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.

Degradation of Polymethylmethacrylate (PMMA) Bioreactors Used for Algal Cultivation.

This paper depicts characteristics of degradation of walls of bioreactors made of polymethylmethacrylate (PMMA) which was used to culture algae. The degradation processes take place stimulated by lighting of external surface and interaction with cultured species on internal surface. Results presented are representative for degradation of a bioreactor tube after the 4-year cultivation of Chlorella sp. Microscopic observations, roughness and transmission tests showed that changes have occurred on the inner surface. The result of use is a decrease in transmission and an increase in roughness. Microscopic observations showed that particles remained after culture, especially in cracks.

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.

Impact of Doping on Cross-Sectional Stress Assessment of 3C-SiC/Si Heteroepitaxy.

In this paper, we used micro-Raman spectroscopy in cross-section to investigate the effect of different doping on the distribution of stress in the silicon substrate and the grown 3C-SiC film. The 3C-SiC films with a thickness up to 10 µm were grown on Si (100) substrates in a horizontal hot-wall chemical vapor deposition (CVD) reactor. To quantify the influence of doping on the stress distribution, samples were non-intentionally doped (NID, dopant incorporation below 1016 cm-3), strongly n-type doped ([N] > 1019 cm-3), or strongly p-type doped ([Al] > 1019 cm-3). Sample NID was also grown on Si (111). In silicon (100), we observed that the stress at the interface is always compressive. In 3C-SiC, instead, we observed that the stress at the interface is always tensile and remains so in the first 4 µm. In the remaining 6 µm, the type of stress varies according to the doping. In particular, for 10 µm thick samples, the presence of an n-doped layer at the interface maximizes the stress in the silicon (~700 MPa) and in the 3C-SiC film (~250 MPa). In the presence of films grown on Si(111), 3C-SiC shows a compressive stress at the interface and then immediately becomes tensile following an oscillating trend with an average value of 412 MPa.

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-PO43- 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.

Biohythane Production in Hydrogen-Oriented Dark Fermentation of Aerobic Granular Sludge (AGS) Pretreated with Solidified Carbon Dioxide (SCO2).

Though deemed a prospective method, the bioconversion of organic waste to biohydrogen via dark fermentation (DF) has multiple drawbacks and limitations. Technological difficulties of hydrogen fermentation may, in part, be eliminated by making DF a viable method for biohythane production. Aerobic granular sludge (AGS) is a little-known organic waste spurring a growing interest in the municipal sector; its characteristics indicate the feasibility of its use as a substrate for biohydrogen production. The major goal of the present study was to determine the effect of AGS pretreatment with solidified carbon dioxide (SCO2) on the yield of H2 (biohythane) production during anaerobic digestion (AD). It was found that an increasing dose of SCO2 caused an increase in concentrations of COD, N-NH4+, and P-PO43- in the supernatant at the SCO2/AGS volume ratios from 0 to 0.3. The AGS pretreatment at SCO2/AGS ratios within the range of 0.1-0.3 was shown to enable the production of biogas with over 8% H2 (biohythane) content. The highest yield of biohythane production, reaching 481 ± 23 cm3/gVS, was obtained at the SCO2/AGS ratio of 0.3. This variant produced 79.0 ± 6% CH4 and 8.9 ± 2% H2. The higher SCO2 doses applied caused a significant decrease in the pH value of AGS, modifying the anaerobic bacterial community to the extent that diminished anaerobic digestion performance.

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.

Ninety-Day Mortality of Thoracoscopic vs Open Lobectomy: A Large Multicenter Cohort Study.

BACKGROUND: Studies have demonstrated a lower incidence of complications after video-assisted thoracoscopic surgery (VATS) lobectomy compared with thoracotomy, but the data on in-hospital and 90-day mortality are inconclusive. This study analyzed whether surgical approach, VATS or thoracotomy, was related to early mortality of lobectomy in lung cancer and determined the differences between in-hospital and 90-day mortality. METHODS: Data of all patients with non-small cell lung cancer who underwent lobectomy between January 1, 2007, and July 30, 2018, were retrieved from Polish National Lung Cancer Registry. Included were 31 433 patients who met all study criteria. After propensity score matching, 4946 patients in the VATS group were compared with 4946 patients in the thoracotomy group. RESULTS: Compared with thoracotomy, VATS lobectomy was related to lower in-hospital (1.5% vs 0.9%, P = .004) and 90-day mortality (3.4% vs 1.8%, P < .001). Mortality at 90 days was twice as high as in-hospital mortality in both the VATS (1.8% vs 0.9%, P < .001) and thoracotomy groups (3.4% vs 1.5%, P < .001). Postoperative complications were less common after VATS compared with thoracotomy (23.6% vs 31.8%, P < .001). CONCLUSIONS: VATS lobectomy is associated with lower in-hospital and 90-day mortality compared with thoracotomy and should be recommended for lung cancer treatment, if feasible. Patients should also be closely monitored after discharge from the hospital, because 90-day mortality is significant higher than in-hospital mortality.

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 Ptot. 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 CODremoved 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/gCODin. 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.

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).

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 Gdansk 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 Gdansk. 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.

Optimization of Lipid Production by Schizochytrium limacinum Biomass Modified with Ethyl Methane Sulfonate and Grown on Waste Glycerol.

One of the most promising avenues of biofuel research relates to using waste as a starting feedstock to produce liquid or gaseous energy carriers. The global production of waste glycerol by the refinery industry is rising year after year. The aim of the present study was to examine the effect of ethyl methane sulfonate (EMS) on the growth rates and intracellular lipid accumulation in heterotrophically-cultured Schizochytrium limacinum microalgae, grown on waste glycerol as the carbon source. The strain S. limacinum E20, produced by incubating a reference strain in EMS for 20 min, was found to perform the best in terms of producing biomass (0.054 gDW/dm3·h) and accumulating intracellular bio-oil (0.021 g/dm3·h). The selected parameters proved to be optimal for S. limacinum E20 biomass growth at the following values: temperature 27.3 °C, glycerol level 249.0 g/dm3, oxygen in the culture 26%, and yeast extract concentration 45.0 g/dm3. In turn, the optimal values for lipid production in an S. limacinum E20 culture were: temperature 24.2 °C, glycerol level 223.0 g/dm3, oxygen in the culture 10%, and yeast extract concentration 10.0 g/dm3. As the process conditions are different for biomass growth and for intracellular lipid accumulation, it is recommended to use a two-step culture process, which resulted in a lipid synthesis rate of 0.41 g/dm3·h.

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.

Ultrasound predictors of left adrenal metastasis in patients with lung cancer: a comparison of computed tomography, positron emission tomography-computed tomography, and endoscopic ultrasound using ultrasound bronchoscope.

INTRODUCTION: Patients with resectable lung cancer require invasive evaluation of the enlarged left adrenal gland (LAG). Few studies showed the utility of endoscopic ultrasound using ultrasound bronchoscope (EUS­B) in LAG assessment. Moreover, little is known on the combination of computed tomography (CT), positron emission tomography-computed tomography (PET­CT), and EUS­B for predicting left adrenal metastasis. PATIENTS AND METHODS: In this retrospective cohort study performed from 2012 to 2019, patients with left adrenal enlargement were evaluated by CT, PET­CT, and EUS­B, followed by complete endoscopic mediastinal staging. The adrenal glands were sampled by EUS­B-guided fine­needle aspiration. Patients were followed for 6 months. RESULTS: During the staging of lung cancer in 2176 patients, 113 enlarged LAGs (5.19%) were biopsied. Malignancy was reported in 51 LAGs (45.13%). Endoscopic ultrasound upstaged 7 patients (6.2%) and downstaged 11 patients (9.37%) after false CT or PET­CT findings. There were no biopsy­related complications. Radiologic predictors of left adrenal metastases had the highest yield at the following cutoff points: Hounsfield units >23, standardized uptake value >4.2, and LAG size >25 mm. Hypoechogenic LAGs with loss of sea­gull shape on EUS­B were associated with a 28.67­fold higher likelihood of metastases. The sensitivity, specificity, accuracy, negative predictive value, and positive predictive value for all ultrasound predictors were 86.21%, 85.45%, 85.84%, 85.45%, and 86.21%, respectively. When combined with radiologic features, the respective values were 93.10%, 94.55%, 93.81%, 92.86%, and 94.74%. CONCLUSIONS: Hypoechogenicity and loss of sea­gull shape on EUS­B are the most reliable predictors of left adrenal metastasis. The combination of CT, PET­CT, and EUS­B improves the noninvasive diagnosis of left adrenal metastases in lung cancer patients.

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).