The characterization of novel cements

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The present study deals with the physical characterization of macrodefect free cements produced by ICI. These materials are made through a specialized mixing technique which incorporates an organic polymer into the cement/water system. The high mechanical strength and low porosity of this class of hardened cement paste had been well documented, however, a detailed characterization of the physical nature of the microstructure had not previously been attempted. Two classes of macrodefect free material were studied, based on Ordinary Portland cement and High Alumina cement, respectively. The porosities of these two materials were determined in their original state and after various forms of heat treatment and conditioning. Samples based on Ordinary Portland cement had a well defined narrow pore size distribution, even after heat treatment, while the High Alumina cement samples displayed a very low total pore volume in their original state, but subsequent heat treatment led to the developement of porosity over a wide range of pore sizes. These fundamental differences in the pore size distributions had significant effects on the homogeneity and reproducibility of the microstructures of the samples. The porosity generated by heat treatment was found to be unstable in the presence of water. In general, reductions in the porosities and permeabilities were observed. This was due to the formation of fresh cement hydrate gel within the pore structure, which caused a shift in the pore size distributions towards smaller pores.British Gas; IC

Masks praxis: theories and practices in modern drama

Mask Praxis is an investigation of the theories and practices behind the uses of the mask in modern drama from 1896 to 2004. The study traces the crisis in humanism through the use of idealist and materialist masks by theatre practitioners and explains how the search for a unified field was overlaid by fractured identities and a slide into dissonance. How important are the masks that people adopt on the stage for understanding their actions in society? How does the metaphorical power and perceptual ambiguity of the mask correlate with intentions of its maker and performer? What is the relationship between the mask and the face of the actor, and what does the mask do that cannot be done unaided? What are the main approaches to actor training that have used masks, and how are these training systems connected to wider belief systems? What do we learn from the act of masking about self-perception and social being, and what are the principal considerations that this gives rise to? This investigation proceeds from a consideration of major theories and practices. Chapter 1 examines mask performance theories, conventions, and typologies. Chapter 2 analyses the specificity of the mask, materials and methods, representative mask-makers and provides casebook studies on the Sartori family and the Masks for Menander Project. Chapter 3 evaluates actor-training under the mask from Copeau to Lecoq. Chapter 4 assesses the masks of idealist modernism and Chapter 5 considers the masks of materialist modernism. The final chapter is dedicated to transnational flows, multinational productions and the notion of connectivity. It brings new evidence to bear on the emergent field of masks, puppets and performing objects and sets down a major overview of the mask as a primary iconographic tool and as a liminoid instrument from which to mediate and direct the flow of power in a system

The importance of recent infection with Mycobacterium tuberculosis in an area with high HIV prevalence: a long-term molecular epidemiological study in Northern Malawi.

BACKGROUND: The proportion of cases of tuberculosis due to recent infection can be estimated in long-term population-based studies using molecular techniques. Here, we present what is, to our knowledge, the first such study in an area with high human immunodeficiency virus (HIV) prevalence. METHODS: All patients with tuberculosis in Karonga District, Malawi, were interviewed. Isolates were genotyped using restriction-fragment-length polymorphism (RFLP) patterns. Strains were considered to be "clustered" if at least 1 other patient had an isolate with an identical pattern. RESULTS: RFLP results were available from 83% of culture-positive patients from late 1995 to early 2003. When strains with <5 bands were excluded, 72% (682/948) were clustered. Maximum clustering was reached using a 4-year window, with an estimated two-thirds of cases due to recent transmission. The proportion clustered decreased with age and varied by area of residence. In older adults, clustering was less common in men and more common in patients who were HIV positive (adjusted odds ratio, 5.1 [95% confidence interval, 2.1-12.6]). CONCLUSIONS: The proportion clustered found in the present study was among the highest in the world, suggesting high rates of recent transmission. The association with HIV infection in older adults may suggest that HIV has a greater impact on disease caused by recent transmission than on that caused by reactivation

Design of activated carbon–clay composites for effluent decontamination

Adsorption offers an efficient technology for removing volatile organic compounds (VOCs) from air pollution sources. Often activated carbons (ACs) are employed owing to their large specific surface areas, high micropore volumes, rapid adsorption capabilities and selectivity towards organic molecules compared to water vapour or air. However, when large volumes of gas are to be treated pressure drop limitations may arise from the use of conventional powder adsorption beds. For these applications conformation of the activated carbon as open channel honeycomb monoliths can take advantage of the almost null pressure drop caused by these structures. Similarly, conformation as extrudates or tubes although increasing the pressure drop due to the turbulent gas flow can improve any diffusion limitations that the open channel monoliths can suffer. Conformation of the AC as a ceramic composite also improves the handling characteristics. By the use of a silicate clay binder a commercially available AC, was conformed in three different monolithic geometries; changing the channel width and the wall thicknesses and as solid extrudates and tubes. The textural and mechanical properties of these conformed composite structures were determined and the results analysed along with their dynamic adsorption capacities towards toluene at 30 C, used as a probe molecule to establish criteria by which the most suitable structure for industrial use could be selected.This work has been supported by the CICYT project MAT2009-09960, Community of Madrid project S-0505/MAT/000227 and CDTI IDI-20091139

Macroporous polymers tailored as supports for large biomolecules: Ionic liquids as porogenic solvents and as surface modifiers

Highly ordered rod-like polymeric monoliths with large-pores have been successfully synthesized using ionic liquids (ILs) IL-1 (1-Butyl-3-methylimidazolium bis (trifluoromethylsulfonyl)imide [BMIM][NTf2]) and IL-2 (1-octyl-3-methylimidazolium bis (trifluoromethylsulfonyl)imide [OMIM][NTf2]) as alternative porogenic solvents. The presence of ILs can not only promote the formation of a highly ordered macroporous structure, control the morphology of the polymer and control the chemical composition of surfaces for monoliths prepared from DVB. In this regard, post-functionalization of the monoliths can be easily achieved using the functional monomers introduced in the polymerization process or the unreacted vinyl groups present in the polymeric matrix. This control has allowed the preparation of monolithic Supported Ionic Liquid-like Phases (m-SILLPs) with excellent morphological properties. These m-SILLPs have been studied as supports for large biomolecules. Bioadsorption studies show that the adsorbed amount of protein reaches values as high as 150–200 mg of protein per gram of support

Determinants of Cluster Size in Large, Population-Based Molecular Epidemiology Study of Tuberculosis, Northern Malawi

Both epidemiologic and strain-related factors may contribute to large clusters of tuberculosis patients

Participant and workplace champion experiences of an intervention designed to reduce sitting time in desk-based workers : SMART work & life

Background: A cluster randomised controlled trial demonstrated the effectiveness of the SMART Work & Life (SWAL) behaviour change intervention, with and without a height-adjustable desk, for reducing sitting time in desk-based workers. Staff within organisations volunteered to be trained to facilitate delivery of the SWAL intervention and act as workplace champions. This paper presents the experiences of these champions on the training and intervention delivery, and from participants on their intervention participation. Methods: Quantitative and qualitative feedback from workplace champions on their training session was collected. Participants provided quantitative feedback via questionnaires at 3 and 12 month follow-up on the intervention strategies (education, group catch ups, sitting less challenges, self-monitoring and prompts, and the height-adjustable desk [SWAL plus desk group only]). Interviews and focus groups were also conducted at 12 month follow-up with workplace champions and participants respectively to gather more detailed feedback. Transcripts were uploaded to NVivo and the constant comparative approach informed the analysis of the interviews and focus groups. Results: Workplace champions rated the training highly with mean scores ranging from 5.3/6 to 5.7/6 for the eight parts. Most participants felt the education increased their awareness of the health consequences of high levels of sitting (SWAL: 90.7%; SWAL plus desk: 88.2%) and motivated them to change their sitting time (SWAL: 77.5%; SWAL plus desk: 85.77%). A high percentage of participants (70%) reported finding the group catch up session helpful and worthwhile. However, focus groups highlighted mixed responses to the group catch-up sessions, sitting less challenges and self-monitoring intervention components. Participants in the SWAL plus desk group felt that having a height-adjustable desk was key in changing their behaviour, with intrinsic as well as time based factors reported as key influences on the height-adjustable desk usage. In both intervention groups, participants reported a range of benefits from the intervention including more energy, less fatigue, an increase in focus, alertness, productivity and concentration as well as less musculoskeletal problems (SWAL plus desk group only). Work-related, interpersonal, personal attributes, physical office environment and physical barriers were identified as barriers when trying to sit less and move more. Conclusions: Workplace champion and participant feedback on the intervention was largely positive but it is clear that different behaviour change strategies worked for different people indicating that a ‘one size fits all’ approach may not be appropriate for this type of intervention. The SWAL intervention could be tested in a broader range of organisations following a few minor adaptations based on the champion and participant feedback. Trial registration: ISCRCTN registry (ISRCTN11618007)

Obesity, chronic disease, age, and in-hospital mortality in patients with covid-19: analysis of ISARIC clinical characterisation protocol UK cohort.

BACKGROUND: Although age, obesity and pre-existing chronic diseases are established risk factors for COVID-19 outcomes, their interactions have not been well researched. METHODS: We used data from the Clinical Characterisation Protocol UK (CCP-UK) for Severe Emerging Infection developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC). Patients admitted to hospital with COVID-19 from 6th February to 12th October 2020 were included where there was a coded outcome following hospital admission. Obesity was determined by an assessment from a clinician and chronic disease by medical records. Chronic diseases included: chronic cardiac disease, hypertension, chronic kidney disease, chronic pulmonary disease, diabetes and cancer. Mutually exclusive categories of obesity, with or without chronic disease, were created. Associations with in-hospital mortality were examined across sex and age categories. RESULTS: The analysis included 27,624 women with 6407 (23.2%) in-hospital deaths and 35,065 men with 10,001 (28.5%) in-hospital deaths. The prevalence of chronic disease in women and men was 66.3 and 68.5%, respectively, while that of obesity was 12.9 and 11.1%, respectively. Association of obesity and chronic disease status varied by age (p < 0.001). Under 50 years of age, obesity and chronic disease were associated with in-hospital mortality within 28 days of admission in a dose-response manner, such that patients with both obesity and chronic disease had the highest risk with a hazard ratio (HR) of in-hospital mortality of 2.99 (95% CI: 2.12, 4.21) in men and 2.16 (1.42, 3.26) in women compared to patients without obesity or chronic disease. Between the ages of 50-69 years, obesity and chronic disease remained associated with in-hospital COVID-19 mortality, but survival in those with obesity was similar to those with and without prevalent chronic disease. Beyond the age of 70 years in men and 80 years in women there was no meaningful difference between those with and without obesity and/or chronic disease. CONCLUSION: Obesity and chronic disease are important risk factors for in-hospital mortality in younger age groups, with the combination of chronic disease and obesity being particularly important in those under 50 years of age. These findings have implications for targeted public health interventions, vaccination strategies and in-hospital clinical decision making

Obesity, Ethnicity, and Risk of Critical Care, Mechanical Ventilation, and Mortality in Patients Admitted to Hospital with COVID-19: Analysis of the ISARIC CCP-UK Cohort.

OBJECTIVE: The aim of this study was to investigate the association of obesity with in-hospital coronavirus disease 2019 (COVID-19) outcomes in different ethnic groups. METHODS: Patients admitted to hospital with COVID-19 in the United Kingdom through the Clinical Characterisation Protocol UK (CCP-UK) developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) were included from February 6 to October 12, 2020. Ethnicity was classified as White, South Asian, Black, and other minority ethnic groups. Outcomes were admission to critical care, mechanical ventilation, and in-hospital mortality, adjusted for age, sex, and chronic diseases. RESULTS: Of the participants included, 54,254 (age = 76 years; 45.0% women) were White, 3,728 (57 years; 41.1% women) were South Asian, 2,523 (58 years; 44.9% women) were Black, and 5,427 (61 years; 40.8% women) were other ethnicities. Obesity was associated with all outcomes in all ethnic groups, with associations strongest for black ethnicities. When stratified by ethnicity and obesity status, the odds ratios for admission to critical care, mechanical ventilation, and mortality in black ethnicities with obesity were 3.91 (3.13-4.88), 5.03 (3.94-6.63), and 1.93 (1.49-2.51), respectively, compared with White ethnicities without obesity. CONCLUSIONS: Obesity was associated with an elevated risk of in-hospital COVID-19 outcomes in all ethnic groups, with associations strongest in Black ethnicities

Admission Blood Glucose Level and Its Association With Cardiovascular and Renal Complications in Patients Hospitalized With COVID-19

OBJECTIVE: To investigate the association between admission blood glucose levels and risk of in-hospital cardiovascular and renal complications. RESEARCH DESIGN AND METHODS: In this multicenter prospective study of 36,269 adults hospitalized with COVID-19 between 6 February 2020 and 16 March 2021 (N = 143,266), logistic regression models were used to explore associations between admission glucose level (mmol/L and mg/dL) and odds of in-hospital complications, including heart failure, arrhythmia, cardiac ischemia, cardiac arrest, coagulation complications, stroke, and renal injury. Nonlinearity was investigated using restricted cubic splines. Interaction models explored whether associations between glucose levels and complications were modified by clinically relevant factors. RESULTS: Cardiovascular and renal complications occurred in 10,421 (28.7%) patients; median admission glucose level was 6.7 mmol/L (interquartile range 5.8-8.7) (120.6 mg/dL [104.4-156.6]). While accounting for confounders, for all complications except cardiac ischemia and stroke, there was a nonlinear association between glucose and cardiovascular and renal complications. For example, odds of heart failure, arrhythmia, coagulation complications, and renal injury decreased to a nadir at 6.4 mmol/L (115 mg/dL), 4.9 mmol/L (88.2 mg/dL), 4.7 mmol/L (84.6 mg/dL), and 5.8 mmol/L (104.4 mg/dL), respectively, and increased thereafter until 26.0 mmol/L (468 mg/dL), 50.0 mmol/L (900 mg/dL), 8.5 mmol/L (153 mg/dL), and 32.4 mmol/L (583.2 mg/dL). Compared with 5 mmol/L (90 mg/dL), odds ratios at these glucose levels were 1.28 (95% CI 0.96, 1.69) for heart failure, 2.23 (1.03, 4.81) for arrhythmia, 1.59 (1.36, 1.86) for coagulation complications, and 2.42 (2.01, 2.92) for renal injury. For most complications, a modifying effect of age was observed, with higher odds of complications at higher glucose levels for patients age <69 years. Preexisting diabetes status had a similar modifying effect on odds of complications, but evidence was strongest for renal injury, cardiac ischemia, and any cardiovascular/renal complication. CONCLUSIONS: Increased odds of cardiovascular or renal complications were observed for admission glucose levels indicative of both hypo- and hyperglycemia. Admission glucose could be used as a marker for risk stratification of high-risk patients. Further research should evaluate interventions to optimize admission glucose on improving COVID-19 outcomes