Formulation of Biocides Increases Antimicrobial Potency and Mitigates the Enrichment of Non-Susceptible Bacteria in Multi-Species Biofilms

The current investigation aimed to generate data to inform the development of risk-assessments of biocide usage. Stabilised domestic drain biofilm microcosms were exposed daily over six months to increasing concentrations (0.01 to 1 %) of the biocide benzalkonium chloride in simple aqueous solution (BAC-s) or in a complex formulation (BAC-f) representative of a domestic cleaning agent. Biofilms were analysed by culture, differentiating by bacterial functional group and by BAC or antibiotic susceptibility. Bacterial isolates were identified by 16S rRNA sequencing and changes in biofilm composition were assessed by high throughput sequencing. Exposure to BAC-f resulted in significantly larger reductions in viable bacteria than BAC-s, whilst bacterial diversity greatly decreased during exposure to both BAC-s and BAC-f, as evidenced by sequencing and viable counts. Increases in the abundance of bacteria exhibiting reduced antibiotic or BAC susceptibility following exposure to BAC at 0.1 % were significantly greater for BAC-s than BAC-f. Bacteria with reduced BAC and antibiotic susceptibility were generally suppressed by higher BAC concentrations and formulation significantly enhanced this effect. Significant decreases in the antimicrobial susceptibility of bacteria isolated from the systems before and after long-term BAC exposure were not detected. In summary, dose-dependent suppression of bacterial viability by BAC was enhanced by formulation. Biocide exposure decreased bacterial diversity and transiently enriched organisms with lower antimicrobial susceptibility that were subsequently supressed by exposure to 1% BAC-f, the concentration most closely reflecting deployment in formulated products

Aerosol particle morphology of residential coal combustion smoke

A study carried out at the University of Pretoria characterised aerosol particle morphology of residential coal combustion smoke. The general approach in this study was on individual particle conglomerations because the radiative, environmental, and health effects of particles may depend on specific properties of individual particles rather than on the averaged bulk composition properties. A novel, miniature denuder system, developed and tested at the University of Pretoria, was used to capture particle emissions from the coal fires. The denuder consists of two silicone rubber traps (for gas phase semi-volatile organic compound monitoring) in series separated by a quartz fibre filter (for particle collection). The denuders were positioned 1 m away from the fire and were connected to pumps that sampled ~5 litres of air over a 10 min sampling interval. A JSM 5800LV Scanning Electron Microscope with a Thermo Scientific EDS was used to analyse the structure and morphology of different aerosol samples from the quartz fibre filters. Eight samples from the different fire lighting methods were selected for SEM analysis. The punched samples were sputter coated with gold for ~15 minutes using a K550 Emitech Sputter Coater. Results show that apart from the fine and ultra-fine particles, coal smoke from domestic burning also contains aerosols greater than 5 μm in diameter. Consequently, we describe the potential for generation of ‘giant’ carbonaceous soot conglomerates with outer diameters of 5 to 100 μm. However, the exact mechanism for formation of such large soot conglomerates remains to be determined. We also describe the presence of spherules and solid ‘melted toffee’ irregular surfaces. Circumstantial evidence is used to postulate and discuss the possible modes of formation in terms of condensation, and partial melting. This work provides a description of the modes of formation and transformation of conglomerates originating from low temperature (<8000C) coal combustion.The University of Johannesburg for financial support through a URC/Faculty of Science grant to the SeTAR Centre and a grant from the Global Alliance for Clean Cookstoves (GACC) to the SeTAR Centre as a Regional Stove Testing and Development Centre.http://www.cleanairjournal.org.zaam201

Influence of fire-ignition methods and stove ventilation rates on gaseous and particle emissions from residential coal braziers

Despite extensive electrification of low-income residential areas on the South African Highveld, extensive use is still made of wood and coal as domestic fuels, particularly for winter space heating. In informal settlements characterised by poverty and lacking electrification, coal is combusted in non-standardised, inefficient and polluting metal braziers, colloquially known as imbaulas. Copious emissions from domestic coal fires result in elevated household and ambient air pollution levels well above national air quality limits. Despite the severity of this pollution as a public health issue, emissions data from residential coal-burning braziers are still scarce. Consequently, there is a need to evaluate the emission characteristics of these devices. In this paper, we report on controlled combustion experiments carried out to investigate systematically influences of fire-ignition methods and stove ventilation rates on gaseous and condensed matter (smoke) emissions from informal residential coal combustion braziers. Two methods of stove ignition—conventional bottom-lit updraft (BLUD) and the top-lit updraft (TLUD) (colloquially known as the Basa njengo Magogo) were investigated. Emission factors (EFs) were found to be dependent on fire ignition method and stove ventilation rates. The top-lit ignition method reduces PM10/PM2.5 by 76% to 80% compared to the BLUD method. Carbon monoxide emissions do not change significantly with the ignition method. Pollutant emissions from normal combustion in high ventilation conditions were low compared to pollutants emitted when an oxygen deficient atmosphere was created under low ventilation conditions. High stove ventilation rates resulted in a 50% reduction in PM10/PM2.5 emissions compared to the low ventilation rates. Emissions of gaseous and particulate matter from incomplete combustion can be minimised by design optimisation of the braziers. Ideally, the emissions of condensed matter particles (which form the bulk of emitted particles in residential coal fires) can be reduced through good mixing of emitted gases and air, and by ensuring a long residence time in the high temperature oxygen rich post combustion zone, to allow for complete oxidation. This study is significant in that it presents the first systematic and comprehensive study of factors affecting emissions from coal braziers

Structure of a shear-line polar low

During March 2013 a series of polar lows originated in a high-vorticity (>10−3 s−1) shear zone that was associated with a prolonged marine cold-air outbreak over the Norwegian Sea. A detailed analysis of one shear-line polar low at the leading edge of the outbreak is presented using comprehensive observations from a well-instrumented aircraft, dropsondes, scatterometer and CloudSat data; and numerical modelling output from a convection-resolving configuration of the Met Office Unified Model. The maximum low-level wind gradient across the shear line was 25 m s−1 over 50 km. High windsto the north and west were within the cold-air mass and were associated with large surface turbulent heat fluxes and convective clouds. Low wind speed to the south and east of the shear line were associated with low heat fluxes and a clear ‘eye’ in the polarlow. Shear-line meso-γ-scale instabilities merging into the polar low appeared important to its structure and development. The model captured the shear line and the polar low structure very well — in particular the strength of the horizontal shear and the mesoscale thermodynamic fields.The spatialstructure of convective cloud bands around the polar low wassimulated reasonably well, but the modelsignificantly underestimated the liquid water content and height of the cloud layers compared to the observations. Shear-line polar lows are relatively common, however this case is arguably the first to be examined with a wide range of in-situ and remote observations allied with numerical model output

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis.

BACKGROUND: Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES: To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN: For effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views. PARTICIPANTS: Children and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months. INTERVENTIONS: Any psychosocial intervention provided in any setting aiming to address the consequences of maltreatment. MAIN OUTCOME MEASURES: Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability. METHODS: Young Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible. RESULTS: We identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to -1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself. CONCLUSIONS: It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions. LIMITATIONS: Studies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses. FUTURE WORK: Studies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes. STUDY REGISTRATION: This study is registered as PROSPERO CRD42013003889. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Tailoring therapies—improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015

The 14th St Gallen International Breast Cancer Conference (2015) reviewed new evidence on locoregional and systemic therapies for early breast cancer. This manuscript presents news and progress since the 2013 meeting, provides expert opinion on almost 200 questions posed to Consensus Panel members, and summarizes treatment-oriented classification of subgroups and treatment recommendation