Advancing age is a much stronger negative predictor of treatment receipt among older veterans with NSCLC than comorbidity. Individualized decisions that go beyond age and include comorbidity are needed to better target NSCLC treatments to older patients who may reasonably benefit.

Direct microscopic observation and an interfacial force model were used to better understand and control microbial adhesion to polymeric ultrafiltration membranes. The model was used to predict a "critical flux", below which cells deposited reversibly, and direct observation was used to visually quantify cell deposition and removal. In preliminary direct observation experiments, permeate reversal (backpulsing) was more effective than cross-flow hydrodynamics at removing deposited cells. In experiments conducted below the critical flux, no cell accumulation was observed over repeated forward-reverse filtration cycles; however, a small fraction of cells deposited irreversibly regardless of the flux, membrane, or solution chemistry. The fraction of irreversibly deposited cells was consistent with the equilibrium surface coverage attained without permeation (i.e., due to heterogeneous adsorption). Although steric forces were not invoked to establish a critical flux, when operating above the critical flux, a balance between permeation drag and steric repulsion appeared to determine the strength of adhesion of cells to membranes. Direct observation also confirmed that above the critical flux fouling occurred and pressure losses accumulated over several backpulse cycles, whereas below the critical flux there were no observable pressure losses or fouling.

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