Patient experience with bronchoscopy: topical versus monitored anesthesia.

BACKGROUND: This study aimed to compare patient experiences during bronchoscopy procedures using either topical anesthesia (TA) or monitored anesthesia care (MA). The goal was to identify circumstances where patients could achieve similar levels of tolerance and satisfaction using only TA, especially in resource-limited settings. METHODS: This study included consecutive patients who underwent bronchoscopy with either TA or MA. Data collected included demographics, indications for bronchoscopy, procedure time, and complications during the procedure. A quality assurance survey was administered to assess patient experience and satisfaction with both procedures. A pre-specified subgroup analysis was performed based on procedure invasiveness and time. RESULTS: This study enrolled 350 (TA 251; MA 99) patients, with an average age of 65 years. Main indications for bronchoscopy included tumor diagnosis (38%), esophageal cancer staging (18%), and pulmonary infection (17%). The average duration of the procedures was 20 min, with MA being associated with a significantly longer procedure time than TA (31 min vs. 16 min; P < 0.001). The overall satisfaction rating with bronchoscopy was significantly higher in the MA group (visual analogue scale, 8.9 vs. 8.2; P = 0.001). Subgroup analyses showed that when less invasive or shorter procedures were performed, TA patients reported tolerance and satisfaction levels comparable to MA patients. CONCLUSIONS: Bronchoscopy with MA offered patients a better experience and greater satisfaction; however, in settings with limited resources, TA alone may provide similar levels of patient tolerance and satisfaction during less invasive or shorter procedures.

Speckle-Free, Angle-Free, Cavity-Free White Laser with a High Color Rendering Index.

The freedom from efficiency droop motivates monochromatic lasers to progress in general lighting applications due to the demand for more efficient and sustainable light sources. Still, a white light based on monochromatic lasers with high lighting quality, such as a high color rendering ability, an angle-independent output, and a speckle-free illumination, has not yet been fabricated nor demonstrated. Random lasers, with the special mechanism caused by multiple scattering, the angle-free emission, and the uncomplicated fabrication processes, inspire us to investigate the feasibility of utilizing them in general lighting. In this work, a white random laser with a high color rendering index (CRI) value, regardless of pumping energy and observing direction, was performed and discussed. We also investigated the stability of white RL as its CIE chromaticity coordinates exhibit negligible differences with increasing pump energy density, retaining its high-CRI measurement. Also, it exhibits angle-independent emission while having a high color rendering ability. After passing through a scattering film, it generated no speckles compared to the conventional laser. We demonstrated the advances in white laser illumination, showing that a white random laser is promising to be applied for high-brightness illumination, biological-friendly lighting, accurate color selections, and medical sensing.

Self-Healing Nanophotonics: Robust and Soft Random Lasers.

Self-healing technology promises a generation of innovation in cross-cutting subjects ranging from electronic skins, to wearable electronics, to point-of-care biomedical sensing modules. Recently, scientists have successfully pulled off significant advances in self-healing components including sensors, energy devices, transistors, and even integrated circuits. Lasers, one of the most important light sources, integrated with autonomous self-healability should be endowed with more functionalities and opportunities; however, the study of self-healing lasers is absent in all published reports. Here, the soft and self-healable random laser (SSRL) is presented. The SSRL can not only endure extreme external strain but also withstand several cutting/healing test cycles. Particularly, the damaged SSRL enables its functionality to be restored within just few minutes without the need of additional energy, chemical/electrical agents, or other healing stimuli, truly exhibiting a supple yet robust laser prototype. It is believed that SSRL can serve as a vital building block for next-generation laser technology as well as follow-on self-healing optoelectronics.