Total Operating Research Articles

The hydrogen atom perturbed by a 1-dimensional Simple Harmonic Oscillator (1d-SHO) potential

Abstract The hydrogen atom perturbed by a constant 1-dimensional weak quadratic potential λz2 is solved at first-order perturbation theory using the eigenstates of the total angular momentum operator - the coupled basis. Physical applications of this result could be found, for example, in the study of a quadratic Zeeman effect weaker than fine-structure effects, or in a perturbation caused by instantaneous generalised van der Waals interactions.

Abstract 4119303: The New Strait-Jacket Designed for Endovascular Therapy Reduces the First Reperfusion Time of Emergency Thrombectomy for Stroke

Introduction: Conscious sedation during cerebrovascular interventional surgery can shorten the time of vascular recanalization and bring significant benefits to patients, but patients are often difficult to cooperate, which affects the operation of interventional surgery. This study aims to develop a novel cerebral vascular intervention strait-jacket and explore its safety and effectiveness in emergency cerebral vascular intervention surgery. Methods: Using the convenient sampling method, patients with acute large artery occlusion stroke who underwent emergency mechanical thrombectomy in Zhongnan Hospital of Wuhan University from September 2018 to March 2021 were selected as the research objects. The control group was treated with conventional restraint belt, and the experimental group was treated with new cerebrovascular interventional surgery strait-jacket. The first reperfusion time, total operation time, modified Rankin score (mRS) at 30 days, intraoperative limb prolapse rate, average surgical cost, and safety indicators were compared between the two groups. The t test, Mann-Whitney U test or Fisher exact test were used for comparison between groups according to the data type. A p<0.05 indicated statistical significance. Results: The new type of cerebrovascular interventional surgical strait-jacket developed in this study are shown in Figure 1, which have been patented and transformed into products. A total of 140 patients were included for mechanical thrombectomy, randomly divided into an experimental group (n=69) and a control group (n=71). Using the new strait-jacket significantly shortened the first reperfusion time (43.5±13.7 vs 50.7±15.7, P=0.039) and the total operation time (81.1±12.6 vs 93.2±21.1, P=0.027). There was a significant decrease in limb dislodgement rate (0% vs 35.2%, P<0.001) and a noticeable reduction in average surgical cost (76315±12400 vs 81462±14142 P=0.040) by using the strait-jacket. In terms of safety performance, using the strait-jacket significantly lower rates of skin redness than the control group (8.7% vs 42.3%, P<0.001). Conclusion: The new type of cerebrovascular interventional surgical strait-jacket is safe, which can effectively shorten the operation time, reduce the rate of intraoperative limb prolapse and the average operation cost, and can bring good social benefits.

Demonstration of Immersive Technologies for Geospatial Learning

Abstract. Immersive technologies are becoming a powerful tool for educators across multiple disciplines including geospatial science. They offer new ways to engage and educate geospatial students, removing barriers that may exist in traditional teaching methods. Especially because the limitations of 2D screens are often exceeded by the complexity of modern data sets. Examples of challenges that educators often encounter are explaining theoretical concepts in the classroom, providing alternate scenarios, preparing students for physical labs, and limited / restricted access to physical sites. Immersive technologies can be a great resource to support on-site lectures and enhance remote learning, a necessity in today's educational panorama. Immersive technologies typically include virtual, augmented, and mixed reality. Each method offers different pedagogical advantages and poses different challenges. Before any implementation, these advantages and challenges must be examined and understood to maximize the benefit of immersive methods to the students and mitigate potential drawbacks that could hinder learning outcomes. This paper provides a review of the different immersive methods, presenting examples of their application in geospatial education with lessons learned and recommendations for future work. The case examples include a variety of different instruments and tasks such as the simulation of GNSS, differential leveling, total station operations, and airborne LiDAR data collection.

A service evaluation of the uptake and effectiveness of a digital delivery of the NHS health check service

ObjectivesTo compare the uptake, effectiveness and costs of a digital version of the National Health Service (NHS) Health Check (DHC) to the standard face-to-face NHS Health Check (F2F).Participants and settingA...

Analysis of War Optimization Algorithm in a Multi-Loop Power System Based on Directional Overcurrent Relays

In electrical power systems, ensuring a reliable, precise, and efficient relay strategy is crucial for safe and trustworthy operation, especially in multi-loop distribution systems. Overcurrent relays (OCRs) have emerged as effective solutions for these challenges. This study focuses on optimizing the coordination of OCRs to minimize the overall operational time of main relays, thereby reducing power outages. The optimization problem is addressed by adjusting the time multiplier setting (TMS) using the War Strategy Optimization (WSO) algorithm, which efficiently solves this constrained problem. This algorithm mimics ancient warfare strategies of attack and defense to solve complex optimization problems efficiently. The results show that WSO provides superior performance in minimizing total operating time and achieving global optimum solutions with reduced computational effort, outperforming traditional optimization methods (i.e., SM, HPSO, GA, RTO, and JAYA). The proposed algorithm shows a net time gains of 7.77 s, 2.57 s, and 0.8484 s when compared to GA, RTO, and JAYA respectively. This robust protection coordination ensures better reliability and efficiency in multi-loop power systems.

Dynamic Energy Management and Control of Networked Microgrids based on Load to Grid Services and Incentive-Based Demand Response Programs: A Multi-Agent Deep Reinforcement Learning Approach

This study has presented the energy management paradigm in a networked microgrid structure based on L2G services and considering incentive-based load response (IBDR) programs and energy market requirements to reduce operating costs, control and restore voltage and frequency index, providing the benefits of subscribers and distribution system operators. In this study, multi-objective functions such as optimal operation based on IBDR structure and energy market requirements, risk assessment, and L2G service approach are configured in the framework of central and local controllers. Optimal operation and risk assessment are analyzed by a multi-task learning algorithm based on multi-objective function and L2G service policies are evaluated based on multi-agent deep reinforcement learning. Control policies are sent by the communication system to the components affecting the optimal power distribution as well as the voltage and frequency controllers. L2G services have been evaluated in different scenarios such as plug-and-play operating conditions, load fluctuations, and operating in island mode. The results of optimal operation based on L2G services show that the IBDR program implementation reduces the total operation cost by 21%. Also, the total operating cost of the proposed framework is 13.97% less than the RL method and 27.8% less than the ANN method.

Gynecologic oncology robot-assisted surgery in octogenarians: Impact of age on hospital stay.

To compare postoperative stay in octogenarians and younger patients undergoing gynecologic oncology robot-assisted surgery. A retrospective review of robot-assisted surgery in Gynecological Oncology division during 2019-2022. We included all consecutive cases. Octogenarians (age ≥80 years) and younger patients were investigated by univariable analysis for characteristics and outcome. A total of 816 robot-assisted surgeries were performed, 426 (52.2%) endometrial cancer, 159 (19.5%) ovarian cancer, 27 (3.3%) cervical cancer, 35 (4.3%) endometrial intraepithelial neoplasia, and in 169 (20.7%) the final pathology was benign. There were 60 (7.4%) octogenarians and 756 (92.6%) younger patients. The proportion of patients with an American Society of Anesthesiology score greater than 2 was higher among octogenarians (66.7% vs 32.0%, P < 0.001). The median console time, surgical time, and total operation theater time were similar between groups (P = 0.303, P = 0.643 and P = 0.688, respectively). Conversion rate did not differ between groups (0.4% among younger patients vs 0% in octogenarians, P > 0.99). The median length of stay in the recovery room was similar in both groups (median 170 min, interquartile range [IQR] 125-225 min vs 170 min, IQR 128-240 min in octogenarians, P = 0.731). Length of hospital stay was similar in both age groups; median 1 day (IQR 1-1) among octogenarians versus 1 (0-1) in younger patients (P = 0.136). Octogenarians undergoing robotic surgery have no increased risk of length of stay or conversion to laparotomy compared with younger patients.

Continuous [C] Content Prediction Model in Molten Steel of the All-Scrap Electric Arc Furnace

The continuous [C] content prediction model in molten steel of the all-scrap electric arc furnace was established through the explicit finite difference method combined with numerical simulation based on the thermodynamics and kinetics of the decarburization reaction. Initially, a method to figure out the average [C] content of mixed input scrap was proposed, which provided a basis for subsequent calculations. Furthermore, scrap melting rate, mixing side-blowing / bottom stirring, and oxygen blowing intensity adjustment of oxygen lance had been considered as the three key elements. Decreasing scrap melting time was beneficial to improving the EAF efficiency because it accounts for 80% of the total operation time. The research found that the scrap melting rate was mainly affected by the solid-liquid phase heat transfer and [C] content transfer, and the heat transfer played a dominant role. Applying mixing side blowing / bottom stirring could lead to an improvement in the mass transfer coefficient of the decarburization reaction, and the value was increased from the range of 0.0059 s-1-0.021 s-1 by using single side-blowing to the range of 0.0079 s-1-0.023 s-1. The mass transfer coefficient could be enhanced by the oxygen intensity adjustment of oxygen lances when mixing side blowing / bottom stirring was used. This was a benefit of deeper jet impact zones on the molten steel surface caused by high oxygen flow. After the model was applied to an industrial site, the prediction accuracy of the endpoint [C] content within the error range of ±0.02% and ±0.01% reached 91.2% and 85.7%, respectively.

Environmental and economic assessment of urban wastewater reclamation from ultrafiltration membrane-based tertiary treatment: Effect of seasonal dynamic

This study aimed to assess the environmental and economic performance of an ultrafiltration (UF) tertiary treatment of effluent from an urban wastewater treatment facility. Data from a UF demonstration plant composed of commercially available equipment, including industrial hollow-fiber membranes was used to project a full-scale facility. The results from the demonstration plant recommended different ranges of transmembrane fluxes and sparging air demands under summer and winter conditions to prevent excessive fouling. The energy balance of the full-scale facility would be 0.308 ± 0.112 kWh·m−3 in summer and 0.140 ± 0.040 kWh·m−3 in winter, with blowers' being the main consumers (86–93 %). CAPEX accounted for €0.030 ± 0.002·m−3 in summer and €0.027 ± 0.002·m−3 in winter and membrane acquisition represented 66–69 % of the investment cost. Energy expenditure was the major OPEX cost (66–79 %), with a total operating cost of €0.077 ± 0.023·m−3 and €0.042 ± 0.008·m−3 in summer and winter, respectively. The final average value obtained for the TAC was €0.107 m−3 in summer and €0.068 m−3 in winter. The environmental assessment confirmed optimizing energy consumption and membrane requirements as the main factors influencing environmental sustainability. Specifically, summer and winter emissions of 0.079–0.175 and 0.043–0.079 kgCO2eq·m−3 (Global warming potential); 8.1 · 10−4–1.7 · 10−3 and 4.8 · 10−3–8.1 · 10−3 m3·m−3 (water consumption); 0.019–0.041 and 0.010–0.019 kg oileq·m−3 (fossil fuel scarcity); and 1.4 · 10−4–2.9 · 10−4 and 7.7 · 10−4–1.4 · 10−4 kg Cueq·m−3 (mineral resource scarcity) were calculated, respectively. The obtained permeate quality complied with the most stringent Spanish and EU regulations.

Optimal Configuration of Electricity-Heat Integrated Energy Storage Supplier and Multi-Microgrid System Scheduling Strategy Considering Demand Response

Shared energy storage system provides an attractive solution to the high configuration cost and low utilization rate of multi-microgrid energy storage system. In this paper, an electricity-heat integrated energy storage supplier (EHIESS) containing electricity and heat storage devices is proposed to provide shared energy storage services for multi-microgrid system in order to realize mutual profits for different subjects. To this end, electric boiler (EB) is introduced into EHIESS to realize the electricity-heat coupling of EHIESS and improve the energy utilization rate of electricity and heat storage equipment. Secondly, due to the problem of the uncertainty in user-side operation of multi-microgrid system, a price-based demand response (DR) mechanism is proposed to further optimize the resource allocation of shared electricity and heat energy storage devices. On this basis, a bi-level optimization model considering the capacity configuration of EHIESS and the optimal scheduling of multi-microgrid system is proposed, with the objectives of maximizing the profits of energy storage suppliers in upper-level and minimizing the operation costs of the multi-microgrid system in lower-level, and solved based on the Karush-Kuhn-Tucker (KKT) condition and Big-M method. The simulation results show that in case of demand response, the total operation cost of multi-microgrid system and the total operation profit of EHIESS are 51,687.73 and 11,983.88 CNY, respectively; and the corresponding electricity storage unit capacity is 9730.80 kWh. The proposed model realizes the mutual profits of EHIESS and multi-microgrid system.

Single-Port Versus Reduced-Port (1 + 1) Robotic Myomectomy and Hysterectomy

Background: We aimed to investigate the reduced-port (RP) robotic surgery as an alternative to the single-port (SP) robotic surgery by first comparing the surgical outcomes between the two groups. Methods: A total of 184 patients who underwent SP robotic myomectomy (SP-RM, n = 94), RP robotic myomectomy (RP-RM, n = 38), SP robotic hysterectomy (SP-RH, n = 33), or RP robotic hysterectomy (RP-RH, n = 19) from October 2020 to April 2022 were analyzed. An 8 mm skin incision 8–10 cm away from the umbilical incision was made for the RP robotic surgery. Results: Of the total of 184 patients, 166 (90.2%) underwent surgery for leiomyoma followed by adenomyosis (n = 10, 5.44%). None of the cases were converted to laparotomy or added additional ports during surgery. Demographic characteristics and surgical outcomes were comparable between RP-RM and SP-RM and between RP-H and SP-H, respectively. However, more leiomyoma were removed in the RP-RM group than the SP-RM group [median 4.2 (range 1–21) vs. median 2.7 (range 1–11), p = 0.009]. The total operating time was longer in the SP-RH group than the RP-RH group (159.8 ± 55.0 min vs. 113.6 ± 24.6 min, p = 0.001). Conclusions: RP robotic surgery is a feasible and effective surgical option for myomectomy and hysterectomy with cosmetic benefits compared to conventional multiport robotic surgery. In conclusion, for surgeons who cannot use the da Vinci SP, RP robotic surgery using the da Vinci® Xi or Si systems may be an alternative option.

Surgical Treatment of Pediatric Foot and Ankle Fractures in a Freestanding Ambulatory Surgery Center is a Safe, Cost-effective Alternative to a Hospital.

In the United States, the number of pediatric fractures treated in ambulatory surgery centers (ASCs) continues to increase. Few studies have compared the outcomes and complications of treating these injuries in a freestanding ASC versus in a hospital setting. The purpose of this study was to compare clinical and radiographic outcomes, treatment times, and costs for treatment of pediatric foot and ankle fractures in the ASC and hospital. A retrospective review identified pediatric patients with isolated, closed, and acute (below 3wk) distal tibia, ankle, or foot fractures who underwent closed reduction in an operating room or operative fixation between January 2015 and December 2019. The patients were divided into 2 groups: ASC and hospital. Medical records were reviewed for patient demographics, mechanism of injury, surgical time, facility time, costs for treatment, and complications. Preoperative and postoperative alignment was assessed on radiographs. Clinical outcomes included pain, weight-bearing, or deformity at final follow-up. Multivariable generalized linear models and logistic regression were used to determine the association between surgical setting and treatment outcomes, times, and costs. Two hundred and twenty-three patients were identified; 115 treated in the ASC and 108 treated in the hospital. Adjusted for age at treatment, injury type, procedure performed, and preoperative alignment, there were no differences in surgical time, clinical or radiographic outcomes, or complications between groups. The mean total operating room time, total facility time, and total charges were significantly lower in patients treated in the ASC than in the hospital. Pediatric distal tibia, ankle, and foot fractures can be safely treated in an ASC with equivalent outcomes and complications compared with those in a hospital setting. Benefits include shorter total surgical and facility times as well as decreased cost of care. These findings could allow for patients to receive more timely and efficient treatment with less financial burden. Level III-therapeutic.

Chemical Bath Deposition of NiFe Alloy Anode for Efficient Alkaline Water Electrolyzer Integration.

Green hydrogen production from water splitting is a feasible way for intermittent renewable energy storage and utilization, where the exploration and scale-up preparation of high-performance anodic oxygen evolution electrocatalysts are critical prerequisites for its industrial-level applications. Herein, a chemical bath deposition of FeNi3 intermetallic alloys onto Ni mesh support is performed, which delivers a current density of 0.62 Acm-2 at 1.72 V versus reversible hydrogen electrode for alkaline water oxidation in 1 m KOH and an excellent electrolysis stability at 0.2 A cm-2 for over 300 h. Moreover, via 3D computational fluid dynamics simulation and flow field optimization, a homogeneous deposition of ≈5400 cm2 NiFe anode is demonstrated within 4 min using the developed flow bath reactor. Once integrating the as-prepared NiFe anodes into alkaline electrolyzer stack, the voltage variation between each unit cell is below 40 mV at a total operation current of 71 A, or ca. current density of 0.2 A cm-2, confirming the uniformity of this batch synthesis protocol and its great potential for industrial alkaline water electrolysis.

Ship Type Selection and Cost Optimization of Marine Container Ships Based on Genetic Algorithm

In the context of the deep-sea transportation supply chain, this paper addresses the complex decision-making problem of vessel allocation and carbon emission optimization for container shipping routes. A bi-level programming model is established, with the upper level aiming to minimize the total operational cost and the lower level focusing on minimizing carbon emissions. Using an example of an operator with five different types of vessels, a genetic algorithm is employed to determine the optimal vessel allocation scheme. The results indicate that the vessel allocation scheme obtained through multiple iterations of the model effectively reduces both carbon emissions and operational costs. Under the condition that the preset labor cost increases year by year, the use of model optimization can significantly reduce the growth of total operating costs. This paper provides theoretical support and practical guidance for shipping companies aiming to optimize decision-making in order to reduce operational costs and carbon emissions.

Surgical Approaches to Proximal Ureteral Stones &gt;1 Cm: A Comparative Study of M-PCNL and Semirigid URSL

Background: For the management of proximal ureteric calculi modalities like Extracorporeal shockwave lithotripsy, mini-Percutaneous Nephrolithotomy, UreteroRenoscopic Lithotripsy, and Retrograde Intra-Renal Surgery have been commonly used. The objective of this study is to compare the efficacy and safety of mini-Percutaneous Nephrolithotomy and semirigid Ureterorenoscopic Lithotripsy in terms of the total operation time, stone clearance rate, duration of hospital stays, post-operative hemoglobin drop, and peri-operative complications. Methods: This study was a hospital-based, prospective, comparative study conducted in the Urology Unit of Nepalgunj Medical College (NGMC). Eighty patients were included in the study, divided into two groups: 40 patients in the m-PCNL group (Group A) and 40 patients in the URSL group (Group B). Results: The mean age of the total patients was 36.34 ± 12.68 years. The mean duration of surgical procedure in m-PCNL Group was 26.93±9.43 minutes and in URSL it was 20.88±7.06 minutes. The mean duration of hospital stay in m-PCNL Group was 3.63±1.10 days and in URSL group it was 2.70±1.24 days. In m-PCNL, 5 cases (12.5%) had fever, 2 cases (5%) had hematuria and in URSL, 10 cases (25%) had a fever, 7 cases (17.5%) had hematuria and 1 case (2.5%) had dyspnea because of pulmonary complication. Conclusion: Our findings demonstrate that both m-PCNL and URSL can be done for proximal ureteric calculi &gt;1cm but m-PCNL has significantly better stone clearance with no residual stone and thus concludes m-PCNL is better than semirigid URSL for the management of proximal ureteric calculi greater than 1cm.

Intravenous injection versus transhepatic intracholecystic injection of indocyanine green (ICG) to outline biliary tree during laparoscopic cholecystectomy

BackgroundTo potentially lessen injuries and associated complications, fluorescence cholangiography has been suggested as a technique for enhancing the visualization and identification of extrahepatic biliary anatomy. The most popular way to administer indocyanine green (ICG) is intravenously, as there is currently little data on ICG injections directly into the gallbladder. In order to visualize extrahepatic biliary anatomy during laparoscopic cholecystectomy (LC), we compared the two different ICG administration techniques. We also examined variations in visualization time, as well as the effectiveness, benefits, and drawbacks of each modality.MethodsIn this prospective randomized clinical study, 60 consecutive adult patients with chronic and acute gallbladder disease were included. Our study conducted from 2022 to 2024 in Surgical Department of Theodor Bilharz Research Institute. Thirty patients underwent LC with intravenous ICG administration (IV-ICG), thirty patients received a direct injection of gallbladder through transhepatic ICG (IC-ICG) and Preoperative, intraoperative, and postoperative patient data were examined.ResultsIn terms of their perioperative and demographic features, the groups were similar. Without a statistically significant difference, the IV-ICG group’s total operating time was less than that of the IC-ICG group (p 0.140). Compared to the transhepatic IC-ICG method, IV-ICG was more accurate in identifying the duodenum and the common hepatic duct (p = 0.029 and p = 0.016, respectively). In the transhepatic IC-ICG and IV-ICG groups, the cystic duct could be identified prior to dissection in 66.6% and 73.3% of cases, respectively, and this increased to 86.6% and 93.3% following dissection. In the transhepatic IC-ICG group, the common bile duct was visible in 93.3% of cases; in the IV-ICG group, it was visible in 90% of cases. Two cases in the IC-ICG group and every case following IV-ICG administration had liver fluorescence (6.6% versus 100%; p < 0.001).ConclusionThe current study shows that for both administration methods, ICG-fluorescence cholangiography can be useful in identifying the extrahepatic biliary anatomy during Calot’s triangle dissection. By avoiding hepatic fluorescence, the transhepatic IC-ICG route can increase the bile duct-to-liver contrast with less expense and no risk of hypersensitivity reactions than the intravenous ICG injection method. We recommend to use both techniques in case of acute cholecystitis with cystic duct obstruction. In cases of liver cirrhosis, we recommend transhepatic IC-ICG as IV-ICG is limited.

Fleet sizing and static rebalancing strategies for shared E-scooters: A case study in Indianapolis, USA

With the rapid development of shared e-scooters, it is essential to understand their usage patterns for formulating informed e-scooter fleet management policies. This study first analyzes the usage pattern of shared e-scooters in Indianapolis, USA, by mining big e-scooter trip data. The analysis reveals an oversupply of shared e-scooters relative to actual user demand. Thus, a minimum fleet sizing algorithm is proposed to determine the required minimum e-scooter fleet size with the objective of reducing total operation cost, while ensuring demand coverage. Furthermore, three heuristic algorithms are proposed to address the static e-scooter rebalancing problem, focusing on minimizing rebalancing distance cost and rebalancing time. These algorithms consider practical operational constraints, including the number of rebalancing vehicles, their capacity, and the frequency of visits to e-scooter stations by rebalancing vehicles. The proposed algorithms are applied to e-scooter rebalancing scenarios with comparisons between the minimum and actual fleet sizes. The case study results in Indianapolis, USA demonstrate that the rebalancing distance cost with the minimum fleet size is significantly lower than that with the actual fleet size. What’s more, the rebalancing time can be reduced by about 12.34% to 27.80% when using the minimum fleet size. The findings of this study offer valuable policy implications and managerial insights for shared e-scooter operators and policymakers in developing effective e-scooter management strategies.

Peripheral blood to next-generation sequencing ready DNA library: a novel engineering design for automation

Whole genome sequencing (WGS) has become a gold standard for diagnosing genomic variation. Peripheral blood is a common sample source for the extraction of nucleic acids for Next-Generation Sequencing (NGS) applications. Here, we present an integrated and fully automated device design that uses new concepts of fluid mechanics, heat-mass transfer, and thermodynamics of enzymatic reactions to extract nucleic acids from the blood and perform DNA library preparation from a pre-filled plate. We demonstrate that the presented device effectively extracts dsDNA with an average of 25.03 µg/mL and 25.91 µg/mL yield from citrate-stabilized human peripheral blood stored in Fresh (4 °C) and Frozen (-20 °C) conditions, respectively. Furthermore, our method automatically extracts nucleic acids and creates a high-quality sequence-ready DNA library from blood stabilized with citrate and EDTA for 8 samples simultaneously in a single run with a total operation time of ~ 7 h. Our results show the required coverage and depth of the genome, highlighting an essential application of this device in processing blood samples for genome sequencing.Graphical

Effect of Sugammadex on Postoperative Pulmonary Complications and Rapid Recovery in Lung Cancer Patients Treated with Video-Assisted Thoracic Surgery: A Retrospective Cohort Study.

This study aimed to investigate the effects of sugammadex on postoperative pulmonary complications and rapid recovery in lung cancer patients undergoing video-assisted thoracic surgery (VATS). A retrospective analysis was conducted on the clinical data of 1131 lung cancer patients. Of these, 631 patients received sugammadex at the end of anesthesia, while 500 patients did not. To mitigate potential confounding factors, propensity score matching (PSM) was employed at a 1:1 ratio. After matching, 435 patients were obtained from each group. Patients who received sugammadex at the end of anesthesia were classified into Group S (n = 435) and those who did not receive sugammadex were Group P (n = 435). Postoperative pulmonary complications, indicators of recovery after surgery, nausea and vomiting, pain and lung infection scores and biochemical indices were compared between the two groups. Compared to Group P, Group S demonstrated statistically significant improvements across multiple perioperative and postoperative outcomes. Group S exhibited a lower incidence of postoperative pulmonary complications (χ2 = 9.52, p = 0.002), as well as reduced durations for several key time intervals: from the cessation of muscle relaxation to extubation (Z = 12.96, p < 0.001), from the conclusion of surgery to extubation (Z = 13.66, p < 0.001), and total operating theatre occupancy (Z = 5.81, p < 0.001). Furthermore, Group S showed accelerated recovery in terms of time to first oral intake (drink: Z = 3.80, p < 0.001; eat: Z = 3.80, p < 0.001), time to defecate (Z = 3.25, p = 0.001), and time to chest tube removal (Z = 5.04, p < 0.001). Pain management outcomes were also superior in Group S, with lower motor visual analogue scale (VAS) scores at both 24 h (Z = 4.71, p < 0.001) and 48 h (Z = 5.05, p < 0.001) postoperatively. Group S additionally demonstrated a lower modified Clinical Pulmonary Infection Score (mCPIS) (Z = 4.68, p < 0.001), reduced complication rates during the general anesthesia awakening period (χ2 = 23.54, p < 0.001), and a lower incidence of renal function abnormalities (χ2 =12.65, p < 0.001). Certain parameters, including total hospital stay duration and postoperative drainage volume, did not differ significantly between the two groups (p > 0.05). Sugammadex can effectively reduce the incidence of postoperative pulmonary complications in lung cancer patients treated with VATS, and help promote their rapid postoperative recovery with significant clinical benefits.

Cost Analysis of End-Stage Renal Disease in Pediatric Patients in Greece.

The cost resulting from peritoneal dialysis (PD), conventional hemodialysis (HD) and online hemodiafiltration (OL-HDF) in pediatric patients with end-stage renal disease (ESRD) has not been estimated to date in Greece. The present single-center retrospective study aimed to estimate the mean annual cost of the above methods, as well as the individual components of this cost. Twenty pediatric patients undergoing the three different methods of renal replacement therapy were included in this study. Their mean total annual cost was estimated by the method of micro-costing and the bottom-up approach. The mean total annual cost for PD patients (n = 7) was estimated at EUR 56,676.04; for conventional HD patients (n = 9), it was EUR 39,786.86; and for OL-HDF patients (n = 4), it was EUR 43,894.73. The PD method was found to be more expensive than the other two methods (p < 0.001 vs. conventional HD and p = 0.024 vs. OL-HDF). PD consumables used for daily application had the greatest contribution to the total annual cost. The total mean annual cost in the groups of patients undergoing HD and OL-HDF did not differ significantly (p = 0.175). The total operating cost of the renal dialysis unit had the greatest contribution to the total mean annual costs of both the conventional HD and OL-HDF techniques. This cost analysis provides useful information to healthcare policymakers who make decisions about the treatment of children with ESRD.