Medium-term performance and maintenance of SUDS:a case-study of Hopwood Park Motorway Service Area, UK

One of the main barriers to implementing SUDS is concern about performance and maintenance costs since there are few well-documented case-studies. This paper summarizes studies conducted between 2000 and 2008 of the performance and maintenance of four SUDS management trains constructed in 1999 at the Hopwood Park Motorway Service Area, central England. Assessments were made of the wildlife value and sedimentation in the SUDS ponds, the hydraulic performance of the coach park management train, water quality in all management trains, and soil/sediment composition in the grass filter strip, interceptor and ponds. Maintenance procedures and costs were also reviewed. Results demonstrate the benefits of a management train approach over individual SUDS units for flow attenuation, water treatment, spillage containment and maintenance. Peak flows, pond sediment depth and contaminant concentrations in sediment and water decreased through the coach park management train. Of the 2007 annual landscape budget of £15,000 for the whole site, the maintenance costs for SUDS only accounted for £2,500 compared to £4,000 for conventional drainage structures. Furthermore, since sediment has been attenuated in the management trains, the cost of sediment removal after the recommended period of three years was only £554 and, if the design is not compromised, less frequent removal will be required in future

Rigidity analysis of HIV-1 protease

We present a rigidity analysis on a large number of X-ray crystal structures of the enzyme HIV-1 protease using the 'pebble game' algorithm of the software FIRST. We find that although the rigidity profile remains similar across a comprehensive set of high resolution structures, the profile changes significantly in the presence of an inhibitor. Our study shows that the action of the inhibitors is to restrict the flexibility of the beta-hairpin flaps which allow access to the active site. The results are discussed in the context of full molecular dynamics simulations as well as data from NMR experiments.Comment: 4 pages, 3 figures. Conference proceedings for CMMP conference 2010 which was held at the University of Warwic

Evaluation of the pathways of tropospheric nitrophenol formation using a multiphase model

International audiencePhenols are a major class of volatile organic compounds (VOC) whose reaction within, and partitioning between, the gas and liquid phases affects their lifetime within the atmosphere, the local oxidising capacity, and the extent of production of nitrophenols, which are toxic chemicals. In this work, a zero-dimension box model was constructed to quantify the relative nitration pathways, and partitioning into the liquid phase, of mono-aromatic compounds in order to help elucidate the formation pathways of 2- and 4-nitrophenol in the troposphere. The liquid phase contributed significantly to the production of nitrophenols for liquid water content (Lc) values exceeding 3×10-9, and for a range of assumed liquid droplet diameter, even though the resultant equilibrium partitioning to the liquid phase was much lower. For example, in a ''typical'' model scenario, with Lc=3×10-7, 58% of nitrophenol production occurred in the liquid phase but only 2% of nitrophenol remained there, i.e. a significant proportion of nitrophenol observed in the gas phase may actually be produced via the liquid phase. The importance of the liquid phase was enhanced at lower temperatures, by a factor ~1.5?2 at 278 K cf. 298 K. The model showed that nitrophenol production was particularly sensitive to the values of the rate coefficients for the liquid phase reactions between phenol and OH or NO3 reactions, but insensitive to the rate coefficient for the reaction between benzene and OH, thus identifying where further experimental data are required

Believing in Multiple Equilibria

If agents have common priors concerning the probability with which equilibrium is selected, they have an incentive to trade beforehand. If their trading process satisfies a certain notion of individual rationality, these trades will reduce and ultimately remove all uncertainty concerning equilibrium selection. In this sense, multiple equilibria engender institutions which can uniquely determine equilibrium

The effects of arthritis gloves on hand pain in people with rheumatoid or inflammatory arthritis : a randomised controlled trial (A-GLOVES TRIAL)

Background: Arthritis (compression) gloves are commonly provided to people with rheumatoid arthritis (RA) and undifferentiated inflammatory arthritis (IA) in the UK health service. These apply pressure and warmth to relieve hand pain, stiffness and improve hand function. A systematic review identified little evidence to support their use.[1] Objectives: This randomised controlled trial tested effectiveness and cost-effectiveness of mid-finger length compression (intervention) gloves (20% Lycra: commonest glove model provided) with control gloves (i.e. oedema gloves: 11% Lycra: fitted at least one size too big) in people with RA and IA. Methods: Both gloves, which had similar thermal qualities although the control gloves did not provide compression, were provided by rheumatology occupational therapists, following training.[2] Participants were also given brief advice on hand exercise and joint protection. Adults with RA/IA and persistent hand pain were randomised 1:1 to the two glove types, stratified by disease modifying anti-rheumatic drug (DMARD) change in previous 12 weeks. The primary outcome was dominant hand pain on activity Visual Analogue Scale (VAS:0–10); other outcomes included night hand pain, hand stiffness (both 0–10 VAS); Measure of Activity Performance Hand (MAP-HAND: 0–3). Multiple linear regression was undertaken to estimate the effect of group allocation on hand pain during activity, adjusting for the stratification variable and baseline values. Cost-effectiveness used individual patient level costs (intervention plus healthcare utilisation) and health benefit data (EQ-5D) to calculate costs and QALYs. Results: 206 participants were randomised (103 to each glove type): median age 59 years [IQR 51,67]; women:166 (81%); mean disease duration: 8.2 (SD 9.5) years; employed:76 (37%); right hand dominant:185 (90%). Of these, 163 (79%) completed 12 week follow-up questionnaires. Both groups reported similar adherence to glove wear (mean 5.2 days/week). At 12 w, hand pain scores in both groups similarly improved: the between-groups mean difference of 0.1 was not statistically significant (95% CI: −0.47 to 0.67; p=0.72). There were no significant differences between groups on any measures, with both groups improving similarly between baseline and 12 w. 73% in both groups considered gloves beneficial. Intervention gloves had higher costs (£552 (SD £464); control £391 (SD £543) but comparable benefits to control gloves. Intervention gloves would cost £83 700 to gain one QALY and were not likely to be cost-effective. Conclusions: Compression (intervention) and loose-fitting arthritis (control) gloves had similar effects on hand pain, stiffness and function. Therefore, compression is not the ‘active ingredient’ in arthritis gloves. Loose fitting gloves providing warmth were perceived as equally effective by participants. We do not know if the therapist effect is important or whether ordinary gloves providing warmth would provide similar results. References: Hammond, et al. Clin Rehabil 2016 30:213–24. Prior, et al. Rheumatology 2017. www.abstractsonline.com/pp8/#!/4205 Acknowledgements: This project was funded by the NIHR Research for Patient Benefit Programme (PB-PG-0214–33010). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health

The routes and kinetics of trichloroacetic acid uptake and elimination in Sitka spruce (Picea sitchensis) saplings via atmospheric deposition pathways

A major flux of trichloroacetic acid (TCA) to forests is via wet deposition, but the transfer of TCA into tree foliage may occur by an above- or below-ground pathway. To investigate the routes and kinetics of TCA uptake, two groups of 10 Sitka spruce saplings (with an equivalent number of controls) were exposed to a single application of 200 μg TCA in solution, either to the soil only, or sprayed as a mist to the foliage only. The needle foliage was subsequently analysed regularly for TCA for 3 months during the growing season. Significant uptake into current year (C) needles was observed from both routes just a few days after application, providing direct evidence of an above-ground uptake route. Uptake of TCA was also observed in the previous year needle class (C+1). Kinetic modelling of the data indicated that the half-life for within-needle elimination (during the growing season) was 50±30 days. Most of the applied TCA appeared to be degraded before uptake, either in the soil, or externally on the sapling foliage

Women's breastfeeding experiences following a significant primary postpartum haemorrhage: A multicentre cohort study

<p>Abstract</p> <p>Background</p> <p>Postpartum haemorrhage (PPH) is a significant and increasing contributor to maternal mortality and morbidity. Following a PPH, women may have difficulties initiating and sustaining breastfeeding, although little has been published on this issue. The aim of this study was to describe breastfeeding experiences in a cohort of women following a significant PPH.</p> <p>Methods</p> <p>This is a descriptive study based on quantitative and qualitative data collected via questionnaires completed in the first week postpartum and at two and four months postpartum, by 206 women participating in a multicentre study of women's experiences of a significant primary postpartum haemorrhage (blood loss of 1500 mL or more in the 24 hours following childbirth, and/or a peripartum fall in haemoglobin (Hb) concentration to 7g/dL or less, or of ≥ 4g/dL).</p> <p>Results</p> <p>Among women with a significant PPH, 63% fully breastfed their babies from birth, whereas 85% said they had hoped to do so (p < 0.001). Only 52% of mothers who intended to either fully or partially breastfeed were able to give their baby the opportunity to suckle within an hour of the birth. Delays were longer in women with greater estimated blood loss and women with the longest delays in breastfeeding were less likely to initiate full breastfeeding. 70% of women with PPH of < 2000 mL were fully breastfeeding in the first postpartum week, whereas less than 50% of those with blood loss ≥ 3000 mL were able to do so. Overall, 58% of women with significant PPH were fully breastfeeding at two and 45% at four months postpartum.</p> <p>In qualitative data, three major themes were identified: 1) Difficulty initiating or sustaining breastfeeding, 2) Need for education and support; and 3) Emotional sequelae.</p> <p>Conclusions</p> <p>Following a significant PPH, women with greater blood loss are less likely to initiate and sustain full breastfeeding and this may be related, in part, to delays in initial contact with their baby as a consequence of the PPH. These findings have implications for postnatal care as these women may require greater support, education and assistance in initiating and sustaining breastfeeding. In particular, enabling the opportunity for the newborn to suckle as soon as is practicable should be encouraged.</p

Increased Risk of Infection and Mortality in Women after Cardiac Surgery Related to Allogeneic Blood Transfusion

Background: Infection and mortality rates are greater in women than in men after cardiac surgery. This study was conducted to assess whether allogeneic blood transfusion could partially account for this gender difference, as transfusion has been associated with immunomodulation. Methods: A cohort study was conducted in 380 patients at the University of Rochester Medical Center. Subjects were adult patients who underwent primary coronary artery bypass graft (CABG) surgery, primary valve replacement surgery, or both. Information was collected about blood components transfused, as well as postoperative infection, pulmonary dysfunction, and in-hospital mortality. Results: Women were more likely to receive allogeneic red blood cells (RBCs) or platelets than men (odds ratio [OR] 21.6, 95% CI 3.8, 124.2) and a greater quantity of blood than men. Patients who received allogeneic blood were 4.4 times more likely to develop an infection than those who did not (95% CI 1.5, 13.2). There was a positive linear correlation between number of units of blood received and number of days with fever (p < 0.001) and hospital length of stay (p < 0.001). This was particularly evident in patients who received four or more units of nonleukoreduced blood components. Women had a greater risk of infection (p = 0.005), pulmonary dysfunction (p = 0.005), and mortality (p = 0.007) than men during hospitalization. Conclusions: One reason for the greater mortality in women after cardiac surgery may be the increased likelihood of receiving nonleukoreduced allogeneic RBCs and platelets. Transfusion increased the risk of infection; infection, then, increased the likelihood of pulmonary dysfunction and mortality.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63383/1/jwh.2007.0397.pd