Diffusion Capacity Research Articles

Analysis of pore formation and carburizing mechanism of magnetite reduction by CO

To investigate the porosity and expansion mechanism of CO-reduced magnetite, the reduced microstructures of magnetite under conventional heating and microwave heating were compared. The microstructure characteristics of magnetite with various reduction degrees were examined in a 60%CO-Ar reduction atmosphere, and the formation and evolution mechanism of the structure were analyzed in conjunction with the reduction effect. The results indicate that the reduction product of CO reduced magnetite possesses a porous structure. Nevertheless, when the gas diffusion is restricted, the reduction process is sluggish and the porous structure is not readily formed. Microwave heating enhances the gas-phase diffusion capacity, thermodynamic carburizing capacity, and solid-phase carbon-oxygen diffusion capacity, resulting in a higher oxygen loss rate than that of conventional heating. Under the experimental conditions, the lattice shrinkage during the Fe3O4 → Fe0.88O transformation and the rapid expansion of Fe0.88O → Fe0.94O are the causes of the crack. Microwaves facilitate the formation of pores and cracks in the product. This study offers a novel concept for the development of foam steel.

Recommendations on interpretive strategies for routine lung function tests

During the annual conference of the German Respiratory Society (DGP = Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin) in 2024, updated recommendations for lung function testing have been published. The original full-length version can be downloaded free of charge as pfd-paper from the journal entitled "Atemwegs- und Lungenkrankheiten, Jahrgang 50 (2024) März (111-184)". In the current recommendations new approaches have been embedded that focus on modern interpretations of lung function results, as has been proposed by the ERS (European Respiratory Society) in collaboration with the ATS (American Thoracic Society). This targets the spirometry, the whole bodyplethysmography, diffusion capacity testing, testing for bronchodilation, unspecific bronchoprovocation in addition to the reference values. Oscillometry and respiratory muscle function testing are also included in the recommendations. The current publication considers itself as a short version of the most important topics of the full-length lung function recommendations. However, reading also the full-length paper is strongly emphasised based on the understanding that lung function testing is highly important in daily clinical practice when dealing with patients suffering from respiratory diseases.

Unleashing the Wild

Feral design aims to act as a transformative framework for design in the Anthropocene. This paper explores its potential to navigate the crises of modernity through a speculative deconstruction of three discrete case studies. Analysing said case studies of counter-culture movements’ operating at the fringes of the law reveals valuable insights into creativity, adaptability, and diffuse design capacity. The essence of feral design has been distilled into five principles, aiming to establish design methodologies. It calls for broader engagement from design researchers to expand the discourse and advance design practices in the Anthropocene. Feral design aims to act as a redirective practice that subverts modern design practice to enable its transition towards sustainment. By understanding the values embodied by different feral entities that respond to the collapse of traditional systems we can better understand how the principles of feral design can be embodied.

Comment on Loddé et al. Does Decreased Diffusing Capacity of the Lungs for Carbon Monoxide Constitute a Risk of Decompression Sickness in Occupational Divers? Int. J. Environ. Res. Public Health 2023, 20, 6516

This letter addresses errors in the statistical analysis found in a paper addressing pulmonary diffusing capacity and decompression sickness. Our re-analysis could not confirm any of the significant statistical contrasts described for the bubble data, invalidating the speculation on the relationships between bubble scores and decompression sickness.

Pulmonary diffusing capacity among individuals recovering from mild to moderate COVID-19: a cross-sectional study

Impaired pulmonary diffusing capacity for carbon monoxide (DLCO) following COVID-19 has been consistently reported among individuals recovering from severe-critical infection. However, most long COVID cases follow non-severe COVID-19. We assessed DLCO among individuals with long COVID recovering from mild to moderate acute illness. A cross-sectional study of adults with long COVID, assessed at a COVID recovery clinic > 3 months following the onset of acute infection, during 2020–2021. Participants subjectively ranked their dyspnea severity based on its impact on their daily living and underwent comprehensive pulmonary function testing (PFT). Clinical correlates for impaired DLCO (defined as < 80%) were assessed using multivariable logistic regression models. A total of 458 individuals, their mean age 45 (SD 16) and 246 (54%) of whom are women, were evaluated at an average of ~ 4 months following acute COVID-19. The most frequent PFT impairment was reduced DLCO, identified among 67 (17%) of the cohort. Clinical correlates of impaired DLCO included women (odds ration [OR] 3.64, 95% confidence interval [CI] 1.78–7.45, p < 0.001), cigarette smoking (OR 2.25, 95% CI 1.14–4.43, p = 0.019), and moderate-severe dyspnea (OR 2.77, 95% CI 1.39–5.50, p = 0.004). BMI inversely correlated with DLCO (OR 0.90, 95% CI 0.85–0.96 per 1 unit, p = 0.002). Impaired DLCO was not uncommon among individuals recovering from mild to moderate COVID-19. Women are at a greater risk, and subjective dyspnea correlated with impaired DLCO. Clinicians can rely on self-reported significant dyspnea to guide further assessment.

Pre-magnetization smashing hydrated vanadium ions to improve redox flow batteries performance

The vanadium redox flow battery (VRFB) has received extensive attention due to its intrinsic safety and high scalability. Currently, there are still deficiencies of low energy efficiency and higher unit capacity cost in VRFB energy storage. Continuously optimizing the battery performance through reducing electrode polarization losses is a necessary way to achieve efficient VRFB energy storage technology. In this study, a method of pre-magnetizing the electrolyte to improve the performance of the battery was proposed. A permanent magnet with an intensity of 0.9 T was used to pre-magnetize the vanadium-ion aqueous electrolyte before feed into the battery stack and working-on, it was found that the diffusion capacity of vanadium ions increased by 133.6 % after pre-magnetized even if the external magnetic field was removed. Meanwhile, both of the charge transfer and concentration polarization resistance of the electrode were reduced. The energy efficiency (EE) of the battery was increased by 6.4 % in the charge–discharge test at current density of 300 mA cm−2. The power density increased by 6.19 % with current density 400 mA cm−2 at most, and it prefers to continuously increase as current larger. The electrolyte pre-magnetization showed significant positive improvements on the electrode reaction kinetics and battery charge–discharge cycle.

Insights into the ternary substitution Na2.96+xK0.04 V2-xNix(PO4)2.98F0.06 with superior rate capability and near-zero strain property

Na3V2(PO4)3 (NVP) is considered the most favorable cathode for sodium-ion batteries due to its solid NASICON skeleton. Nevertheless, poor intrinsic conductivity is insufficient for its further commercialization. In this paper, we present a promising K/Ni/F co-doped and carbon nanotubes (CNTs) encapsulated Na2.96+xK0.04 V2-xNix(PO4)2.98F0.06 (KNF@CNTsx) cathode materials. The synthesis of KNF@CNTsx is achieved using a facile sol-gel method. The replacement of Na+ with K+ broadens the migratory pathway and supports the crystal skeleton, while F− substitution reduces the average grain dimension, thereby increasing the diffusion rate of Na+. Furthermore, the reduction of resistance by Ni2+ doping enables optimization of the transport of electrical charge, while also facilitating the optimization of chemically-defined properties. Concurrently, the optimal quantity of carbon capping and wrapping of CNTs facilitate the formation of efficacious conductive network, which diminishes the size of grains and shortens the pathway for the diffusion of Na+. This network could also serve as a buffer against crystal deformation. In conclusion, the modified KNF@CNTsx samples exhibit notable enhancements in their conductivity, ion diffusion capacity, and structural stability. Among them, the KNF@CNTs0.04 sample exhibits a capacity for reversibility of 93.3 mAh g−1 at 50C, with a remaining capacity of 68.5 mAh g−1 after 4000 successive long charge-discharge cycles. Ex-situ electrochemical XRD demonstrates the V3+/V4+ redox reaction occurs accompanied by the phase transfer reaction, during which Na+ prefers to diffuse along c-axial in the crustal structure. Moreover, volume alteration of this KNF@CNTs0.04 cellular entity is miniscule and reversible during the charge-discharge process, further confirming the stabilized construction and near-zero strain property. The after-cycled XRD/SEM/XPS certify the improved chemical and structural stability of KNF@CNTs0.04, indicating the constructive effects of K/Ni/F ternary substitution.

Usefulness of monitoring mycophenolic acid exposure in systemic sclerosis-related interstitial lung disease: a retrospective cohort study

BackgroundSystemic sclerosis-related interstitial lung disease (SSc-ILD) represents a significant cause of morbidity and mortality in Systemic Sclerosis (SSc). Mycophenolate mofetil (MMF) is currently the first line treatment for SSc-ILD. There is no recommendation on the dosage of mycophenolic acid (MPA) blood concentrations, so we aimed to study the correlation between MPA exposure and respiratory outcomes in this population.MethodsWe conducted a retrospective cohort study of SSc-ILD patients treated with MMF in our center. According to our policy, a complete patient evaluation was performed approximately one year after MMF initiation, during which the mycophenolic acid (MPA) residual rate (RR) was measured. We analyzed the association between RR and changes in forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) over time.ResultsForty-three SSc-ILD patients were included. Patients with higher RR levels (≥ 1.5 mg/L) had a significantly better FVC evolution with a higher proportion of stabilization and lower proportion of FVC decrease (p = 0.024). RR above 1.5 mg/L was a predictive factor of reduced FVC decline compared with lower RR levels adjusting for MMF dose and duration of MMF exposure (p = 0.008). There was no difference regarding DLCO outcome.ConclusionOur study suggests that optimal MPA exposure, as indicated by RR levels, may better protect against FVC decline in SSc-ILD patients treated with MMF. Routine monitoring of MPA exposure could be beneficial in optimizing treatment outcomes. Prospective, multicenter studies are needed to further explore the relationship between MPA exposure and clinical outcomes in SSc-ILD.

Diffusion capacity and static hyperinflation as markers of disease progression predict 3-year mortality in COPD: Results from COSYCONET.

Chronic obstructive pulmonary disease (COPD) exhibits diverse patterns of disease progression, due to underlying disease activity. We hypothesized that changes in static hyperinflation or KCO % predicted would reveal subgroups with disease progression unidentified by preestablished markers (FEV1, SGRQ, exacerbation history) and associated with unique baseline biomarker profiles. We explored 18-month measures of disease progression associated with 18-54-month mortality, including changes in hyperinflation parameters and transfer factor, in a large German COPD cohort. Analysing data of 1364 patients from the German observational COSYCONET-cohort, disease progression and improvement patterns were assessed for their impact on mortality via Cox hazard regression models. Association of biomarkers and COPD Assessment test items with phenotypes of disease progression or improvement were evaluated using logistic regression and random forest models. Increased risk of 18-54-month mortality was linked to decrease in KCO % predicted (7.5% increments) and FEV1 (20 mL increments), increase in RV/TLC (2% increments) and SGRQ (≥6 points), and an exacerbation grade of 2 at 18 months. Decrease in KCO % predicted ≥7.5% and an increase of RV/TLC ≥2% were the most frequent measures of 18-month disease progression occurring in ~52% and ~46% of patients, respectively. IL-6 and CRP thresholds exhibited significant associations with medium- and long-term disease measures. In a multicentric cohort of COPD, new markers of current disease activity predicted mid-term mortality and could not be anticipated by baseline biomarkers.

Effect of Various Carbon Coating Techniques on the Electrochemical Performance of Li4Ti5O12 Synthesized by Sol-Gel Method

This study aimed to prepare spinel carbon-coated Li4Ti5O12 (LTO/C) via sol-gel reaction and applied as a high-performance lithium-ion battery anode. The LTO powder was coated using various carbon sources, super P (SP), sugar and PVDF-assisted SP. The crystal structure, morphology, conductivity and electrochemical performance of the samples were examined using X-ray diffraction (XRD), Field Emission scanning electron microscopy (FESEM), Fourier Transform Infrared (FTIR) spectroscopy, Electrochemical Impedance Spectroscopy (EIS) and Cyclic Voltammetry/Charge-discharge (CV/CD), respectively. The XRD analysis results showed that the samples contain highly crystalline spinel LTO as the main phase and rutile as impurity. The FESEM image showed that SP covers the entire LTO surface more homogenous than sugar. However, sugar carbon makes roughness on the LTO surface. FTIR spectra showed that the coating using sugar and PVDF still contain hydrocarbon element. Electrochemical performance evaluations showed that SP carbon-coated-LTO possesses higher lithium diffusion and specific capacity than pure LTO, while sugar-coated-LTO shows the lowest specific capacity. Moreover, the SP carbon-coated-LTO sample high-rate capability has improved during full cell evaluation, delivering a discharge capacity of 249, 231, 211, 194, 58, and 23 mAhg-1 at the charge or discharge current density of 0.05, 0.1, 0.5, 1, 5, and 10 C, respectively.

Assessing the Diffusion of Military Power Capacity of Middle Powers: The Case of Turkey

ABSTRACT Great powers’ military power diffusion (MPD) is superior to Middle Powers (M.P.) in technology acquisition, military innovation, and state & financial capacity. However, M.P.s have started to enhance their MPD thanks to their growing impact on international politics. In this vein, this paper aims to offer an alternative explanation of MPD by introducing a novel theoretical framework, Military Power Diffusion Capacity (hereafter MPDC), to assess how M.P.s’ MPD influences the balance of power and warfare at both regional and international levels. In doing so, this article is structured into three sections. First, we investigate the existing theoretical frameworks on military power diffusion and the spread of military power by middle-ranking states. Second, we examine the historical evolution of Turkey’s defence industry. Third, we introduce our MPDC framework and test it to the Turkey’s case. Here, we propose a five-layered MPDC framework based on the following determining factors: 1) Sustainable Financial & State Capacity, 2) Geopolitical and strategic rivalries, 3) Domestic conditions, 4) Civil-Military bargaining levels, and 5) regional and global power status-driven aspirations. Then, we scrutinize Turkey’s MPDC since the 1990s within our five-layered framework to assess the implications of its MPD on the changing international security environment.

Imaging, Pulmonary Function, and Histopathologic Findings of Persistent Fibrosis in a Longitudinal Cohort Three Years after Severe COVID-19 Infection.

Fibrotic-like abnormalities are present in 60% of a single-center, longitudinal, multi-ethnic cohort 3-years after severe COVID-19. They are independently associated with male sex, low BMI, shorter telomere length, increased severity of illness, and mechanical ventilation; Black race and asthma are protective. Participants with fibrotic-like abnormalities are more likely to have reduced diffusion capacity and 6-minute walk distance. Fibrotic-like abnormalities persist but modestly improve over time. Transbronchial biopsies show small airways histopathology, consistent with high prevalence of air trapping in expiration, and infrequent interstitial thickening. This study highlights the need for continued monitoring of patients with persistent fibrosis after severe COVID-19.

Cardiac Fatigue in Male Athletes with Exercise-Induced Pulmonary Impairments After a Very Long-Distance Triathlon.

Prolonged strenuous exercise can transiently decrease cardiac function. Other studies have identified three major exercise-induced pulmonary changes: bronchoconstriction, dynamic hyperinflation and pulmonary oedema with reduced alveolar-capillary membrane diffusing capacity. This study investigated whether athletes with one of these pulmonary dysfunctions following a very long-distance triathlon exhibit similar cardiac alterations as those without dysfunctions. Sixty trained male triathletes (age 39 ± 9years) underwent baseline and post-race assessments, including echocardiography (with standard, 2D-strain and myocardial work assessments), spirometry and double-diffusion technique to evaluate alveolar-capillary membrane diffusing capacity for carbon monoxide (DMCO). Cardiac function in athletes with exercise-induced bronchoconstriction (> 10% decrease FEV1), dynamic hyperinflation (> 10% decrease inspiratory capacity) or impaired diffusion capacity (> 20% decrease DMCO/alveolar volume) were compared with those without these dysfunctions. The race lasted 14h 20min ± 1h 26min. Both systolic and diastolic cardiac functions declined post-race. Post-race, 18% of athletes had bronchoconstriction, 58% dynamic hyperinflation and 40% impaired diffusing capacity. Right and left ventricular standard and 2D-strain parameters were similar before the race in all subgroups and changed similarly post-race, except E/E', which decreased in the bronchoconstriction subgroup and increased in those with diffusion impairment. Global constructive work decreased by ~ 19% post-race (2302 ± 226 versus 1869 ± 328mmHg%, P < 0.001), more pronounced in athletes with diffusion impairment compared with others (- 26 ± 13 versus - 15 ± 9%, P = 0.001) and positively correlated with DMCO/alveolar volume reduction. After a very long-distance triathlon, bronchoconstriction and hyperinflation were not associated with significant cardiac changes, whereas impaired alveolar-capillary membrane diffusing capacity was associated with a more significant decline in myocardial function. These findings highlight the complex relationship between pulmonary gas exchange abnormalities and cardiac fatigue following prolonged strenuous exercise.

Pulmonary sarcoidosis: differences in lung function change over time

IntroductionGiven the heterogeneity of sarcoidosis, predicting disease course of patients remains a challenge. Our aim was to determine whether the 3-year change in pulmonary function differed between pulmonary function phenotypes...

Fibrotic outcomes from SARS-CoV-2 virus interstitial pneumonia.

Following the onset of the new COVID-19 pandemic, particular attention is paid to the long-term outcomes, especially concerning patients affected by the SARS-CoV-2 virus leading to interstitial pneumonia. The aim of this research is to evaluate the possible evolution over time of interstitial pneumonia into post-inflammatory fibrosing interstitial disease. This research included 42 patients admitted to the COVID ward for SARS-CoV-2 interstitial pneumonia, 10 patients with mild pneumonia and respiratory failure who were treated with O2 only, 32 patients with severe pneumonia in which O2 and non-invasive ventilation were used for respiratory assistance, and 4 patients treated with invasive mechanical ventilation. At 70±30 days, 6, 12, 24, and 36 months after discharge, the cohort of patients carried out the evaluation of inflammation indices, high-resolution computed tomography (CT) chest scans, and functional respiratory tests. The comparative analysis showed that 83.3% of patients had residual parenchymal lung disease at 36-month follow-up, with a significantly higher rate in those with severe pneumonia and more extensive disease on initial CT. Regarding the pulmonary involvement model, patients presented ground-glass opacity or peripheral parenchymal bands, or a combination of them, peri- and intralobular interstitial thickening, which may be representative of fibrotic interstitial lung disease. There is a correlation between the severity of pneumonia, the inflammatory state, the need to increase respiratory support, and the quantity and persistence of CT-related lesions. Reductions in respiratory functions and exercise capacity were observed, the latter more pronounced in patients (24%) who had contracted severe pneumonia and required ventilatory support.Pulmonary outcomes from SARS-CoV-2 respiratory infections show a wide range of radiological findings, from complete recovery to stable outcomes of thickening and distortion of the interstitial architecture. From a functional point of view, there is an impairment of the alveolar-capillary diffusion capacity and, in cases who had contracted severe pneumonia, desaturation and reduced exercise tolerance in 24% of cases at a 36-month follow-up.

A decision rule for identifying patients at high risk for impaired lung diffusion capacity after COVID-19

Aim. To elaborate a decision rule for identifying the main predictors of impaired lung diffusion capacity after COVID-19. Materials and methods. The retrospective study included 341 patients without underlying lung diseases (median age 48 years) who experienced COVID-19 with bilateral pneumonia. The median extent of parenchymal lesion in the acute phase of COVID-19 (CTmax) was 50%. Spirometry, body plethysmography, and lung diffusion capacity for carbon monoxide (DLCO) test were performed. The data were analyzed by descriptive statistics, correlation analysis, one-dimensional logistic regression analysis with an assessment of odds ratios (OR), and multivariate logistic regression analysis. Receiver operating characteristic (ROC) analysis was used to assess the quality of the binary classifier model.Results. The initial model for predicting reduced DLCO (&lt; 80% of predicted) included the following predictors: CTmax, time interval from the COVID-19 onset, gender, age, body mass index. Backward stepwise regression was applied, and a binary classifier model that includes CTmax was obtained. The sensitivity and specificity of the model for the training sample were 80 and 67%, respectively, for the test sample – 79 and 70%, respectively. The analysis of OR showed that OR &gt; 1 was observed at СTmax &gt; 40%.Conclusion. The decision rule was obtained for predicting impaired lung diffusion capacity after COVID-19 with virus-associated lung damage in patients without underlying bronchopulmonary diseases. Patients with CTmax &gt; 40% require more thorough clinical follow-up with DLCO monitoring after the acute phase of COVID-19

Endothelial function in patients after severe or critical acute phase of COVID-19 one year after the disease onset

BACKGROUND. The SARS-CoV-2 virus not only causes respiratory diseases but also significantly impacts endothelial function, which may be one of the mechanisms for developing long-term consequences of coronavirus disease (COVID-19). OBJECTIVE. To determine the levels of endothelial function markers (endothelin-1, thrombomodulin) in the peripheral blood of individuals who experienced non-hospital pneumonia on the background of COVID-19, in the early post-acute phase and one year after the onset of the disease, and to analyze the changes in individual levels of these markers. MATERIALS AND METHODS. The main group consisted of 16 individuals (age – 57.5 (43.8; 64.5) years, 8 (50.0 %) men, 7 (50.0 %) women), who were examined twice: at visit 1 – on day 60.0 (56.3; 62.5) from the onset of the disease; at visit 2 – on day 312.5 (300.0; 365.0) from the onset of the disease. The control group consisted of 10 individuals (age – 58.5 (39.5; 67.8) years, 4 (40.0 %) men, 6 (60.0 %) women). General clinical and laboratory methods were used, as well as an assessment of lung diffusion capacity (DLсо). RESULTS. At visit 1, the clinical status of 16 (100.0 %) individuals in the main group was impaired. At visit 2, the clinical status of 12 (75.0 %) individuals normalized, while 4 (25.0 %) individuals showed improvement; the severity of dyspnea according to the mMRC scale and heart rate decreased, and SpO2 and DLсо levels increased (p&lt;0.01, p&lt;0.01, p&lt;0.01, and p=0.03, respectively). The level of endothelin-1 in the control group was 14.6 (11.7; 17.0) pg/ml, and the thrombomodulin level was 451.7 (403.9; 652.4) pg/ml. The level of endothelin-1 at visit 1 in the main group was 11.1 (6.8; 15.9) pg/ml, and at visit 2 – 14.4 (11.2; 20.0) pg/ml (p=0.02), not differing from the control group (p=0.48 and p=0.61, respectively). The level of thrombomodulin at visit 1 in the main group was 723.1 (689.1; 1012.2) pg/ml, and at visit 2 – 811.5 (713.3; 911.7) pg/ml (p=0.40), which was higher than in the control group (p=0.01 and p=0.01, respectively). CONCLUSIONS. One year after COVID-19, most individuals show normalization of clinical status and improvement in lung diffusion capacity; however, elevated thrombomodulin levels persist, which requires further investigation. In some patients, the level of endothelin-1 also increases, which is why they should be monitored not only by a family doctor or a pulmonologist but also by a cardiologist.

New role of calcium-binding fluorescent dye alizarin complexone in detecting permeability from articular cartilage to subchondral bone.

Osteoarthritis (OA) is a chronic degenerative joint disorder characterized by the progressive deterioration of articular cartilage and concomitant alterations in subchondral bone architecture. However, the precise mechanisms underlying the initiation and progression of OA remains poorly understood. In the present study, we explored whether the calcification in the articular cartilage occurred in the early stage of mouse OA model, generated by the surgery destabilization of the medial meniscus (DMM), via the intra-articular injection of alizarin complexone due to its anionic nature for binding calcium-containing crystals. Although we did not observe the calcification in the articular cartilage of early stage of DMM mice, we unexpectedly identified alizarin complexone had the diffusion capacity for detecting the permeability from the articular cartilage to subchondral bone. Our data showed that the diffusion of alizarin complexone from the articular cartilage to calcified cartilage was greater in the early stage of DMM mice than that in sham controls. Additionally, we observed enhanced penetration of alizarin complexone through the periosteum in DMM mice compared to sham mice. In summary, we developed a novel imaging method that offers a valuable tool for further exploration of biochemical communication underlying OA development. Our findings provided new evidence that increased molecular interactions between the articular cartilage and subchondral bone is involved in the pathogenesis of OA progression.

Why do patients stay in hospital after enhanced recovery thoracoscopic wedge resection? A prospective observational study.

This single-centre prospective observational study aimed to investigate reasons for prolonged hospitalization [over the median length of stay (LOS)] after enhanced recovery thoracoscopic [ERAS 3-port video-assisted thoracoscopic surgery (VATS)] wedge resection. All patients were evaluated twice-daily by an investigator for reasons of hospitalization. Each reason was analysed individually. Predictors for prolonged hospitalization were identified using a multivariable backward stepwise logistic regression model. A total of 150 consecutive patients (lymphadenectomy 8.7%) were included from November 2022 to December 2023, with a median LOS of 1 (interquartile range 1-2) day. Of these, 55 patients (36.7%) experienced prolonged hospitalization. The main reasons included postoperative pain (16.0%), air leak (14.7%) and social factors (14.7%), followed by oxygen dependency (7.3%), gastrointestinal factors (5.3%), urinary factors (4.7%), pneumonia (1.3%), pleural effusion (1.3%), chylothorax (0.7%), atrial fibrillation (0.7%), confusion (0.7%) and fatigue (0.7%). Multivariable analysis revealed that an increase in the percentage of predicted forced expiratory volume in 1 s (FEV1%pre) by 1% [odds ratio (OR) 0.41, P = 0.023) and percentage of predicted diffusing capacity for carbon monoxide (DLCO%pre) by 1% (OR 0.95, P = 0.002) decreased likelihood of prolonged hospitalization. Conversely, each additional pack-year (OR 1.01, P = 0.028) and living alone (OR 3.55, P = 0.005) increased the risk of prolonged hospitalization. Prolonged hospitalization (LOS > 1 day) after ERAS 3-port VATS wedge resection, with 8.7% lymphadenectomy, was mainly due to pain, air leak and social factors. Smokers with decreased FEV1%pre or DLCO%pre and patient living alone were at increased risk. ClinicalTrials.gov: NCT06118593 (https://clinicaltrials.gov/study/NCT06118593?cond=why%20in%20hospital&rank=2).

Reference equations for DLNO and DLCO in Mexican Hispanics: influence of altitude and race

ObjectivesThis study aimed to evaluate pulmonary diffusing capacity for nitric oxide (DLNO) and pulmonary diffusing capacity for carbon monoxide (DLCO) in Mexican Hispanics born and raised at 2240 m altitude...