Polarization analysis of p̄ produced in pA collisions

A quite simple procedure for the generation of a polarized antiproton beam could be worked out if antiprotons are produced with some polarization. In order to investigate this possibility measurements of the polarization of produced antiprotons have been started at a CERN/PS test beam. The polarization will be determined from the asymmetry of the elastic antiproton scattering at a liquid hydrogen target in the CNI region for which the analyzing power is well known. The data are under analysis and an additional measurement is done in 2018. Details on the experiment and the ongoing data analysis will be given.

Drift chamber calibration and particle identification in the P-349 experiment

The goal of the P-349 experiment is to test whether 3.5 GeV/c antiprotons produced in high-energy proton-proton collisions are polarized in view of the preparation of a polarized antiproton beam. In this article, we present the details of the ongoing analysis focused on the drift chambers calibration and particle identification with DIRC.

Non-intercostal access for video-assisted thoracic surgery-analysis of technical advantages and disadvantages

Background

Video-assisted thoracoscopic surgery (VATS) lobectomy has become an accepted method for the treatment of early-stage non-small-cell lung cancer (NSCLC). The standard VATS approach is an intercostal one which is often followed by postoperative pain due to injury of the intercostal nerve. The non-intercostal techniques of VATS include the subxiphoid, transcervical, transdiaphragmatic and transoral procedures.

Methods

The technical difficulty of operative management of the anatomical structures during VATS anatomical resection are compared for the intercostal, subxiphoid and transcervical approaches.

Results

Some operative steps have different range of difficulty, which are analyzed in detail.

Conclusions

The clearest advantages of the non-intercostal approaches include less postoperative pain and superradial bilateral mediastinal lymphadenectomy in case of the transcervical approach. However, the non-intercostal approaches are more technically demanding procedures, which therapeutic role has to be clarified in the future.

BEST Life-"Bringing ECMO Simulation To Life"-How Medical Simulation Improved a Regional ECMO Program

The implemented "ECMO for Greater Poland" program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region. The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF), and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication. Finally, it promotes donation after circulatory death (DCD) strategy in selected organ donor cases. ECMO enables recovery of organs' function after unsuccessful lifesaving treatment. Because this organizational model is complex and expensive, we use advanced high-fidelity medical simulation to prepare for real-life implementation. During the first four months, we performed scenarios mimicking "ECMO for DCD," "ECMO for ECPR (extended cardiopulmonary resuscitation)," "ECMO for RRF" and "ECMO in hypothermia." It helped to create algorithms for aforementioned program arms. In the following months, three ECMO courses for five departments in Poznan (capitol city of Greater Poland) were organized and standardized operating procedures for road ECMO transportation within Medical Emergency System were created. Soon after simulation program, 38 procedures with ECMO perfusion therapy including five road transportations on ECMO were performed. The Maastricht category II DCD procedures were done four times on real patients and in two cases double successful kidney transplantations were carried out for the first time in Poland. ECMO was applied in two patients with hypothermia, nine adult patients with heart failure, and five with RRF, for the first time in the region. In the pediatric group, ECMO was applied in four patients with RRF and 14 with heart failure after cardiac surgery procedures. Additionally, one child was treated successfully following 200 km-long road transport on ECMO. We achieved good and promising results especially in VV ECMO therapy. Simulation-based training enabled us to build a successful procedural chain, and to eliminate errors at the stage of identification, notification, transportation, and providing ECMO perfusion therapy. We discovered the important role of medical simulation, not only to test the medical professional's skills, but also to promote ECMO therapy in patients with critical/life-threatening states. Moreover, it also resulted in increase of the potential organ pool from DCD in the Greater Poland region.

"Extracorporeal Membrane Oxygenation for Greater Poland" Program: How to Save Lives and Develop Organ Donation?

The "ECMO for Greater Poland" program takes full advantage of the extracorporeal membrane oxygenation (ECMO) perfusion therapy opportunities to promote the health of the 3.5 million inhabitants in the region. The main implementation areas are treatment of patients with hypothermia; severe reversible respiratory failure (RRF); critical states resulting in heart failure, that is, cardiac arrest, cardiogenic shock, or acute intoxication; and promotion of the donor after circulatory death (DCD) strategy in selected organ donor cases, after unsuccessful life-saving treatment, to achieve organ recovery. This organizational model is complex and expensive, so we used advanced high-fidelity medical simulation tests to prepare for real-life experience. Over the course of 4 months we performed scenarios including "ECMO for DCD," "ECMO for extended cardiopulmonary resuscitation," "ECMO for RRF," and "ECMO in hypothermia." Soon after these simulations, Maastricht category II DCD procedures were performed involving real patients and resulting in 2 successful double kidney transplantations for the first time in Poland. One month later we treated 2 hypothermia patients (7 adult patients with heart failure and 5 patients with reversible respiratory failure) with ECMO for the first time in the region. Fortunately, we have discovered an important new role of medical simulation. It can be used not only for skills testing but also as a tool to create non-existing procedures and unavailable algorithms. The result of these program activities will promote the care and treatment of patients in critical condition with ECMO therapy as well as increase the potential organ pool from DCDs in the Greater Poland region of Poland.

Transcervical uniportal pulmonary lobectomy

Background

The aim of the study is a description of surgical technique of uniportal transcervical video-assisted thoracoscopic surgery (VATS) for pulmonary lobectomy.

Methods

We used a collar neck incision (transcervical) of an average length 5-8 centimeters. The manubrium of the sternum is elevated with a hook connected to the Zakopane II frame (Aesculap-Chifa, B. Braun, Nowy Tomyśl, Poland). The first step is a transcervical extended mediastinal lymphadenectomy (TEMLA), for improved staging and possible improved survival. The nodes removed during TEMLA undergo intraoperative imprint cytology examination. In case of no metastasis a uniportal VATS lobectomy through the neck follows. Ventilation of the operated lung is disconnected and the pleural cavity is entered by opening of the mediastinal pleura. Pleural adhesions, if present are managed with electrocautery. The branches of the pulmonary artery and vein are sequentially dissected and managed with endostaplers or vascular clips. The lobar bronchus and the fissures are divided with endostaplers and the resected lobe is removed in an endobag.

Results

There were 16 patients operated on in the period 1.2.2016-30.7.2016. There were two conversions-in one patient with left lower lobe tumor we had to convert to uniportal VATS left lower lobectomy due to extensive adhesions. In the other patient undergoing right lower lobectomy there was a conversion to right thoracotomy because of the bleeding from the pulmonary artery. There was no mortality and complications occurred in three patients. The mean operative time was 245.6 min (range, 145-385 min) for the whole TEMLA procedure with imprint cytology and lobectomy and 175.6 min (range, 75-295 min) for a lobectomy solely.

Conclusions

A uniportal transcervical VATS approach for pulmonary lobectomy combined with transcervical extended mediastinal lobectomy (TEMLA) provides an opportunity for radical pulmonary resection and superradical extensive mediastinal lymphadenectomy.

Anaerobic Digestion Effluents (ADEs) Treatment Coupling with Chlorella sp. Microalgae Production

  Nutrient removal effectiveness from anaerobic digestion effluents (ADEs) by Chlorella sp. cultivation and microalgae biomass productivity were evaluated in this study. The results showed that the highest Chlorella sp. biomass productivities of 386.5 ± 24.1 mg dry weight/L•d and 338.3 ± 11.0 mg dry weight/L•d were respectively obtained with the anaerobically digested effluent of municipal wastewater sludge and effluent from a fermentation tank treating dairy wastewater. Lower (p < 0.05) microalgal growth was achieved with anaerobically digested effluents of maize silage and swine slurry and cattle manure. The increase of the initial ammonia nitrogen concentration in ADEs to the level of 160 mg/L did not encourage Chlorella sp. productivity because of phosphorus limitation. The removal efficiencies of ammonia nitrogen, total nitrogen, total phosphorus, and chemical oxygen demand (COD) reached 99.7%, 98.6%, 88.2%, and 58.7%, respectively, depending on the source of ADE, but not on the initial ammonia nitrogen concentrations.

Production of highly and broad-range specific monoclonal antibodies against hemagglutinin of H5-subtype avian influenza viruses and their differentiation by mass spectrometry

Background

The highly pathogenic avian influenza viruses of the H5 subtype, such as the H5N1 viral strains or the novel H5N8 and H5N2 reassortants, are of both veterinary and public health concern worldwide. To combat these viruses, monoclonal antibodies (mAbs) against H5 hemagglutinin (HA) play a significant role. These mAbs are effective diagnostic and therapeutic agents and powerful tools in vaccine development and basic scientific research. The aim of this study was to obtain diagnostically valuable mAbs with broad strain specificity against H5-subtype AIVs.

Results

We applied the hybridoma method to produce anti-HA mAbs. The cloning and screening procedures resulted in the selection of 7 mouse hybridoma cell lines and their respective antibody clones. Preliminary immunoreactivity studies showed that these newly established mAbs, all of the IgG1 isotype, had high specificity and broad-range activities against the H5 HAs. However, these studies did not allow for a clear distinction among the selected antibodies and mAb-secreting hybridoma clones. To differentiate the analyzed mAbs and determine the exact number of hybridoma clones, peptide mapping of the Fc and Fab fragments was performed using a Matrix-Assisted Laser Desorption Ionization Time of Flight (MALDI-TOF/TOF) mass spectrometer. Detailed analyses of the acquired MS and MS/MS spectra confirmed that the Fc fragments constituted highly conserved species- and isotype-immunoglobulin components, whereas the Fab fragments exhibited considerable variation in the sequences that determine antibody specificity. This approach enabled unambiguous characterization of the selected mAbs according to their peptide composition. As a result, 6 different clones were distinguished.

Conclusions

Our work provided a unique panel of anti-H5 HA mAbs, which meets the demand for novel, high-specificity analytical tools for use in serologic surveillance. Applications of these mAbs in areas other than diagnostics are also possible. Moreover, we demonstrated for the first time that peptide mapping of antibody fragments with mass spectrometry is an efficient method for the differentiation of antibody clones and relevant antibody-producing cell lines. The method may be successfully used to characterize mAbs at the protein level.

Electronic supplementary material

The online version of this article (10.1186/s12985-017-0886-2) contains supplementary material, which is available to authorized users.

Studies of discrete symmetries in decays of positronium atoms

A positronium - a bound state of electron and positron - is an eigenstate of parity and charge conjugation operators which decays into photons. It is a unique laboratory to study discrete symmetries whose precision is limited, in principle, by the effects due to the weak interactions expected at the level of 10−14 and photon-photon interactions expected at the level of 10−9.

The Jagiellonian Positron Emission Tomograph (J-PET) is a detector for medical imaging as well as for physics studies involving detection of electronpositron annihilation into photons. The physics case covers the areas of discrete symmetries studies and genuine multipartite entanglement. The J-PET detector has high angular and time resolution and allows for determination of spin of the positronium and the momenta and polarization vectors of annihilation quanta. In this article, we present the potential of the J-PET system for studies of discrete symmetries in decays of positronium atoms.

Influence of microwave heating on biogas production from Sida hermaphrodita silage

This study compared the effects on biogas production of suspended sludge versus a combination of suspended sludge and immobilized biomass, and microwave versus convection heating. Biogas production was the highest in the hybrid bioreactor heated by microwaves (385L/kg VS) and also the most stable, as shown by the FOS/TAC ratio and pH. Regardless of the type of heating, biogas production was 8% higher with immobilized biomass than without. Although the lag phase of biogas production was shorter with microwave heating than without, the log phase was longer, and biogas production in the microwave heated bioreactors took about twice as long (ca. 40days) to plateau as in the conventionally heated bioreactors. These differences in the profile of biogas production are likely due to the athermal effects of microwave irradiation.

Novel scintillating material 2-(4-styrylphenyl)benzoxazole for the fully digital and MRI compatible J-PET tomograph based on plastic scintillators

A novel plastic scintillator is developed for the application in the digital positron emission tomography (PET). The novelty of the concept lies in application of the 2-(4-styrylphenyl)benzoxazole as a wavelength shifter. The substance has not been used as scintillator dopant before. A dopant shifts the scintillation spectrum towards longer wavelengths making it more suitable for applications in scintillators of long strips geometry and light detection with digital silicon photomultipliers. These features open perspectives for the construction of the cost-effective and MRI-compatible PET scanner with the large field of view. In this article we present the synthesis method and characterize performance of the elaborated scintillator by determining its light emission spectrum, light emission efficiency, rising and decay time of the scintillation pulses and resulting timing resolution when applied in the positron emission tomography. The optimal concentration of the novel wavelength shifter was established by maximizing the light output and it was found to be 0.05 ‰ for cuboidal scintillator with dimensions of 14 mm x 14 mm x 20 mm.

Subxiphoid uniportal VATS thymectomy

Background

To present the technique of minimally invasive extended thymectomy performed through the uniportal subxiphoid approach, with double elevation of the sternum for nonthymomatous myasthenia gravis (MG).

Methods

Operative technique: the whole dissection was performed through the 4-7 cm transverse or longitudinal subxiphoid incision with use of videothoracoscope. The sternum was elevated with two hooks connected to the sternal frame (Rochard bar, Aesculap-Chifa, Nowy Tomysl, Poland). The lower hook was inserted through the subxiphoid incision and the superior hook was inserted percutaneously, after the mediastinal tissue including the major mediastinal vessels were dissected from the inner surface of the sternum. The fatty tissue of the anterior mediastinum and the aorta-pulmonary window was completely removed.

Results

There were four patients in the period 1.1.2017-30.4.2017. There was no mortality and morbidity.

Conclusions

The uniportal subxiphoid approach combined with double elevation of the sternum enabled very extensive thymectomy in case of thymoma.

The Zakopane Pulmonary Hospital experience on subxiphoid thymectomy

BACKGROUND

To present the technique of minimally invasive extended thymectomy performed through the subxiphoid-bilateral subcostal video-assisted thoracoscopic surgery (VATS) approach, with double elevation of the sternum for nonthymomatous myasthenia gravis (MG).

METHODS

The whole dissection was performed through the 4-7 cm transverse subxiphoid incision with single 10 mm extra-long bariatric laparoscopy ports inserted subcostally to the right and left chest cavities for videothoracoscope and subsequently for chest tubes. The sternum was elevated with two hooks connected to the sternal frame (Rochard bar, Aesculap-Chifa, Nowy Tomysl, Poland). The lower hook was inserted through the subxiphoid incision and the superior hook was inserted percutaneously, after the mediastinal tissue including the major mediastinal vessels were dissected from the inner surface of the sternum. The fatty tissue of the anterior mediastinum and the aorta-pulmonary window was completely removed.

RESULTS

There were 147 patients (62 patients operated on for thymomas, 75 patients for nonthymomatous MG and 10 for rethymectomies) in the period 1.1.2009-30.3.2016. There was no mortality and morbidity. The mean operative time was 109.1 min (range, 75-150 min).

CONCLUSIONS

The subxiphoid approach combined with bilateral single port subcostal VATS and double elevation of the sternum enables very extensive thymectomy in case of nonthymomayous MG.

Effect of a static magnetic field on activated sludge community

The aim of this study was to determine the effect of a static magnetic field (SMF) on the composition of activated sludge biocenosis. The experiment was carried out in two parallel bench scale Sequencing Batch Reactors (SBRs). Both SBRs were treated with dairy wastewater. The activated sludge in the first SBR was exposed to an SMF via the induction of a 0.6 T magnetic field generated by four magnetic liquid activators. The second reactor (control reactor) was operated at the same operational parameters but the activated sludge was not exposed to the SMF. The mean length of the bacterium Eikelboom Type 0092 was lower in the SMF-exposed reactor than in the control reactor. Different activated sludge morphologies in SBRs were reflected in the values of the sludge volume index and sludge biotic index calculated on the basis of the microfauna composition.

Definitions and standard indications of minimally-invasive techniques in thymic surgery

BACKGROUND

The minimally invasive thoracic procedures are those performed through the intercostal, subxiphoid, subcostal or transcervical incisions. In most of these procedures (with exception of some transcervical procedures) the video-assisted thoracic surgery (VATS) technique is used for performance of an operation under guidance of a video monitor.

METHODS

According to the definition the minimally invasive procedures do not include the sternal manubriotomy (upper sternal split), transverse sternotomy and subcutaneous longitudinal sternotomy. Currently, a minimally invasive extended thymectomy became a widespread procedure advised for nonthymomatous myasthenia gravis (MG) and early-stage thymomas. The definition of an extended thymectomy is a removal of the whole thymus with the surrounding adipose tissue. Instead of the term "extended thymectomy" some authors recommended a term "complete thymectomy", which means total removal of the whole thymus, without the adjacent fatty tissue.

RESULTS

There are a lot of doubts about the definition of extended thymectomy. There have been no prospective randomized trials comparing the transsternal and minimally invasive approaches for MG or thymomas. Possible scenarios for such trials are analyzed in this paper.

CONCLUSIONS

There are several issues of a minimally invasive thymectomy for MG and thymomas necessitating further clarifications.

The role of simulation to support donation after circulatory death with extracorporeal membrane oxygenation (DCD-ECMO)

Maintaining the viability of organs from donors after circulatory death (DCD) for transplantation is a complicated procedure, from a time perspective in the absence of appropriate organizational capabilities, that makes such transplantation cases difficult and not yet widespread in Poland. We present the procedural preparation for Poland’s first case of organ (kidney) transplantation from a DCD donor in which perfusion was supported by extracorporeal membrane oxygenation (ECMO). Because this organizational model is complex and expensive, we used advanced high-fidelity medical simulation to prepare for the real-life implementation. The real time scenario included all crucial steps: prehospital identification, cardiopulmonary resuscitation (CPR), advanced life support (ALS); perfusion therapy (CPR-ECMO or DCD-ECMO); inclusion and exclusion criteria matching, suitability for automated chest compression; DCD confirmation and donor authorization, ECMO organs recovery; kidney harvesting. The success of our first simulated DCD-ECMO procedure in Poland is reassuring. Soon after this simulation, Maastricht category II DCD procedures were performed, involving real patients and resulting in two successful double kidney transplantations. During debriefing, it was found that the previous simulation-based training provided the experience to build a successful procedural chain, to eliminate errors at the stage of identification, notification, transportation, donor qualifications and ECMO organ perfusion to create DCD-ECMO algorithm architecture.