Enteric Virus Survival in Package Plants and the Upgrading of the Small Treatment Plants Using Ozone

Post-chlorinated effluent collected with a portable viral concentrator from four treatment plants in Jefferson County, Kentucky, yielded infective viral particles from three plants from spring through late fall. The pH, ,chlorine, turbidity, and coliform levels of these effluents indicated that viral persistence was correlated with inefficient processing which produced effluent environments that inhibited disinfection by chlorine. The disinfection potential of ozone was tested on secondary effluent and finished water seeded with poliovirus and Esaheriahia coli. Low doses of ozone inactivated viruses and bacteria in treated water, but not in effluent. The inactivation of bacteria by ozone does not appear to be caused by cell lysis. Inability of poliovirus to form plaques correlated with inhibition of capsid penetration. Electron micrographs revealed that ozone degrades capsids. Ozonation produced low levels of COD and TOC reduction in package plant effluent. Since the reaction rates were not a simple function of COD levels and ozone dose it would be difficult to standardize dose rates. The relative inefficiency of ozone in reduction of biological and non-biological pollutants in effluents, combined with its high cost, does not favor a recommendation for ozonation as a tack-on process to upgrade these plants

Comparison of vertical cup-to-disc ratio estimates using stereoscopic and monoscopic cameras

Background: The use of monoscopic cameras for glaucoma screening is increasing due to their portability, lower cost, and non-mydriatic capabilities. However, it is important to compare the accuracy of such devices with stereoscopic cameras that are used clinically and are considered the gold standard in optic disc assessment. The aim of this study is to compare vertical cup-to-disc ratio (VCDR) estimates obtained using images taken with a monoscopic and stereoscopic camera. Methods: Participants were selected from the Tema Eye Survey. Eligible subjects had images of at least one eye taken with two cameras. They were classified as meeting the glaucoma threshold if an eye had a VCDR estimate >97.5th percentile, corresponding to >0.725 for this population. Hence, we used 0.725 as the cutoff to group eyes into two categories: positive and negative. We calculated sensitivity, specificity, and predictive values of VCDR assessed by expert readers at a reading center for monoscopic photos using stereoscopic photos as the gold standard. Results: Three hundred and seventy-nine eyes of 206 participants were included in the study. Most participants were female (60.2%) and the most common age group was 50–59 years (36.4%). Sixteen eyes met the glaucoma threshold (VCDR > 0.725). Of these, the VCDR estimates of 14 eyes (87.5%) disagreed on the glaucoma threshold from the two cameras. The sensitivity to detect glaucoma with the monoscopic camera was 14.3% (95% CI: 4.0, 40.3). Conclusions: The low sensitivity of monoscopic photos suggests that stereoscopic photos are more useful in the diagnosis of glaucoma

Nicotinamide–2,2,2-trifluoro­ethanol (2/1)

The nicotinamide (NA) mol­ecules of the title compound, 2C6H6N2O·C2H3F3O, form centrosymmetric R 2 2(8) hydrogen-bonded dimers via N—H⋯O contacts. The asymmetric unit contains two mol­ecules of NA and one trifluoroethanol molecule disordered over two sites of equal occupancy. The packing consists of alternating layers of nicotinamide dimers and disordered 2,2,2-trifluoro­ethanol mol­ecules stacking in the c-axis direction. Intra­molecular C—H⋯O and inter­molecular N—H⋯N, O—H⋯N, C—H⋯N, C—H⋯O and C—H⋯F inter­actions are present

Peculiar spectral and power spectral behaviour of the LMXB GX 13+1

We present results of an analysis of all 480 ks of Rossi X-ray Timing Explorer Proportional Counter Array data obtained from 17 May 1998 to 11 October 1998 on the luminous low mass X-ray binary GX 13+1. We analysed the spectral properties in colour-colour diagrams (CDs) and hardness-intensity diagrams (HIDs) and fitted the power spectra with a multi-Lorentzian model. GX 13+1 traces out a curved track in the CDs on a time scale of hours, which is very reminiscent of a standard atoll track containing an island, and lower and upper banana branch. However, both count rate and power spectral properties vary along this track in a very unusual way, not seen in any other atoll or Z source. The count rate, which varied by a factor of ~1.6, along a given track first decreases and then increases, causing the motion through the HIDs to be in the opposite sense to that in the CD, contrary to all other Z and atoll sources. Along a CD track, the very low frequency noise uniquely decreases in amplitude from ~5 to ~2% (rms). The high frequency noise amplitude decreases from ~4% to less than 1% and its characteristic frequency decreases from ~10 to \~5 Hz. The 57-69 Hz quasi-periodic oscillation (QPO) found earlier is also detected, and no kHz QPOs are found. In addition the entire track shows secular motion on a time scale of about a week. The average count rate as well as the amplitude of the very low frequency noise correlate with this secular motion. We discuss a possible explanation for the peculiar properties of GX 13+1 in terms of an unusual orientation or strength of a relativistic jet.Comment: 15 pages, 13 figures. Accepted for publication in A&

Patient recruitment to a randomized clinical trial of behavioral therapy for chronic heart failure

BACKGROUND: Patient recruitment is one of the most difficult aspects of clinical trials, especially for research involving elderly subjects. In this paper, we describe our experience with patient recruitment for the behavioral intervention randomized trial, "The relaxation response intervention for chronic heart failure (RRCHF)." Particularly, we identify factors that, according to patient reports, motivated study participation. METHODS: The RRCHF was a three-armed, randomized controlled trial designed to evaluate the efficacy and cost of a 15-week relaxation response intervention on veterans with chronic heart failure. Patients from the Veterans Affairs (VA) Boston Healthcare System in the United States were recruited in the clinic and by telephone. Patients' reasons for rejecting the study participation were recorded during the screening. A qualitative sub-study in the trial consisted of telephone interviews of participating patients about their experiences in the study. The qualitative study included the first 57 patients who completed the intervention and/or the first follow-up outcome measures. Factors that distinguished patients who consented from those who refused study participation were identified using a t-test or a chi-square test. The reason for study participation was abstracted from the qualitative interview. RESULTS: We successfully consented 134 patients, slightly more than our target number, in 27 months. Ninety-five of the consented patients enrolled in the study. The enrollment rate among the patients approached was 18% through clinic and 6% through telephone recruitment. The most commonly cited reason for declining study participation given by patients recruited in the clinic was 'Lives Too Far Away'; for patients recruited by telephone it was 'Not Interested in the Study'. One factor that significantly distinguished patients who consented from patients who declined was the distance between their residence and the study site (t-test: p < .001). The most frequently reported reason for study participation was some benefit to the patient him/herself. Other reasons included helping others, being grateful to the VA, positive comments by trusted professionals, certain characteristics of the recruiter, and monetary compensation. CONCLUSIONS: The enrollment rate was low primarily because of travel considerations, but we were able to identify and highlight valuable information for planning recruitment for future similar studies

'I'm sure we made it a better study…': Experiences of adults with intellectual disabilities and parent carers of patient and public involvement in a health research study.

Patient and public involvement is considered integral to health research in the United Kingdom; however, studies documenting the involvement of adults with intellectual disabilities and parent carers in health research studies are scarce. Through group interviews, this study explored the perspectives and experiences of a group of adults with intellectual disabilities and a group of parent carers about their collaborative/participatory involvement in a 3-year study which explored the effectiveness of annual health checks for adults with intellectual disabilities. Thematic analysis identified five key themes consistent across both groups; authenticity of participation, working together, generating new outcome measures, dissemination of findings and involvement in future research. Although reported anecdotally rather than originating from the analysis, increased self-confidence is also discussed. The groups' unique perspectives led to insights not previously considered by the research team which led to important recommendations to inform healthcare practice