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Designing for exceedance events consists in designing a continuous route for overland flow to deal with flows exceeding the sewer system’s capacity and to mitigate flooding risk. A review is carried out here on flood safety/hazard criteria, which generally establish thresholds for the water depth and flood velocity, or a relationship between them. The effects of the cross-section shape, roughness and slope of streets in meeting the criteria are evaluated based on equations, graphical results and one case study. An expedited method for the verification of safety criteria based solely on flow is presented, saving efforts in detailing models and increasing confidence in the results from simplified models. The method is valid for 0.1 m2/s ≤h.V≤ 0.5 m2/s. The results showed that a street with a 1.8% slope, K≈ 75 m1/3s−1 and a rectangular cross-section complies with the threshold h.V = 0.3 m2/s for twice the flow of a street with the same width but with a conventional cross-section shape. The flow will be four times greater for a 15% street slope. The results also highlighted that the flood flows can vary significantly along the streets depending on the sewers’ roughness and the flow transfers between the major and minor systems, such that the effort detailing a street’s cross-section must be balanced with all of the other sources of uncertainty.

RESUMO Após validação de dois diferentes métodos de mensuração de pressão arterial sistólica (PAS) não invasivos ou indiretos (oscilométrico e Doppler vascular) com o invasivo ou direto (cateterização arterial - padrão ouro) em 12 gatos hígidos anestesiados de mesma faixa etária, os métodos não invasivos foram avaliados e comparados em 24 gatos hígidos e conscientes, divididos em quatro grupos de idade. Em cada animal, procedeu-se à mensuração da pressão pelos métodos Doppler e oscilométrico. O método oscilométrico foi o primeiro a ser realizado, e, logo em seguida, o método Doppler. Os valores considerados foram obtidos das médias de sete medidas consecutivas para cada método, com intervalo de 30 segundos entre elas. A primeira medida e as medidas discrepantes (variação ˃ 20% PAS), obtidas com sinais óbvios de estresse e/ou com movimentação do animal, foram descartadas. Os métodos de mensuração oscilométrico e Doppler, embora tenham apresentado médias estatisticamente diferentes em todos os grupos, quando comparados em cada grupo, apresentaram uma correlação significativa, alta e positiva. Ou seja, sempre que for obtido um valor elevado por um método, o mesmo fato ocorrerá com o outro método e vice-versa. Clinicamente, a diferença observada não é relevante, uma vez que a diferença média dos valores obtida pelos dois métodos, em cada grupo, foi menor que 1,1%. ABSTRACT After two different validation systolic blood pressure measurement methods (PAS), not invasive or indirect (oscillometric and doppler vascular) with invasive or direct (arterial catheterization - Gold Standard) in 12 anesthetized healthy cats of the same age group, not invasive methods were evaluated and compared in 24 healthy conscious cats, divided into four age groups. In each animal, we proceeded to measure the pressure by Doppler and oscillometric methods. The oscillometric method was the first to be performed, and, shortly thereafter, the doppler method. The values considered were obtained from averages from seven consecutive measurements for each method with an interval of thirty seconds between them. The first measurement and disparate measurements (range ˃ 20% PAS) obtained with obvious signs of stress and / or animal movement were discarded. Methods of oscillometric and doppler measurement, although statistically different averages were shown in all groups when compared, each group showed a significant high positive correlation, meaning that when a high value is obtained by a method, the same occurs with the other method, and vice versa. Clinically, the observed difference is not relevant since the mean difference values obtained by the two methods, in each group was lower than 1.1%.

The role of environmental forcings on the fecal contamination dynamics in small coastal streams was investigated, using the Aljezur coastal stream (Portugal) as a test case. An integrated modeling approach, combining hydrological and coupled hydrodynamic-fecal indicator bacteria models, was applied to selected scenarios of relevant forcings, on the basis of previously calibrated and validated model applications. The forcings investigated included: tides, winds, waves, atmospheric pressure, bathymetry, river flow, and upstream fecal bacteria concentrations; this study targeted the characterization of the relative importance of these factors on the fecal contamination dynamics, to enhance our understanding of small coastal streams water quality dynamics. Results highlight distinct patterns for dry and wet periods. Fecal bacteria transport is mainly forced by tidal propagation, in dry periods; and by freshwater flows, during wet periods. The analysis reveals a complex hydraulic and water quality dyna...

Since ancient times, it is understood that stormwater from constructed areas should be managed somehow. Waste and pollution transported by stormwater poses quantity and quality problems, affecting public health and the quality of the environment. Sanitation infrastructures in urbanized regions have different development levels and the perception of stormwater changed considerably during the centuries and especially in recent years. Still, there is an evident worldwide heterogeneity when analyzing the lack of studies on urban stormwater conducted in some Asian or African countries. Strategies for sustainable stormwater management are needed at different decision levels (political, regional or local scale, for instance) but all of them need information and a clear understanding of the possibilities that are at stake as well as the main consequences of each decision. A sound approach to stormwater management should be flexible, based on local characteristics, and should take into consideration temporal, spatial and administrative factors and law, among other issues. Economic or technical constraints define different decision scenarios. Best Management Practices should be seen as an opportunity for development and improvement of social, educational and environmental conditions in urbanized and surrounding areas. Therefore they require an ample perspective and the participation of different stakeholders. High-quality decision needs time and a fair overview of the problem: the purpose of this document is to contribute to sustainable stormwater management, informing on the most relevant factors that should be assessed and their interaction. A flowchart has been produced and is presented, indicating the most relevant steps, processes and information that should be taken into account in urban development. 6787-6798 46 DHA/NRE Water Research

This study aims at understanding the fecal contamination behavior in a small coastal stream (Aljezur, Portugal), which has significant economic and ecological values. Like in most small coastal systems, circulation and water renewal in the Aljezur stream exhibit a strong variability due to their dependence on tides, waves, intermittent river flows, and a highly variable morphology. Hence, the problem was approached through a combination of field surveys and the development and application of a hard-coupled three-dimensional hydrodynamic and fecal contamination model. Salinity and temperature results have shown that mixing and transport in the stream are very sensitive to the river flow and wind forcing. The model is able to represent the main patterns and trends observed in Escherichia coli and fecal enterococcus concentrations along the stream, for different environmental and contamination conditions, suggesting die-off rates on the order of 0.50–0.55 day−1. Die-off rate and the representation of the sediment-associated processes were identified as the major remaining sources of uncertainty in the model. Results show that, owing to the processes that occur along the stream, fecal bacteria reach the beaches water in numbers that comply with the European Bathing Waters Directive, even during the summer periods when the upstream concentrations are larger. In particular, results suggest a direct relation between the tidal propagation upstream and the reduction of the fecal bacteria concentrations along the stream that can be relevant for the development of a strategy for the management of the system’s water safety.

Combined sewer systems are often unable to respond adequately to rising water volumes draining from urban areas during rainfall events, resulting in frequent direct discharges into receiving waters and floods, with severe environmental and economic impacts. Despite stricter legislation on pollution control and flood risk assessment, there are still some challenges regarding the development of early warning systems based on water quality issues and fully integrated models. An innovative, real-time urban warning system for flooding and pollution events was built for the Alcântara basin (the largest in Lisbon), to provide timely information to wastewater management entities and to civil protection services. The platform provides real-time access to monitoring data and, based on 48-hour precipitation forecasts, predicts the performance of the system through the integrated use of mathematical models for both drainage network and estuary. Predictions are automatically compared and validated with on-line data. This paper presents the overall design of the system and main results obtained thus far. The analysis of the system shows the ability of the integrated models to represent the main spatial and temporal patterns observed, effectively predicting the system response to precipitation events and estimating volumes discharged into the water bodies and their average pollution loads. Furthermore, the overall results strongly indicate UV-Vis spectra to be reliable for TSS and COD estimation in sewer systems. f7 p10 DHA/GTI

This questionnaire study looked at the diagnostics tests and specimens used to screen for Chlamydia trachomatis in UK genitourinary medicine (GUM) clinics. Replies were received from 70% (185/265) of clinics. Half used only one site to screen women. One-third took anal swabs from patients who had anal sex and 10% took oropharyngeal swabs from patients who had oral sex. Immunoassays were used to screen men for chlamydia in 86% of the clinics and women in 88%. Only 60% of male and 62% of female immunoassays were supplemented by a second test. Six per cent of clinics used molecular technique (MT) to screen men and 4% to screen women and 4% were trying to acquire it. Culture was not available to 58% of clinics. MT was not available to 81%, 89% of which was due to non provision locally and/or cost. Only 7% of clinicians thought that using MT for screening was unnecessary. There were significant differences in the availability of the technique between large academic and small clinics. A national review of GUM strategies to screen for C. trachomatis with adequate funding is urgently needed.

The current proposal for a revised European Directive concerning the quality of bathing water significantly increases the demands for the control of wet-weather discharges. A densely urbanised combined catchment was modelled for a 19-year long rainfall series in order to assess the current situation and to evaluate the benefits of potential solutions. Storage and advanced physical-chemical treatment of stormwater in the STP may significantly contribute for the reduction of the overflow volumes but reductions of the spill frequency under 2.5 spill days per bathing season are hardly obtained. This study reveals the severe strains that the local rainfall pattern may place on the control of the frequency of wet-weather discharges, pointing to serious technical, social and economical implications, at the local and at the national level, if the current proposal for a revised European Directive on Bathing Water is enforced.

OBJECTIVES: To determine the penile, perianal, and oropharyngeal candidal colonisation rates among homosexual and heterosexual males attending an STD clinic. To determine the prevalence of balanitis and candidal balanitis in the two groups. SUBJECTS: 252 heterosexual and 210 homosexual male patients attending consecutively the STD clinic in Coventry, England. DESIGN: A prospective study recording sexual behaviour, relevant history, symptoms, and examination. Specimens for candida culture were collected from the glans penis, perianal area, and oropharynx. RESULTS: Among the 462 men studied, penile, perianal, and oropharyngeal colonisation rates were 74 (16%), 70 (15%), and 116 (25%) respectively. On examination, 47 (10%) were found to have balanitis. Of the 74 patients with penile colonisation, 26 (37%) were symptomatic and 20 (27%) had balanitis. The 223 heterosexual and the 196 homosexual males who had sexual intercourse within 3 months had comparable colonisation rates of candida on the penis, perianal area, and oropharynx. Balanitis was seen in 31 heterosexuals (14%) and candidal balanitis in 16 (7%); the incidence was significantly less in homosexuals where balanitis was seen in 12 (6%) and candidal balanitis in four (2%). CONCLUSIONS: Itching or burning sensations after sex were the most common symptoms associated with penile colonisation with candida and were present in more than one third. Candidal balanitis was commoner in those who had vaginal than those who had anal intercourse within 3 months.

Wet weather urban discharges are responsible for bathing water contamination. The proposal for a revised EU Directive concerning the quality of bathing water imposes significantly more stringent requirements for the management of bathing water quality, with particularly important repercussions on beaches subjected to short-term pollution incidents. The paper reviews the aspects from EU legislation most directly related to the problem of wet-weather discharges, placing special emphasis on the recent revision process of the Directive on bathing water quality, and evaluates the benefits of some potential solutions based on continuous modelling of a combined sewer system. Increasing the sewer system storage capacity or the STP hydraulic capacity may substantially reduce the untreated discharge volumes, but spill frequency reductions under 2 to 3 spill days per bathing season will hardly be achieved. Results show the severe strains that local rainfall patterns would place on compliance with the Commission's proposal for a revised Directive and highlight the importance of the changes introduced in the amended proposal recently approved by the Council, making it less prescriptive if adequate measures are adopted to prevent bathers' exposure to short-term pollution incidents.

Six sewer sections of different combined and pseudo-separate catchments were continuously monitored for flow and sampled at preset intervals, over dry and wet weather periods. First flushes with high TSS and COD levels were observed in the outlet sewers of a 10 ha combined catchment and of an 8 ha stormwater pseudo-separate system. Higher TSS and COD concentrations were also found during the rain events in a 22 ha combined catchment. However, in two upstream 5 ha combined catchments, only a slight increase in TSS levels and no changes in COD were observed during the rain events. These results support that most of the flushed matter is stored in the larger and flatter combined sewers. Even for small intensity rain events, important increases in TSS, VTSS and COD were observed at an interceptor sewer serving several small pseudo-separate systems (80 ha). Values of all parameters tended to decrease over successive rain events and, in a third sub-event, were even smaller than the dry-weather ones. By using a simple conceptual-modelling approach, a suitable and useful relationship between precipitation and TSS loads could be established for each of the six monitored sections. However additional experimental data are needed to fully calibrate the models. If calibrated for a wide range of rain events, possibly these would allow for the evaluation of the TSS loads for longer periods.

This paper discusses the use of water quality deterministic modelling together with an integrated approach to assess the impact of urban stormwater discharges into ephemeral watercourses, based on the study of a Portuguese catchment. The description of the main aspects, difficulties and benefits found during data collection and model calibration and verification is presented, and the associated uncertainties and errors discussed. Experimental results showed a strong short- and long-term impact of sewer discharges on rivers, and confirmed deposition, resuspension and transport of pollutants as important processes for the water quality. However, the resuspension of riverbed sediment pollutants during storms was probably more significant than the direct impact of the urban discharges. The HydroWorks model was used since it allows for the calculation of pollutant build-up on catchment surfaces and in gully pots, their wash-off, and the deposition and erosion of sediments in sewers. However, it uses several constants, which could not be independently calibrated, increasing the uncertainty already associated with the data. River flows have quite different magnitude from the sewer system overflows, which, together with the difficulties in evaluating river flow rates, makes the integrated modelling approach rather complex and costly.

This paper discusses the use of water quality deterministic modelling together with an integrated approach to assess the impact of urban stormwater discharges into ephemeral watercourses, based on the study of a Portuguese catchment. The description of the main aspects, difficulties and benefits found during data collection and model calibration and verification is presented, and the associated uncertainties and errors discussed. Experimental results showed a strong short- and long-term impact of sewer discharges on rivers, and confirmed deposition, resuspension and transport of pollutants as important processes for the water quality. However, the resuspension of riverbed sediment pollutants during storms was probably more significant than the direct impact of the urban discharges. The HydroWorks™ model was used since it allows for the calculation of pollutant build-up on catchment surfaces and in gully pots, their wash-off, and the deposition and erosion of sediments in sewers. However, it uses several constants, which could not be independently calibrated, increasing the uncertainty already associated with the data. River flows have quite different magnitude from the sewer system overflows, which, together with the difficulties in evaluating river flow rates, makes the integrated modelling approach rather complex and costly.

The rehabilitation of large urban catchments is a complex duty that involves multidisciplinary teams, requires large investments and causes strong social and urban impacts. Therefore, the definition of a rehabilitation strategy plays a very important role and should be based on the integrated analysis of the entire catchment.

The carbon dioxide (CO2) laser is a surgical tool recognized for its capacity of combined simultaneous tissue transection and hemostasis without unwanted distant transmission of energy.To determine the potential of laser-assisted rhytidectomy.A preliminary group of 18 patients were treated for facial rejuvenation by a technique of laser-assisted rhytidectomy with excellent results.No major complications including hematoma were seen.Based on these initial findings, we conclude that laser-assisted rhytidectomy shows great promise for better results with diminished risks.

Hemangiomas of the head and neck region can be a therapeutic challenge depending on their size, flow rate, and location. The neodymium-yttrium aluminum garnet (Nd-YAG) laser was used to treat 16 pediatric and adult patients with cavernous, capillary, and mixed hemangiomas as well as hypertrophic port-wine stains of the head and neck. Low-power energy and intermittent short exposure accomplished photocoagulation with minimal damage to surrounding tissue. Follow-up study in these patients has ranged from 1 to 3 years with excellent results in 14 of 16 patients. Few complications and no major morbidity or mortality occurred. Photocoagulation of hemangiomas of the head and neck using the Nd-YAG laser appears to be an exciting new therapeutic option for this difficult problem. Further clinical study and follow-up appear to be warranted.

Previous studies have shown the carbon dioxide (CO2) laser to be effective in the treatment of actinic cheilitis. After CO2 laser abrasion, normal skin and marked cosmetic improvement of the lip were noted. In our study, twenty-three patients were treated with CO2 laser abrasions for cosmetic improvement of facial lines and actinic changes. Pre- and postoperative histopathologic examinations were made on two patients. Preoperative examination of specimens from actinically damaged skin showed atypical keratinocytes in the basal layer of the epidermis, with overlying dense compact orthokeratosis and parakeratosis. Abundant solar elastosis was seen in the papillary dermis. Postoperative histologic specimens showed a normal-appearing epidermis with fibrosis in the papillary dermis and minimal solar elastosis (about four weeks after laser treatment). At present, various modalities are available for the regeneration of the aged skin, including chemical peels and dermabrasion. Significantly fewer complications were noted with CO2 laser abrasion than with these methods. Thus, CO2 laser abrasion can be useful in the cosmetic and medical treatment of the aged skin. Marked clinical and histologic improvement has been demonstrated.

The current proposal for a revised European Directive concerning the quality of bathing water significantly increases the demands for the control of wet-weather discharges. A densely urbanised combined catchment was modelled for a 19-year long rainfall series in order to assess the current situation and to evaluate the benefits of potential solutions. Storage and advanced physical-chemical treatment of stormwater in the STP may significantly contribute for the reduction of the overflow volumes but reductions of the spill frequency under 2.5 spill days per bathing season are hardly obtained. This study reveals the severe strains that the local rainfall pattern may place on the control of the frequency of wet-weather discharges, pointing to serious technical, social and economical implications, at the local and at the national level, if the current proposal for a revised European Directive on Bathing Water is enforced.

Wet weather urban discharges are responsible for bathing water contamination. The proposal for a revised EU Directive concerning the quality of bathing water imposes significantly more stringent requirements for the management of bathing water quality, with particularly important repercussions on beaches subjected to short-term pollution incidents. The paper reviews the aspects from EU legislation most directly related to the problem of wet-weather discharges, placing special emphasis on the recent revision process of the Directive on bathing water quality, and evaluates the benefits of some potential solutions based on continuous modelling of a combined sewer system. Increasing the sewer system storage capacity or the STP hydraulic capacity may substantially reduce the untreated discharge volumes, but spill frequency reductions under 2 to 3 spill days per bathing season will hardly be achieved. Results show the severe strains that local rainfall patterns would place on compliance with the Commission's proposal for a revised Directive and highlight the importance of the changes introduced in the amended proposal recently approved by the Council, making it less prescriptive if adequate measures are adopted to prevent bathers' exposure to short-term pollution incidents.