bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary and Secondary Kinase Genotypes Correlate With the Biological and Clinical Activity of Sunitinib in Imatinib-Resistant Gastrointestinal Stromal Tumor
Authors: Heinrich Michael C. , Maki Robert G. , Corless Christopher L. , Antonescu Cristina R. , Harlow Amy , Griffith Diana , Town Ajia , Mckinley Arin , Ou Wen-Bin , Fletcher Jonathan A. , Fletcher Christopher D.M. , Huang Xin , Cohen Darrel P. , Baum Charles M. , Demetri George D.
Published: October 2008

Purpose

Most gastrointestinal stromal tumors (GISTs) harbor mutant KIT or platelet-derived growth factor receptor α (PDGFRA) kinases, which are imatinib targets. Sunitinib, which targets KIT, PDGFRs, and several other kinases, has demonstrated efficacy in patients with GIST after they experience imatinib failure. We evaluated the impact of primary and secondary kinase genotype on sunitinib activity.

Patients and Methods

Tumor responses were assessed radiologically in a phase I/II trial of sunitinib in 97 patients with metastatic, imatinib-resistant/intolerant GIST. KIT/PDGFRA mutational status was determined for 78 patients by using tumor specimens obtained before and after prior imatinib therapy. Kinase mutants were biochemically profiled for sunitinib and imatinib sensitivity.

Results

Clinical benefit (partial response or stable disease for ≥ 6 months) with sunitinib was observed for the three most common primary GIST genotypes: KIT exon 9 (58%), KIT exon 11 (34%), and wild-type KIT/PDGFRA (56%). Progression-free survival (PFS) was significantly longer for patients with primary KIT exon 9 mutations (P = .0005) or with a wild-type genotype (P = .0356) than for those with KIT exon 11 mutations. The same pattern was observed for overall survival (OS). PFS and OS were longer for patients with secondary KIT exon 13 or 14 mutations (which involve the KIT-adenosine triphosphate binding pocket) than for those with exon 17 or 18 mutations (which involve the KIT activation loop). Biochemical profiling studies confirmed the clinical results.

Conclusion

The clinical activity of sunitinib after imatinib failure is significantly influenced by both primary and secondary mutations in the predominant pathogenic kinases, which has implications for optimization of the treatment of patients with GIST.
Body-Mass Index and Progression of Hepatitis B: A Population-Based Cohort Study in Men
Authors: Yu Ming-Whei , Shih Wei-Liang , Lin Chih-Lin , Liu Chun-Jen , Jian Jhih-Wei , Tsai Keh-Sung , Chen Chien-Jen
Published: October 2008

Purpose

To determine prospectively whether body-mass index (BMI) is associated with liver-related morbidity and mortality among male hepatitis B virus (HBV) carriers.

Patients and Methods

We performed a prospective study of 2,903 male HBV surface antigen–positive government employees who were free of cancer at enrollment between 1989 and 1992. Main outcome measures included ultrasonography, biochemical tests, incident hepatocellular carcinoma (HCC), and liver-related death.

Results

During mean follow-up of 14.7 years, 134 developed HCC and 92 died as a result of liver-related causes. In Cox proportional hazards models adjusting for age, number of visits, diabetes, and use of alcohol and tobacco, the hazard ratios for incident HCC were 1.48 (95% CI, 1.04 to 2.12) in overweight men (BMI between 25.0 and 29.9 kg/m2) and 1.96 (95% CI, 0.72 to 5.38) in obese men (BMI ≥ 30.0 kg/m2), compared with normal-weight men (BMI between 18.5 and 24.9 kg/m2). Liver-related mortality had adjusted hazard ratios of 1.74 (95% CI, 1.15 to 2.65) in overweight men and 1.50 (95% CI, 0.36 to 6.19) in obese men. Excess BMI was also associated with the occurrence of fatty liver and cirrhosis detected by ultrasonography, as well as elevated ALT and γ-glutamyltransferase (GGT) activity during follow-up. The association of BMI with GGT was stronger than with ALT, and elevated GGT activity and cirrhosis were the strongest predictors for incident HCC and liver-related death.

Conclusion

This longitudinal cohort study indicates that excess body weight is involved in the transition from healthy HBV carrier state to HCC and liver-related death among men.
“BRCAness” Syndrome in Ovarian Cancer: A Case-Control Study Describing the Clinical Features and Outcome of Patients With Epithelial Ovarian Cancer Associated With BRCA1 and BRCA2 Mutations
Authors: Tan David S.P. , Rothermundt Christian , Thomas Karen , Bancroft Elizabeth , Eeles Rosalind , Shanley Susan , Ardern-Jones Audrey , Norman Andrew , Kaye Stanley B. , Gore Martin E.
Published: October 2008

Purpose

We evaluated the clinical impact of germ-line BRCA1/2 mutations in patients with epithelial ovarian cancer (EOC) on responses to first and subsequent lines of chemotherapy, treatment-free interval (TFI) between each line of therapy, and overall survival (OS).

Patients and Methods

Twenty-two EOC patients with germ-line BRCA1 or BRCA2 mutations (BRCA-positive) were selected from our database and matched (1:2) with 44 nonhereditary EOC controls (defined by no associated personal history of breast cancer and no family history of breast and ovarian cancer or an uninformative BRCA mutation test) for stage, histologic subtype, age, and year of diagnosis. All patients received primary platinum-based chemotherapy. Statistical comparisons included responses after first-, second-, and third-line treatment (χ2/Fisher's exact test) and median OS (Kaplan-Meier method/log-rank test).

Results

Compared with controls, BRCA-positive patients had higher overall (95.5% v 59.1%; P = .002) and complete response rates (81.8% v 43.2%; P = .004) to first line treatment, higher responses to second and third line platinum-based chemotherapy (second line, 91.7% v 40.9% [P = .004]; third line, 100% v 14.3% [P = .005]) and longer TFIs. A significant improvement in median OS in BRCA-positive patients compared with controls was observed from both time of diagnosis (8.4 v 2.9 years; P < .002) and time of first relapse (5 v 1.6 years; P < .001). BRCA status, stage, and length of first response were independent prognostic factors from time of first relapse.

Conclusion

BRCA-positive EOC patients have better outcomes than nonhereditary EOC patients. There exists a clinical syndrome of BRCAness that includes serous histology, high response rates to first and subsequent lines of platinum-based treatment, longer TFIs between relapses, and improved OS.
Phase III, Double-Blind, Randomized Study Comparing Lapatinib Plus Paclitaxel With Placebo Plus Paclitaxel As First-Line Treatment for Metastatic Breast Cancer
Authors: Di Leo Angelo , Gomez Henry L. , Aziz Zeba , Zvirbule Zanete , Bines Jose , Arbushites Michael C. , Guerrera Stephanie F. , Koehler Maria , Oliva Cristina , Stein Steven H. , Williams Lisa S. , Dering Judy , Finn Richard S. , Press Michael F.
Published: October 2008

Purpose

Lapatinib, a dual tyrosine kinase inhibitor of epidermal growth factor receptor (EGFR/ErbB1) and human epidermal growth factor receptor 2 (HER-2/ErbB2), is effective against HER-2–positive locally advanced or metastatic breast cancer (MBC). This phase III trial evaluated the efficacy of lapatinib in HER-2–negative and HER-2–uncharacterized MBC.

Patients and Methods

Women with MBC were randomly assigned to first-line therapy with paclitaxel 175 mg/m2 every 3 weeks plus lapatinib 1,500 mg/d or placebo. A preplanned retrospective evaluation of HER-2 status was performed using fluorescence in situ hybridization and immunohistochemistry. The primary end point was time to progression (TTP); secondary end points were objective response rate (ORR), clinical benefit rate (CBR), event-free survival (EFS), and overall survival (OS).

Results

In the intent-to-treat population (n = 579), there were no significant differences in TTP, EFS, or OS between treatment arms, although differences in ORR and CBR were noted. In 86 HER-2–positive patients (15%), treatment with paclitaxel-lapatinib resulted in statistically significant improvements in TTP, EFS, ORR, and CBR compared with paclitaxel-placebo. No differences between treatment groups were observed for any end point in HER-2–negative patients. The most common adverse events were alopecia, rash, and diarrhea. The incidence of diarrhea and rash was significantly higher in the paclitaxel-lapatinib arm. The rate of cardiac events was low, and no difference was observed between treatment arms.

Conclusion

Patients with HER-2–negative or HER-2–untested MBC did not benefit from the addition of lapatinib to paclitaxel. However, first-line therapy with paclitaxel-lapatinib significantly improved clinical outcomes in HER-2–positive patients. Prospective evaluation of the efficacy and safety of this combination is ongoing in early and metastatic HER-2–positive breast cancer patients.
Role of Age and Health in Treatment Recommendations for Older Adults With Breast Cancer: The Perspective of Oncologists and Primary Care Providers
Authors: Hurria Arti , Wong F. Lennie , Villaluna Doojduen , Bhatia Smita , Chung Cathie T. , Mortimer Joanne , Hurvitz Sara , Naeim Arash
Published: October 2008

Purpose

To determine the impact of age and health status on adjuvant treatment recommendations for older patients with breast cancer from the perspective of medical oncologists and primary care physicians with geriatric expertise.

Patients and Methods

One hundred fifty-one oncologists and 158 primary care physicians with geriatric expertise participated in an online survey. The survey described hypothetical patients of varying ages (70, 75, 80, and 85 years) and health status (good, average, and poor) who had node-positive, hormone receptor–positive, human epidermal growth factor receptor 2 (HER-2)/neu–negative; and hormone receptor–negative, HER-2/neu–positive breast cancers. The effects of patient age and health status on the survey participants’ adjuvant treatment recommendations were examined using generalized estimation equation methods.

Results

The majority of both oncologists and primary care physicians recommended some form of adjuvant therapy for patients of all ages (70, 75, 80, and 85 years) and health status. Both oncologists and primary care providers were less likely to recommend adjuvant treatment as a patient's age increased or health status declined (P < .0001). There were no significant differences in treatment recommendations among primary care physicians and oncologists for patients with hormone receptor–negative, HER-2/neu–positive tumors (P = .54). However, primary care providers were more likely than oncologists to recommend no adjuvant treatment for patients age 75 years or older with hormone receptor–positive, HER-2/neu–negative tumors (P < .01).

Conclusion

Age and health status influence oncologists’ and primary care providers’ adjuvant treatment recommendations. Evidence-based guidelines for breast cancer treatment in older adults taking into account age and health status are needed.
Cohort Study of Fatty Acid Synthase Expression and Patient Survival in Colon Cancer
Authors: Ogino Shuji , Nosho Katsuhiko , Meyerhardt Jeffrey A. , Kirkner Gregory J. , Chan Andrew T. , Kawasaki Takako , Giovannucci Edward L. , Loda Massimo , Fuchs Charles S.
Published: October 2008

Purpose

Energy balance seems to be important in the pathogenesis of colon cancer. Fatty acid synthase (FASN) is physiologically regulated by energy balance and is often upregulated in colorectal cancer. Nonetheless, the influence of FASN expression on patient outcome is uncertain.

Patients and Methods

Using the database of 647 patients with colon cancer in two independent cohort studies, FASN overexpression was detected in 84 tumors (13%) by immunohistochemistry. Cox proportional hazards models calculated hazard ratios (HRs) of colon cancer–specific and overall mortalities, adjusted for patient characteristics and related tumoral features, including KRAS, BRAF, p53, microsatellite instability and the CpG island methylation phenotype.

Results

There were 279 deaths, including 160 colon cancer–specific deaths. FASN overexpression was associated with a significant reduction in colon cancer–specific mortality by both univariate and multivariate analyses (adjusted HR, 0.41; 95% CI, 0.19 to 0.89) and an insignificant trend toward improved overall mortality (adjusted HR, 0.75; 95% CI, 0.50 to 1.13). Notably, the effect of FASN expression on mortality might be different according to body mass index (BMI; Pinteraction = .019); the adjusted HR of overall mortality for FASN overexpression was 0.63 (95% CI, 0.39 to 1.02) among patients with BMI less than 27.5 kg/m2 and 2.91 (95% CI, 1.19 to 7.12) among those with BMI ≥ 27.5 kg/m2. Moreover, the adverse effect of moderate overweight/obesity on overall survival was limited to FASN-positive tumors (adjusted HR, 4.10; 95% CI, 1.14 to 14.8; BMI ≥ 27.5 kg/m2 v < 27.5 kg/m2).

Conclusion

Among nonobese patients with colon cancer, tumoral FASN overexpression is associated with improved survival, whereas among moderately overweight or obese patients (BMI ≥ 27.5 kg/m2), FASN overexpression may predict a worse outcome.
Transduction of Anti-Cell Death Protein FNK Suppresses Graft Degeneration After Autologous Cylindrical Osteochondral Transplantation
Authors: Nakachi Noriki , Asoh Sadamitsu , Watanabe Nobuyoshi , Mori Takashi , Matsushita Takashi , Takai Shinro , Ohta Shigeo
Published: October 2008

This study shows that artificial super antiapoptotic FNK protein fused with a protein transduction domain (PTD-FNK) maintains the quality of osteochondral transplant by preventing chondrocyte death. Cylindrical osteochondral grafts were obtained from enhanced green fluorescent protein (EGFP)-expressing transgenic rats, in which living chondrocytes express green fluorescence, and submerged into medium containing PTD-FNK, followed by transplantation into cartilage defects of wild-type rats by impact insertion simulating autologous transplantation. The tissues were histologically evaluated by hematoxylineosin and Safranin-O staining. At 1 week, chondrocyte alignment was normal in the PTD-FNK treatment group, whereas all grafts without PTD-FNK treatment showed mixed cluster cell distribution. At 4 weeks, all grafts with PTD-FNK treatment showed almost normal matrix, whereas two grafts without PTD-FNK treatment showed fibrocartilage. Notably, all grafts with PTD-FNK retained high intensity of Safranin-O staining, but all grafts without PTD-FNK largely lost Safranin-O staining. PTD-FNK significantly suppressed a decrease in the survival rate and the density of EGFP-positive cells at 1 and 2 weeks, and this tendency continued at 4 weeks. The results of terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP)-nick end-labeling staining showed that PTD-FNK inhibited cell death, indicating that PTD-FNK protects chondrocyte death and suppresses graft degeneration.
Life satisfaction and quality of life amongst elderly Portuguese living in the community
Authors: Fonseca Antnio M , Pal Constana , Martin Igncio
Published: October 2008

The aim of this paper is to study the difference between life satisfaction and quality of life as general measures of wellbeing among older people and how both variables relate differently to individual, social, relational and instrumental determinants. A group of 234 elderly Portuguese
living in their own homes in rural and urban areas were studied. The results obtained identify a group of individuals with low levels of schooling and possessing reduced income, which seems to influence the evaluation of the quality of life but not the life satisfaction. Life satisfaction,
seen as a psychological dimension, appears as a variable associated more with personality characteristics and less with external variables, regardless of whether they are physical, social or environmental. The perception of quality of life seems to be clearly associated not only with socio-demographic
variables but also with physical and contextual variables.
Comparing Environmental and Biological Surrogates for Biodiversity at a Local Scale
Authors: Carmel Yohay , Stoller-Cavari Liron
Published: October 2008

A recent debate concerns the relative merit of the two major types of surrogates for biodiversity, biological surrogates and environmental surrogates. Evidence, in the form of direct comparison of these two surrogate types, is scarce. We conducted a direct comparison of the performance of a series of biological and environmental surrogates, at a local scale (300 km2), which is often the relevant scale for land planning and management. Performance was referred to as the degree of surrogate congruence with a spatial pattern of diversity of woody species, of geophytes, and of land snails. "Environmental domains", surrogates based on numerical classification of environmental variables (topography, soil, and vegetation cover), outperformed other environmental surrogates (qualitatively delineated vegetation units and physiographic land types). The environmental domains surrogates were robust to subjective decisions on a number of classes and on input variables that drove the classification. The best biological surrogate was the woody species diversity pattern, with performance similar to that of the environmental domains. Our results support the notion that environmental domains may be reliable and cost-effective surrogates for biodiversity at small scales, particularly in data-poor regions.
Early Molecular Evolution
Authors: Trifonov Edward N.
Published: October 2008

Four fundamentally novel, recent developments make a basis for the Theory of Early Molecular Evolution. The theory outlines the molecular events from the onset of the triplet code to the formation of the earliest sequence/structure/function modules of proteins. These developments are: (1) Reconstruction of the evolutionary chart of codons; (2) Discovery of omnipresent protein sequence motifs, apparently conserved since the last common ancestor; (3) Discovery of closed loops—standard structural modules of modern proteins; (4) Construction of protein sequence space of module size fragments, with far-reaching evolutionary implications. The theory generates numerous predictions, confirmed by massive nucleotide and protein sequence analyses, such as existence of two distinct classes of amino acids, and their periodical distribution along the sequences. The emerging picture of the earliest molecular evolutionary events is outlined: consecutive engagement of codons, formation of the earliest short peptides, and growth of the polypeptide chains to the size of loop closure, 25-30 residues.
Mechanisms of metformin inhibiting lipolytic response to isoproterenol in primary rat adipocytes
Authors: Zhang Tingting , He Jinhan , Xu Chong , Zu Luxia , Jiang Hongfeng , Pu Shenshen , Guo Xiaohui , Xu Guoheng
Published: October 2008

The mobilization of free fatty acids (FFA) from adipose tissue to the bloodstream primarily depends on triacylglycerol lipolysis in adipocytes. Catecholamines are major hormones that govern lipolysis through elevating cellular cAMP production and activating protein kinase, cAMP dependent, catalytic, alpha (PKA) and mitogen-activated protein kinase 1/2 (MAPK1/3). Obesity and type 2 diabetes are associated with elevated levels of systemic FFA, which restricts glucose utilization and induces insulin resistance. The biguanide metformin exerts its antihyperglycemic effect by enhancing insulin sensitivity, which is associated with decreased levels of circulating FFA. In this study, we examined the characteristics and basis of the inhibitory effect of metformin on adrenergic-stimulated lipolysis in primary rat adipocytes. We measured the release of FFA and glycerol as an index of lipolysis and examined the major signalings of the lipolytic cascade in primary rat adipocytes. Metformin at 250–500 μM efficiently attenuated FFA and glycerol release from the adipocytes stimulated with 1 μM isoproterenol. To elucidate the basis for this antilipolytic action, we showed that metformin decreased cellular cAMP production, reduced the activities of PKA and MAPK1/3, and attenuated the phosphorylation of perilipin during isoproterenol-stimulated lipolysis. Further, metformin suppressed isoproterenol-promoted lipase activity but did not affect the translocation of lipase, hormone-sensitive from the cytosol to lipid droplets in adipocytes. This study provides evidence that metformin acts on adipocytes to suppress the lipolysis response to catecholamine. This antilipolytic effect could be a cellular basis for metformin decreasing plasma FFA levels and improving insulin sensitivity.
Measuring the effectiveness of performance-based training
Authors: Bowman William , Messner Michael , Regli Stig , Bender Jon
Published: October 2008

This article describes a statistical analysis of small water systems’ turbidity data within the framework of a logic model for the USEPA's Performance-Based Training (PBT) program. The logic model shows the theoretical linkages between optimization training for small system operators; operator application of optimization techniques; improvements in plant filtration performance; and public health protection. The analysis comprised two phases. For the first phase, the authors used Bayesian analysis of turbidity data to test the statistical significance of changes in finished water quality resulting from training for small water system operators. For the second phase, the authors estimated the potential health benefits resulting from measured improvements in filtration performance. Considering only the improved removal of the pathogen Cryptosporidium, the expected annual health benefit of PBT is about ten fewer cases of infection per thousand persons served (within a 95% credible interval 0 to 18 fewer infections), though there may be benefits associated with the removal of other pathogens. The article also describes factors contributing to uncertainty in the estimated potential health benefits. The proposed two-phase approach supports the USEPA's development of drinking water program indicators which are meaningful, measurable, broadly applicable and change-sensitive.
The effect of cyanuric acid on the disinfection rate of Cryptosporidium parvum in 20-ppm free chlorine
Authors: Shields Joan M. , Arrowood Michael J. , Hill Vincent R. , Beach Michael J.
Published: October 2008

Cyanuric acid is used to stabilize free chlorine to reduce photodegradation in outdoor swimming pools. While there have been numerous studies examining its effect on the disinfection rates of bacteria and viruses, it is not known whether cyanuric acid can significantly impact the effectiveness of hyperchlorination for inactivating Cryptosporidium oocysts present in fecally-contaminated swimming pools. This study examined the effect of cyanuric acid on the disinfection rate of Cryptosporidium parvum under swimming pool hyperchlorination conditions (20 mg/ml free chlorine). When 50 mg/L cyanuric acid was present there was a 0.70-log10 reduction in oocyst viability after 10 hours as compared to a 3.7-log10 reduction without cyanuric acid. Aids to remediation, such as decreasing the pH to enhance the germicidal efficiency of the free chlorine and doubling the amount of free chlorine residual, were still unable to achieve a 3-log10 reduction. Current public health recommendations for hyperchlorination and pool remediation are insufficient for pools using cyanurate-stabilized chlorine to achieve a three log inactivation of the parasite.
GIS-based analysis of the fate of waste-related pathogens Cryptosporidium parvum, Giardia lamblia and Escherichia coli in a tropical canal network
Authors: Diallo Mamadou B. C. , Anceno Alfredo J. , Tawatsupa Benjawan , Tripathi Nitin K. , Wangsuphachart Voranuch , Shipin Oleg V.
Published: October 2008

Urban canals play a major socio-economic role in many tropical countries and, particularly, Thailand. One of the overlooked functions that they perform is a significant attenuation of waste-related pathogens posing considerable health risk, as well as pollution attenuation in general. The study dealt with a comparison of three canals receiving: (i) municipal, (ii) mainly industrial and (iii) mainly agricultural wastewater, listed in order of progressively decreasing organic loading. The occurrence and fate of waterborne Cryptosporidium parvum, Giardia lamblia and Escherichia coli were monitored in the canals by both real-time PCR and conventionally for 12 months. The pathogens are etiological agents of an estimated 38% and 47% of diarrhea cases worldwide and in Thailand, respectively. The geographic information system (GIS) was used to evaluate and map point and, particularly, non-point pollution sources which allowed differentiating the canal sections in terms of predominant pathogen sources. The flowthrough canals, which can be viewed as waste stabilization ponds, were found to be efficiently removing the pathogens at the following generalized specific rates: 0.3 (C. parvum), 1.2 (G. lamblia), 1.8 (E. coli) log10/km.d in the dry season. The rates decreased in the rainy season for E. coli and G. lamblia, but increased for C. parvum which indicated different removal mechanisms. Data suggest that E. coli and G. lamblia were mainly removed through sedimentation and sunlight (UV) irradiation, while the likely mechanism for C. parvum was predation. Overall, the specific pathogen removal rates positively correlated with the canal organic loading rates in the rainy season. As an important result, an estimate of the municipal pollution mitigation by over 2,280 km canals in the Greater Bangkok suggests that concomitant to the pathogens at least 36–95 tons of BOD5 is being removed daily, thereby saving the receiving Chao Phraya River and Bight of Bangkok, by far exceeding current, from major eutrophication problems.
A water contamination incident in Oslo, Norway during October 2007; a basis for discussion of boil-water notices and the potential for post-treatment contamination of drinking water supplies
Authors: Robertson Lucy , Gjerde Bjørn , Hansen Elisabeth Furuseth , Stachurska-Hagen Teresa
Published: October 2008

Over a 5 day period in October 2007 a boil-water notice was served on the majority of Oslo, capital city of Norway, as a result of a combination of bacteriological findings (coliforms, intestinal enterococci, and E. coli), and very low numbers of Cryptosporidium oocysts and Giardia cysts in 10 L water samples taken from the water distribution network. The water source had been regularly monitored for these parasites and generally found to be negative. Over 460,000 residents were affected by the boil-water notice, as were many thousands of businesses.

Despite an extensive outbreak of waterborne giardiasis in Bergen, Norway during 2004/2005, occurrence of parasites in Norwegian drinking water supplies has apparently continued to be considered to be of minimal relevance by Norwegian health authorities. Here we describe the background and occurrence of the episode in Oslo, including the species of Cryptosporidium detected, and use this event, in conjunction with incidents from other countries, as a basis to discuss the following issues: 1) under which circumstances should the occurrence of Cryptosporidium oocysts and Giardia cysts in water supplies trigger the issue of a boil-water notice, and 2) the possibilities and probabilities of post-treatment contamination events in the water distribution network.
Measuring the benefit of orthophosphate treatment on lead in drinking water
Authors: Cardew P. T.
Published: October 2008

Many water companies are adding low concentrations of orthophosphate to the water supply in order to reduce lead concentrations in drinking water produced from corrosion of lead service pipes. Despite the erratic nature of lead concentrations measured at customer properties it has been possible to quantify the impact of treatment on lead concentrations and thereby quantify the effectiveness of treatment at both a regional and zonal level. This showed that the treatment policy has delivered more than 90 per cent reduction in lead concentrations, and was largely in accordance with theory. Across the region, lead performance and the reduction in lead performance show significant variation. A large part of this variation can be accounted for by variations in the proportion of leaded properties supplied through lead service pipes. Analysis showed that the proportion of particulate lead has also reduced significantly over the last decade. This is attributed to improved mechanical robustness of the corrosion layer caused by changes in its physical structure. This appears to be a very slow process with a natural time-scale of years.
Addressing disease surveillance needs for marine recreational bathers
Authors: Turbow David
Published: October 2008

Contamination of the nearshore marine environment contributes to a high burden of illness among recreational bathers. Disease surveillance activities carried out by local, state, and territorial agencies in the United States are at present voluntary and passive. Several gaps in the existing regulatory framework for beach management and public health protection are highlighted in this paper. The need for disease surveillance of marine bathers is established. A demonstration is made of how surveillance activities can be used to guide risk management and gauge the effectiveness of current water contact standards. Recommendations are offered for agencies to improve surveillance and protect public health. A foundation is presented on which to develop a model marine health code.
Is fecal contamination of drinking water after collection associated with household water handling and hygiene practices? A study of urban slum households in Hyderabad, India
Authors: Eshcol Jayasheel , Mahapatra Prasanta , Keshapagu Sarita
Published: October 2008

Water-borne illness, primarily caused by fecal contamination of drinking water, is a major health burden in the state of Andhra Pradesh, India. Currently drinking water is treated at the reservoir level and supplied on alternate days, necessitating storage in households for up to 48 hrs. We hypothesized that fecal contamination occurs principally during storage due to poor water handling. In this study we tested for coliform bacteria in water samples collected at distribution points as household storage containers were filled, and then tested containers in the same households 24–36 hours after collection. We also conducted an observational survey to make an assessment of water handling and hygiene. Ninety-two percent (47/51) of samples tested at supply points were adequately chlorinated and bacterial contamination was found in two samples with no residual chlorine. Samples collected from household storage containers showed an increase in contamination in 18/50 houses (36%). Households with contaminated stored samples did not show significant differences in demographics, water handling, hygiene practices, or sanitation. Nevertheless, the dramatic increase in contamination after collection indicates that until an uninterrupted water supply is possible, the point at which the biggest health impact can be made is at the household level.
Seasonality of Cryptosporidium oocyst detection in surface waters of Meru, Kenya as determined by two isolation methods followed by PCR
Authors: Muchiri John M. , Ascolillo Luke , Mugambi Mutuma , Mutwiri Titus , Ward Honorine D. , Naumova Elena N. , Egorov Andrey I. , Cohen Seth , Else James G. , Griffiths Jeffrey K.
Published: October 2008

Meru, Kenya has watersheds which are shared by wildlife, humans and domesticated animals. These surface waters can be contaminated by the waterborne pathogen Cryptosporidium. To quantify the seasonality and prevalence of Cryptosporidium in Meru regional surface waters, we used a calcium carbonate flocculation (CCF) and sucrose floatation method, and a filtration and immunomagnetic bead separation method, each of which used PCR for Cryptosporidium detection and genotyping. Monthly water samples were collected from January through June in 2003 and 2004, bracketing two April-May rainy seasons. We detected significant seasonality with 8 of 9 positive samples from May and June (p<0.0014), which followed peak rainy season precipitation and includes some of the subsequent dry season. Six of 9 positive samples revealed C. parvum, and 3 contained C. andersoni. None contained C. hominis. Our results indicate that Meru surface waters are Cryptosporidium-contaminated at the end of rainy seasons, consistent with the timing of human infections reported by others from East Africa and contrasting with the onset of rainy season peak incidence reported from West Africa.
A sea change ahead for recreational water quality criteria
Authors: Boehm Alexandria B. , Ashbolt Nicholas J. , Colford John M. , Dunbar Lee E. , Fleming Lora E. , Gold Mark A. , Hansel Joel A. , Hunter Paul R. , Ichida Audrey M. , McGee Charles D. , Soller Jeffrey A. , Weisberg Stephen B.
Published: October 2008

The United States Environmental Protection Agency is committed to developing new recreational water quality criteria for coastal waters by 2012 to provide increased protection to swimmers. We review the uncertainties and shortcomings of the current recreational water quality criteria, describe critical research needs for the development of new criteria, as well as recommend a path forward for new criteria development. We believe that among the most needed research needs are the completion of epidemiology studies in tropical waters and in waters adversely impacted by urban runoff and animal feces, as well as studies aimed to validate the use of models for indicator and pathogen concentration and health risk predictions.
Temporal analyses of Salmonellae in a headwater spring ecosystem reveals the effects of precipitation and runoff events
Authors: Gaertner James P. , Garres Tiffany , Becker Jesse C. , Jimenez Maria L. , Forstner Michael R. J. , Hahn Dittmar
Published: October 2008

Sediments and water from the spring and slough arm of Spring Lake, the pristine headwaters of the San Marcos River, Texas, were analyzed for Salmonellae by culture and molecular techniques before and after three major precipitation events, each with intermediate dry periods. Polymerase chain reaction (PCR)-assisted analyses of enrichment cultures detected Salmonellae in samples after all three precipitation events, but failed to detect them immediately prior to the rainfall events. Detection among individual locations differed with respect to the precipitation event analyzed, and strains isolated were highly variable with respect to serovars. These results demonstrate that rainwater associated effects, most likely surface runoff, provide an avenue for short-term pollution of aquatic systems with Salmonellae that do not, however, appear to establish for the long-term in water nor sediments.
A decentralized and onsite wastewater management course: bringing together global concerns and practical pedagogy
Authors: Gaulke L. S. , Borgford-Parnell J. L. , Stensel H. D.
Published: October 2008

This paper reports on the design, implementation, and results of a course focused on decentralized and onsite wastewater treatment in global contexts. Problem-based learning was the primary pedagogical method, with which students tackled real-world problems and designed systems to meet the needs of diverse populations. Both learning and course evaluations demonstrated that the course was successful in fulfilling learning objectives, increasing student design skills, and raising awareness of global applications. Based on this experience a list of recommendations was created for co-developing and team-teaching multidisciplinary design courses. These recommendations include ideas for aligning student and teacher goals, overcoming barriers to effective group-work, and imbedding continuous course assessments.
Artificial wetlands performance: nitrogen removal
Authors: Durán-de-Bazúa Carmen , Guido-Zárate Alejandro , Huanosta Thalía , Padrón-López Rosa Martha , Rodríguez-Monroy Jesús
Published: October 2008

Artificial wetlands (AW) are a promising option for wastewater treatment in small communities due to their high performance in nutrients removal and low operation and maintenance costs. Nitrogen can favour the growth of algae in water bodies causing eutrophication when present at high concentrations. Nitrogen can be removed through different mechanisms (e.g. nitrification-denitrification, adsorption and plant uptake). Environmental conditions such as temperature and relative humidity can play an important role in the performance of these systems by promoting the growth of macrophytes such as reeds and cattails (e.g. Phragmites australis, Typha latifolia respectively). In this paper, two AW systems were compared, one located in Mexico City, Mexico at an altitude higher than 2,000 m above the sea level, and the second one located in Villahermosa, Tabasco, Mexico at an a altitude near the sea level (27 m). Both systems comprised five reactors (147-L plastic boxes) filled with volcanic slag and gravel and intermittently fed with synthetic water. The removal nitrogen efficiency found for the system located in Mexico City was higher than that of the Tabasco system (90 and 80% as TKN respectively). The higher temperatures in the Tabasco system did not enhanced the nitrogen removal as expected.
Quantitative and qualitative characteristics of grey water for reuse requirements and treatment alternatives: the case of Jordan
Authors: Ghunmi Lina Abu , Zeeman Grietje , Lier Jules van , Fayyed Manar
Published: October 2008

The objective of this work is to assess the potentials and requirements for grey water reuse in Jordan. The results revealed that urban, rural and dormitory grey water production rate and concentration of TS, BOD5, COD and pathogens varied between 18–66 L cap−1d−1, 848–1,919, 200–1,056, and 560–2,568 mg L−1 and 6.9E2–2.7E5 CFU mL−1, respectively. The grey water compromises 64 to 85% of the total water flow in the rural and urban areas. Storing grey water is inevitable to meet reuse requirements in terms of volume and timing. All the studied grey waters need treatment, in terms of solids, BOD5, COD and pathogens, before storage and reuse. Storage and physical treatment, as a pretreatment step should be avoided, since it produces unstable effluents and non-stabilized sludge. However, extensive biological treatment can combine storage and physical treatments. Furthermore, a batch-fed biological treatment system combining anaerobic and aerobic processes copes with the fluctuations in the hydrographs and pollutographs as well as the present nutrients. The inorganic content of grey water in Jordan is about drinking water quality and does not need treatment. Moreover, the grey water SAR values were 3–7, revealing that the concentrations of monovalent and divalent cations comply with agricultural demand in Jordan. The observed patterns in the hydrographs and pollutographs showed that the hydraulic load could be used for the design of both physical and biological treatment units for dormitories and hotels. For family houses the hydraulic load was identified as the key design parameter for physical treatment units and the organic load is the key design parameter for biological treatment units.
Effect of solid and liquid retention times on hydrolysis of maize
Authors: Heaven S. , Banks C. J. , Cornell M.
Published: October 2008

First stage hydrolysis/acidification, using maize as the substrate, was carried out both in single pass (SP) reactors at different hydraulic retention times (HRT) and in hydraulic flush (HF) reactors in which the solids and liquid retention time were uncoupled. The HF reactors were operated at two different loadings (2 and 4 g VS l−1 d−1) and at liquid retention times between 2–16 days with solids held for 20 days. The volatile solids destruction (VS destroyed d−1) and specific methane potential (l CH4 g VSadded d−1) of the intermediate products formed in the SP reactors both decreased with increasing retention and showed a maximum VS destruction of 55.6% at a 2-day HRT. The HF reactors showed a slightly lower VS destruction at the same loading but the methane potential was slightly higher as the intermediate COD produced had a greater proportion of volatile fatty acids (VFA) present. At the loading used it was necessary to operate the HF reactors at a HRT of less than 8 days to have any benefit over the SP reactors.
The valuation of malnutrition in the mono-digestion of maize silage by anaerobic batch tests
Authors: Hinken L. , Urban I. , Haun E. , Urban I. , Weichgrebe D. , Rosenwinkel K.-H.
Published: October 2008

Anaerobic digestion is a technology which is used to produce methane from organic solids and energy crops. Especially in recent years, the fermentation of energy crops has become more and more important because of increasing costs for energy and special benefits for renewable energy sources in Germany. Anaerobic bacteria require macro and micro nutrients to grow. Absence of these elements can inhibit the anaerobic process significantly. In particular mono-substrates like maize or certain industrial wastewater often cannot provide all required nutrients. For this reason this research investigates the influence of substrate and trace elements on anaerobic digestion in detail. Different agricultural anaerobic biomasses are analysed with special regard to their trace element content. Based on these results, the influence of three trace elements (iron, cobalt, and nickel) on anaerobic digestion was studied in anaerobic batch tests at different sludge loading rates and for different substrates (maize and acetate). Biogas production was found to be 35% for maize silage and up to 70% higher for acetate with trace element dosage than in the reference reactor.
Hydraulic retention time impact of treated recirculated leachate on the hydrolytic kinetic rate of coffee pulp in an acidogenic reactor
Authors: Houbron E. , González-López G. I. , Cano-Lozano V. , Rustrían E.
Published: October 2008

This study attempted to investigate the impact of HRT of treated leachate recirculation on hydrolysis solubilization rate of coffee pulp in an acidogenic reactor. Coffee pulp presents more than 70% of organic matter and around of 30% of lignin and cellulose. Five lab scale reactors of 20 litres were used. Each reactor was fed with 5 kg of fresh coffee pulp and anaerobic sludge was used as inoculate. HRT of 0.5, 1, 3 and 10 days were applied. Each experiment shows that Total, Soluble and VFA COD appear rapidly in the removed leachate. HRT have a great impact on hydrolytic rate with an optimal value of 32,000 mg.L−1.d−1.

Low HRT increases hydrolysis rate and in consequence reduces duration of the hydrolytic phase. Also composition and concentration of VFA are influenced by HRT. Low ones favour acetic acid production and high ones permit the production of butyric. Low HRT generates leachate more easily fermentable. Efficiency of solubilization and acidification are independent of the HRT and present average values of 78% and 65% respectively. By batch feeding solid and continuous recirculation of treated leachate, HRT and SRT could be dissociated, where solid had a very high retention without problems of load, mixing and inhibition, and liquid could be recirculated with a very high rate. Under these low HRT condition, the first reactor of a two stage anaerobic system could reduces the hydrolysis duration of organic solid waste like coffee pulp and generate an optimal leachate for the methanization process.
Effects of chemical and enzymatic treatments on the hydrolysis of swine wastewater
Authors: Lee Y. H. , Chung Y.-C. , Jung J.-Y.
Published: October 2008

Slow degradation of swine wastewater mainly due to the particulate and recalcitrant organic matters is a main disadvantage of anaerobic digestion leading to very long solids retention time. Therefore, to accelerate hydrolysis known as the rate-limiting step of the overall digestion process, chemical treatment processes under various acidic and alkaline conditions as well as enzymatic treatment processes using cellulase and protease enzymes were tested for the hydrolysis of the swine wastewater. The effectiveness of various treatment processes was compared mainly by means of an increment of soluble organics in the treated swine wastewater. Among various treatment processes tested in this study, cellulase enzymatic treatment resulted in the most efficient hydrolysis of the swine wastewater. For the cellulase enzymatic hydrolysis, the observed hydrolytic constant value was 0.42 d−1 and 26.6% of soluble organics in the swine wastewater increased within 12 hr. Compared to untreated swine wastewater, pre-treated swine wastewater by cellulase enzymatic process showed 10.7% higher anaerobic digestibility at the end of 20 d incubation and 29% higher initial methane production rate. These results further confirmed the transformation of particulate and recalcitrant organic compounds in the swine wastewater into soluble and relatively easily biodegradable organic products by the cellulase enzymatic hydrolysis.
Codigestion of manure and industrial organic waste at centralized biogas plants: process imbalances and limitations
Authors: Nielsen H. B. , Angelidaki I.
Published: October 2008

The present study focuses on process imbalances in Danish centralized biogas plants treating manure in combination with industrial waste. Collection of process data from various full-scale plants along with a number of interviews showed that imbalances occur frequently. High concentrations of ammonia or long chain fatty acids is in most cases expected to be the cause of microbial inhibitions/imbalances while foaming in the prestorage tanks and digesters is the most important practical process problem at the plants. A correlation between increased residual biogas production (suboptimal process conditions) and high fractions of industrial waste in the feedstock was also observed. The process imbalances and suboptimal conditions are mainly allowed to occur due to 1) inadequate knowledge about the waste composition, 2) inadequate knowledge about the waste degradation characteristics, 3) inadequate process surveillance, especially with regard to volatile fatty acids, and 4) insufficient pre-storage capacity causing inexpedient mixing and hindering exact dosing of the different waste products.
Mathematical modelling of disintegration-limited co-digestion of OFMSW and sewage sludge
Authors: Esposito G. , Frunzo L. , Panico A. , d'Antonio G.
Published: October 2008

This paper presents a mathematical model able to simulate under dynamic conditions the physical, chemical and biological processes prevailing in a OFMSW and sewage sludge anaerobic digestion system. The model proposed is based on differential mass balance equations for substrates, products and bacterial groups involved in the co-digestion process and includes the biochemical reactions of the substrate conversion and the kinetics of microbial growth and decay. The main peculiarity of the model is the surface based kinetic description of the OFMSW disintegration process, whereas the pH determination is based on a nine-order polynomial equation derived by acid-base equilibria. The model can be applied to simulate the co-digestion process for several purposes, such as the evaluation of the optimal process conditions in terms of OFMSW/sewage sludge ratio, temperature, OFMSW particle size, solid mixture retention time, reactor stirring rate, etc. Biogas production and composition can also be evaluated to estimate the potential energy production under different process conditions. In particular, model simulations reported in this paper show the model capability to predict the OFMSW amount which can be treated in the digester of an existing MWWTP and to assess the OFMSW particle size diminution pre-treatment required to increase the rate of the disintegration process, which otherwise can highly limit the co-digestion system.