Concepts for critical appraisal of an original research paper.

With the ever-growing evidence base it is more difficult to keep abreast of relevant issues in health care. Studies are also becoming more complex in order to address specific research and clinical questions. Appropriate interpretation of these studies is paramount to a progressive practice in health care. This article presents an intellectual framework for the critical appraisal of an original research article. (author abstract)

Operating space diagrams: a tool for designers of wastewater treatment plants

Recent years have seen the introduction of new and varied designs of activated sludge plants. With increasing needs for higher efficiencies and lower costs, the possibility of a plant that operates more effectively has created the need for tools that can be used to evaluate and compare designs at the design stage. One such tool is the operating space diagram. It is the aim of this paper to present this tool and demonstrate its application and relevance to design using a simple case study. In the case study, use of the operating space diagram suggested changes in design that would improve the flexibility of the process. It also was useful for designing suitable control strategies.

Using the World Wide Web to revolutionise technology transfer and training in the water and wastewater industries

Industry professionals of the near future will be supported by an IT infrastructure that enables them to complete a task by drawing on resources and people with expertise anywhere in the world, and access to knowledge through specific training programs that address the task requirements. The increasing uptake of new technologies enables information to reach a diverse population and to provide flexible learning environments 24 hours a day, 7 days a week. This paper examines one of the key areas where the World Wide Web will impact on the water and wastewater industries, namely technology transfer and training. The authors will present their experiences of developing online training courses for wastewater industry professionals over the last two years. The perspective is that of two people working at the coalface.

ReoPro rules: results from the 'DoTirofiban and ReoPro give similar efficacy trial' (TARGET) - A Key Paper Evaluation (Topol, Ej et al)

In the treatment of atherosclerotic disease, stenting in the presence of a glycoprotein (GP) IIb/IIIa antagonist is becoming an increasingly common procedure. The ‘Do Tirofiban and ReoPro Give Similar Efficacy Trial’ (TARGET) was designed to determine whether the cheaper tirofiban was as effective and safe as abciximab in the prevention of ischaemic events with stenting. Unexpectedly, abciximab was shown to be superior to tirofiban. Tirofiban is a selective GP IIb/IIIa antagonist whereas abciximab has additional anti-inflammatory actions, which may contribute to its superiority.

Is bucindolol BEST? (A Key Paper Evaluation)

Carvedilol, a non-selective β-adrenoceptor blocker with ancillary properties, and metoprolol and bisoprolol, selective β1-blockers without ancillary properties, have been shown to reduce mortality and morbidity in heart failure. In the Beta-blocker Evaluation of Survival Trial (BEST), bucindolol, a non-selective β-adrenoceptor blocker with different ancillary properties to carvedilol, did not reduce overall survival in heart failure. Possible explanations for this include: more Blacks being included in the trial, bucindolol being more ‘sympatholytic’ than the other β-blockers and more advanced heart failure in BEST. Another possible explanation is that bucindolol is stimulating cardiac β2-adrenoceptors to counter the effects of inhibiting cardiac β1-adrenoceptors. Bucindolol is not the best treatment and carvedilol, metoprolol and bisoprolol should be preferred in heart failure.

Clopidogrel: A CURE in acute coronary syndromes? (A Key Paper Evaluation)

The standard approach to preventing acute coronary syndromes (ACSs)has been to inhibit platelet aggregation with aspirin and to inhibit blood coagulation with low molecular-weight heparin (LMWH). Even with this combination there is still a substantial short and long-term cardiovascular risk. The Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) trial [1] compared clopidogrel plus aspirin against aspirin alone in patients with ACSs. The clopidogrel regimen was a loading dose of 300 mg p.o. followed by 75 mg/day and the recommended dose of aspirin was 75 - 325 mg/day. The first primary outcome was a composite of death from cardiovascular causes, non-fatal myocardial infarction (MI) or stroke and this occurred significantly less often in the clopidogrel than the placebo group (9.3 vs. 11.4%). Although there were more clopidogrel patients with life-threatening bleeding (clopidogrel 2.2%, placebo 1.8%), this represented GI haemorrhages and bleeding at sites of arterial puncture rather than fatal bleeding. This trial suggests a role for clopidogrel in the long-term treatment of ACSs

The influence of calcium on granular sludge in a full-scale UASB treating paper mill wastewater

Calcium precipitation can have a number of effects on the performance of high-rate anaerobic performance including cementing of the sludge bed, limiting diffusion, and diluting the active biomass. The aim of this study was to observe the influence of precipitation in a stable full-scale system fed with high-calcium paper factory wastewater. Granules were examined from an upflow anaerobic sludge blanket reactor (volume 1,805 m(3)) at a recycled paper mill with a loading rate of 5.7-6.6 kgCOD.m(-3).d(-1) and influent calcium concentration of 400-700 gCa(.)m(-3). The granules were relatively small (1 mm), with a 200-400 mum core of calcium precipitate as observed with energy dispersive X-ray spectroscopy. Compared to other granules, Methanomicrobiales not Methanobacteriales were the dominant hydrogen or formate utilisers, and putative acidogens were filamentous. The strength of the paper mill fed granules was very high when compared to granules from other full-scale reactors, and a partial linear correlation between granule strength and calcium concentration was identified.

The anammox case - A new experimental manifesto for microbiological eco-physiology

The anaerobic ammonium oxidation process is a new process for ammonia removal from wastewater. It is also a new microbial physiology that was previously believed to be impossible. The identification of Candidatus Brocadia anammoxidans and its relatives as the responsible bacteria was only possible with the development of a new experimental approach. That approach is the focus of this paper. The approach is a modernisation of the Winogradsky/Beyerinck strategy of selective enrichment and is based on the introduction of the molecular toolbox and modern bioreactor engineering to microbial ecology. It consists of five steps: (1) postulation of an ecological niche based on thermodynamic considerations and macro-ecological field data; (2) engineering of this niche into a laboratory bioreactor for enrichment culture; (3) black-box physiological characterisation of the enrichment culture as a whole; (4) phylogenetic characterisation of the enriched community using molecular tools; (5) physical separation of the dominant members of the enrichment culture using gradient centrifugation and the identification of the species of interest in accordance with Koch's postulates; (6) verification of the in situ importance of these species in the actual ecosystems. The power of this approach is illustrated with a case study: the identification of the planctomycetes responsible for anaerobic ammonium oxidation. We argue that this was impossible using molecular ecology or conventional 'cultivation based techniques' alone. We suggest that the approach might also be used for the microbiological study of many interesting microbes such as anaerobic methane oxidisers.

Phase equilibria and thermodynamics of zinc fuming slags

A range of materials is treated in zinc fuming processes to recover metal values and produce benign slag waste products. The selection of the optimum process conditions in these various technologies can be greatly assisted by the use of a chemical thermodynamic model of the system. In this paper the effects of slag chemistry on the liquidus temperatures, subliquidus phase equilibria and thermodynamic properties are described by the F*A*C*T computer package with the new thermodynamic database of the ZnO-PbO-FeO-Fe2O3-CaO-SiO2 system. The implications of these findings for plant practice are discussed.

Engineering closure of an open pit gold operation in a semi-arid climate

Along with material characteristics and geometry, the climate in which a mine is located can have a dramatic effect on the appropriate options for rehabilitation. The paper outlines the setting, mining, milling and waste disposal at Kidston Gold Mine's open pit operations in the semi-arid climate of North Queensland, Australia, before focusing on the engineering aspects of the rehabilitation of Kidston. The mine took a holistic and proactive approach to rehabilitation, and was prepared to demonstrate a number of innovative approaches, which are described in the paper. Engineering issues that had to be addressed included the geotechnical stability and deformation of waste rock dumps, including a 240 m high in-pit dump: the construction and performance monitoring of a “store and release” cover over potentially acid forming mineralised waste rock; erosion from the side slopes of the waste rock dumps; the in-pit co-disposal of waste rock and thickened tailings; the geotechnical stability of the tailings dam wall; the potential for erosion of bare tailings; the water balance of the tailings dam; direct revegetation of the tailings; and the pit hydrology. The rehabilitation of the mine represents an important benchmark in mine site rehabilitation best practice, from which lessons applicable worldwide can be shared.

An overview of APSIM, a model designed for farming systems simulation

The Agricultural Production Systems Simulator (APSIM) is a modular modelling framework that has been developed by the Agricultural Production Systems Research Unit in Australia. APSIM was developed to simulate biophysical process in farming systems, in particular where there is interest in the economic and ecological outcomes of management practice in the face of climatic risk. The paper outlines APSIM's structure and provides details of the concepts behind the different plant, soil and management modules. These modules include a diverse range of crops, pastures and trees, soil processes including water balance, N and P transformations, soil pH, erosion and a full range of management controls. Reports of APSIM testing in a diverse range of systems and environments are summarised. An example of model performance in a long-term cropping systems trial is provided. APSIM has been used in a broad range of applications, including support for on-farm decision making, farming systems design for production or resource management objectives, assessment of the value of seasonal climate forecasting, analysis of supply chain issues in agribusiness activities, development of waste management guidelines, risk assessment for government policy making and as a guide to research and education activity. An extensive citation list for these model testing and application studies is provided. Crown Copyright (C) 2002 Published by Elsevier Science B.V. All rights reserved.