Advanced nursing practice: a review of scopes of practice in cancer care.

The establishment of advanced nurse practitioners (ANPs) has expanded considerably in recent years and shown to result in substantial contributions to numerous fields of health care. Due to advancements in treatments and innovations in medicine, patients with cancer are living longer, requiring a multifactorial holistic approach in which ANPs, due to their skills and knowledge, can be best utilised, as they are able to provide the expert care required at various stages of the patient journey. This article explores scopes of practice from ANPs working with oncology patients in a tertiary cancer centre, making explicit their roles, in addition to highlighting experienced challenges and future directions of care.

Acacia Wood Fractionation Using Deep Eutectic Solvents: Extraction, Recovery, and Characterization of the Different Fractions.

The selective extraction and recovery of different lignocellulosic molecules of interest from forestry residues is increasing every day not only to satisfy the needs of driving a society toward more sustainable approaches and materials (rethinking waste as a valuable resource) but also because lignocellulosic molecules have several applications. For this purpose, the development of new sustainable and ecologically benign extraction approaches has grown significantly. Deep eutectic solvents (DESs) appear as a promising alternative for the processing and manipulation of biomass. In the present study, a DES formed using choline chloride and levulinic acid (ChCl:LA) was studied to fractionate lignocellulosic residues of acacia wood (Acacia dealbata Link), an invasive species in Portugal. Different parameters, such as temperature and extraction time, were optimized to enhance the yield and purity of recovered cellulose and lignin fractions. DESs containing LA were found to be promising solvent systems, as the hydrogen bond donor was considered relevant in relation to lignin extraction and cellulose concentration. On the other hand, the increase in temperature and extraction time increases the amount of extracted material from biomass but affects the purity of lignin. The most promising DES system, ChCl:LA in a ratio of 1:3, was found to not significantly depolymerize the extracted lignin, which presented a similar molecular weight to a kraft lignin. Additionally, the 31P NMR results revealed that the extracted lignin has a high content of phenolic OH groups, which favor its reactivity. A mixture of ChCl:LA may be considered a fully renewable solvent, and the formed DES presents good potential to fractionate wood residues.

Batch and fed-batch simultaneous saccharification and fermentation of primary sludge from pulp and paper mills.

Primary sludge from a Portuguese pulp and paper mill, containing 60% of carbohydrates, and unbleached pulp (as reference material), with 93% of carbohydrates, were used to produce ethanol by simultaneous saccharification and fermentation (SSF). SSF was performed in batch or fed-batch conditions without the need of a pretreatment. Cellic® CTec2 was the cellulolytic enzymatic complex used and Saccharomyces cerevisiae (baker's yeast or ATCC 26602 strain) or the thermotolerant yeast Kluyveromyces marxianus NCYC 1426 were employed. Primary sludge was successfully converted to ethanol and the best results in SSF efficiency were obtained with S. cerevisiae. An ethanol concentration of 22.7 g L-1 was produced using a content of 50 g L-1 of carbohydrates from primary sludge, in batch conditions, with a global conversion yield of 81% and a production rate of 0.94 g L-1 h-1. Fed-batch operation enabled higher solids content (total carbohydrate concentration of 200 g L-1, equivalent to a consistency of 33%) and a reduction of three-quarters of cellulolytic enzyme load, leading to an ethanol concentration of 40.7 g L-1, although with lower yield and productivity. Xylitol with a concentration up to 7 g L-1 was also identified as by-product in the primary sludge bioconversion process.

Integrated bioconversion of pulp and paper primary sludge to second generation bioethanol using Saccharomyces cerevisiae ATCC 26602.

Primary sludge, from different pulp and paper mills, was used as feedstock in simultaneous saccharification and fermentation (SSF) processes to produce ethanol. SSF was carried out with Saccharomyces cerevisiae ATCC 26602 yeast and NS 22192 enzymatic extract using 150gL(-1) of carbohydrates (CH) from primary sludge. The effect of sterilization, reduction of enzyme dosage and fed-batch vs. batch conditions were studied. The removal of sterilization can be considered since no contamination or atypical by-products were observed, although SSF efficiency slightly decreased. The reduction of the enzyme dosage from 35 to 15FPUgCH(-1) was successful. Despite of initial mixing difficulties, batch SSF enabled higher ethanol concentration (41.7gL(-1)), conversion yield (48.9%) and productivity (0.78gL(-1)h(-1)), compared to the fed-batch process at the same conditions of low enzyme dosage of 5FPUgCH(-1) and high solids content of 21.7%, rarely found in literature.