Com o objetivo de se avaliar a importância do \"clearance\" do dietilenotriamino-pentacetato marcado com Tecnécio 99m (DTPA-Tecnécio-99m) em portadores de pneumopatia por amiodarona foram estudados 40 indivíduos, em quatro grupos. Grupo I: 10 voluntários normais, assintomáticos e não fumantes (8 homens e 2 mulheres), com média de idade de 56,80 anos. Grupo II: 10 voluntários normais, assintomáticos e fumantes (6 homens e 4 mulheres ), com média de idade de 27,50 anos. Grupo III: 10 pacientes não fumantes ( 4 homens e 5 mulheres ), com média de idade de 52,90 anos. Todos faziam uso crônico de amiodarona por via oral. Grupo IV: 10 pacientes portadores de pneumopatia por amiodarona, quatro ex-fumantes, dois fumantes e quatro não fumantes ( 8 homens e 2 mulheres) com média de idade de 52,90 anos. Todos faziam uso de amiodarona por via oral e nenhum fumou nas 4 semanas que precederam o estudo. Após espirometria que constou do registro da curva volume-tempo, todos inalaram 4 ml de solução salina contendo 740 MBq de DTPA Tecnécio-99m, durante cinco minutos. Através de uma c~mara de cintilação computadorizada foram obtidas imagens pulmonares, definindo-se 9 áreas de interesse. Para cada região escolhida foi determinada uma curva de \"clearance\" extraindo-se o valor de meia-vida biológica em minu- tos ( T 1/2 ) e a taxa percentual de \" clearance\" alvéolo capilar do radioaerossol por minuto (K%/min). Observamos que, das variáveis espirométricas consideradas, a capacidade vital forçada (CVF) e o volume expiratório forçado no 1 segundo (VEF1) mostraram diferenças significantes entre os grupos I e IV. A contagem total de radioatividade de ambos os pulmões não mostrou relação com a CVF e o VEF1. O \" clearance \" pulmonar do DTPA Tecnécio-99m foi maior nos grupos 11 e IV, porém não permitindo sua diferenciação. Estes resultados permitem concluir: Os pacientes portadores de pneumonite por amiodaro- na apresentam\" clearance \" alvéolo-capilar de DTPA Tecnécio-99m significativamente maior que os indivíduos do grupo de normais não fumantes. Este fato também se verificou em relação aos pacientes em uso crônico de amiodarona mas sem evidências de pneumopatia. Não é possível diferenciar os fumantes dos portadores de pneumonite por amiodarona através da análise da integridade da barreira alvéolo-epitelial com DTPA Tecnécio-99m. Comparativamente, o estudo da integridade alvéolo-epitelial pelo \"clearance\" pulmonar de DTPA Tecnécio-99m é mais sensível que a espirometria na avaliação da pneumonite por amiodarona, permitindo diferenciar estes pacientes dos que fazem uso crônico da droga / In order to evaluate the role of the clearance of 99m Technetium chelated to diethylenetriamine-penta-acetate ( 99mTc-DTPA) in amiodarone induced pulmonary disease, 40 individuaIs were studied in four groups. Group I: 10 normal non smoking volunteers (8 men and 2 women ), whose mean age was 56.80 years. Group lI: 10 normal smoking volunteers ( 6 men and 4 women ), aging 27.50 years in average. Group III: 10 non smoking patients ( 4 men and women ), aging 52.90 years in average, who were chronically taking oral amiodarone. Group IV: 10 patients with amiodarone induced pul- monary disease (8 men and 2 women), four non-smokers, two smokers and four previous smokers. Their mean age was 62.90 years. AIl of them were taking oral amiodarone and none has smoked in the 4 weeks previous to the study. After spirometry, where a volume-time curve was registered, alI individuaIs inhaled 740 MBq of 99mTc-DTPA diluted in 4 ml of saline, for five minutes. Pulmonary images were obtained in a computadorized scintillation camera and 9 regions of interest were selected. A clearance curve of each region was determined, from which the effective half-life in minutes (T 1/2 ) and the alveolar-capilar clearance rate per minute ( k%/min ) of the radiolabeled aerosol were mea- sured. The spirometric analys disclosed a statistically lower value of the forced vital capacity ( FVC ) and forced expiratory volume in the first second ( FEV1 ) in the patients of group IV when compared to group I. The total radioactivity count for both lungs were not influenced by FVC and FEV1. The 99mTc-DTPA clearance rate was higher in groups 11 and IV, but these two groups could not be statistically differentiated. Based on these results it 1s concluded: patients with amiodarone induced pulmonary pneumonitis have higher clearance rates of 99m Tc-DTPA than normal non smoking controls and than patients taking amiodarone but with no lung toxicity. It is not possible to separate patients with amiodarone induced disease from normal smokers by determining 99m Tc-DTPA clearance rates. The determination of the alveolar-epithelial barrier integrity by 99m Tc-DTPA clearance rate is a more sensitive test than spirometry in the evaluation of amiodarone induced pneumonitis making it possible to differentiate these patients from those who take the drug and have no lung toxicity

目的：針對心血管初級預防，世界各國均推薦某一年齡段人群全部測量膽固醇以估算心血管病發病風險。此舉耗費高且非必須，本研究旨在建立並驗證一個新型的选择性膽固醇篩查模型，用以篩查需藥物治療之高危人群，并在成本效益方面與其它篩查模型相比較。 / 方法：本模型具體采用兩步法：首先利用一個足夠高的假設膽固醇值代入心血管病風險預測方程，用以系統性的高估絶大多數人的心血管病風險；其次只有假設心血管病風險高於推薦治療閾值時，該個體才需要測量膽固醇，並進行實際心血管病風險分析。 / 英国健康调查和中国营养与健康调查是本次研究的合适数据。我們首先探索最優的假設膽固醇值，尋找到最後膽固醇值之後，我們將繼續測試我們的新型膽固醇篩查模型，在不同的治療閾值下，表現是否穩定。我們以靈敏度，特異度和徐篩查人群為指標，比較我們模型與全民篩查模型和英國NICE 選擇篩查模型相比較。之後我們估算在中英人群中應用該篩查模型，所需耗費的成本和可預防心血管事件數。 / 结果：與全名篩查模型相比，我們的模型靈敏度相若但可以節省80%左右的篩查費用。模型的靈敏度主要取決於所採用的假設膽固醇值，與所用風險預測方程，治療閾值和人群心血管風險分佈無關。當以均數加2 倍標準差作為假設膽固醇值時，靈敏度可達到97.5%左右，特異度可以達到90%左右，符合預期。模型應用於中國人群得到的結果類似。值得註意的是，在中國人群中，即使不測量膽固醇，模型靈敏度亦接近95%。此外，將膽固醇篩查項目限制于男性50-84歲，女性60-84 歲年齡段可以進一步減少篩檢費用。在人群影響方面，我們模型可預防心血管事件數比全名篩查模型略少，但成本大大降低。英國NICE 模型適用於某些特定情況，但並非全部。 / 結論：我們的新型篩查模型靈敏度與全民篩查模型相若，但可以節省大量篩查費用。在资源匮乏地区，可考虑在某一特定年龄段运用我们的模型已达到进一步减少费用的效果。如果本研究结果得到进一步数据证实，對於中國人群而言，膽固醇測量可能並非心血管風險評估所必須。 / Objectives / Since the mid 1990s, most guidelines on primary prevention of cardiovascular disease (CVD) have recommended regular cholesterol measurement for all adults or those above a certain age (which is known as mass screening). Cholesterol measurement comprises a large cost of CVD prevention and is not necessarily required in those who do not need drug intervention. In order to reduce this cost, we have developed a new selective cholesterol screening model in order to determine whose cholesterol should be measured for drug prevention. The model was evaluated and compared with other widely adopted models in basic model performance as well as cost effectiveness. / Methods / The new model has two steps. In the first step, we purposely over-estimated the majority of respondents’ CVD risk by substituting a sufficiently high hypothetical cholesterol value in the risk estimation. We then recommend cholesterol measurement only to those with the estimated CVD risk above a predetermined risk threshold for drug treatment. In the second step, the CVD risk is re-estimated based on the individual’s real cholesterol consentration. Those with a risk above the treatment threshold are recommended for drug treatment. / We evaluated the performance of our two-step model with data from the Health Survey for England and re-evaluated it with data from the China Nutrition and Health Survey 2002. By varying the hypothetical cholesterol values and treatment thresholds in CVD risk, we assessed the sensitivity, specificity and proportion of the population who need to measure cholesterol and compared it with the US mass screening model and the UK NICE selective screening model. We further compared the costs and CVD events avoided in the compared screening programmes. We also examined how the age restriction should be set in cholesterol screening programmes. / Results / As compared to mass screening, our new model can achieve a high sensitivity and save some 80% the cost of cholesterol measurements. The sensitivity depends mainly on the hypothetical cholesterol level used and seems independent of population’s CVD risk, treatment cut-off values and risk prediction model. The model performed well in almost all the conditions tested. When the hypothetical cholesterol was set at MEAN+2SD, the resulting sensitivity of our selective screening model was almost always above 95% and close to the expected 97.5%. The sensitivity was only compromised slightly if cholesterol is not measured at all for the Chinese population. Furthermore, in order to save more costs, cholesterol measurement could be better restricted to men aged 50-84 and women 60-84 years regardless of the screening model used. In CVD events prevented, mass screening is always the best but our model can prevent almost as many. In costs, mass screening is always the most expensive but our model can save all or most of the cost. The NICE selective model can perform as well as our model only when it is used in an appropriate manner and in certain circumstances. / Conclusion / Our new cholesterol screening model has a high sensitivity which is comparable to that of universal screening programs but can save most of the cost on cholesterol measurements. In where resources are particular sparse, our model can also perform well by applying it only to certain age groups, which will further save cholesterol measurement costs. Cholesterol measurement could even be completely avoided for the Chinese population if our findings can be re-confirmed correct with more updated data. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Hu, Xuefeng. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 114-121). / Abstract also in Chinese. / Abstract (in English) --- p.i / Abstract (in Chinese) --- p.iv / Acknowledgements --- p.vi / Abbreviations used in the thesis --- p.viii / List of Tables --- p.xvi / List of Figures --- p.xviii / List of Boxes --- p.xix / Chapter 1. --- Introduction --- p.1 / Chapter 1.1 --- The burden of cardiovascular disease --- p.1 / Chapter 1.2 --- Primary prevention of CVD --- p.2 / Chapter 1.3 --- The high-risk individual strategy for CVD primary prevention --- p.3 / Chapter 1.3.1 --- The high risk individual strategy is effective --- p.4 / Chapter 1.3.2 --- The high risk individual strategy is cost-effective --- p.4 / Chapter 1.4 --- Who should be treated with drugs? --- p.5 / Chapter 1.4.1 --- The single risk factor strategy --- p.5 / Chapter 1.4.2 --- The overall CVD risk strategy --- p.7 / Chapter 1.4.3 --- Scope of CVD primary prevention --- p.8 / Chapter 1.5 --- Methods for assessing the CVD risk --- p.9 / Chapter 1.6 --- Current strategies for cholesterol measurements --- p.10 / Chapter 1.6.1 --- United States National Cholesterol Education Program --- p.13 / Chapter 1.6.2 --- American Heart Association CVD and Stroke prevention guideline --- p.14 / Chapter 1.6.3 --- The U.S. Preventive Services Task Force guideline --- p.15 / Chapter 1.6.4 --- New Zealand guideline 2003 --- p.16 / Chapter 1.6.5 --- Australian guideline 2009 --- p.17 / Chapter 1.6.6 --- The Joint British Society guideline-2 --- p.17 / Chapter 1.6.7 --- UK Department of Health guideline on vascular check --- p.18 / Chapter 1.6.8 --- China Blood Lipid Modification Guideline 2007 --- p.18 / Chapter 1.6.9 --- Summary of the reviewed guidelines --- p.19 / Chapter 1.7 --- Rationale for a selective screening model --- p.20 / Chapter 1.8 --- The UK NICE model --- p.22 / Chapter 1.9 --- Objectives of this study --- p.24 / Chapter 2 --- Methods --- p.25 / Chapter 2.1 --- The new cholesterol screening model --- p.25 / Chapter 2.2 --- Framework for evaluating the new screening model --- p.27 / Chapter 2.3 --- Indexes for evaluating the basic performance of screening models --- p.28 / Chapter 2.3.1 --- Sensitivity, specificity and % need cholesterol measurement --- p.28 / Chapter 2.3.2 --- Sensitivity analysis for model performance --- p.29 / Chapter 2.3.2.1 --- Using different hypothetical cholesterol values --- p.29 / Chapter 2.3.2.2 --- Using different treatment cut-off thresholds --- p.30 / Chapter 2.3.2.3 --- Using different populations --- p.30 / Chapter 2.3.2.4 --- Using different risk equations --- p.31 / Chapter 2.4 --- Data --- p.31 / Chapter 2.4.1 --- The Health Survey for England --- p.31 / Chapter 2.4.1.1 --- Background and aim of the survey --- p.31 / Chapter 2.4.1.2 --- Survey design --- p.32 / Chapter 2.4.1.2.1 --- Sampling Frame --- p.32 / Chapter 2.4.1.2.2 --- Weighting variables --- p.33 / Chapter 2.4.1.3 --- Data collection --- p.33 / Chapter 2.4.1.3.1 --- Blood cholesterol --- p.34 / Chapter 2.4.1.3.2 --- Blood pressure --- p.34 / Chapter 2.4.1.3.3 --- Smoking --- p.34 / Chapter 2.4.1.3.4 --- History of CVD and diabetes --- p.34 / Chapter 2.4.1.3.5 --- Treatment history --- p.35 / Chapter 2.4.2 --- The 2002 China National Nutrition and Health Survey --- p.35 / Chapter 2.4.2.1 --- Survey design --- p.36 / Chapter 2.4.2.2 --- Data collection --- p.36 / Chapter 2.4.2.2.1 --- Blood pressure --- p.36 / Chapter 2.4.2.2.2 --- Blood cholesterol --- p.38 / Chapter 2.4.2.2.3 --- Smoking --- p.38 / Chapter 2.4.2.2.4 --- History of CVD, diabetes and drug treatment --- p.38 / Chapter 2.4.3 --- Subjects eligible for analysis in this study --- p.38 / Chapter 2.5 --- CVD risk prediction --- p.43 / Chapter 2.5.1 --- The Framingham risk equation for the UK population --- p.43 / Chapter 2.5.2 --- The Asian equation for the Chinese population --- p.44 / Chapter 2.5.3 --- Adjusting for cholesterol and blood pressure --- p.45 / Chapter 2.5.4 --- Deriving the hypothetical cholesterol --- p.46 / Chapter 2.6 --- Identifying the appropriate age ranges for cholesterol measurement --- p.47 / Chapter 2.7 --- Comparing various screening models and options --- p.47 / Chapter 2.7.1 --- Compared screening models and options --- p.47 / Chapter 2.7.1 --- Indices for the performance of the screening options --- p.49 / Chapter 2.7.2 --- Costs of different screening options --- p.50 / Chapter 2.7.2.1 --- Components of screening cost from societal perspective --- p.50 / Chapter 2.7.2.1.1 --- Cost for inviting people for data collection --- p.50 / Chapter 2.7.2.1.2 --- Cost for the full risk assessment --- p.51 / Chapter 2.7.2.1.3 --- Treatment cost --- p.51 / Chapter 2.7.2.1.4 --- Cost saved for avoided CVD events --- p.52 / Chapter 2.7.2.2 --- Components of screening cost from health system’s perspective --- p.52 / Chapter 2.7.3 --- Number of CVD events avoidable --- p.53 / Chapter 2.8 --- Statistical analysis --- p.54 / Chapter 2.8.1 --- Descriptive analysis --- p.54 / Chapter 2.8.2 --- Cross-tabulation analysis --- p.54 / Chapter 2.8.3 --- Survey data analysis --- p.54 / Chapter 3 --- Results --- p.57 / Chapter 3.1 --- Description of data --- p.57 / Chapter 3.1.1 --- The UK population --- p.57 / Chapter 3.1.1.1 --- Sumamry of CVD risk and risk factors --- p.57 / Chapter 3.1.1.2 --- Distribution of age --- p.57 / Chapter 3.1.1.3 --- Distribution of blood pressure and blood cholesterol --- p.58 / Chapter 3.1.1.4 --- Distribution of the predicted 10-year CVD risk --- p.62 / Chapter 3.1.1.5 --- Relation between the risk threshold and age --- p.63 / Chapter 3.1.2 --- The Chinese population --- p.65 / Chapter 3.1.2.1 --- Summary of CVD risk and risk factors --- p.65 / Chapter 3.1.2.2 --- Distribution of age --- p.65 / Chapter 3.1.2.3 --- Distribution of blood pressure and blood cholesterol --- p.66 / Chapter 3.1.2.4 --- Distribution of the predicted 10-year CVD risk --- p.69 / Chapter 3.1.2.5 --- Relation between the risk threshold and age --- p.70 / Chapter 3.2 --- Performance of our new screening model --- p.72 / Chapter 3.2.1 --- Performance according to cholesterol values in the UK population --- p.72 / Chapter 3.2.2 --- Performance according to treatment cut-offs in the UK population --- p.73 / Chapter 3.2.3 --- Performance according to cholesterol values in the Chinese population --- p.73 / Chapter 3.2.4 --- Performance according to the risk cut-offs in the Chinese population --- p.74 / Chapter 3.2.4 --- Performance using different risk equations --- p.76 / Chapter 3.3 --- Comparison with other existing screening models --- p.77 / Chapter 3.3.1 --- Performance of the 3 models within an age-restricted UK population --- p.79 / Chapter 3.3.2 --- Performance of the 3 models within an age-restricted Chinese population --- p.81 / Chapter 3.3.3 --- Performance of the 3 models in the entire UK population --- p.83 / Chapter 3.3.4 --- Performance of the 3 models in the entire Chinese population --- p.84 / Chapter 3.3.5 --- Costs of various screening options --- p.87 / Chapter 3.3.6 --- Number of CVD events avoidable of the screening programmes --- p.92 / Chapter 4 --- Discussion --- p.96 / Chapter 4.1.1 --- Performance at different hypothetical cholesterol values --- p.96 / Chapter 4.1.2 --- Performance at various treatment cut-off thresholds --- p.97 / Chapter 4.1.3 --- Performance with different risk equations --- p.98 / Chapter 4.1.4 --- Performance in different populations --- p.99 / Chapter 4.1.5 --- Performance with different survival functions --- p.99 / Chapter 4.2 --- Further modifications of the model --- p.100 / Chapter 4.2.1 --- A model without any cholesterol measurement --- p.100 / Chapter 4.2.2 --- Age restriction for selective models --- p.102 / Chapter 4.2.3 --- Our model with potential personalized treatment cut-off --- p.103 / Chapter 4.2.4 --- Three key things to ensure model performance in other population --- p.104 / Chapter 4.3 --- CVD events preventable --- p.105 / Chapter 4.3.1 --- Importance of age restriction --- p.105 / Chapter 4.3.2 --- Limitations of the NICE model --- p.106 / Chapter 4.4 --- Costs of different screening models --- p.107 / Chapter 4.4.1 --- Cost from different perspectives --- p.107 / Chapter 4.4.2 --- Cholesterol measurement cost and routine data collection --- p.108 / Chapter 4.4.3 --- Cost components --- p.109 / Chapter 4.4.4 --- Ways to reduce cholesterol measurement costs --- p.109 / Chapter 4.4.5 --- Costs and gain of the missing 2.5% high risk individuals --- p.109 / Chapter 4.5 --- Strengths and limitations of this study --- p.110 / Chapter 4.6 --- Recommendations --- p.113 / References --- p.114

Displaced femoral neck fractures comprise more than a third of all hip fractures. There is controversy as to the optimal treatment. Despite attempts to improve the methods for internal fixation, complication rates have been almost unchanged: 20-40% non-union and late segmental collapse in another 10-20%. Internal fixation has been the preferred treatment in Scandinavia, whereas primary hemi- or total arthroplasty have been more prevalent in the rest of Europe and North America. In this study, patients 75 years or older, including those with mental impairment, were randomized to either internal fixation or cemented primary total hip arthroplasty (THA). A total of 146 hips in 143 patients were followed for two years. After one year 23% had died, and after two years 29%. Mortality was about the same in both groups. The accumulated mortality was pronounced among the mentally impaired patients. In the internal fixation group, 44% underwent further surgery. In the THA group, 18% dislocated. The dislocation rate was higher for the mentally impaired patients. The Harris hip scores were higher in the THA group, whereas pain was more common in the internal fixation group. The first 50 patients in each treatment group were studied concerning heterotopic ossification (HO), a well-known complication after THA. The incidence of HO in the THA group was similar to what is found after THA due to osteoarthritis. However, only 1/39 developed severe symptoms. A subgroup of 100 patients was included in a study concerning nutritional status and functional capacity using the Modified Norton scale, Katz index of ADL and a questionnaire measuring instrumental activities of daily living. The THA group fared better concerning weight change over time, locomotion and pain. The nutritional intervention did not show any measurable effects. All patients were followed until two years postoperatively and all fracturerelated hospital costs, including reoperations, were calculated. We found no difference in total costs between the treatment groups. Costs to the municipality were calculated comparing the baseline cost before surgery with the average cost per month during the first postoperative year. No difference was found between the treatment groups. On the basis of our results, we recommend arthroplasty for patients in this age group with normal mental function and high functional demands.

<p>The current study aimed to describe the extent and reasons for substituting and switching HAART at the Katutura Intermediate Hospital in Windhoek, Namibia</p>

<p>The current study aimed to describe the extent and reasons for substituting and switching HAART at the Katutura Intermediate Hospital in Windhoek, Namibia</p>

Irradiation with ultraviolet (UV) light is used for the disinfection of bacterial contaminants in the production of potable water, and in the treatment of selected wastewaters. However, efficacy of UV disinfection is limited by the combined effect of suspended solids concentration and UV absorbance. Limited published UV disinfection data are available that account for the combined effects of UV dose, suspended solids concentration and UV absorbance. This present lack of a rigorous quantitative understanding of the kinetics of UV disinfection limits process optimisation and wider application of UV treatment. The development and validation of an adequate model to describe UV disinfection kinetics presented in this thesis can therefore be justified by an increased confidence of reliability of design for UV disinfection. Using the published data of Nguyen (1999), four established model forms were assessed to account for the combined effect of suspended solids and/or soluble UV absorbing compounds, and UV dose on the efficacy of disinfection. The four model forms were: a log-linear form, Davey Linear-Arrhenius (DL-A), Square-Root (or Ratkowsky- Belehradek) and a general nth order Polynomial (nOP) form that was limited to a third order. Criteria for assessment of an adequate predictive model were established including: accuracy of predicted against observed values, percent variance accounted for (%V), and; appraisal of residuals. The DL-A model was shown to best fit the data for UV disinfection of Escherichia coli (ATCC 25922); followed by the nOP, log-linear and Square-Root forms. However, the DL-A form must be used in conjunction with a first-order chemical reaction equation, and was shown to predict poorly at high experimental values of UV dose (> 40,000 μWs cm-2). The DL-A model was not amenable to extrapolation beyond the observed UV dose range. To overcome the shortcomings of the Davey Linear-Arrhenius model synthesis of two new, non-linear model forms was undertaken. The two models were a modified exponentially damped polynomial (EDPm) and a form based on the Weibull probability distribution. The EDPm model has three terms: a rate coefficient (k), a damping coefficient (λ), and; a breakpoint dose ([dose]B). The rate coefficient governs the initial rate of disinfection prior to the onset of tailing, whilst the breakpoint is the UV dose that indicates the onset of tailing. The damping coefficient controls curvature in the survivor curve. The Weibull model has just two terms: a dimensionless scale parameter (β0), and; a shape parameter (β1). The scale parameter represents the level of disinfection in the tail of the survivor curve (as log10 N/N0), whilst the shape parameter governs the degree of curvature of the survivor data. Each model was assessed against the independent and published UV disinfection data of Nelson (2000) for treatment of faecal coliforms in a range of waste stabilisation pond effluents. Both models were found to be well suited to account for tailing in these UV disinfection data. Overall, the EDPm model gave a better fit to the data than the Weibull model form. To rigorously validate the suitability of the new EDPm and Weibull models a series of experimental trials were designed and carried out in a small-scale pilot UV disinfection unit. These trials included data determined specifically at low values of UV dose (<10,000 μWs cm-2) to fill the gap in the experimental data of Nguyen (1999). The experimental trials were carried out using a commercially available, UV disinfection unit (LC5TM from Ultraviolet Technology of Australasia Pty Ltd). Purified water contaminated with Escherichia coli (ATCC 25922) with a range of feed water flow rates (1 to 4 L min-1) was used. E. coli was selected because it is found in sewage, or water contaminated with faecal material, and is used as an indicator for the presence of enteric pathogens. E. coli should not be present in potable water. The hydrodynamics of water flow within the disinfection unit were established using digital video photography of dye trace studies with Methylene Blue. Nominal UV dose (2,700 to 44,200 μWs cm-2) was controlled by manipulating the flow rate of feed water through the UV disinfection unit (i.e. residence time), or by varying the exposed length of the control volume of the disinfection unit. The transmittance of the feed water (at 254 nm) was adjusted by the addition of either a soluble UV absorbing agent (International RoastTM instant coffee powder; 0.001 to 0.07 g L-1), or by addition of suspended matter as diatomaceous earth (Celite 503TM; 0.1 to 0.7 g L-1, with a median particle size of 23 μm). The absorbing agent (instant coffee), when in a comparable concentration, was found to produce a greater reduction in water transmission than the suspended material (Celite 503TM). It therefore contributed to a greater reduction in the initial rate of disinfection. Neither agent was found to produce a systematic reduction in the observed efficacy of disinfection however. Experimental results highlight that in the absence of soluble absorbing agents, or suspended solids, the initial rate of disinfection is higher when fewer viable bacteria are initially present. Both the new EDPm and Weibull forms gave a good fit to the experimental data. The EDPm better fitted the data on the basis of residual sum-of-squares (0.03 to 2.13 for EDPm cf. 0.16 to 4.37 for the Weibull form). These models are both of a form suitable for practical use in modelling UV disinfection data. Results of this research highlight the impact of water quality, as influenced by the combined effect of UV dose, suspended solids concentration and UV absorbance, on small-scale UV disinfection for potable water production. Importantly, results show that the concentration of soluble UV absorbing agents and suspended solids are not in themselves sufficient criteria on which to base assessment of efficacy of UV disinfection / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1342403 / Thesis (M.Eng.Sc.) - University of Adelaide, School of Chemical Engineering, 2008

Irradiation with ultraviolet (UV) light is used for the disinfection of bacterial contaminants in the production of potable water, and in the treatment of selected wastewaters. However, efficacy of UV disinfection is limited by the combined effect of suspended solids concentration and UV absorbance. Limited published UV disinfection data are available that account for the combined effects of UV dose, suspended solids concentration and UV absorbance. This present lack of a rigorous quantitative understanding of the kinetics of UV disinfection limits process optimisation and wider application of UV treatment. The development and validation of an adequate model to describe UV disinfection kinetics presented in this thesis can therefore be justified by an increased confidence of reliability of design for UV disinfection. Using the published data of Nguyen (1999), four established model forms were assessed to account for the combined effect of suspended solids and/or soluble UV absorbing compounds, and UV dose on the efficacy of disinfection. The four model forms were: a log-linear form, Davey Linear-Arrhenius (DL-A), Square-Root (or Ratkowsky- Belehradek) and a general nth order Polynomial (nOP) form that was limited to a third order. Criteria for assessment of an adequate predictive model were established including: accuracy of predicted against observed values, percent variance accounted for (%V), and; appraisal of residuals. The DL-A model was shown to best fit the data for UV disinfection of Escherichia coli (ATCC 25922); followed by the nOP, log-linear and Square-Root forms. However, the DL-A form must be used in conjunction with a first-order chemical reaction equation, and was shown to predict poorly at high experimental values of UV dose (> 40,000 μWs cm-2). The DL-A model was not amenable to extrapolation beyond the observed UV dose range. To overcome the shortcomings of the Davey Linear-Arrhenius model synthesis of two new, non-linear model forms was undertaken. The two models were a modified exponentially damped polynomial (EDPm) and a form based on the Weibull probability distribution. The EDPm model has three terms: a rate coefficient (k), a damping coefficient (λ), and; a breakpoint dose ([dose]B). The rate coefficient governs the initial rate of disinfection prior to the onset of tailing, whilst the breakpoint is the UV dose that indicates the onset of tailing. The damping coefficient controls curvature in the survivor curve. The Weibull model has just two terms: a dimensionless scale parameter (β0), and; a shape parameter (β1). The scale parameter represents the level of disinfection in the tail of the survivor curve (as log10 N/N0), whilst the shape parameter governs the degree of curvature of the survivor data. Each model was assessed against the independent and published UV disinfection data of Nelson (2000) for treatment of faecal coliforms in a range of waste stabilisation pond effluents. Both models were found to be well suited to account for tailing in these UV disinfection data. Overall, the EDPm model gave a better fit to the data than the Weibull model form. To rigorously validate the suitability of the new EDPm and Weibull models a series of experimental trials were designed and carried out in a small-scale pilot UV disinfection unit. These trials included data determined specifically at low values of UV dose (<10,000 μWs cm-2) to fill the gap in the experimental data of Nguyen (1999). The experimental trials were carried out using a commercially available, UV disinfection unit (LC5TM from Ultraviolet Technology of Australasia Pty Ltd). Purified water contaminated with Escherichia coli (ATCC 25922) with a range of feed water flow rates (1 to 4 L min-1) was used. E. coli was selected because it is found in sewage, or water contaminated with faecal material, and is used as an indicator for the presence of enteric pathogens. E. coli should not be present in potable water. The hydrodynamics of water flow within the disinfection unit were established using digital video photography of dye trace studies with Methylene Blue. Nominal UV dose (2,700 to 44,200 μWs cm-2) was controlled by manipulating the flow rate of feed water through the UV disinfection unit (i.e. residence time), or by varying the exposed length of the control volume of the disinfection unit. The transmittance of the feed water (at 254 nm) was adjusted by the addition of either a soluble UV absorbing agent (International RoastTM instant coffee powder; 0.001 to 0.07 g L-1), or by addition of suspended matter as diatomaceous earth (Celite 503TM; 0.1 to 0.7 g L-1, with a median particle size of 23 μm). The absorbing agent (instant coffee), when in a comparable concentration, was found to produce a greater reduction in water transmission than the suspended material (Celite 503TM). It therefore contributed to a greater reduction in the initial rate of disinfection. Neither agent was found to produce a systematic reduction in the observed efficacy of disinfection however. Experimental results highlight that in the absence of soluble absorbing agents, or suspended solids, the initial rate of disinfection is higher when fewer viable bacteria are initially present. Both the new EDPm and Weibull forms gave a good fit to the experimental data. The EDPm better fitted the data on the basis of residual sum-of-squares (0.03 to 2.13 for EDPm cf. 0.16 to 4.37 for the Weibull form). These models are both of a form suitable for practical use in modelling UV disinfection data. Results of this research highlight the impact of water quality, as influenced by the combined effect of UV dose, suspended solids concentration and UV absorbance, on small-scale UV disinfection for potable water production. Importantly, results show that the concentration of soluble UV absorbing agents and suspended solids are not in themselves sufficient criteria on which to base assessment of efficacy of UV disinfection / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1342403 / Thesis (M.Eng.Sc.) - University of Adelaide, School of Chemical Engineering, 2008

Irradiation with ultraviolet (UV) light is used for the disinfection of bacterial contaminants in the production of potable water, and in the treatment of selected wastewaters. However, efficacy of UV disinfection is limited by the combined effect of suspended solids concentration and UV absorbance. Limited published UV disinfection data are available that account for the combined effects of UV dose, suspended solids concentration and UV absorbance. This present lack of a rigorous quantitative understanding of the kinetics of UV disinfection limits process optimisation and wider application of UV treatment. The development and validation of an adequate model to describe UV disinfection kinetics presented in this thesis can therefore be justified by an increased confidence of reliability of design for UV disinfection. Using the published data of Nguyen (1999), four established model forms were assessed to account for the combined effect of suspended solids and/or soluble UV absorbing compounds, and UV dose on the efficacy of disinfection. The four model forms were: a log-linear form, Davey Linear-Arrhenius (DL-A), Square-Root (or Ratkowsky- Belehradek) and a general nth order Polynomial (nOP) form that was limited to a third order. Criteria for assessment of an adequate predictive model were established including: accuracy of predicted against observed values, percent variance accounted for (%V), and; appraisal of residuals. The DL-A model was shown to best fit the data for UV disinfection of Escherichia coli (ATCC 25922); followed by the nOP, log-linear and Square-Root forms. However, the DL-A form must be used in conjunction with a first-order chemical reaction equation, and was shown to predict poorly at high experimental values of UV dose (> 40,000 μWs cm-2). The DL-A model was not amenable to extrapolation beyond the observed UV dose range. To overcome the shortcomings of the Davey Linear-Arrhenius model synthesis of two new, non-linear model forms was undertaken. The two models were a modified exponentially damped polynomial (EDPm) and a form based on the Weibull probability distribution. The EDPm model has three terms: a rate coefficient (k), a damping coefficient (λ), and; a breakpoint dose ([dose]B). The rate coefficient governs the initial rate of disinfection prior to the onset of tailing, whilst the breakpoint is the UV dose that indicates the onset of tailing. The damping coefficient controls curvature in the survivor curve. The Weibull model has just two terms: a dimensionless scale parameter (β0), and; a shape parameter (β1). The scale parameter represents the level of disinfection in the tail of the survivor curve (as log10 N/N0), whilst the shape parameter governs the degree of curvature of the survivor data. Each model was assessed against the independent and published UV disinfection data of Nelson (2000) for treatment of faecal coliforms in a range of waste stabilisation pond effluents. Both models were found to be well suited to account for tailing in these UV disinfection data. Overall, the EDPm model gave a better fit to the data than the Weibull model form. To rigorously validate the suitability of the new EDPm and Weibull models a series of experimental trials were designed and carried out in a small-scale pilot UV disinfection unit. These trials included data determined specifically at low values of UV dose (<10,000 μWs cm-2) to fill the gap in the experimental data of Nguyen (1999). The experimental trials were carried out using a commercially available, UV disinfection unit (LC5TM from Ultraviolet Technology of Australasia Pty Ltd). Purified water contaminated with Escherichia coli (ATCC 25922) with a range of feed water flow rates (1 to 4 L min-1) was used. E. coli was selected because it is found in sewage, or water contaminated with faecal material, and is used as an indicator for the presence of enteric pathogens. E. coli should not be present in potable water. The hydrodynamics of water flow within the disinfection unit were established using digital video photography of dye trace studies with Methylene Blue. Nominal UV dose (2,700 to 44,200 μWs cm-2) was controlled by manipulating the flow rate of feed water through the UV disinfection unit (i.e. residence time), or by varying the exposed length of the control volume of the disinfection unit. The transmittance of the feed water (at 254 nm) was adjusted by the addition of either a soluble UV absorbing agent (International RoastTM instant coffee powder; 0.001 to 0.07 g L-1), or by addition of suspended matter as diatomaceous earth (Celite 503TM; 0.1 to 0.7 g L-1, with a median particle size of 23 μm). The absorbing agent (instant coffee), when in a comparable concentration, was found to produce a greater reduction in water transmission than the suspended material (Celite 503TM). It therefore contributed to a greater reduction in the initial rate of disinfection. Neither agent was found to produce a systematic reduction in the observed efficacy of disinfection however. Experimental results highlight that in the absence of soluble absorbing agents, or suspended solids, the initial rate of disinfection is higher when fewer viable bacteria are initially present. Both the new EDPm and Weibull forms gave a good fit to the experimental data. The EDPm better fitted the data on the basis of residual sum-of-squares (0.03 to 2.13 for EDPm cf. 0.16 to 4.37 for the Weibull form). These models are both of a form suitable for practical use in modelling UV disinfection data. Results of this research highlight the impact of water quality, as influenced by the combined effect of UV dose, suspended solids concentration and UV absorbance, on small-scale UV disinfection for potable water production. Importantly, results show that the concentration of soluble UV absorbing agents and suspended solids are not in themselves sufficient criteria on which to base assessment of efficacy of UV disinfection / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1342403 / Thesis (M.Eng.Sc.) - University of Adelaide, School of Chemical Engineering, 2008

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Thesis (M.A.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 55 pages. Includes bibliographical references.