, presenting challenges for dissection, despite the assistance of energy devices. Bronchoscopic intervention was required, during which two abdominal subcutaneous fat pads were retrieved. Conclusion: This innovative approach offers promise in the management of BPF and signals potential advancements in enhancing treatment efficacy and patient recovery. [ABSTRACT FROM AUTHOR]

Simple Summary: Surgery for centrally located lung cancer after previous cancer treatments can be challenging due to the lungs adhering to the chest wall. We investigated whether using the Cavitron Ultrasonic Surgical Aspirator (CUSA) could help. We focused on patients who had thoracoscopic salvage anatomic lung resections after systemic or radiotherapy with and without CUSA. The CUSA group took more time for surgery but had less bleeding. Our analysis found that older age carried more risk for complications, and using CUSA decreased bleeding, whereas radiotherapy increased the risk of bleeding. CUSA seems to prevent harm to blood vessels and airways, which could lead to less bleeding during this specific type of minimally invasive lung cancer surgery. In centrally located lung tumors, salvage pulmonary resections pose challenges due to adhesions between the pulmonary parenchyma, chest wall, and hilum. This study aimed to investigate the surgical outcomes associated with Cavitron Ultrasonic Surgical Aspirator (CUSA) usage in thoracoscopic salvage pulmonary resections. Patients with centrally located advanced-stage lung tumors who underwent salvage anatomic resections following systemic or radiotherapy were included. They were categorized into CUSA and non-CUSA groups, and perioperative parameters and surgical outcomes were analyzed. Results: The study included 7 patients in the CUSA group and 15 in the non-CUSA group. Despite a longer median surgical time in the CUSA group (3.8 h vs. 6.0 h, p = 0.021), there was a significant reduction in blood loss (100 mL vs. 250 mL, p = 0.014). Multivariate analyses revealed that the use of CUSA and radiotherapy had opposing effects on blood loss (β: −296.7, 95% CI: −24.8 to −568.6, p = 0.034 and β: 282.9, 95% CI: 19.7 to 546.3, p = 0.037, respectively). In conclusion, while using CUSA in the salvage anatomic resection of centrally located lung cancer may result in a longer surgical time, it is crucial in minimizing blood loss during the procedure. [ABSTRACT FROM AUTHOR]

The standard treatment for early-stage lung cancer is complete tumor excision by limited resection of the lung. Preoperative localization is used before video-assisted thoracoscopic surgery (VATS) to improve the accuracy of pulmonary nodule excision. However, lung atelectasis and hypoxia resulting from controlling apnea during the localization procedure may affect the localization accuracy. Pre-procedural pulmonary recruitment may improve the respiratory mechanics and oxygenation during localization. In this study, we investigated the potential benefits of pre-localization pulmonary recruitment prior to pulmonary ground-glass nodule localization in a hybrid operating room. We hypothesized that pre-localization pulmonary recruitment would increase the localization accuracy, improve oxygenation, and prevent the need for re-inflation during the localization procedure. We retrospectively enrolled patients with multiple pulmonary nodule localizations before surgical intervention in our hybrid operating room. We compared the localization accuracy between patients who had undergone pre-procedure pulmonary recruitment and patients who had not. Saturation, re-inflation rate, apnea time, procedure-related pneumothorax, and procedure time were also recorded as secondary outcomes. The patients who had undergone pre-procedure recruitment had better saturation, shorter procedure time, and higher localization accuracy. The pre-procedure pulmonary recruitment maneuver was effective in increasing regional lung ventilation, leading to improved oxygenation and localization accuracy. [ABSTRACT FROM AUTHOR]

In this paper, two new families of asynchronous channel-hopping (CH) sequences—Symmetric Maximum-Length CH (SML-CH) Sequences and Relaxed Difference Set (RDS) of Maximum-Length CH (RDSML-CH) Sequences—are constructed. For the first time, the maximum-length sequences (also called as m-sequences) are used to create 2-D CH matrices with a reduced number of “jump” columns. The two new constructions carry the desirable properties of maximum rendezvous diversity (MRD) and even channel use (ECU) and, more importantly, have the shortest periods in their categories of constructions. Another contribution is on the embedment of optical orthogonal codes (OOCs) to eliminate “stay” columns in the RDSML-CH matrices, thus resulting in the first and only family of the asynchronous CH sequences that can asymptotically achieve the theoretical period lower bound. To support the RDSML-CH construction, a new shortened RDS algorithm for creating the OOCs with smaller weight-to-length ratios than the existing ones is proposed. Numerical and simulation analyses show that the two new constructions have a good balance of short period, MRD, ECU, short time-to-rendezvous (TTR) mean, small TTR variance, and short maximum-TTR, thus more suitable for practical CR wireless networks than the existing constructions. [ABSTRACT FROM AUTHOR]

• After chlorine depletion, the reaction still progresses and is faster than photolysis alone. • When chlorine is depleted, O 3 becomes the major reactant that degrades ketamine. • High ozone yields were found in both sunlight/HOCl and sunlight/ClO−. • The high concentration and contribution of O 3 were confirmed by a kinetic model. • Ozone reacts with primary and secondary amine-containing pharmaceuticals. Sunlight-induced photoirradiation of chlorine (sunlight/chlorine) can be observed in outdoor swimming pools and open-channel disinfection units for wastewater treatment. In this study, the degradation of ketamine, an environmentally persistent pharmaceutical, under sunlight irradiation in the presence of a low concentration of chlorine (1 mg/L as Cl 2) was investigated to elucidate the evolution of reactive species and their contribution to ketamine removal. •OH dominates the initial stage of sunlight/chlorine; however, after chlorine depletion, reactions still progress with an observed rate constant (k obs = 7.6 ± 0.50 × 10−3 min−1) an order of magnitude higher than photolysis alone (k obs = 2.9 ± 0.15 × 10−4 min−1). When chlorine is depleted, O 3 becomes the major reactant that degrades ketamine. High O 3 yields were found in both sunlight/HOCl (12.5 ± 0.5% at pH 5) and sunlight/ClO− (10 ± 1% at pH 10) systems. At sub-µM levels, O 3 resulted in substantial removal of ketamine, and even faster rates were observed in the presence of sunlight. A kinetic model was also established, and evaluate time-dependent concentration levels during sunlight/chlorine. The model simulation showed that the cumulative O 3 concentration could reach 0.91 μM, and O 3 contributed 31% ketamine removal during the sunlight/chlorine process. Primary and secondary amine functional groups were demonstrated to be the reaction sites of O 3 ; other pharmaceuticals, such as atenolol and metoprolol, underwent similar phenomena. In addition, the experimental and model results further indicated that sunlight/ClO 2 − or ClO 2 also participates in the degradation of ketamine with a minor role; trace amounts (below nM level) of ClO 2 − and ClO 2 were estimated by the simulation. [Display omitted] [ABSTRACT FROM AUTHOR]

Urine source separation, as an innovative concept for the reuse of microlevel nutrients in human urine, has drawn increasing attention recently. Consequently, removing coexisting pharmaceuticals in urine is necessary for further reuse. This study is the first to apply the solar-driven persulfate process (Solar/PS) to the investigation of cephradine (CFD) and caffeine (CAF) degradation in synthetic human urine. The results showed that significantly more degradation of CFD and CAF occurs with the Solar/PS process than with persulfate oxidation and direct sunlight photolysis, respectively. The generated reactive species ·OH, SO 4 ·–, O 2 ·– and 1O 2 were identified in the Solar/PS process. While SO 4 ·– played a dominant role at pH 6, it played a minor role at pH 9 due to the lower amount generated under alkaline conditions. The presence of chloride and ammonia negatively impacted the photodegradation of both compounds. In contrast, bicarbonate exhibited no effect on CAF but enhanced CFD degradation owing to its amino-acid-like structure, which has a higher reactivity toward CO 3 ·–. Although total organic carbon (TOC) was partially mineralized after 6 h of operation, no Microtox® toxicity was observed. [Display omitted] • CAF and CFD were effectively removed in synthetic urine via the Solar/PS process. • SO 4 ·– contributed dominantly at pH 6, while·OH played a major role at pH 9. • Cl- and NH 3 in synthetic urine had a negative impact on CAF and CFD degradation. • HCO 3 - in synthetic urine exhibited no effect on CAF but enhanced CFD degradation. • No Microtox® toxicity was observed in synthetic urine after the operation. [ABSTRACT FROM AUTHOR]