Indocyanine Green for Leakage Control in Isolated Limb Perfusion

Sarcomas are characterized by a high metastatic potential and aggressive growth. Despite surgery, chemotherapy plays an important role in the treatment of these tumors. Optimal anti-cancer therapy with maximized local efficacy and minimized systemic side effects has been the object of many studies for a long time. To improve the local efficacy of anti-tumor therapy, isolated limb perfusion with high-dose cytostatic agents has been introduced in surgical oncology. In order to control the local distribution of substances, radiolabeled cytostatic drugs or perfusion solutions have been applied but often require the presence of specialized personnel and result in a certain exposure to radiation. In this study, we present a novel strategy using indocyanine green to track tumor perfusion with high-dose cytostatic therapy. In a rat cadaver model, the femoral vessels were cannulated and connected to a peristaltic pump to provide circulation within the selected limb. The perfusion solution contained indocyanine green and high-dose doxorubicin. An infrared camera enabled the visualization of indocyanine green during limb perfusion, and subsequent leakage control was successfully performed. Histologic analysis of sections derived proximally from the injection site excluded systemic drug dispersion. In this study, the application of indocyanine green was proven to be a safe and cost- and time-efficient method for precise leakage control in isolated limb perfusion with a high-dose cytostatic agent.

Overview of Energy Management and Leakage Control Systems for Smart Water Grids and Digital Water

Current and future smart cities are moving towards the zero-net energy use concept. To this end, the built environment should also be designed for efficient energy use and play a significant role in the production of such energy. At present, this is achieved by focusing on energy demand in buildings and to the renewable trade-off related to smart power grids. However, urban water distribution systems constantly carry an excess of hydraulic energy that can potentially be recovered to produce electricity. This paper presents a comprehensive review of current strategies for energy production by reviewing the state-of-the-art of smart water systems. New technologies (such as cyber-physical systems, digital twins, blockchain) and new methodologies (network dynamics, geometric deep learning) associated with digital water are also discussed. The paper then focuses on modelling the installation of both micro-turbines and pumps as turbines, instead of/together with pressure reduction valves, to further demonstrate the energy-recovery methods which will enable water network partitioning into district metered areas. The associated benefits on leakage control, as a source of energy, and for contributing to overall network resilience are also highlighted. The paper concludes by presenting future research directions. Notably, digital water is proposed as the main research and operational direction for current and future Water Distribution Systems (WDS) and as a holistic, data-centred framework for the operation and management of water networks.