Chemistry of the Oxidant, Ferrate, Its Interaction With Specific Organics Found in Waste Water

It became obvious during this investigation that while much work has been done with ferrate (VI) chemistry, discrepancies existed in the literature and very little attention had been given possible engineering uses. This work attempted to fulfill these two needs in an exploratory manner. The preparative techniques were reviewed and mechanical improvements made in one which allowed improved yields. Essentially what was done was to enlarge and improve the filtering technique of the product and use cooler temperatures throughout the preparation. This greatly shortened the time required. Then it was learned that the addition of ethyl alcohol to the final filtrate, after product separation, produced more ferrate (VI) but of lower purity. Qualitative studies showed however, that for most situations high purity was not required. The procedure developed resulted in doubled yields and reduced time of preparation

On the effects of mass and momentum transfer from droplets impacting on steady two-dimensional rimming flow in a horizontal cylinder

Motivated by applications in aero-engines, steady two-dimensional thin-filmflow on the inside of a circular cylinder is studied when the filmsurface is subject to mass and momentum transfer from impacting droplets. Asymptotic analysis is used systematically to identify distinguished limits that incorporate these transfer effects at leading order and to provide a new mathematical model. Applying both analytical and numerical approaches to the model, a set of stable steady, two-dimensional solutions that fit within the rational framework is determined. A number of these solutions feature steep fronts and associated recirculating pools, which are undesirable in an aeroengine since oil may be stripped away from the steep fronts when there is a core flow external to the film, and recirculation may lead to oil degradation. The model, however, provides a means of investigating whether the formation of the steep fronts on the filmsurface and of internal recirculation pools can be delayed, or inhibited altogether, by designing jets to deliver prescribed distributions of oil droplets or by the judicious siting of oil sinks. Moreover, by studying pathlines, oil-residence times can be predicted and systems optimized

The Effect of Low Temperature Laundering and Detergents on the Survival of Escherichia coli and Staphylococcus aureus on Textiles Used in Healthcare Uniforms

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Aims: To determine the survival of Escherichia coli and Staphylococcus aureus on cotton and polyester and the effectiveness of low temperature laundering and detergents on the removal of microorganism from healthcare laundry. Methods and Results: Survival of E. coli and S. aureus on polyester or cotton was assessed over 3 weeks and the efficacy of a domestic wash (40°C and 60°C) and a range of detergents was also determined. Both bacteria were able to survive on cotton (5 log(10)) and polyester (0.28 log(10)) for up to 3 weeks. Laundering at 40°C resulted in a 3.5 log(10) removal of the initial 7.7 log(10) inoculum and some cross contamination to sterile fabrics (3 log(10). Increasing the temperature to 60°C resulted in the complete removal of the initial inoculum. Conclusions: This study shows that most of the microorganisms are removed at 40°C however, those cells still remaining may have the potential for further contamination to the clinical environment and patients Significance and Impact of Study: National Health Service (NHS) nurses are required to domestically launder their uniforms at 60°C to ensure safe removal of microorganisms, 33% of NHS staff questioned said they launder their uniforms at 40°C, which could potentially result in transmission of Hospital Acquired Infections (HAIs)

Reduced keratin expression in colorectal neoplasia and associated fields is reversible by diet and resection

Abstract Background Patients with adenomatous colonic polyps are at increased risk of developing further polyps suggesting field-wide alterations in cancer predisposition. The current study aimed to identify molecular alterations in the normal mucosa in the proximity of adenomatous polyps and to assess the modulating effect of butyrate, a chemopreventive compound produced by fermentation of dietary residues. Methods A cross-sectional study was undertaken in patients with adenomatous polyps: biopsy samples were taken from the adenoma, and from macroscopically normal mucosa on the contralateral wall to the adenoma and from the mid-sigmoid colon. In normal subjects biopsies were taken from the mid-sigmoid colon. Biopsies were frozen for proteomic analysis or formalin-fixed for immunohistochemistry. Proteomic analysis was undertaken using iTRAQ workflows followed by bioinformatics analyses. A second dietary fibre intervention study arm used the same endpoints and sampling strategy at the beginning and end of a high-fibre intervention. Results Key findings were that keratins 8, 18 and 19 were reduced in expression level with progressive proximity to the lesion. Lesional tissue exhibited multiple K8 immunoreactive bands and overall reduced levels of keratin. Biopsies from normal subjects with low faecal butyrate also showed depressed keratin expression. Resection of the lesion and elevation of dietary fibre intake both appeared to restore keratin expression level. Conclusion Changes in keratin expression associate with progression towards neoplasia, but remain modifiable risk factors. Dietary strategies may improve secondary chemoprevention. Trial registration number ISRCTN90852168. Keywords: ADENOMA, BUTYRATE, CYTOKERATINS, DIETARY FIBR

Immunophoretic rapid diagnostic tests as a source of immunoglobulins for estimating malaria sero-prevalence and transmission intensity

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background Sero-epidemiological methods are being developed as a tool for rapid assessment of malaria transmission intensity. Simple blood collection methods for use in field settings will make this more feasible. This paper describes validation of such a method, by analysing immunoglobulins from blood retained within immunophoretic rapid diagnostic tests (RDTs) for Plasmodium falciparum. RDTs are now widely used for the diagnosis of malaria and estimation of parasite rates, and this method represents a further use for these devices in malaria control. Methods Immunoglobulins eluted from RDTs, designed to detect parasite histidine rich protein-2 (HRP-2), were analysed by indirect ELISA for IgG recognizing the P. falciparum blood stage antigens merozoite surface protein-119 (MSP-119) and apical membrane antigen-1 (AMA-1). Optimal storage conditions for RDTs were evaluated by comparing antibody responses from RDTs stored in dry or humid conditions at 4°C or at ambient temperature (with or without air-conditioning) for 7, 31 or 70 days. Antibody levels estimated using 3,700 RDT samples from attendees at health facilities in North-eastern Tanzania were compared with contemporaneously collected filter paper blood spots (FPBS) and used to estimate seroconversion rates. Results Storage of RDTs at 4°C was optimal for immunoglobulin recovery but short-term storage at ambient temperatures did not substantially affect anti-malarial IgG levels. Results from RDTs were comparable with those from FPBSs, for both antigens. RDT-generated titres tended to be slightly higher than those generated from FPBSs, possibly due to greater recovery of immunoglobulins from RDTs compared to filter paper. Importantly, however, RDT-based seroconversion rates, and hence serological estimates of malaria transmission intensity, agreed closely with those from FPBSs. Conclusion RDTs represent a practical option for collecting blood for sero-epidemiological surveys, with potential cost and logistical advantages over filter paper and other blood collection methods. RDT-based seroepidemiology can be incorporated into routine monitoring of malaria endemicity, providing information to supplement parasite prevalence rates and generating rapid, robust assessment of malaria transmission intensity at minimal extra cost.Published versio

Basic Subsistence Needs and Overall Health Among Human Immunodeficiency Virus-infected Homeless and Unstably Housed Women

Some gender differences in the progression of human immunodeficiency virus (HIV) infection have been attributed to delayed treatment among women and the social context of poverty. Recent economic difficulties have led to multiple service cuts, highlighting the need to identify factors with the most influence on health in order to prioritize scarce resources. The aim of this study was to empirically rank factors that longitudinally impact the health status of HIV-infected homeless and unstably housed women. Study participants were recruited between 2002 and 2008 from community-based venues in San Francisco, California, and followed over time; marginal structural models and targeted variable importance were used to rank factors by their influence. In adjusted analysis, the factor with the strongest effect on overall mental health was unmet subsistence needs (i.e., food, hygiene, and shelter needs), followed by poor adherence to antiretroviral therapy, not having a close friend, and the use of crack cocaine. Factors with the strongest effects on physical health and gynecologic symptoms followed similar patterns. Within this population, an inability to meet basic subsistence needs has at least as much of an effect on overall health as adherence to antiretroviral therapy, suggesting that advances in HIV medicine will not fully benefit indigent women until their subsistence needs are met

Osteochondral Allograft Transplantation in Professional Athletes: Rehabilitation and Return to Play

For the treatment of large chondral and osteochondral defects of the knee, osteochondral allograft transplantation (OCA) is an effective solution with relatively high rates of return to sport. In professional athletes, rehabilitation following OCA is a critical component of the process of returning the athlete to full sports activity and requires a multidisciplinary team approach with frequent communication between the surgical and rehabilitation teams (physical therapists, athletic trainers, coaching staff). In this review, we describe our five-phase approach to progressive rehabilitation of the professional athlete after OCA, which takes into account the biological processes of healing and optimization of neuromuscular function required for the demands of elite-level sport. The principles of early range of motion, proper progression through the kinetic chain, avoidance of pain and effusion, optimization of movement, regimen individuation, and integration of sports-specific activities underlie proper recovery

Educational Interventions to Improve Advance Care Planning Discussions, Documentation and Billing

Background/Objectives: To determine the impact of educational interventions, clinic workflow redesign, and quality improvement coaching on the frequency of advance care planning (ACP) activities for patients over the age of 65. Design: Nonrandomized before-and-after study. Setting: 13 ambulatory care clinics with 81 primary care providers in eastern and central North Carolina. Participants: Patients across 13 primary care clinics staffed by 66 physicians, 8 physician assistants and 7 family nurse practitioners. Interventions: Interprofessional, interactive ACP training for the entire interprofessional team and quality improvement project management with an emphasis on workflow redesign. Measurements: From July 2017 through June 2018—number of ACP discussions, number of written ACP documents incorporated into the electronic medical record (EMR), number of ACP encounters billed. Results: Following the interventions, healthcare providers were more than twice as likely to conduct ACP discussions with their patients. Patients were 1.4 times more likely to have an ACP document included in their electronic medical record. Providers were significantly (p < 0.05) more likely to bill for an ACP encounter in only one clinic. Conclusions: Implementing ACP education for all clinic staff, planning for workflow changes to involve the entire interprofessional team and supporting ACP activities with quality improvement coaching leads to statistically significant improvements in the frequency of ACP discussions, the number of ACP documents included in the electronic medical record and number of ACP encounters billed

Individual freedom versus collective responsibility: too many rights make a wrong?

Individuals might reasonably expect the freedom to make their own decisions regarding their health. However, what happens when an individual's wishes conflict with what is in that individual's best interests? How far should an individual's rights be restricted for his or her own benefit? Similarly, what limitations should be placed on an individual's behaviour when that person's wishes go against what is good for the population in general? Here we discuss the issues that can arise when the rights of individuals conflict with individual and population benefits in relation to infectious diseases