Autonomic dysfunction in patients with advanced cancer; prevalence, clinical correlates and challenges in assessment

<p>Abstract</p> <p>Background</p> <p>The results of a small number of studies of autonomic function in patients with advanced cancer suggest that autonomic dysfunction (AD) is common. In other disease-specific groups this is associated with decreased survival, falls and symptoms such as postural hypotension, nausea, early satiety and fatigue. The contribution of AD to symptoms in advanced cancer is unknown.</p> <p>Methods</p> <p>We conducted a prospective cohort study designed to identify the risk factors for falls in patients with advanced cancer. Ambulant adult patients admitted consecutively to palliative care services were invited to participate. Participants underwent an assessment at baseline which included standard clinical tests of autonomic function, assessment of symptom severity, muscle strength, anthropometric measurements, walking speed, medication use, comorbidities and demographics. Information regarding survival was recorded ten months following cessation of recruitment. The clinical correlates of AD, defined as definite or severe dysfunction using Ewing's classification, were examined by univariate and multivariate logistic regression analysis. Survival analysis was conducted using Kaplan-Meier plots and the log rank test.</p> <p>Results</p> <p>Of 185 patients recruited, 45% were unable to complete all of the clinical tests of autonomic function. Non-completion was associated with scoring high on clinical indicators of frailty. It was possible to accurately classify 138/185 (74.6%) of participants as having either definite or severe versus normal, early or atypical AD: 110 (80%) had definite/severe AD. In logistic regression analysis, age (OR = 1.07 [95% CI; 1.03-1.1] <it>P </it>= 0.001) and increased severity of fatigue (OR = 1.26 [95% CI; 1.05-1.5] <it>p </it>= 0.016) were associated with having definite/severe AD. In analysis adjusted for age, median survival of participants with definite/severe AD was shorter than in those with normal/early/atypical classification (χ²= 4.3, <it>p </it>= 0.038).</p> <p>Conclusions</p> <p>Autonomic dysfunction is highly prevalent in patients with advanced cancer and is associated with increased severity of fatigue and reduced survival. Due to frailty, up to 45% of participants were unable to complete standard clinical tests of autonomic function. In order to further investigate the impact of AD and the therapeutic potential of treatment of AD in patients with advanced cancer, the validity of alternative novel methods of assessing autonomic function must be appraised.</p

Antimicrobial Properties of Vertically Aligned Nano-Tubular Copper

In this work, the antimicrobial properties of vertically aligned nano-tubular Cu arrays (NT-Cu) fabricated via a template-based electrodeposition approach were investigated. The NT-Cu display good bactericidal activity against S.aureus and bacteriostatic properties against E.coli, S.sonnei, S.enterica and C.albicans. In contrast, Cu-foil electrodeposited from the same solution shows low biological activity against the same microorganisms. The antimicrobial activity of NT-Cu depends on both the type of microorganism and exposure time. After 6 hours of exposure, over 99.99% (log red = 4.43) of S.aureus population was inactivated, whereas, for E.coli, S.sonnei, S.enterica and C.albicans it was 97.8, 94.2, 89.9, and 90.3%, respectively

First demonstration of hydrophobic membrane contactors for removal of ammonia from condensate wastewater

Hydrophobic membrane contactors represent a promising solution to the problem of recovering ammoniacal nitrogen from wastewater. The process has been shown to work best with wastewater streams that present high ammonia concentrations, low buffering capacities and low total suspended solids. The removal of ammonia from rendering condensate, produced during heat treatment of waste animal tissue, was assessed in this research using a hydrophobic membrane contactor. The main objective was to test the ammonia stripping technology using two types of hydrophobic membrane materials, polypropylene and polytetrafluoroethylene, at pilot scale and carry out process modification for ammonia removal. The results demonstrate that polypropylene membranes are not compatible with the condensate waste as it caused wetting. The polytetrafluoroethylene membranes showed potential and had a longer lifetime than the polypropylene membranes, removing up to 64% of ammonia from the condensate waste. The product formed contained a 30% concentrated ammonium sulphate salt which has a potential application as a fertilizer. This is the first demonstration of hydrophobic membrane contactors for treatment of condensate wastewater

Activated Graphene Oxide-Calcium Alginate Beads for Adsorption of Methylene Blue and Pharmaceuticals

The remarkable adsorption capacity of graphene-derived materials has prompted their examination in composite materials suitable for deployment in treatment of contaminated waters. In this study, crosslinked calcium alginate–graphene oxide beads were prepared and activated by exposure to pH 4 by using 0.1M HCl. The activated beads were investigated as novel adsorbents for the removal of organic pollutants (methylene blue dye and the pharmaceuticals famotidine and diclofenac) with a range of physicochemical properties. The effects of initial pollutant concentration, temperature, pH, and adsorbent dose were investigated, and kinetic models were examined for fit to the data. The maximum adsorption capacities qmax obtained were 1334, 35.50 and 36.35 mg g−1 for the uptake of methylene blue, famotidine and diclofenac, respectively. The equilibrium adsorption had an alignment with Langmuir isotherms, while the kinetics were most accurately modelled using pseudo- first-order and second order models according to the regression analysis. Thermodynamic parameters such as ΔG°, ΔH° and ΔS° were calculated and the adsorption process was determined to be exothermic and spontaneous

First demonstration of hydrophobic membrane contactors for removal of ammonia from condensate wastewater

Hydrophobic membrane contactors represent a promising solution to the problem of recovering ammoniacal nitrogen from wastewater. The process has been shown to work best with wastewater streams that present high ammonia concentrations, low buffering capacities and low total suspended solids. The removal of ammonia from rendering condensate, produced during heat treatment of waste animal tissue, was assessed in this research using a hydrophobic membrane contactor. The main objective was to test the ammonia stripping technology using two types of hydrophobic membrane materials, polypropylene and polytetrafluoroethylene, at pilot scale and carry out process modification for ammonia removal. The results demonstrate that polypropylene membranes are not compatible with the condensate waste as it caused wetting. The polytetrafluoroethylene membranes showed potential and had a longer lifetime than the polypropylene membranes, removing up to 64% of ammonia from the condensate waste. The product formed contained a 30% concentrated ammonium sulphate salt which has a potential application as a fertilizer. This is the first demonstration of hydrophobic membrane contactors for treatment of condensate wastewater

Oxygen transfer of microbubble clouds in aqueous solutions: application to wastewater

This study aims at improving the knowledge on the effects of gas injection, bubbles sizes and contaminants on oxygen transfer in microbubble clouds. First the effects of gas injection on oxygen transfer are studied and linked to several parameters that change together with changes in flow rate, namely bubble sizes and rise velocities. Oxygen transfer is then studied in the presence of contaminants that are shown to affect bubble size distribution, modify bubble dynamics and interfacial mass transfer. Oxygen transfer efficiencies are also measured in wastewater and compared with those obtained in aqueous solutions. The agreement between contaminated water in the lab (Triton X100) and wastewater experiments is emphasised as this offers the possibility to develop fundamental understanding relevant to wastewater under laboratory conditions. The role of the surfactants on the volumetric oxygen transfer coefficient is further analysed in terms of specific interfacial area and transfer coefficients, respectively. Interestingly, this shows that the increase in oxygen transfer efficiency as the concentration in Pentanol increases is due to the increase in interfacial area while the transfer coefficients decrease

Pilot scale study: first demonstration of hydrophobic membranes for the removal of ammonia molecules from rendering condensate wastewater

Hydrophobic membrane contactors represent a promising solution to the problem of recycling ammoniacal nitrogen (N-NH4) molecules from waste, water or wastewater resources. The process has been shown to work best with wastewater streams that present high N-NH4 concentrations, low buffering capacities and low total suspended solids. The removal of N-NH4 from rendering condensate, produced during heat treatment of waste animal tissue, was assessed in this research using a hydrophobic membrane contactor. This study investigates how the molecular composition of rendering condensate wastewater undergo changes in its chemistry in order to achieve suitability to be treated using hydrophobic membranes and form a suitable product. The main objective was to test the ammonia stripping technology using two types of hydrophobic membrane materials, polypropylene (PP) and polytetrafluoroethylene (PTFE) at pilot scale and carry out: (i) Process modification for NH3 molecule removal and (ii) product characterization from the process. Theresults demonstrate that PP membranesarenotcompatiblewiththecondensate wasteasit caused wetting. The PTFE membranes showed potential and had a longer lifetime than the PP membranes and removed upto64%ofNH3 moleculesfromthecondensate waste. The product formed contained a 30%concentrated ammonium sulphate salt which has a potential application as a fertilizer. This is the first demonstration of hydrophobic membrane contactors for treatment of condensate wastewate