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Margaretha B Breebaart,1,2 Jordi Branders,2 Luc Sermeus,3 Sultan Termurziev,2 Helene Camerlynck,2 Lennert Van Putte,1 Marnik Van Putte Minelli,1 Stefan De Hert4 1Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium; 2Department of Anesthesia, Antwerp University Hospital, Edegem, Belgium; 3Department of Anesthesiology, St. Luc University Hospital, Brussels, Belgium; 4Department of Anesthesia and Perioperative Medicine, Ghent University Hospital, Ghent, BelgiumCorrespondence: Margaretha B BreebaartDepartment of Anesthesia, Antwerp University Hospital, Wilrijkstraat 10, Edegem, 2650, BelgiumTel +32 486911691Email Margaretha.breebaart@uza.bePurpose: Continuous sciatic nerve blocks have proven benefits for postoperative analgesia after foot surgery. However, the optimal mode of administration remains a point of debate. Ultrasound guided subparaneural injection accelerates onset time and increases duration after a single shot sciatic nerve block. This double blind prospective randomized trial compares the 48-hour local anesthetic (LA) dose consumption of an automated intermittent bolus technique to a continuous infusion regimen in a subparaneural sciatic nerve catheter after hallux valgus surgery.Patients and Methods: Patients scheduled for hallux valgus surgery were randomized to receive either a continuous infusion of levobupivacaine 0.125% at 5mL/h (group A) or an intermittent automated bolus of 9.8 mL every 2 hours with a background of 0.1 mL/h (group B), both with a PCA bolus of 6 mL and lockout of 30 minutes. The 48 hour LA consumption, PCA boluses, Numeric Rating Scale (NRS), satisfaction and return of normal sensation were recorded.Results: Sixteen patients were excluded because of protocol violation or technical problems and 42 patients remained for analysis. The 48 hour ropivacaine consumption was higher in group A (293 ± 60 mL) than group B (257± 33 mL). The median and highest NRS scores and patient satisfaction were not statistically different between groups. Normal sensation returned after 75 ± 22 hours (group A) and 70 ± 17 hours (group B).Conclusion: Programmed bolus administration in subparaneural sciatic nerve catheters reduces LA consumption 48 hours after surgery with equal analgesia and patient satisfaction. Return of sensation is variable and can last more than 75 hours.Keywords: locoregional anesthesia, sciatic nerve block, postoperative pain, local anesthetics, levobupivacaine, orthopedic surgery

CO2 adsorption process in a composite geopolymer/zeolite 13X material has been analysed for post combustion carbon capture application, in dynamic conditions for a CO2/N2 gas mixture. Such composite material represents a valid alternative to conventional sorbents owing to the affinity and synergy between zeolite and the geopolymer binder as well as improved mechanical resistance and lower cost. Experimental analysis has been focused both on complete adsorption tests to determine the material maximum adsorption capacity and on breakthrough tests in transient conditions in (cyclic adsorption/desorption). Particular care has been devoted to thermal effects associated to adsorption and their effect on adsorption capacity and kinetics. Experimental data have been employed to support the development of a novel numerical model, based on Sips adsorption approach for sorbent capacity, and capable to describe the adsorption process, accounting for both mass and energy transport in the sorbent bed. The model proved able to describe well the experimental data at different CO2 feed concentration, and thus it has been employed in a predictive way to inspect process operating parameters and sorbent bed design on the resulting adsorption capacity, breakthrough time, and temperature profile. In particular, the model compared the results obtained in a scaled-up configuration (suitable to an industrial application) with those of the lab-scale system.

Methane Chemical Looping mixed dry reforming - CLMDR (dry reforming and partial oxidation) is an integrate process that utilizes CO2 directly, in presence of carrier materials, for the production of syngas with tuneable H2/CO molar ratio. Herein Cerium oxide was selected as reference source of oxygen and its use in the CLMDR process was evaluated by means of thermodynamic tools of Aspen Plus process simulator. Crucial features such as reforming and regeneration operative temperature, oxygen to methane molar ratio and CO2 addition were investigated in order to identify the most suitable and effective conditions for process. Simulation results of the proposed metal oxide were compared on the basis of methane conversion and syngas purity. Relevantly, cerium-based oxide was found to be selective in syngas production even when CO2 was added to the reforming reactor. After the required thermodynamic validation, a fixed bed reactor on lab scale was specifically designed and fabricated, and cerium oxide oxygen carrier characterized by Thermogravimetric analysis. Thermodynamic results and experimental tests proved the solid/gas chemical reaction takes place with appreciable conversions, and they also demonstrated the stability of the oxygen carrier redox properties during several cycles, thus confirming the feasibility of this new process.

Commercial hollow fiber filters for micro- and ultrafiltration are based on size exclusion and do not allow the removal of small molecules such as antibiotics. Here, we demonstrate that a graphene oxide (GO) layer can be firmly immobilized either inside or outside polyethersulfone-polyvinylpyrrolidone hollow fiber (Versatile PES®, hereafter PES) modules and that the resulting core-shell fibers inherits the microfiltration ability of the pristine PES fibers and the adsorption selectivity of GO. GO nanosheets were deposited on the fiber surface by filtration of a GO suspension through a PES cartridge (cut-off 0.1-0.2 μm), then fixed by thermal annealing at 80 °C, rendering the GO coating stably fixed and unsoluble. The filtration cut-off, retention selectivity and efficiency of the resulting inner and outer modified hollow fibers (HF-GO) were tested by performing filtration on water and bovine plasma spiked with bovine serum albumin (BSA, 66 kDa, ≈15 nm size), monodisperse polystyrene nanoparticles (52 nm and 303 nm sizes), with two quinolonic antibiotics (ciprofloxacin and ofloxacin) and rhodamine B (RhB). These tests showed that the microfiltration capability of PES was retained by HF-GO, and in addition the GO coating can capture the molecular contaminants while letting through BSA and smaller polystyrene nanoparticles. Combined XRD, molecular modelling and adsorption experiments show that the separation mechanism does not rely only on physical size exclusion, but involves intercalation of solute molecules between the GO layers.

Objective: To report the safety and efficacy results of patients enrolled in the Italian Nivolumab Renal Cell Cancer Expanded Access Programme. Patients and Methods: Patients with metastatic renal cell cancer (mRCC) previously treated with agents targeting the vascular endothelial growth factor pathway were eligible to receive nivolumab 3 mg/kg once every 2 weeks. Patients included in the analysis had received ≥1 dose of nivolumab and were monitored for adverse events (AEs) using Common Terminology Criteria for Adverse Events (CTCAE) v.4.0. Results: A total of 389 patients were enrolled between July 2015 and April 2016, of whom 18% were aged ≥75 years, 6.7% had non-clear cell RCC, 49.6% had bone and 8.2% brain metastases, and 79% had received ≥2 previous lines of therapy. The most common any-grade treatment-related AEs were fatigue (13%) and rash (9%). Twenty-two patients (5.7%) discontinued treatment because of AEs. There were no treatment-related deaths. The objective response rate was 23.1%. At a median follow-up of 12 months, the median progression-free survival was 4.5 months (95% confidence interval 3.7–6.2) and the 12-month overall survival rate was 63%. Similar survival rates were reported among patients with non-clear-cell histology, elderly patients, those with bone and/or brain metastases, and those who had received prior first-line sunitinib or pazopanib, or prior everolimus. Conclusion: The safety and efficacy observed were consistent with those reported in the pivotal Checkmate 025 trial. Results in patients with non-clear-cell mRCC who were elderly, pretreated with everolimus, and had bone and/or brain metastases encourage the use of nivolumab in these categories of patients. © 2018 The Authors BJU International

An innovative membrane-based process for the separation of gaseous streams has been developed and tested at lab-scale. The new process can be conveniently carried out on the same modules currently employed for conventional gas separation membrane systems, and it relies on periodic swing of the downstream pressure, while upstream conditions are kept constant. Such new unit operation is run with no need of switching streams, and it allows to process constant flow rate and composition of both feed and retentate, while permeate is collected at assigned frequency, resulting in an overall on-average steady state process. An on-off control strategy over time of permeate collection produces alternate sorption/desorption steps in the membrane, associated to increase/decrease cycles of downstream pressure in the process, in a similar fashion to pressure swing adsorption (PSA). Indeed, consistently with the hybrid nature of the new process, the specific dynamic control of downstream pressure allows the exploitation of both resistive (permeation) and capacitive (adsorption) properties of the membrane, and the associated characteristics in terms of selectivity. By changing the duration of pressure swing period, the resistive or capacitive properties of the membrane can be conveniently tuned in order to explore different performances of the process, in terms of key component recovery and separation factor