Water Sensitive Urban Design retrofits in Copenhagen - 40% to the sewer, 60% to the city

Water Sensitive Urban Design (WSUD) is emerging in Denmark. This interdisciplinary desk study investigated the options for WSUD retrofitting in a 15 km(2) combined sewer catchment area in Copenhagen. The study was developed in collaboration with the City of Copenhagen and its water utility, and involved researchers representing hydrogeology, sewer hydraulics, environmental chemistry/economics/engineering, landscape architecture and urban planning. The resulting catchment strategy suggests the implementation of five sub-strategies. First, disconnection is focused within sites that are relatively easy to disconnect, due to stormwater quality, soil conditions, stakeholder issues, and the provision of unbuilt sites. Second, stormwater runoff is infiltrated in areas with relatively deep groundwater levels at a ratio that doesn't create a critical rise in the groundwater table to the surface. Third, neighbourhoods located near low-lying streams and public parks are disconnected from the sewer system and the sloping terrain is utilised to convey runoff. Fourth, the promotion of coherent blue and green wedges in the city is linked with WSUD retrofits and urban climate-proofing. Fifth, WSUD is implemented with delayed and regulated overflows to the sewer system. The results are partially adopted by the City of Copenhagen and currently under pilot testing.

Micropollutants in stormwater runoff and combined sewer overflow in the Copenhagen area, Denmark

Stormwater runoff contains a broad range of micropollutants. In Europe a number of these substances are regulated through the Water Framework Directive, which establishes Environmental Quality Standards (EQSs) for surface waters. Knowledge about discharge of these substances through stormwater runoff and combined sewer overflows (CSOs) is essential to ensure compliance with the EQSs. Results from a screening campaign including more than 50 substances at four stormwater discharge locations and one CSO in Copenhagen are reported here. Heavy metal concentrations were detected at levels similar to earlier findings, e.g., with copper found at concentrations up to 13 times greater than the Danish standard for surface waters. The concentration of polyaromatic hydrocarbons (PAHs) exceeded the EQSs by factors up to 500 times for stormwater and 2,000 times for the CSO. Glyphosate was found in all samples whilst diuron, isoproturon, terbutylazine and MCPA were found only in some of the samples. Diethylhexylphthalate (DEHP) was also found at all five locations in concentrations exceeding the EQS. The results give a valuable background for designing further monitoring programmes focusing on the chemical status of surface waters in urban areas.

The acute phase response in the rodent

In the rodent, the general response to acute inflammation and tissue damage is characterized by a complex rearrangement in the pattern of concentrations of proteins in the plasma leading to an increase in the sedimentation rate of erythrocytes, an increase in leukocyte concentration in the bloodstream, and a decrease in the hematocrit. Body temperature changes only slightly or not at all. The reasons for the change in plasma concentrations of proteins are changes in their rates of synthesis in the liver. Degradation of plasma proteins is not affected. The details of the acute phase response evolved in the interaction of species with their environment. Therefore, it is not surprising to find differences in the details of the acute phase response among species. For example, alpha 2-macroglobulin is a strongly positive acute phase reactant in the rat, but not in the mouse; C-reactive protein is a strongly positive acute phase protein in the mouse, but is not found in the rat. An inducible acute phase cysteine proteinase inhibitor system, which has evolved from a primordial kininogen gene, has been observed so far only in the rat. The changes in the synthesis rates of acute phase proteins during inflammation are closely reflected by corresponding changes in intracellular mRNA levels. In the liver, the capacity to induce the acute phase pattern of synthesis and secretion of plasma proteins probably develops around birth. Changes in mRNA levels are brought about by changes in transcription rates or by changes in mRNA stability. Kinetics of mRNA changes during the acute phase response differ for individual proteins. The main signal compound for eliciting the acute phase response in liver seems to be interleukin-6/interferon-beta 2/hepatocyte stimulating factor, whereas interleukin-1 leads to typical acute phase changes in mRNA levels only for alpha 1-acid glycoprotein, albumin, and transthyretin. Plasma protein genes are expressed in various extrahepatic tissues, such as the choroid plexus, the yolk sac, the placenta, the seminal vesicles, and other sites. All these tissues are involved in maintaining protein homeostasis in associated extracellular compartments by synthesis and secretion of proteins. Synthesis and secretion of plasma proteins in paracompartmental organs other than the liver is not influenced by the acute phase stimuli.

Reduction of optic nerve fibers in patients with Alzheimer disease identified by laser imaging

In this case-control study, we compared the optic nerves (ONs) by clinical examination and scanning laser ophthalmoscopy (SLO) of 40 patients with Alzheimer disease (AD) and 50 controls. There was a reduction in the number of ON fibers in patients with AD, with a threefold greater odds ratio for a larger optic cup-to-disc ratio in patients with AD.

The extended role of the nurse--opportunity or threat?

Nursing practice is undergoing changes that are both exciting and controversial. The UKCC Scope of Professional Practice has encouraged nurses to re-evaluate their practice and, as a result, nurses from various fields have expanded their roles to meet the changing needs of patients and the profession. Published evidence shows that nurses can be as effective as doctors within these expanded roles, but that there is a danger that gender issues will cloud the debate because of the assumption that all nurses are female and all doctors are male. This problem is especially evident when female nurses perform an extended role involving male patients, although female doctors are in a similar position and work with the same patients without undue comment. The roles of doctors and nurses should complement each other, and all practitioners should work for the benefit of patients in their care, rather than defending traditional roles and hierarchy. There is confusion surrounding accountability of nurses who work in an extended role between the medical and the nursing profession, and both the Royal College of Nursing and the British Medical Association need to clarify the situation. This article looks at the arguments for and against the extended role of the nurse specialist and discusses current opinions within the nursing and medical fields. The article also describes how nurses at Midland Fertility Services have successfully extended their role to encompass ultra-sound-guided oocyte retrieval and surgical sperm recovery.

In vitro fertilization. The Jamaican experience

In June 2000, twenty-eight infertile couples were treated by in vitro fertilization and embryo transfer at our initial assisted reproduction programme carried out in conjunction with Midland Fertility Services, Aldridge, Birmingham, England. A pre-requisite for treatment was that on day 3 of the menstrual cycle the levels of follicle stimulating hormone (FSH) and oestradiol (E2) should be < 10 i mu/l and < 100 pg/ml respectively in the female partner. The ages of the women ranged from 26 to 42 years with a mean age of 35.5 years. Down regulation was carried out by using buserelin acetate 0.5 microgram subcutaneously from day 21 of the cycle for 21 days. This process was completed when the ovaries and pituitary gland were quiescent and the endometrial thickness < 4 mm in diameter. On completion of down regulation the gonadotrophin hormone, pergonal (dosage of 150-450 units) was used for ovarian hyperstimulation. A total of 294 oocytes (mean of 10.5, range 2-45) were retrieved of which 138 were fertilized (mean of 4.9, range of 0-28). Twenty-four patients each received a mean of two embryos. Five patients (20.8%) had positive pregnancy tests. Three patients (0.1%) developed ovarian hyperstimulation syndrome (OHSS), one had the severe, and two, the mild form of the syndrome. All three cases were treated successfully. The success at the initial IVF controlled ovarian hyperstimulation augers well for the future of infertile couples seeking treatment at the Fertility Management Unit, The University of the West Indies, Jamaica.

Should equine athletes commence training during skeletal development?: changes in tendon matrix associated with development, ageing, function and exercise

In human athletes, conditioning, training and competition are commenced before skeletal maturity. Yet in equine athletics, racing of young (age 2 years) horses remains contentious. Tendon injury persists as major causes of wastage in equine athletes. Minimising injury and associated welfare issues could involve a radical approach to the timing and implementation of conditioning and training. Tendons were examined from Thoroughbreds, Dutch Warmblood foals, working horses and also a group of wild horses to evaluate effects of age, function and exercise. Gross mechanical properties did not differ significantly with age or exercise, but showed a high variance within each group. Mechanical properties of tendon tissue showed significant differences as a function of age and location. The collagen fibril crimp angle and length showed a regional reduction in the central core with exercise and age, with a synergistic effect. Regional differences in collagen fibril diameter were seen in long-term exercised older horses, but not in short-term exercised, or younger, horses. The higher proportion of small fibrils in the central region of the long-term exercised horses did not correlate with new collagen formation and therefore appear to result from disassembly of the larger diameter fibrils. Fibril diameter distributions were influenced by exercise regimens in the growing foal. Changes in molecular composition occurred in longer-term exercise and older horses, in the centre of the tendon, with higher levels of type III collagen and changes in glycosaminoglycan (GAG) content. Cartilage Oligomeric Matrix Protein (COMP) levels also appear to be modulated by age, function and superimposition of exercise. These changes were all exacerbated with age and exercise, suggesting appropriate exercise in young horses may lead to a lower incidence of injury than in older horses. An hypothesis is advanced that immature tendon can respond to exercise while mature tendon has limited, if any, ability to do so. These findings support potentially controversial earlier conditioning and racing of younger, rather than older, equine athletes.

O-GLYCBASE version 4.0: a revised database of O-glycosylated proteins

O-GLYCBASE is a database of glycoproteins with O-linked glycosylation sites. Entries with at least one experimentally verified O-glycosylation site have been compiled from protein sequence databases and literature. Each entry contains information about the glycan involved, the species, sequence, a literature reference and http-linked cross-references to other databases. Version 4.0 contains 179 protein entries, an approximate 15% increase over the last version. Sequence logos representing the acceptor specificity patterns for GalNAc, GlcNAc, mannosyl and xylosyl transferases are shown. The O-GLYCBASE database is available through the WWW at http://www.cbs.dtu.dk/databases/OGLYCBASE/

Contamination of embryo transfer catheter and treatment outcome in in vitro fertilization

PURPOSE

The effect of embryo transfer (ET) catheter contamination with mucus and/or blood on treatment outcome in an in vitro fertilization (IVF) program was evaluated.

METHODS

One thousand four ET procedures in 877 patients having conventional IVF in the long (1189 cycle) and short (15 cycles) protocol were analyzed to determine the impact of catheter contamination on the incidence of retained embryos and the clinical pregnancy rate.

RESULTS

Catheter contamination with mucus and/or blood is a feature of difficult ET. Embryos were significantly more likely to be retained when the transfer catheter was contaminated with mucus (17.8 versus 3.3%) or blood (12 versus 3.3%). When the catheter was contaminated and an embryo(s) was retained and immediately retransferred, the pregnancy rate was not compromised. The pregnancy rate was significantly reduced when the ET catheter was contaminated with blood (15.5 versus 27.1%; P = 0.002), but no embryo was retained in the catheter set.

CONCLUSIONS

Catheter contamination compromises the treatment outcome in IVF only when there is no associated retained embryo(s). As increased vigilance in searching for extruded embryos may not be practical, we suggest that cervical mucus should be routinely aspirated and ET performed as atraumatically as possible.

Multiple attempts at embryo transfer: does this affect in-vitro fertilization treatment outcome?

In this study, we retrospectively analysed data from 877 patients who had 1204 embryo transfer procedures following in-vitro fertilization (IVF) at Midland Fertility Services, UK, between January 1991 and December 1995 to investigate the factors contributing to failure of embryo transfer at first attempt and the impact of immediate retransfer of retained embryos on the treatment outcome. Embryos were significantly more likely to be retained when the embryo transfer catheter was contaminated with mucus (3.3 versus 17.8%, P = 0.000001) or blood (3.3 versus 12%, P = 0.00001) and when the transfer procedure was difficult compared with when it was easy (20.3 versus 0.8%, P = 0.00001). There was no significant difference in the clinical pregnancy rate between those who had all their embryos transferred at the first attempt (24.7%) and those who required more than one attempt (23.2%). The types of embryo transfer catheter used in the unit did not show any difference in terms of embryo retention. Although we recommend aspiration of cervical mucus in order to reduce the rate of retained embryos, there is no evidence from our study to suggest that pregnancy rate is compromised when embryos are retained, provided they are discovered and immediately retransferred into the uterine cavity. Immediate retransfer is more convenient to the patients and reduces the laboratory workload without compromising the treatment outcome.

Interaction of apomorphine and amantadine with ethanol in men

Male moderate drinkers (n = 12) drank ethanol (0.8 g/kg) and then ingested one of the following: apomorphine (5 mg), amantadine (200 mg), or placebo. Subjects were tested on a battery of physiological and behavioral measures using a double-blind, within-subjects, crossover design. Postethanol ingestion of apomorphine significantly increased ethanol's effect on 3 out of the 8 measures employed (divided attention, objective and subjective inebriation ratings) without significantly altering blood ethanol concentrations or the rate of blood ethanol decline. There was no indication that apomorphine antagonized ethanol's effects. In contrast to reports indicating that amantadine antagonized ethanol depression in rodents, amantadine did not significantly alter the degree of ethanol intoxication in humans. The increase in intoxication induced by apomorphine supports suggestions that dopaminergic systems may be involved in mediating ethanol intoxication and that the sobering effect of catecholamine-augmenting drugs results from noradrenergic, rather than combined noradrenergic and dopaminergic, stimulation. Further studies are necessary to elucidate the role of pre- and postsynaptic dopaminergic receptors in mediating these effects.

A review of psychoactive drug-involved deaths in nine major United States cities

Detailed psychosocial and biomedical data were collected in 2,000 psychoactive drug-involved deaths occurring from 1972 through 1974 in nine large cities in the United States. The cases were selected representatively by the medical examiners or coroners in each city. Also, proficiency studies were carried out of the toxicological laboratories associated with these nine cooperating data collection centers. There were striking intercity psychosocial and biomedical differences in these psychoactive drug-involved deaths. These differences were based not simply in demographic regional population differences but also on the kinds of psychoactive drugs used as well as the role of the drug in contributing to death and whether the death was a result of an accident, suicide, homicide, or unknown intent. Also, a lack of uniformity was demonstrated in the quality control of the toxicological laboratories associated with the offices of these nine medical examiners or coroners, which suggests varying degrees of accuracy in resulting medicolegal diagnoses. Hence national programs of drug abuse deterrence or prevention and treatment should deal specifically with the variety of psychoactive drug-involved deaths occurring in different urban areas rather than approaching these problems globally as if they were uniform and homogeneous, and our toxicological proficiency studies accentuate the importance of mandatory quality control studies for all toxicological laboratories in the United States.

Normal vaginal axis

Vaginograms were done on 20 normal women to determine the exact axis, length, and direction of the normal vagina. The vagina was found to be a curved organ with a distinct upper portion that has an axis between the third and fourth sacral vetebrae. The importance of restoring this axis in pelvic surgery, especially for vault prolapse, is discussed.

Reversal of ethanol intoxication in humans: an assessment of the efficacy of L-dopa, aminophylline, and ephedrine

The effect of postethanol treatment with L-Dopa, aminophylline and/or ephedrine was investigated. In one experiment, healthy, male, moderate drinkers ingested ethanol (0.8 g/kg) and then either L-Dopa (1.5 g), or placebo. In a second experiment, subjects ingested ethanol followed by aminophylline (200 mg), ephedrine (50 mg), aminophylline (200 mg) plus ephedrine (50 mg), or placebo. Double-blind, within-subjects, crossover designs were employed. Treatment with L-Dopa significantly reduced ethanol's effect on the electroencephalogram, motor coordination, and divided attention performance (t-test for paired data). Treatment with aminophylline and/or ephedrine also significantly reduced ethanol's effects on the electroencephalogram and motor coordination. The ethanol-antagonism may result from central noradrenergic stimulation.

Reversal of ethanol intoxications in humans: an assessment of the efficacy of propranolol

The effect of post-ethanol ingestion of a single dose of propranolol on acute intoxication was studied in 13 healthy male volunteers. A within subjects, double-blind, crossover design was employed. Each subject participated in two experimental sessions. In each session, subjects took a battery of tests under three conditions: Sober, Alcohol (0.8 g/kg) and Alcohol (1.1 g/kg) + Pill, in that order. The pill contained propranolol (40 mg) in one session and placebo in the other. Ethanol significantly reduced motor coordination, memory and divided attention performance and altered mood scores. Propranolol significantly increased ethanol's effects on divided attention, inebriation ratings and the electroencephalogram without significantly altering blood alcohol concentrations. There was no indication that propranolol antagonized any of ethanol's effects. These results agree with studies indicating that ethanol's effects are increased by a reduction in the functional capacity of central catecholamine systems. It is suggested that central catecholamine-stimulating drugs may reverse some of ethanol's effects.

A comparison of suicide and non-suicide deaths involving psychotropic drugs in four major U.S. cities

By use of a standard reporting form, extensive data were gathered on 651 deaths involving psychotropic drugs and recorded with the Coroner's or Medical Examiner's Office in each of four major U.S. cities. Thirty-six per cent of these deaths were listed as "Definitely Suicide" and 44% were listed as "Non-Suicide." A comparison was made of the age, sex, race, occupational category, and type of drug involved for each of these two groups, by city. In general, the Suicide group tended to be older, from higher occupational levels, and more often female. Blacks were under-represented among the Suicides but over-represented among the Non-Suicides. Suicide deaths tended to be associated with barbiturates, analgesics, and/or sedatives, while the Non-Suicides usually died from an accidental abuse of narcotics, usually heroin. These findings tended to be similar for each city, although some inter-city differences were noted.

Analysis of results of toxicological examinations performed by coroners' or medical examiners' laboratories in 2000 drug-involved deaths in nine major U. S. cities

Data were collected on 2000 deaths in which psychoactive drugs were involved. The data were submitted by medical examiners or coroners in nine U. S. cities from their case files. The 2000 cases comprise a representative sample from each of these cities of deaths from psychoactive drugs between 1972 through 1974. This report details inter-city differences in methods and practices of the toxicological examination as well as the type and numbers of drugs reported. Even when the same analytical method was used in various cities, there were differences in extraction solvent and extraction pH. Of the 3909 drugs detected, 2945 were quantitated; the number of drugs quantitatively measured per case studied ranged from a low of 0.82 for New York to a high of 2.20 for Washington, D.C. The number of different drugs quantitatively measured varied from 16 for New York to 30 for San Francisco; however, New York qualitatively assayed for the presence of a total of 25 drugs. The number and type of drugs found per case varied. Methadone, for example, was found in 60% of the cases reported by New York and in 49% of the cases from Washington, D.C., but in only about 10% of cases reported by Philadelphia, Dallas, Miami, and San Francisco, and in less than 1% of Los Angeles and Cleveland cases; it was not reported by Chicago. Phenmetrazine-caused deaths were reported only by Dallas (one case) and Washington, D.C. (29 cases). From the data as a whole, information is presented for 33 drugs as to the concentration in physiological tissues and fluids. Analysis of single psychoactive drug cases and single-drug-plus-ethanol cases shows that, in the presence of ethanol, the toxic blood concentration of imipramine, amytriptyline, meprobamate, thioridazine, morphine, propoxyphene, methaqualone, and all barbiturates was decreased by an average of 50%.

Analysis of results of toxicological examinations performed by coroners' or medical examiners' laboratories in 2000 drug-involved deaths in nine major U. S. cities

Data were collected on 2000 deaths in which psychoactive drugs were involved. The data were submitted by medical examiners or coroners in nine U. S. cities from their case files. The 2000 cases comprise a representative sample from each of these cities of deaths from psychoactive drugs between 1972 through 1974. This report details inter-city differences in methods and practices of the toxicological examination as well as the type and numbers of drugs reported. Even when the same analytical method was used in various cities, there were differences in extraction solvent and extraction pH. Of the 3909 drugs detected, 2945 were quantitated; the number of drugs quantitatively measured per case studied ranged from a low of 0.82 for New York to a high of 2.20 for Washington, D.C. The number of different drugs quantitatively measured varied from 16 for New York to 30 for San Francisco; however, New York qualitatively assayed for the presence of a total of 25 drugs. The number and type of drugs found per case varied. Methadone, for example, was found in 60% of the cases reported by New York and in 49% of the cases from Washington, D.C., but in only about 10% of cases reported by Philadelphia, Dallas, Miami, and San Francisco, and in less than 1% of Los Angeles and Cleveland cases; it was not reported by Chicago. Phenmetrazine-caused deaths were reported only by Dallas (one case) and Washington, D.C. (29 cases). From the data as a whole, information is presented for 33 drugs as to the concentration in physiological tissues and fluids. Analysis of single psychoactive drug cases and single-drug-plus-ethanol cases shows that, in the presence of ethanol, the toxic blood concentration of imipramine, amytriptyline, meprobamate, thioridazine, morphine, propoxyphene, methaqualone, and all barbiturates was decreased by an average of 50%.

Unit activity in posterior association cortex of cat

1. "Association" neurons in the posterior middle suprasylvian gyrus of cat were found to be predominantly polysensory, with 82% of the units in the chloralose-anesthetized preparation responding to auditory, visual, and somatic stimuli. There was no evidence of response differentiation associated with cortical depth distribution. Most units responded with a short-latency response (median 35-60 ms) to all stimulus modalities, with the response to visual stimulation occurring at the shortest latency. Among polysensory cells, almost half responded with equal probability to auditory, visual, and somatic stimulation. The visual stimulus was the most potent for those cells responding with a higher probability to a single modality. Varying degrees of response complexity were noted in some cells in terms of changes in responsivity over time, discharge to stimulus offset, and inhibition of spontaneous activity. The unitary discharge was seen to occur on the negative peak and slope of the locally recorded evoked potential. When only the larger amplitude spikes were analyzed, most of the unitary activity occurred on the negative peak of the evoked potential. Almost half of trimodally responsive cells displayed similar phase relationships between unitary activity and evoked potentials for all three modalities. The absolute refractory period for most cells was from 200 to 300 ms, with relative refractory periods extending up to 30 s...