Enhancing Patient Selection in Stage IIIA-IIIB NSCLC: Invasive Lymph Node Restaging after Neoadjuvant Therapy

Restaging of mediastinal lymph nodes plays a crucial role in the multimodal treatment of stage IIIA Non-Small-Cell Lung Cancer (NSCLC). This study aimed to assess the impact of restaging using endobronchial ultrasound (EBUS), endoesophageal ultrasound (EUS), and transcervical extended mediastinal lymphadenectomy (TEMLA) after neoadjuvant chemotherapy (CHT) or chemoradiotherapy (CRT) on the 5-year overall survival (OS) of patients with NSCLC diagnosed with clinical stage IIIA-IIIB and metastatic ipsilateral mediastinal nodes (N2) who underwent radical pulmonary resections. Patients diagnosed with stage IIIA-IIIB NSCLC and N2 mediastinal nodes were included in this study. Restaging of mediastinal lymph nodes was performed using EBUS, EUS, and TEMLA. The patients were divided into two groups based on the restaging method: the TEMLA restaging group and the chest CT scan-only group. The primary outcome measure was the 5-year OS rate, and the secondary outcome measures included median OS and survival percentages. Statistical analysis, including the log-rank test, was conducted to assess the differences between the two groups. The TEMLA restaging group demonstrated significantly better overall survival compared to the chest CT scan-only group (log-rank test, p = 0.02). This was evident through a four-fold increase in median OS (59 vs. 14 months) and a higher 5-year OS rate of 55.9% (95% CI: 40.6-71.1) compared to 25.0% (95% CI: 13.7-36.3) in the chest CT scan-only group (p = 0.003). Invasive restaging of mediastinal lymph nodes improves the selection of patients with stage IIIA-IIIB (N2) NSCLC after neoadjuvant therapy. The use of EBUS, EUS, and TEMLA provides valuable information for identifying patients who may benefit from surgery by identifying N2 to N0-1 downstaging. These findings emphasize the importance of incorporating restaging procedures into the treatment decision-making process for NSCLC patients with mediastinal lymph node involvement.

Suitability of pre-digested dairy effluent for mixotrophic cultivation of the hydrogen-producing microalgae Tetraselmis subcordiformis

The costs associated with microalgal biomass production can be reduced by leveraging alternative and cheap growth media. Digestate from fermentation reactors is a particularly interesting candidate for use in cultivating mixotrophic species. The aim of the present study was to assess whether pre-digested milk-industry effluent can be harnessed to grow Tetraselmis subcordiformis and produce hydrogen. The experimental series with 25% and 50% effluent in the growth medium performed the best, producing more than 2000 mgVS biomass/dm3. The biogas produced in these variants contained over 60% hydrogen. Increasing the effluent in the medium to 75% led to significant deterioration of performance, both in terms of T. subcordiformis biomass growth and biohydrogen production. The highest efficiency of nitrogen and phosphorus removal, respectively 98.1 ± 1.9% and 97.1 ± 1.4%, was observed in the system to which 25% of sewage was introduced. Increasing the share of fermented wastewater directly reduced the efficiency of removing biogenic compounds. A very strong negative correlation was found between initial N-NH4 in the growth medium and T. subcordiformis biomass production rates (R2 = 0.9177).

Removal of CO2 from Biogas during Mineral Carbonation with Waste Materials

Biogas represents a source of renewable energy that could provide a replacement for fossil fuels to meet the increasing demand for energy. The upgrading of biogas through the removal of CO₂ to a content of 95-97% of CH₄ is necessary to increase its calorific value. This review focuses on biogas upgrading technologies using wastes or residues that enable the performing of mineral carbonation. In this research, we analyzed a natural biogas or synthetic one with a content of about (40-50%) of carbon dioxide. The chemical absorption is also briefly described in this study, due to its being the first step in innovative absorption and regeneration processes using mineral carbonization. Wastes with high calcium contents, i.e., ashes, steel-making slags, and stabilized wastewater anaerobic sludge, were considered for direct carbonization, taking into account the leaching of particles from carbonated wastes/residues. Moreover, the different types of reactors used for mineral carbonation have been described. The presented technological solutions are easy to use and economical, and some of them also take into account the regeneration of reagents. However, in the context of their direct use in biogas plants, it is necessary to consider the availability of wastes and residues.

Technological, Ecological, and Energy-Economic Aspects of Using Solidified Carbon Dioxide for Aerobic Granular Sludge Pre-Treatment Prior to Anaerobic Digestion

The technology of aerobic granular sludge (AGS) seems prospective in wastewater bio-treatment. The characteristics as well as compactness and structure of AGS have been proved to significantly affect the effectiveness of thus far deployed methods for sewage sludge processing, including anaerobic digestion (AD). Therefore, it is deemed necessary to extend knowledge on the possibilities of efficient AGS management and to seek viable technological solutions for methane fermentation of sludge of this type, including by means of using the pre-treatment step. Little is known about the pre-treatment method with solidified carbon dioxide (SCO₂), which can be recovered in processes of biogas upgrading and enrichment, leading to biomethane production. This study aimed to determine the impact of AGS pre-treatment with SCO₂ on the efficiency of its AD. An energy balance and a simplified economic analysis of the process were also carried out. It was found that an increasing dose of SCO₂ applied in the pre-treatment increased the concentrations of COD, N-NH₄⁺, and P-PO₄^3- in the supernatant in the range of the SCO₂/AGS volume ratios from 0.0 to 0.3. No statistically significant differences were noted above the latter value. The highest unit yields of biogas and methane production, reaching 476 ± 20 cm³/gVS and 341 ± 13 cm³/gVS, respectively, were obtained in the variant with the SCO₂/AGS ratio of 0.3. This experimental variant also produced the highest positive net energy gain, reaching 1047.85 ± 20 kWh/ton total solids (TS). The use of the higher than 0.3 SCO₂ doses was proved to significantly reduce the pH of AGS (below 6.5), thereby directly diminishing the percentage of methanogenic bacteria in the anaerobic bacterial community, which in turn contributed to a reduced CH₄ fraction in the biogas.

The Possibility of Deploying CO2 from Biogas Combustion to Improve the Productivity of a Periodical Chlorella vulgaris Culture

BACKGROUND

Carbon dioxide (CO2) is the major contributor to the global emissions of greenhouse gases, which necessitates the search for its fixation and utilization methods. Engaging photosynthesizing microorganisms for its biosequestration is one of the prospective technologies applied to this end. Considering the paucity of literature works on the possibilities of deploying CO2 from biogas combustion to intensify microalgae production, this research aimed to identify the feasibility of using this type of CO2 in Chlorella vulgaris culture by evaluating biomass production yield and CO2 biosequestration effectiveness.

METHODS

The experiment was performed in glass PBR, in which the culture medium occupied the volume of 1.0 dm3, and the gaseous phase occupied 0.3 dm3. The reactors were continuously illuminated by fluorescent lamps. The temperature of flue gases and air fed to reactors, and culture temperature was 20 °C ± 2 °C.

RESULTS

The use of flue gases promoted a more rapid biomass growth, reaching 77.8 ± 3.1 mgVS/dm3⋅d, and produced a higher microalgae concentration, i.e., 780 ± 58 mgVS/dm3. Nevertheless, the flue gas-fed culture turned out to be highly sensitive, which was manifested in a decreased culture medium pH and relatively quickly achieved decay phase of the C. vulgaris population. The microalgae effectively assimilated CO2, reducing its concentration from 13 ± 1% to 1 ± 0.5% in the effluent from the photobioreactor.

CONCLUSIONS

The flue gases were found not to affect the qualitative composition of the microalgal biomass. However, strict control and monitoring of microalgae biomass production is necessary, as well as rapid responses in flue gas-fed systems. This is an important hint for potential operators of such technological systems on the large scale. Regardless of the possibility of deploying microalgae to fix and utilize CO2, a justified avenue of research is to look for cheap sources of CO2-rich gases.

Effect of Pharmaceutical Sludge Pre-Treatment with Fenton/Fenton-like Reagents on Toxicity and Anaerobic Digestion Efficiency

Sewage sludge is successfully used in anaerobic digestion (AD). Although AD is a well-known, universal and widely recognized technology, there are factors that limit its widespread use, such as the presence of substances that are resistant to biodegradation, inhibit the fermentation process or are toxic to anaerobic microorganisms. Sewage sludge generated by the pharmaceutical sector is one such substance. Pharmaceutical sewage sludge (PSS) is characterized by high concentrations of biocides, including antibiotics and other compounds that have a negative effect on the anaerobic environment. The aim of the present research was to determine the feasibility of applying Advanced Oxidation Processes (AOP) harnessing Fenton's (Fe²⁺/H₂O₂) and Fenton-like (Fe³⁺/H₂O₂) reaction to PSS pre-treatment prior to AD. The method was analyzed in terms of its impact on limiting PSS toxicity and improving methane fermentation. The use of AOP led to a significant reduction of PSS toxicity from 53.3 ± 5.1% to 35.7 ± 3.2%, which had a direct impact on the taxonomic structure of anaerobic bacteria, and thus influenced biogas production efficiency and methane content. Correlations were found between PSS toxicity and the presence of Archaea and biogas yields in the Fe²⁺/H₂O₂ group. CH₄ production ranged from 363.2 ± 11.9 cm³ CH₄/g VS in the control PSS to approximately 450 cm³/g VS. This was 445.7 ± 21.6 cm³ CH₄/g VS (1.5 g Fe²⁺/dm³ and 6.0 g H₂O₂/dm³) and 453.6 ± 22.4 cm³ CH₄/g VS (2.0 g Fe²⁺/dm³ and 8.0 g H₂O₂/dm³). The differences between these variants were not statistically significant. Therefore, due to the economical use of chemical reagents, the optimal tested dose was 1.5 g Fe²⁺/6.0 g H₂O₂. The use of a Fenton-like reagent (Fe³⁺/H₂O₂) resulted in lower AD efficiency (max. 393.7 ± 12.1 cm³ CH₄/g VS), and no strong linear relationships between the analyzed variables were found. It is, therefore, a more difficult method to estimate the final effects. Research has proven that AOP can be used to improve the efficiency of AD of PSS.

Ultrasonic Disintegration to Improve Anaerobic Digestion of Microalgae with Hard Cell Walls-Scenedesmus sp. and Pinnularia sp

Microalgae are considered to be very promising feedstocks for biomethane production. It has been shown that the structure of microalgal cell walls can be highly detrimental to the anaerobic digestibility of biomass. Therefore, there is a real need to seek ways to eliminate this problem. The aim of the present study was to assess the effect of ultrasonic disintegration of Scenedesmus sp. and Pinnularia sp. microalgal biomass on the performance and energy efficiency of anaerobic digestion. The pretreatment was successful in significantly increasing dissolved COD and TOC in the system. The highest CH₄ yields were noted for Scenedesmus sp. sonicated for 150 s and 200 s, which produced 309 ± 13 cm³/gVS and 313 ± 15 cm³/gVS, respectively. The 50 s group performed the best in terms of net energy efficiency at 1.909 ± 0.20 Wh/gVS. Considerably poorer performance was noted for Pinnularia sp., with biomass yields and net energy gains peaking at CH₄ 250 ± 21 cm³/gVS and 0.943 ± 0.22 Wh/gVS, respectively. Notably, the latter value was inferior to even the non-pretreated biomass (which generated 1.394 ± 0.19 Wh/gVS).

Performance of an Innovative Low-Cost Recycled Filling (LCRF) in Anaerobic Treatment of Dairy Effluent-A Pilot-Scale Study

The rapid growth in dairy production leads to increasing outputs of high-load effluent, necessitating new methods of treating such waste. Anaerobic processes have been increasingly popular but are hamstrung by limited nutrient removal efficiency. The aim of the present study was to investigate whether low-cost recycled filling (LCRF) improves the anaerobic treatment of dairy effluent. The addition of LCRF was found to increase both COD removal (86.1 ± 2.6%-92.8 ± 1.6%) and P_tot. removal (22.1 ± 3.5% to 36.9 ± 4.6%) from the wastewater. The LCRF ensured near-neutral pH and stabilized the structure of the anaerobic microbe community (including Archaea) across all pollutant loads tested. This translated to efficient biogas production and high methane content in the LCRF reactors, peaking at 0.35 ± 0.01 m³/kg COD_removed and 68.2 ± 0.6% (respectively) in the best-performing variant.

Effect of Acid Whey Pretreatment Using Ultrasonic Disintegration on the Removal of Organic Compounds and Anaerobic Digestion Efficiency

Acid whey is a by-product of the dairy industry that should be utilized or appropriately neutralized. Anaerobic processes represent a group of prospective methods for whey processing, and a key priority in their development is to improve their technological and economical effectiveness. The present study aimed to determine the effect of ultrasonic disintegration (UD) of acid whey on the course and effectiveness of methane fermentation. The study results demonstrated that extending the UD duration resulted in increased concentrations of dissolved forms of COD and TOC, efficiency of organic matter biodegradation, and CH₄ production. The best effects were achieved at 900 s US, including CH₄ production of 0.203 ± 0.01 dm³/gCOD_in. and CH₄ content accounting for 70.9 ± 2.8%. Organic compounds were removed with the following efficiencies: COD-78.7 ± 2.1%, TOC-80.2 ± 1.3%, and BOD₅-84.1 ± 1.6%. The highest net energy gain of 5.763 Wh was achieved upon UD of 300 s. Extension of UD time had no significant effect on the improvement in the energetic effectiveness of anaerobic digestion. A strong positive correlation was found between COD and TOC concentrations in the dissolved phase and CH₄ production yield.

Liquid fraction of digestate pretreated with membrane filtration for cultivation of Chlorella vulgaris

To make microalgae cultivation economically feasible, different waste streams that may serve as cultivation media are being searched for. The aim of this study was membrane filtration of the liquid fraction of digestate (LFD) to produce permeate that will be an effective medium for the cultivation of Chlorella vulgaris. Microfiltration (MF) and ultrafiltration (UF) with ceramic membranes were used in one- and two-stage systems at transmembrane pressures (TMP) of 0.2, 0.3, and 0.4 MPa. The hydraulic capacities of the membrane modules allowed MF at 0.2 MPa to be selected as the most feasible variant of the one-stage variants. The use of MF permeates for microalgae cultivation resulted in the highest biomass yield, due to optimum pH (about 8.8), low color, and high nutrient concentration (about 290 mg/dm³ of ammonium and about 22 mg/dm³ of orthophosphates). The high pH (about 9.7) of the UF permeates, which increased the concentration of free ammonia, reduced microalgae growth by 50% compared to the growth noted with the MF permeates. Due to the low nutrient concentration, the use of permeates from the two-stage systems resulted in microalgae growth more than two times lower than the use of MF permeates. Mathematical modeling indicated that the component of the cultivation medium that most significantly affected microalgae growth was the initial ammonium concentration.

Anaerobic Reactor Filling for Phosphorus Removal by Metal Dissolution Method

A commonly indicated drawback of anaerobic wastewater treatment is the low effectiveness of phosphorus removal. One possibility to eliminate this disadvantage is the implementation of active fillings that contain admixtures of metals, minerals, or other elements contributing to wastewater treatment intensification. The aim of the research was to present an active filling produced via microcellular extrusion technology, and to determine its properties and performance in anaerobic wastewater treatment. The influence of copper and iron admixtures on the properties of the obtained porous extrudate in terms of its functional properties was also examined. The Barus effect increased with the highest content of the blowing agent in the material from 110 ± 12 to 134 ± 14. The addition of metal powders caused an increase in the extrudate density. The modification of PVC resulted in the highest porosity, amounting to 47.0% ± 3.2%, and caused the tensile strength to decrease by about 50%. The determined values ranged from 211.8 ± 18.3 MPa to 97.1 ± 10.0 MPa. The use of the filling in anaerobic rectors promoted COD removal, intensified biogas production, and eliminated phosphorus with an efficiency of 64.4% to 90.7%, depending on the type of wastewater and applied technological parameters.

Applicability of water from the Bay of Gdańsk as a growth medium for mixotrophic culture of Platymonas subcordiformis

P. subcordiformis is a potentially promising species with commercial, environmental and technological viability for industrial applications. The great potential of these microalgae lies in their fast biomass growth, pollution resistance, and compatibility with different culture media. This study aimed to determine the efficiency of P. subcordiformis biomass production in a medium prepared with water from the Bay of Gdańsk. The tested medium supported high biomass growth rates which reached 317.58 ± 42.31 mgV⁢S/dm3⋅d in the best-performing variant, with a final concentration of 3493.3 ± 465.4 mgV⁢S/dm3⋅d. In the autotrophic culture, nitrogen and phosphorus removal exceeded 98%. Amending the mixotrophic culture with glucose did not affect P. subcordiformis concentrations. However, it did significantly limit the demand for nutrients in the biomass and reduced chlorophyll a production in the cells.

Verification of electron beam parameters in an intraoperative linear accelerator using dosimetric and radiobiological response methods

BACKGROUND

The availability of linear accelerators (linac) for research purposes is often limited and therefore alternative radiation sources are needed to conduct radiobiological research. The National Centre for Radiation Research in Poland recently developed an intraoperative mobile linac that enables electron irradiation at energies ranging from 4 to 12 MeV and dose rates of 5 or 10 Gy/min. The present study was conducted to evaluate the electron beam parameters of this intraoperative linac and to verify the set-up to evaluate out-of-field doses in a water phantom, which were determined through dosimetric and biological response measurements.

MATERIALS AND METHODS

The distribution of radiation doses along and across the radiation beam were measured in a water phantom using a semiconductor detector and absolute doses using an ionisation chamber. Two luminal breast cancer cell lines (T-47D and HER2 positive SK-BR-3) were placed in the phantom to study radiation response at doses ranging from 2 to 10 Gy. Cell response was measured by clonogenic assays.

RESULTS AND CONCLUSION

The electron beam properties, including depth doses and profiles, were within expected range for the stated energies. These results confirm the viability of this device and set-up as a source of megavoltage electrons to evaluate the radiobiological response of tumour cells.

Endosonographic predictors of malignancy in a left adrenal gland in lung cancer patients - a comparison of EUS-b, CT and PET-CT

INTRODUCTION

Patients with resectable lung cancer require invasive evaluation of enlarged left adrenal gland (LAG). There are only few studies showing utility of endosonography with single ultrasound bronchoscope (EUS-b) in LAG assessment. Combination of CT, PET-CT and EUS-b and ultrasonographic predictors of malignancy (M1b/c) in LAG are not well known.

PATIENTS AND METHODS

A two center cohort retrospective study was performed from 2012 to 2019. Enlarged LAGs were evaluated by CT, PET-CT and EUS-b. Then, a complete endoscopic mediastinal staging was performed, enlarged LAGs were sampled by EUS-b-FNA. Patients were followed up for 6-months.

RESULTS

During the diagnosis of 2176 staged LCP, 113 (5.19%) enlarged LAGs were biopsied. 51 (45.13%) were positive for malignancy, predominantly adenocarcinoma (46.9%). Endosonography up-staged 7 (6.2%) patients, and down-staged 11 (9.37%) after false CT or PET-CT findings. No complications were noted after any biopsies. Radiological predictors of LAG metastases had the highest yield if cut offs were set as follows: HU>23, SUV>4.2 and LAG size >25mm. Hypoechogenic LAGs with loss of sea-gull shape in EUS-b indicated 28.67 times bigger likelihood of metastases. The sensitivity, specificity, accuracy, NPV and PPV for all measured ultrasound predictors were: 86.21%, 85.45%, 85.84%, 85.45%, 86.21%, combined with radiological measurements: 93.10%, 94.55%, 93.81%, 92.86% and 94.74%, respectively.

CONCLUSIONS

Hypoechogenicity and loss of sea-gull shape in EUS-b are the most reliable predictors of malignancy in enlarged LAG. A combination of radiological assessment based on CT/PET-CT and EUS-b findings improves noninvasive diagnostics for LAG metastases in LCP.

Efficiency of sweet whey fermentation with psychrophilic methanogens

Sweet whey is a waste product from the dairy industry that is difficult to manage. High hopes are fostered regarding its neutralization in the methane fermentation. An economically viable alternative to a typical mesophilic fermentation seems to be the process involving psychrophilic bacteria isolated from the natural environment. This study aimed to determine the feasibility of exploiting psychrophilic microorganisms in methane fermentation of sweet whey. The experiments were carried out under dynamic conditions using Bio Flo 310 type flow-through anaerobic bioreactors. The temperature inside the reactors was 10 ± 1 °C. The HRT was 20 days and the OLR was 0.2 g COD/dm³/day. The study yielded 132.7 ± 13.8 mL biogas/g_CODremoved. The CH₄ concentration in the biogas was 32.7 ± 1.6%, that of H₂ was 8.7 ± 4.7%, whereas that of CO₂ reached 58.42 ± 2.47%. Other gases were also determined, though in lower concentrations. The COD and BOD₅ removal efficiency reached 21.4 ± 0.6% and 17.6 ± 1.0%, respectively.

Effect of static magnetic field on microbial community during anaerobic digestion

Dairy wastewater is characterized by high concentration of organic compounds and is commonly used for energy production. Methods for enhancement of biogas production include application of magnetizers on the digester to induce static magnetic field (SMF). The study aimed at investigation of Bacteria and Archaea communities during anaerobic digestion of model dairy wastewater exposed to SMF. Magnetic field caused a significant increase in methane production to 373.2 mL/g VS compared to 200.2 mL/g VS in a control reactor and methane content to 56.8% compared to 49.1% in a control reactor. In both reactors, the biomass was dominated by Trichococcus sp. The relative abundance of lactic acid bacteria was of about 10% higher in the reactor exposed to SMF. This higher number of Lactobacillales resulted from a higher acetate production, which additionally caused enhanced growth of Methanosarcinacaea in the reactor exposed to SMF. SMF also stimulated the growth of hydrogenotrophic methanogens.

How paramedics perceive internal noise in ambulance? sensory processing sensitivity (SPS) and Subjective Noise Assessment

Introduction:

This article discusses the correlation between sensory processing sensitivity (SPS) as a feature of personality and temperament and paramedics’ subjective perception of noise inside an ambulance. Description of the theoretical basis of SPS has been strongly depicted.

Materials and methods:

Polish translation of SPS 12-item short scale and a survey concerning the subjective perception of noise inside an ambulance have been used in this research. Assessment of noise included its three sources: emergency vehicle siren, resistance of rolling tires and noise produced by diesel engines. 46 paramedics from mobile emergency care units working in Poznan and the Poznan’s district have taken part in the research. Paramedics with higher SPS results were selected, creating a highly sensitive people (HSP) group.

Results:

When non-HSP people were compared to paramedics from the HSP group, an emergency signal was considered more burdensome for HSP paramedics. The intensity of noise generated by the vehicle’s suspension elements and tires was significantly higher in cars more than 3 years old. Older paramedics (≥30 years old) evaluated the intensity as well as burdensomeness of noise generated by suspension’s elements and tires, higher than the younger (<30 years old) ones.

Conclusions:

Both paramedics and drivers as occupational groups are liable to noise, which seems to be particularly harmful and burdensome to the HSP group. Further studies should be provided in this area. This may lead to an increase not only in their productivity but also in their quality of life.

Bacterial expression and characterization of an anti-CD22 single-chain antibody fragment

Single-chain variable fragment (scFv) antibodies are fusion proteins of the variable regions of the heavy and light chains of immunoglobulins connected with a short linker peptide. They possess unique and superior features compared to whole antibodies for immunotherapy of various carcinomas, including hematologic B-cell malignancies. In the presented study we obtained efficient production of the recombinant anti-CD22 scFv in Escherichia coli expression system. The active recombinant protein was successfully recovered from inclusion bodies. Assays were performed to assess the in vitro targeting properties and specificity of the obtained anti-CD22 scFv antibody in the CD22 positive and negative lymphoma cell lines.

Removal of biogenic compounds from the post-fermentation effluent in a culture of Chlorella vulgaris

Wastewater rich in organic carbon, nitrogen and phosphorus may serve as a convenient source of carbon and nutrients for a year-long microalgae production. Scientific reports indicate that some single-cell microalgae such as Chlorella and Scenedesmus, are highly tolerant to wastewater environments and efficiently remove biogenic compounds. The aim of this study was to determine the possibility of using the effluent produced in the process of anaerobic degradation of whey as a culture medium for the multiplication of Chlorella vulgaris algae biomass and to characterise their growth efficiency and rate. The content of nitrogen and phosphorus in wastewater was sufficient for conducting an effective culture of algae. The efficiency of nitrogen removal in the flow system was 15.61 ± 1.38 mg N/dm³/day.

Microwave support of the alcoholic fermentation process of cyanobacteria Arthrospira platensis

The search for a balance between the energy-related challenges of the future and providing nutritional security has resulted in the development of a market for biofuels of successive generations. The larger their portion in biofuel production, the less the prices of agricultural products will increase. The use of algae, cyanobacteria and aquatic plants in the production of liquid fuels is an alternative. The aim of this study was to determine the effect of thermal hydrolysis on degradation of polysaccharides contained in biomass of cyanobacteria Arthrospira platensis and to assess the effectiveness of ethanol production from preconditioned biomass. The study is aimed at the selection of the most advantageous parameters of thermochemical hydrolysis to reach the experiment variant with the best effects, degree of polysaccharide degradation and effectiveness of alcohol fermentation. The experiment was divided into two stages; in stage I, the possibility of obtaining fermentable sugars by hydrothermal and chemical treatment of the substrate was tested. Stage II involved an assessment of the effectiveness of the pretreatment methods to produce bioethanol in alcohol fermentation. Yeast used in industrial ethanol production-Saccharomyces cerevisiae As4-was used in the alcohol fermentation. The results have shown that the temperature of 150 °C was the most beneficial for the process of thermohydrolysis, and the mash in the microwave-heated sample contained the highest concentration of alcohol (0.97 g/l), which is 98% more than in the control mash and 37% more than in the conventionally heated sample.

Transcervical extended mediastinal lymphadenectomy for mediastinal restaging after induction therapy

Background

The aim of this study was to retrospectively evaluate long-term survival of stage IIIA-N2 non-small cell lung cancer patients operated after induction chemotherapy or chemoradiotherapy and negative mediastinal restaging with transcervical extended mediastinal lymphadenectomy (TEMLA).

Methods

From January 2007 to December 2013, 48 stage IIIA-N2 non-small cell lung cancer (NSCLC) patients (36 men, 12 women) underwent anatomic pulmonary resection after induction therapy and negative result of mediastinal restaging with TEMLA. Mean age was 58.3 years (range, 46–75 years). There were 28 squamous cell carcinomas, 13 adenocarcinomas, 1 mixed carcinoma and 6 non-small cell lung cancers. Neoadjuvant chemotherapy was given in 24 patients, chemoradiotherapy in 23 and chemotherapy with bradytherapy in 1 patient. All patients were followed-up until death or 60 months since pulmonary resection.

Results

There were 29 pneumonectomies, 2 lower bilobectomies and 17 lobectomies. 2 patients had R1 resection. After negative TEMLA, persistent metastatic N2 nodes were discovered in 5 patients (10.4%). The only complication after TEMLA was bilateral vocal cord paralysis observed in 1 patient (2.1%); 2 patients died in early postoperative period due to bronchial fistula (4.2%). Overall 5-year survival of patients operated after negative TEMLA was 39.5%. 5-year survival was not statistically different in patients who underwent lobectomy/bilobectomy and in patients who underwent pneumonectomy (47.4% vs. 34.5%). Five-year survival was lower in patients after chemoradiotherapy than in patients after chemotherapy alone (21.7% vs. 56.0%, P=0.022). 5-year survival was not statistically different in patients with true mediastinal downstaging and in patients with false negative TEMLA (41.9% vs. 20%, P=0.19).

Conclusions

Stage IIIA-N2 non-small cell lung cancer patients who underwent pulmonary resection after induction treatment and negative mediastinal restaging with TEMLA showed good long-term survival. In these patients aggressive surgery, including pneumonectomy, lead to satisfactory outcomes. However, prognosis of patients after induction chemoradiotherapy was worse.

Expression and purification of recombinant human insulin from E. coli 20 strain

The number of people with diabetes is estimated to be over 370 million, in 2030 it will increase to 552 million. In Poland, the number of people with diabetes is estimated to be 3.5 million (9.1%). According to the estimates of the International Diabetes Federation, the percentage of patients in the adult Polish population will increase to around 11% over the next 20 years. Despite the appearance of insulin analogues on the pharmaceutical market, insulin delivery is still the most effective method of pharmacotherapy in cases of extremely high hyperglycemia. A new bacterial host strain (Escherichia coli 20) was obtained at the Institute of Biotechnology and Antibiotics and a new pIBAINS expression vector was constructed that provides greater efficiency in the production of recombinant human insulin. In the IBA Bioengineering Department, successful attempts were made to produce recombinant human insulin on a laboratory and quarter-technical scale, and several batches were performed on a semi-technical scale. The production process has been divided into several stages: 1. biosynthesis of insulin in the fermenter, 2. isolation, purification and dissolution of inclusion bodies, 3. protein renaturation, 4. enzymatic reaction with trypsin, 5. multi-stage purification of insulin using low-pressure and HPLC techniques. At each stage of insulin production, qualitative and quantitative analyses were performed to confirm identity and purity. In particular, the molecular weight of insulin, the amount of insulin and the content of protein impurities were studied. The results of these experiments are presented in this work.

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.