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Sample records for nordheim integral treatment

  1. Support Systems for Treatment Integrity

    ERIC Educational Resources Information Center

    Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

    2016-01-01

    Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately operationalized treatment integrity procedures…

  2. Special features of Fowler-Nordheim stress degradation of SiC-MOSFETs

    NASA Astrophysics Data System (ADS)

    Murakami, Eiichi; Oda, Kazuhiro; Takeshita, Tatsuya

    2016-04-01

    SiC-MOSFETs have been markedly developed, and the main issues remaining are high-temperature stability and gate-oxide integrity. In this paper, we report special features of I ds-V gs and I g-V gs characteristics of commercially available SiC-MOSFETs during high-gate-voltage and high-temperature stress. Moreover, we introduce simple analytical models that reveal the effects of the trapped charges on the characteristics. Interface states around the conduction-band edge are suggested to be the key mechanisms of Fowler-Nordheim stress degradation (FN degradation) as well as negative bias temperature instability (NBTI), which affects both mobility and carrier density. Hole trapping is also important in FN degradation as well as NBTI. Near-interfacial electron trapping and detrapping found in positive bias temperature instability (PBTI) is also observed in FN degradation. A continuous I g increase during FN stress, which is the most specific to SiC-MOSFETs, is related to the observation that near-interfacial electron trapping has little effect on FN tunneling.

  3. Integrated nonthermal treatment system study

    SciTech Connect

    Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J.; Quapp, W.J.; Bechtold, T.; Brown, B.; Schwinkendorf, W.; Swartz, G.

    1997-01-01

    This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

  4. Fowler-Nordheim emission modified by laser pulses in the adiabatic regime

    NASA Astrophysics Data System (ADS)

    Rokhlenko, A.; Lebowitz, J. L.

    2016-06-01

    We investigate enhanced field emission due to a continuous or pulsed oscillating field added to a constant electric field E at the emitter surface. When the frequency of oscillation, field strength, and property of the emitter material satisfy the Keldysh condition γ<1 /2 , one can use the adiabatic approximation for treating the oscillating field, i.e., consider the tunneling through the instantaneous Fowler-Nordheim barrier created by both fields. Due to the great sensitivity of the emission to the field strength, the average tunneling current can be much larger than the current produced by only the constant field. We carry out the computations for arbitrary strong constant electric fields, beyond the commonly used Fowler-Nordheim approximation which exhibit, in particular, an important property of the wave function inside the potential barrier where it is found to be monotonically decreasing without oscillations.

  5. Blow-up rate estimates for the solutions of the bosonic Boltzmann-Nordheim equation

    NASA Astrophysics Data System (ADS)

    Bandyopadhyay, J.; Velázquez, J. J. L.

    2015-06-01

    In this paper, we study the behavior of a class of mild solutions of the homogeneous and isotropic bosonic Boltzmann-Nordheim equation near the blow-up. We obtain some estimates on the blow-up rate of the solutions and prove that, as long as a solution is bounded above by the critical singularity /1 x (the equilibrium solutions behave like this power law near the origin), it remains bounded in the uniform norm. In Sec. III of the paper, we prove a local existence result for a class of measure-valued mild solutions, which is of independent interest and which allows us to solve the Boltzmann-Nordheim equation for some classes of unbounded densities.

  6. Nordheim-Gorter like behavior and one carrier conduction in a quasi-one-dimensional system

    NASA Technical Reports Server (NTRS)

    Datta, T.; Hermann, A. M.; Deck, R. J.; Somoano, R. B.

    1980-01-01

    A linear correlation has been observed between the thermopower and the conductivity in the high-temperature state (T greater than 220 K) of the TTF halide and pseudohalide salts. It is suggested that this correlation indicates conduction by a single type of carrier under two types of scattering and represents the first reported extension of the Nordheim-Gorter behavior to any quasi-one-dimensional conductor.

  7. On the Blow Up and Condensation of Supercritical Solutions of the Nordheim Equation for Bosons

    NASA Astrophysics Data System (ADS)

    Escobedo, M.; Velázquez, J. J. L.

    2014-08-01

    In this paper we prove that the solutions of the isotropic, spatially homogeneous Nordheim equation for bosons with bounded initial data blow up in finite time in the L ∞ norm if the values of the energy and particle density are in the range of values where the corresponding equilibria contain a Dirac mass. We also prove that, in the weak solutions, whose initial data are measures with values of particle and energy densities satisfying the previous condition, a Dirac measure at the origin forms in finite time.

  8. On the Cauchy Problem for the Homogeneous Boltzmann-Nordheim Equation for Bosons: Local Existence, Uniqueness and Creation of Moments

    NASA Astrophysics Data System (ADS)

    Briant, Marc; Einav, Amit

    2016-06-01

    The Boltzmann-Nordheim equation is a modification of the Boltzmann equation, based on physical considerations, that describes the dynamics of the distribution of particles in a quantum gas composed of bosons or fermions. In this work we investigate the Cauchy theory of the spatially homogeneous Boltzmann-Nordheim equation for bosons, in dimension d≥slant 3. We show existence and uniqueness locally in time for any initial data in L^∞ (1+| v| ^s) with finite mass and energy, for a suitable s, as well as the instantaneous creation of moments of all order.

  9. On the Cauchy Problem for the Homogeneous Boltzmann-Nordheim Equation for Bosons: Local Existence, Uniqueness and Creation of Moments

    NASA Astrophysics Data System (ADS)

    Briant, Marc; Einav, Amit

    2016-04-01

    The Boltzmann-Nordheim equation is a modification of the Boltzmann equation, based on physical considerations, that describes the dynamics of the distribution of particles in a quantum gas composed of bosons or fermions. In this work we investigate the Cauchy theory of the spatially homogeneous Boltzmann-Nordheim equation for bosons, in dimension d≥slant 3 . We show existence and uniqueness locally in time for any initial data in L^∞ (1+| v| ^s) with finite mass and energy, for a suitable s, as well as the instantaneous creation of moments of all order.

  10. Impact of Treatment Integrity on Intervention Effectiveness

    ERIC Educational Resources Information Center

    Fryling, Mitch J.; Wallace, Michele D.; Yassine, Jordan N.

    2012-01-01

    Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity…

  11. Advances in Treatment Integrity Research: Multidisciplinary Perspectives on the Conceptualization, Measurement, and Enhancement of Treatment Integrity

    ERIC Educational Resources Information Center

    Schulte, Ann C.; Easton, Julia E.; Parker, Justin

    2009-01-01

    Documenting treatment integrity is an important issue in research and practice in any discipline concerned with prevention and intervention. However, consensus concerning the dimensions of treatment integrity and how they should be measured has yet to emerge. Advances from three areas in which significant treatment integrity work has taken…

  12. Practical Consideration of Both Endurance and Performance for Sub-90 nm Embedded Two Transistor Fowler-Nordheim Tunneling Flash Memory

    NASA Astrophysics Data System (ADS)

    Lee, Yong Kyu; Seo, Boyoung

    2012-02-01

    Practical consideration about performance and endurance of two transistor Fowler-Nordheim tunneling (2T-FN) embedded flash cell has been suggested to expand its application not only for subscriber identity module (SIM) but also new various uses in smart-phone. We present practical 35% improvement on endurance characteristics (ΔVth) without any performance degradation.

  13. A simple method for determination of Fowler-Nordheim tunnelling parameters

    NASA Astrophysics Data System (ADS)

    Casados-Cruz, G.; Reyes-Barranca, M. A.; Moreno-Cadenas, J. A.

    2011-05-01

    A simple technique for extracting the Fowler-Nordheim (FN) tunnelling parameters is proposed. It consists of measuring the Drain-Source current of a floating gate transistor while a linear ramp voltage is applied to a simple injector structure attached to the transistor's floating gate. Such a test device is fabricated using a standard CMOS process. The parameters obtained can be used in a freely available electrical simulator as SPICE3f5 (NGSPICE), but in general it can be easily adapted to other SPICE-like programs. We describe the technique step-by-step and a comparison is made of simulated and measured FN tunnelling parameters, for a floating gate transistor with tunnelling injectors. A good agreement has been found between experimental and simulated data.

  14. INTEGRATED WATER TREATMENT SYSTEM PERFORMANCE EVALUATION

    SciTech Connect

    SEXTON RA; MEEUWSEN WE

    2009-03-12

    This document describes the results of an evaluation of the current Integrated Water Treatment System (IWTS) operation against design performance and a determination of short term and long term actions recommended to sustain IWTS performance.

  15. Waste treatment integration in space

    NASA Technical Reports Server (NTRS)

    Baresi, L.; Kern, R.

    1991-01-01

    The circumstances and criteria for space-based waste treatment bioregenerative life-support systems differ in many ways from those needed in terrestrial applications. In fact, the term "waste" may not even be appropriate in the context of nearly closed, cycling, ecosystems such as those under consideration. Because of these constraints there is a need for innovative approaches to the problem of "materials recycling". Hybrid physico-chemico-biological systems offer advantages over both strictly physico-chemico or biological approaches that would be beneficial to material recycling. To effectively emulate terrestrial cycling, the use of various microbial consortia ("assemblies of interdependent microbes") should be seriously considered for the biological components of such systems. This paper will examine the use of consortia in the context of a hybrid-system for materials recycling in space.

  16. Waste treatment integration in space.

    PubMed

    Baresi, L; Kern, R

    1991-10-01

    The circumstances and criteria for space-based waste treatment bioregenerative life-support systems differ in many ways from those needed in terrestrial applications. In fact, the term "waste" may not even be appropriate in the context of nearly closed, cycling, ecosystems such as those under consideration. Because of these constraints there is a need for innovative approaches to the problem of "materials recycling". Hybrid physico-chemico-biological systems offer advantages over both strictly physico-chemico or biological approaches that would be beneficial to material recycling. To effectively emulate terrestrial cycling, the use of various microbial consortia ("assemblies of interdependent microbes") should be seriously considered for the biological components of such systems. This paper will examine the use of consortia in the context of a hybrid-system for materials recycling in space. PMID:11537702

  17. Treatment Integrity Assessment in the Schools: An Evaluation of the Treatment Integrity Planning Protocol

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Kratochwill, Thomas R.

    2009-01-01

    The Treatment Integrity Planning Protocol (TIPP) provides a structured process for collaboratively creating a treatment integrity assessment within a consultation framework. The authors evaluated the effect of the TIPP on the implementation of an intervention designed to improve the consistency of students' mathematics performance. Treatment…

  18. Relationships among the physical parameters required to give a linear relation between slope and intercept of Fowler-Nordheim plots.

    PubMed

    Gotoh, Y; Tsuji, H; Ishikawa, J

    2001-10-01

    For field emitters with a given surface condition, but different apex radii, there exists an empirical linear relationship between the slopes and intercepts of their Fowler-Nordheim plots. This behavior is quite different from that predicted by the theory with the assumption of a smooth surface. We have already characterized the possible reasons for this discrepancy; one possibility is that the emission area rapidly increases with increase in the apex radius. The previous report (Jpn. J. Appl. Phys. Part II 32 (1993) L342), however, showed a curved relation between the slope and the intercept of Fowler-Nordheim plots. In the present article, we try to extract the relationship between the emission area and the apex radius needed in order to give a linear relationship between slope and intercept of the F-N plots. As an additional result of the present analysis, the change in work function of the field emitting surface is demonstrated. PMID:11770752

  19. Barriers to Infertility Treatment: An Integrated Study

    PubMed Central

    Mosalanejad, Leili; Parandavar, Nehle; Abdollahifard, Sareh

    2014-01-01

    Background: Infertility is one of the most important events in life. Despite the negative impact of infertility, a significant number of women struggling to conceive do not consult a physician and do not fallow up infertility treatment. This integrated study aimed to investigate a large amount of factors which influenced discontinuation of infertility treatment. Methods: This integrated study (qualitative – quantitative study) was done on infertile women who had referred to infertility center in Jahrom University of medical sciences using purposive sampling. In the first study, data were collected from a valid questionnaire with 22 questions in a 5-point likert scale about barriers to infertility treatments and in the second study, as a phenomenology approach, data collection was done using deep unstructured interviews and focused groups were aimed to identify deep individual experiences about it. Results: major barriers to infertility treatments included the probability of treatment failure (52.5%), couple’s age and possibility of high risk pregnancy (51.5%), Painfulness of some treatment methods such as laparoscopy (50.5%). Qualitative results led to the identification of three main themes: Nature of treatment, negative thinking, social and cultural factors. Conclusion: As a result, we suggest family education and enrichment of cultural context in the field of infertility; infertile people would be willing to pursue infertility treatments. PMID:24373278

  20. Fowler-Nordheim tunneling induced charge transfer plasmons between nearly touching nanoparticles.

    PubMed

    Wu, Lin; Duan, Huigao; Bai, Ping; Bosman, Michel; Yang, Joel K W; Li, Erping

    2013-01-22

    Reducing the gap between two metal nanoparticles down to atomic dimensions uncovers novel plasmon resonant modes. Of particular interest is a mode known as the charge transfer plasmon (CTP). This mode has been experimentally observed in touching nanoparticles, where charges can shuttle between the nanoparticles via a conductive path. However, the CTP mode for nearly touching nanoparticles has only been predicted theoretically to occur via direct tunneling when the gap is reduced to ~0.4 nm. Because of challenges in fabricating and characterizing gaps at these dimensions, experiments have been unable to provide evidence for this plasmon mode that is supported by tunneling. In this work, we consider an alternative tunneling process, that is, the well-known Fowler-Nordheim (FN) tunneling that occurs at high electric fields, and apply it for the first time in the theoretical investigation of plasmon resonances between nearly touching nanoparticles. This new approach relaxes the requirements on gap dimensions, and intuitively suggests that with a sufficiently high-intensity irradiation, the CTP can be excited via FN tunneling for a range of subnanometer gaps. The unique feature of FN tunneling induced CTP is the ability to turn on and off the charge transfer by varying the intensity of an external light source, and this could inspire the development of novel quantum devices. PMID:23215253

  1. Fowler-Nordheim plot characteristics for ZnO virtual field emitter array

    NASA Astrophysics Data System (ADS)

    Al-Tabbakh, Ahmed A.

    2015-09-01

    Linear and nonlinear Fowler-Nordheim (FN) plots from semiconductors emitters arrays were equally reported by researchers with occasionally inexplicit justification of either behaviour. Interpretation of experimental field emission data depends on explaining the FN plot behaviour from these arrays. The FN plot behaviour was investigated for virtual arrays of ZnO emitters with defined geometries based on fundamental electron tunnelling from semiconductors. The effects of emitters' size distribution, saturation of conduction band (CB) current and contribution of valence band (VB) current on FN plot behaviour were investigated and discussed in detail. Comparison with some experimental results was introduced in support of the discussion. Results showed that saturation of CB current and contribution of VB electrons may not always be manifested as a well-observed deviation from linear characteristic of the FN plot. In addition, the dependence of the CB current on the emitters' geometries was found to affect the FN plot behaviour. The present investigation is thought to be of great importance to field emission community and help for better interpretation of experimental field emission data.

  2. [Integrated multidisciplinary treatment modalities for obesity].

    PubMed

    Yu, Jian-chun

    2010-02-01

    The rapid increase of obesity nationwide and worldwide has threatened human health and caused the increase of metabolic diseases and the changes of disease spectrum. Its co-morbidities, mortality, and relevant socio-economic issues have became global concerns. Integrated multidisciplinary treatment modalities have emerged in recent years. For severely obese patients body mass index (BMI>40 kg/m(2) or obese patients (BMI 35 - 40 kg/m(2)) with co-morbidities such as severe diabetes, obesity-associated cardiac lesions, severe sleep apnea, infertility, and osteoarthritis that affect the daily life, minimally invasive laparoscopic bariatric surgery (such as Lap Banding) can achieve satisfactory results by reducing body weight in long term, treating or preventing the co-morbidities, and ultimately decreasing mortality. Multidisciplinary treatment modalities for tumors, obesity, and other diseases have been widely adopted. This strategy may play increasingly important roles in improving the treatment effectiveness, upgrading healthcare services, and addressing interdisciplinary problems. PMID:20236577

  3. [Integrated treatments of rectal carcinoma (review)].

    PubMed

    Gennari, Leandro; Doci, Roberto; Rossetti, Carlo; Bagnoli, Pietro; Eboli, Marco; Brocchi, Andrea

    2002-01-01

    We have reviewed the international literature regarding the treatment of rectal carcinoma. Over the last decades the evolution of treatment methods has led to a drastic fall in the incidence of local recurrences which has gone from a wide range (15-40%) to a much lower figure (10%). This favourable result has been reached also due to improvement in surgical techniques (total mesorectal excision) and to the use of an association of preoperative radio and chemotherapy. However, the drugs and dosage of these as well as of the RT still have to be defined. In our experience the integrated treatment has brought a downstaging of the T in 60% of cases and of the N in 15%. PMID:12613323

  4. Conceptual and Methodological Issues in Treatment Integrity Measurement

    ERIC Educational Resources Information Center

    McLeod, Bryce D.; Southam-Gerow, Michael A.; Weisz, John R.

    2009-01-01

    This special series focused on treatment integrity in the child mental health and education field is timely. The articles do a laudable job of reviewing (a) the current status of treatment integrity research and measurement, (b) existing conceptual models of treatment integrity, and (c) the limitations of prior research. Overall, this thoughtful…

  5. Enhanced integrated nonthermal treatment system study

    SciTech Connect

    Biagi, C.; Schwinkendorf, B.; Teheranian, B.

    1997-02-01

    The purpose of the Enhanced Nonthermal Treatment Systems (ENTS) study is to evaluate alternative configurations of one of the five systems evaluated in the Integrated Nonthermal Treatment Systems (INTS) study. Five alternative configurations are evaluated. Each is designed to enhance the final waste form performance by replacing grout with improved stabilization technologies, or to improve system performance by improving the destruction efficiency for organic contaminants. AU enhanced systems are alternative configurations of System NT-5, which has the following characteristics: Nonthermal System NT-5: (1) catalytic wet oxidation (CWO) to treat organic material including organic liquids, sludges, and soft (or combustible) debris, (2) thermal desorption of inorganic sludge and process residue, (3) washing of soil and inorganic debris with treatment by CWO of removed organic material, (4) metal decontamination by abrasive blasting, (5) stabilization of treated sludge, soil, debris, and untreated debris with entrained contamination in grout, and (6) stabilization of inorganic sludge, salts and secondary waste in polymer. System NT-5 was chosen because it was designed to treat combustible debris thereby minimizing the final waste form volume, and because it uses grout for primary stabilization. The enhanced nonthermal systems were studied to determine the cost and performance impact of replacing grout (a commonly used stabilization agent in the DOE complex) with improved waste stabilization methods such as vitrification and polymer.

  6. Enhancing Treatment Integrity Maintenance through Fading with Indiscriminable Contingencies

    ERIC Educational Resources Information Center

    Gross, Thomas J.; Duhon, Gary J.; Doerksen-Klopp, Bethany

    2014-01-01

    School psychologists are often asked to develop treatment to remediate students' academic skills or social behavior problems. When teachers implement treatment recommendations with high levels of treatment integrity, students benefit. Treatment integrity has been enhanced by use of direct training, performance feedback, and negative…

  7. Automated radiotherapy treatment plan integrity verification

    SciTech Connect

    Yang Deshan; Moore, Kevin L.

    2012-03-15

    Purpose: In our clinic, physicists spend from 15 to 60 min to verify the physical and dosimetric integrity of radiotherapy plans before presentation to radiation oncology physicians for approval. The purpose of this study was to design and implement a framework to automate as many elements of this quality control (QC) step as possible. Methods: A comprehensive computer application was developed to carry out a majority of these verification tasks in the Philips PINNACLE treatment planning system (TPS). This QC tool functions based on both PINNACLE scripting elements and PERL sub-routines. The core of this technique is the method of dynamic scripting, which involves a PERL programming module that is flexible and powerful for treatment plan data handling. Run-time plan data are collected, saved into temporary files, and analyzed against standard values and predefined logical rules. The results were summarized in a hypertext markup language (HTML) report that is displayed to the user. Results: This tool has been in clinical use for over a year. The occurrence frequency of technical problems, which would cause delays and suboptimal plans, has been reduced since clinical implementation. Conclusions: In addition to drastically reducing the set of human-driven logical comparisons, this QC tool also accomplished some tasks that are otherwise either quite laborious or impractical for humans to verify, e.g., identifying conflicts amongst IMRT optimization objectives.

  8. Integration of Antiretroviral Therapy with Tuberculosis Treatment

    PubMed Central

    Abdool Karim, Salim S.; Naidoo, Kogieleum; Grobler, Anneke; Padayatchi, Nesri; Baxter, Cheryl; Gray, Andrew L.; Gengiah, Tanuja; Gengiah, Santhanalakshmi; Naidoo, Anushka; Jithoo, Niraksha; Nair, Gonasagrie; El-Sadr, Wafaa M.; Friedland, Gerald; Abdool Karim, Quarraisha

    2011-01-01

    Background We previously reported that integrating antiretroviral therapy (ART) with tuberculosis treatment reduces mortality. However, optimal time to initiate ART during tuberculosis treatment remains contentious. Methods To address this, we conducted a 3-arm, open-label randomized controlled trial in South Africa in acid-fast bacilli smear positive patients (n=642) with HIV and CD4+ counts <500 cells/mm3. Findings on the early therapy group (ART initiated within 4 weeks of tuberculosis treatment initiation, n=214) and late therapy group (ART initiated within the first 4 weeks of the continuation phase of tuberculosis treatment, n=215) are presented here. Results Median CD4+ count and viral load at baseline was 150 cells/mm3 and 161000 copies/ml, being similar in both groups. Incidence rate of AIDS or death was 6.9 (18/259.4) and 7.8 (19/244.2) per 100 person-years in the early and late therapy groups respectively (Incidence Rate Ratio (IRR)=0.89; 95%Confidence Interval (95%CI): 0.44,1.79; P=0.73). However, in patients with CD4+ counts <50 cells/mm3, the incidence rates of AIDS or death were 8.5 (early) and 26.3 (late) per 100 person-years (IRR=0.32; 95%CI: 0.07,1.13; P=0.06). Immune reconstitution inflammatory syndrome (IRIS) incidence rates were 20.2 (early) and 7.7 (late) per 100 person-years (IRR=2.62; 95%CI: 1.48,4.82; P<0.001). Adverse events requiring antiretroviral drug switches occurred in 10 (early) and 1 (late) patients (P=0.006). Conclusions The benefits of AIDS-free survival balanced against the risks of IRIS and ART-related adverse events, support early ART initiation in patients with CD4+ counts <50 cells/mm3 and deferred ART initiation to the continuation phase of tuberculosis treatment when CD4+ counts are higher. PMID:22010915

  9. Investigating the Relationship between Training Type and Treatment Integrity.

    ERIC Educational Resources Information Center

    Sterling-Turner, Heather E.; Watson, T. Steuart; Wildmon, Mark; Watkins, Carrie; Little, Elizabeth

    2001-01-01

    Investigates the relationship between three training procedures (didactic, modeling, or rehearsal feedback) and treatment integrity. Results indicate that higher levels of treatment integrity were associated with direct training procedures. Discusses implications for treatment planning and potential ramifications for consultants working in…

  10. RAPID COMMUNICATION: Influence of nitrogen concentration in nitrided oxides on interface trap generation caused by Fowler-Nordheim injection

    NASA Astrophysics Data System (ADS)

    Chen, T. P.; Huang, Jiayi; Tse, M. S.

    2002-11-01

    In this study, a novel technique, i.e. the direct-current current-voltage method is used to quantitatively examine the influence of nitrogen concentration in nitrided oxides on interface trap generation caused by Fowler-Nordheim injection. A power-law stress time dependence of interface trap generation is always observed. As the nitrogen concentration is increased, the exponent of the power law is reduced leading to a significant suppression of interface trap generation. However, no significant polarity dependence from the influence of nitrogen concentration is observed. These experimental findings are used to clarify the two models that have been proposed to explain the reduced degradation of nitrided oxides under electrical stress.

  11. K West integrated water treatment system subproject safety analysis document

    SciTech Connect

    SEMMENS, L.S.

    1999-02-24

    This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System.

  12. Integrated Treatment of Substance Use and Psychiatric Disorders

    PubMed Central

    Kelly, Thomas M.; Daley, Dennis C.

    2013-01-01

    Epidemiological studies find that psychiatric disorders, including mental disorders and substance use disorders, are common among adults and highly comorbid. Integrated treatment refers to the focus of treatment on two or more conditions and to the use of multiple treatments such as the combination of psychotherapy and pharmacotherapy. Integrated treatment for comorbidity has been found to be consistently superior compared to treatment of individual disorders with separate treatment plans. This article focuses on a review of the risks for developing comorbid disorders and the combinations of treatments that appear to be most effective for clients with particular comorbid disorders. PMID:23731427

  13. An Evaluation of the Observer Effect on Treatment Integrity in a Day Treatment Center for Children

    ERIC Educational Resources Information Center

    Howard, Monica R.; Burke, Raymond V.; Allen, Keith D.

    2013-01-01

    Treatment integrity is an important concern in treatment centers but is often overlooked. Performance feedback is a well-established approach to improving treatment integrity, but is underused and undervalued. One way to increase its value to treatment centers may be to expose unrealized benefits on the observer who collects the performance…

  14. Barriers to Implementing Treatment Integrity Procedures: Survey of Treatment Outcome Researchers

    ERIC Educational Resources Information Center

    Perepletchikova, Francheska; Hilt, Lori M.; Chereji, Elizabeth; Kazdin, Alan E.

    2009-01-01

    Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity…

  15. Treatment Integrity in Behavioral Consultation: Measurement, Promotion, and Outcomes

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Kratochwill, Thomas R.

    2008-01-01

    The purpose of this article is to provide an overview of the current state of research in the area of treatment integrity as it relates to behavioral consultation. To this end, four primary topics are discussed. First, a rationale for why treatment integrity is an important professional and methodological concern is presented. Second,…

  16. Effects of Verbal and Graphed Feedback on Treatment Integrity

    ERIC Educational Resources Information Center

    Zoder-Martell, Kimberly; Dufrene, Brad; Sterling, Heather; Tingstrom, Daniel; Blaze, John; Duncan, Neelima; Harpole, Lauren

    2013-01-01

    Treatment integrity is the degree to which an intervention is implemented as designed and is critical for concluding whether the intervention is responsible for treatment outcomes. This study aimed to add to the integrity literature by examining graphed performance feedback alone and in conjunction with verbal performance feedback for increasing…

  17. Summary of comparative results integrated nonthermal treatment and integrated thermal treatment systems studies

    SciTech Connect

    1996-12-01

    In July 1994, the Idaho National Engineering Laboratory (INEL), under a contract from U.S. Department of Energy`s (DOE) Environment Management Office of Science and Technology (OST, EM-50) published a report entitled {open_quotes}Integrated Thermal Treatment System Study - Phase 1 Results{close_quotes} (EGG-MS-11211). This report was the culmination of over a year of analysis involving scientists and engineers within the DOE complex and from private industry. The purpose of that study was {open_quotes}to conduct a systematic engineering evaluation of a variety of mixed low level waste (MLLW) treatment system alternatives.{close_quotes} The study also {open_quotes}identified the research and development, demonstrations, and testing and evaluation needed to assure unit operability in the most promising alternative system.{close_quotes} This study evaluated ten primary thermal treatment technologies, organized into complete {open_quotes}cradle-to-grave{close_quotes} systems (including complete engineering flow sheets), to treat DOE MLLW and calculated mass balances and 20-year total life cycle costs (TLCC) for all systems. The waste input used was a representative heterogenous mixture of typical DOE MLLW. An additional study was conducted, and then, based on response to these studies, additional work was started to investigate and evaluate non-thermal treatment options on a footing comparable to the effort devoted to thermal options. This report attempts to present a summary overview of the thermal and non-thermal treatment technologies which were examined in detail in the process of the above mentioned reviews.

  18. Maintaining Cultural Integrity in Residential Treatment

    ERIC Educational Resources Information Center

    Pazaratz, Don

    2005-01-01

    Cross-cultural residential placement of children and adolescents requires careful attention to the youth's culture of origin, so that the delivery of the treatment service is respectful of his or her way of life. Cultural protection in treatment facilities, as a principle, ensures that the traditions, symbols, values, norms, and the worldview, as…

  19. Integrated treatment of multiple subgingival fractures.

    PubMed

    Cheshire, P D

    1991-08-01

    With careful planning an apparently "hopeless case" can be treated successfully and conservatively. The case report of an 18 year old male requiring a combined periodontic, endodontic and prosthodontic approach is presented. With emphasis on treatment planning and emergency cover in the new dental contract, the approach to the treatment plan is discussed. PMID:1813937

  20. Barriers to Implementing Treatment Integrity Procedures in School Psychology Research: Survey of Treatment Outcome Researchers

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; DiGennaro Reed, Florence D.

    2012-01-01

    Treatment integrity data are essential to drawing valid conclusions in treatment outcome studies. Such data, however, are not always included in peer-reviewed research articles in school psychology or related fields. To gain a better understanding of why treatment integrity data are lacking in the school psychology research, we surveyed the…

  1. Fowler-Nordheim electron tunneling mechanism in Ni/SiO2/n-4H SiC MOS devices

    NASA Astrophysics Data System (ADS)

    Kodigala, Subba Ramaiah; Chattopadhyay, S.; Overton, C.; Ardoin, I.

    2015-12-01

    The Ni/SiO2/n-type 4H SiC MOS devices have been fabricated for microelectronic device applications. The SiO2 layer employed in the MOS devices is grown by wet thermal oxidation process. The current-field characteristics of Ni/SiO2/n-type 4H SiC MOS devices are quiet interestingly studied by employing Fowler Nordheim (FN) conduction tunneling model, which is verified by theoretical simulation. It is learnt that the tunneling current through the barrier in the MOS devices promptly obeys the FN conduction tunneling mechanism. The simulation results show that the current in the MOS device increases and barrier height decreases with increasing temperature and internal electric field. Therefore, the correction factor for the barrier height of n-type 4H SiC/SiO2 MOS device due to the influence of both the temperature and internal electric field is employed. The barrier height observed by the experiments is apparently smaller than the simulated one of an ideal MOS device. However, after employing all the correction factors to the barrier height, the simulated current-field curves fairly coincide with the experimental results. The reason for obtaining smaller experimental barrier height for MOS devices is substantially explored with the support of current-field (J-F) analysis. On the other hand, this article comprehensively addresses the effects of quantum mechanical, interface trap density and thickness of 4H-SiC on the barrier height.

  2. The Fowler-Nordheim behavior and mechanism of photo-sensitive field from SnS{sub 2} nanosheets

    SciTech Connect

    Suryawanshi, Sachin R.; Chaudhari, Nilima S.; Warule, Sambhaji S.; More, Mahendra A.

    2015-06-24

    Here in, we report photo-sensitive field emission measurements of SnS{sub 2} nanosheets at base pressure of ∼1×10{sup −8} mbar are reported. The nonlinear Fowler-Nordheim (F-N) plot is elucidate according to a (F-N) model of calculation based on shift in a saturation of conduction band current density after light illumination and prevalence of valence band current density at high electric field values. The model of calculation suggests that the slope variation before and after visible light illumination of the F-N plot, in the high-field and low-field regions, does not depend on the magnitude of saturation but also depend on charge carrier (electron) concentration get increased in conduction band. The F-N model of calculation is important for the fundamental understanding of the photo-sensitive field emission mechanism of semiconducting SnS{sub 2}. The replicate F-N plots exhibit similar features to those observed experimentally. The model calculation suggests that the nonlinearity of the F-N plot is a characteristic of the photo-enhanced energy band structure of the photo-sensitive semiconductor material.

  3. Characterization of NiSi nanowires as field emitters and limitations of Fowler-Nordheim model at the nanoscale

    NASA Astrophysics Data System (ADS)

    Belkadi, Amina B.; Gale, E.; Isakovic, A. F.

    2015-03-01

    Nanoscale field emitters are of technological interest because of the anticipated faster turn-on time, better sustainability and compactness. This report focuses on NiSi nanowires as field emitters for two reasons: (a) possible enhancement of field emission in nanoscale field emitters over bulk, and (b) achieving the same field emission properties as in bulk, but at a lower energy cost. To this end, we have grown, fabricated and characterized NiSi nanowires as field emitters. Depending on the geometry of the NiSi nanowires (aspect ratio, shape etc.), the relevant major field emission parameters, such as (1) the turn-on field, (2) the work function, and (3) the field enhancement factor, can be comparable or even superior to other recently explored nanoscale field emitters, such as CdS and ZnO. We also report on a comparative performance of various nanoscale field emitters and on the difficulties in the performance comparison in the light of relatively poor applicability of the standard Folwer-Nordheim model for field emission analysis for the case of the nanoscale field emitters. Proposed modifications are discussed. This work is supported through SRC-ATIC Grant 2011-KJ-2190. We also acknoweldge BNL-CFN and Cornell CNF facilities and staff.

  4. Evaluating Alcoholism Treatment Programs: An Integrated Approach.

    ERIC Educational Resources Information Center

    Cronkite, Ruth C.; Moos, Rudolf H.

    1978-01-01

    Examined variables (social background, intake symptoms, program type, treatment experiences, and perceptions of environment) related to posttreatment functioning of alcoholic patients. Results showed the combined explanatory power of program-related variables was more than expected. Explained variance was shared between patient-related and…

  5. Phosphorus removal from secondary effluents through integrated constructed treatment system.

    PubMed

    Xiong, Jibing; Qin, Yong; Mahmood, Qaisar; Liu, Hanhu; Yang, Dejun

    2011-01-01

    The treatment capacity of an integrated constructed treatment system (CTS) was explored which was designed to reduce phosphorus (P) from secondary effluents. The integrated CTS was combined with vertical-flow constructed wetland, floating bed and sand filter. The vertical wetland was filled from the bottom to the top with gravels, steel slag and peat. Vetiverzizanioides (L.) Nash was selected to grow in the vertical constructed wetland while Coixlacrymajobi L. was grown in floating bed. The results suggested that integrated CTS displayed excellent removal efficiency for chemical oxygen demand (COD), dissolved phosphorus (DP), and total phosphorus (TP). The average COD removal efficiency of the integrated CTS was 90.45% after 40 days of operation, the average DP and TP removal efficiencies of the integrated CTS were 97.43% and 96.40%, respectively. The integrated CTS has good potential in removing COD as well as P from secondary effluents. PMID:21570097

  6. Treatment Integrity: An Essential--But Often Forgotten--Component of School-Based Interventions

    ERIC Educational Resources Information Center

    Lane, Kathleen L.; Bocian, Kathleen M.; MacMillan, Donald L.; Gresham, Frank M.

    2004-01-01

    In this article, the authors introduce the construct of treatment integrity and illustrate the importance of treatment integrity as it relates to school-based intervention. Specifically, the authors address the following questions: What is treatment integrity? Why is it important to assess treatment integrity? How can treatment integrity be…

  7. Spiritually Integrated Treatment of Depression: A Conceptual Framework

    PubMed Central

    Peteet, John R.

    2012-01-01

    Many studies have found an inverse correlation between religious/spiritual involvement and depression. Yet several obstacles impede spiritually integrated treatment of depressed individuals. These include specialization and fragmentation of care, inexperience of clinicians and spiritual care providers, ideological bias, boundary and ethical concerns, and the lack of an accepted conceptual framework for integrated treatment. Here I suggest a framework for approaching these obstacles, constructed from a unified view of human experience (having emotional, existential, and spiritual dimensions); spirituality seen as a response to existential concerns (in domains such as identity, hope, meaning/purpose, morality, and autonomy in relation to authority, which are frequently distorted and amplified in depression); a rationale for locating spiritually oriented approaches within a clinician's assessment, formulation, and treatment plan; and recognition of the challenges and potential pitfalls of integrated treatment. PMID:22577530

  8. Extraction of emission parameters for large-area field emitters, using a technically complete Fowler-Nordheim-type equation

    NASA Astrophysics Data System (ADS)

    Forbes, Richard G.

    2012-03-01

    In papers on cold field electron emission from large-area field emitters (LAFEs), it has become widespread practice to publish a misleading Fowler-Nordheim-type (FN-type) equation. This equation over-predicts the LAFE-average current density by a large highly variable factor thought to usually lie between 103 and 109. This equation, although often referenced to FN’s 1928 paper, is a simplified equation used in undergraduate teaching, does not apply unmodified to LAFEs and does not appear in the 1928 paper. Technological LAFE papers often do not cite any theoretical work more recent than 1928, and often do not comment on the discrepancy between theory and experiment. This usage has occurred widely, in several high-profile American and UK applied-science journals (including Nanotechnology), and in various other places. It does not inhibit practical LAFE development, but can give a misleading impression of potential LAFE performance to non-experts. This paper shows how the misleading equation can be replaced by a conceptually complete FN-type equation that uses three high-level correction factors. One of these, or a combination of two of them, may be useful as an additional measure of LAFE quality; this paper describes a method for estimating factor values using experimental data and discusses when it can be used. Suggestions are made for improved engineering practice in reporting LAFE results. Some of these should help to prevent situations arising whereby an equation appearing in high-profile applied-science journals is used to support statements that an engineering regulatory body might deem to involve professional negligence.

  9. Managing integrated oncology treatment in virtual networks.

    PubMed

    Stanicki, Verena; Becker, Matthias; Böckmann, Britta

    2015-01-01

    Interdisciplinary and intersectoral coordinated healthcare management based on Clinical Practice Guidelines is essential to achieve high quality in oncological networks. The objective of our research project is to create a cookbook, which can be used by oncological networks as a template. The cookbook is based on guideline-compliant care processes. To develop these care processes, the three S3-guidelines breast, colon and prostate carcinoma have been formalized. The thus-obtained platform-independent process fragments were transformed into an underlying metamodel, which is based on HL7 and can be used for modeling clinical pathways. Additional, qualitative guided interviews were chosen to capitalize on the experts' (e.g. chief residents, resident specialists) wide knowledge and experience in oncological health care management. One of these use cases (tumor board scheduling) is developed for a healthcare management platform which is linked to a national electronic case record. The projected result of our approach is a cookbook which shows, how the treatment can be controlled by interdisciplinary and intersectoral care processes in an oncological network. PMID:26063274

  10. Biological treatment and ozone oxidation: Integration or coupling?

    PubMed

    Di Iaconi, Claudio

    2012-02-01

    Wastewaters generated by many economically relevant industrial activities contain recalcitrant organic compounds which pass unaltered through biological stage of the treatment plant making it difficult to meet the discharge limits currently in force. Therefore, an additional treatment is usually required to remove these compounds. In this study, the application of ozonation together with biological treatment was investigated. In particular, the effectiveness of biological degradation followed by or integrated with ozonation for treating the effluents produced by three environmentally relevant activities (i.e., leather and textile processing and municipal waste landfilling) are compared in the present paper. The results show that biological treatment followed by ozonation does not guarantee depurative levels sufficient for discharge for landfill leachates and tannery wastewater. On the contrary, thanks to the synergy between biological degradation and ozonation, integrated treatment significantly improves the process performance for all the investigated wastewaters, thus allowing the discharge limits to be met. PMID:22206914

  11. Process modeling for the Integrated Nonthermal Treatment System (INTS) study

    SciTech Connect

    Brown, B.W.

    1997-04-01

    This report describes the process modeling done in support of the Integrated Nonthermal Treatment System (INTS) study. This study was performed to supplement the Integrated Thermal Treatment System (ITTS) study and comprises five conceptual treatment systems that treat DOE contract-handled mixed low-level wastes (MLLW) at temperatures of less than 350{degrees}F. ASPEN PLUS, a chemical process simulator, was used to model the systems. Nonthermal treatment systems were developed as part of the INTS study and include sufficient processing steps to treat the entire inventory of MLLW. The final result of the modeling is a process flowsheet with a detailed mass and energy balance. In contrast to the ITTS study, which modeled only the main treatment system, the INTS study modeled each of the various processing steps with ASPEN PLUS, release 9.1-1. Trace constituents, such as radionuclides and minor pollutant species, were not included in the calculations.

  12. Treatment of domain integrals in boundary element methods

    SciTech Connect

    Nintcheu Fata, Sylvain

    2012-01-01

    A systematic and rigorous technique to calculate domain integrals without a volume-fitted mesh has been developed and validated in the context of a boundary element approximation. In the proposed approach, a domain integral involving a continuous or weakly-singular integrand is first converted into a surface integral by means of straight-path integrals that intersect the underlying domain. Then, the resulting surface integral is carried out either via analytic integration over boundary elements or by use of standard quadrature rules. This domain-to-boundary integral transformation is derived from an extension of the fundamental theorem of calculus to higher dimension, and the divergence theorem. In establishing the method, it is shown that the higher-dimensional version of the first fundamental theorem of calculus corresponds to the well-known Poincare lemma. The proposed technique can be employed to evaluate integrals defined over simply- or multiply-connected domains with Lipschitz boundaries which are embedded in an Euclidean space of arbitrary but finite dimension. Combined with the singular treatment of surface integrals that is widely available in the literature, this approach can also be utilized to effectively deal with boundary-value problems involving non-homogeneous source terms by way of a collocation or a Galerkin boundary integral equation method using only the prescribed surface discretization. Sample problems associated with the three-dimensional Poisson equation and featuring the Newton potential are successfully solved by a constant element collocation method to validate this study.

  13. Integrating harm reduction therapy and traditional substance abuse treatment.

    PubMed

    Marlatt, G A; Blume, A W; Parks, G A

    2001-01-01

    One-size-fits-all therapy has not worked well for a majority of substance users seeking help. New approaches to substance abuse treatment are desperately needed. Traditional models of service delivery offer little, if any, help to people who may not choose abstinence as a goal. To address this concern, the Bridging the Gap Conference was sponsored by the San Francisco Department of Public Health. The overall goals of the conference were to improve standards of care, develop best practice principles for integrating harm reduction approaches into traditional substance abuse services, and increase the accessibility of quality services to people in need of alcohol and drug treatment. G. Alan Marlatt gave a keynote address on the integration of harm reduction therapy into traditional treatment services, an expanded version of which is presented in this article. Such integration would broaden the scope of services available to a larger group of consumers of substance abuse treatment. Furthermore, harm reduction therapy would infuse traditional treatment practices with scientifically-based pragmatism that pays close attention to individual and community public health needs. Because of its tolerance of treatment goals other than abstinence, harm reduction therapy offers the greatest hope to expand the availability of substance abuse services to people who have not benefited from traditional abstinence-based treatment models. PMID:11332996

  14. Strong deviations from Fowler-Nordheim behavior for field emission from individual SiC nanowires due to restricted bulk carrier generation

    NASA Astrophysics Data System (ADS)

    Choueib, M.; Ayari, A.; Vincent, P.; Bechelany, M.; Cornu, D.; Purcell, S. T.

    2009-02-01

    We report here field-emission (FE) studies of individual single-crystal SiC nanowires that showed several distinct I/V regimes including strong saturation resulting in highly nonlinear Fowler-Nordheim plots. The saturation is due to the formation of a depletion layer near the nanowire ends as predicted for FE from semiconductors and appears after in situ control of the surface cleanliness. This work opens the door to improving the uniformity, stability, and photon control of mass-produced planar nanowire FE cathodes and shows how FE can be used for transport measurements on individual semiconducting nanowires.

  15. Determination of Fowler-Nordheim tunneling parameters in Metal-Oxide-Semiconductor structure including oxide field correction using a vertical optimization method

    NASA Astrophysics Data System (ADS)

    Toumi, S.; Ouennoughi, Z.; Strenger, K. C.; Frey, L.

    2016-08-01

    Current conduction mechanisms through a Metal-Oxide-Semiconductor structure are characterized via Fowler-Nordheim (FN) plots. The extraction of the FN parameters like the electron/hole effective mass in oxide mox and in semiconductor msc, the barrier height at the semiconductor-oxide interface ϕB, and the correction oxide voltage Vcorr for a MOS structure is made using a vertical optimization process on the current density without any assumption about ϕB or mox. An excellent agreement is obtained between the FN plots calculated with the FN parameters extracted using a vertical optimization process with the experimental one.

  16. Improving Treatment Integrity through a Functional Approach to Intervention Support

    ERIC Educational Resources Information Center

    Liaupsin, Carl J.

    2015-01-01

    A functional approach to intervention planning has been shown to be effective in reducing problem behaviors and promoting appropriate behaviors in children and youth with behavior disorders. When function-based intervention plans are not successful, it is often due to issues of treatment integrity in which teachers omit or do not sufficiently…

  17. Effects of Video Modeling on Treatment Integrity of Behavioral Interventions

    ERIC Educational Resources Information Center

    DiGennaro-Reed, Florence D.; Codding, Robin; Catania, Cynthia N.; Maguire, Helena

    2010-01-01

    We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased…

  18. A Comparison of Treatment Integrity Assessment Methods for Behavioral Intervention

    ERIC Educational Resources Information Center

    Koh, Seong A.

    2010-01-01

    The purpose of this study was to examine the similarity of outcomes from three different treatment integrity (TI) methods, and to identify the method which best corresponded to the assessment of a child's behavior. Six raters were recruited through individual contact via snowball sampling. A modified intervention component list and 19 video clips…

  19. Changing Donor Funding and the Challenges of Integrated HIV Treatment.

    PubMed

    Nattrass, Nicoli; Hodes, Rebecca; Cluver, Lucie

    2016-01-01

    Donor financing for HIV prevention and treatment has shifted from supporting disease-specific ("vertical") programs to health systems strengthening ("horizontal") programs intended to integrate all aspects of care. We examine the consequences of shifting resources from three perspectives: first, through a broad analysis of the changing policy context of health care financing; second, through an account of changing priorities for HIV treatment in South Africa; and third, through a description of some clinical consequences that the authors observed in a research study examining adherence to antiretroviral therapy (ART) and sexual health among adolescents. We note that AIDS responses are neither completely vertical nor horizontal but rather increasingly diagonal, as disease-specific protocols operate alongside integrated supply chain management, human resource development, and preventive screening. We conclude that health care programs are better conceived of as networks of policies requiring different degrees of integration into communities. PMID:27437818

  20. Integrated anaerobic/aerobic biological treatment for intensive swine production.

    PubMed

    Bortone, Giuseppe

    2009-11-01

    Manure processing could help farmers to effectively manage nitrogen (N) surplus load. Many pig farms have to treat wastewater. Piggery wastewater treatment is a complex challenge, due to the high COD and N concentrations and low C/N ratio. Anaerobic digestion (AD) could be a convenient pre-treatment, particularly from the energetic view point and farm income, but this causes further reduction of C/N ratio and makes denitrification difficult. N removal can only be obtained integrating anaerobic/aerobic treatment by taking into account the best use of electron donors. Experiences gained in Italy during development of integrated biological treatment approaches for swine manure, from bench to full scale, are reported in this paper. Solid/liquid separation as pre-treatment of raw manure is an efficient strategy to facilitate liquid fraction treatment without significantly lowering C/N ratio. In Italy, two full scale SBRs showed excellent efficiency and reliability. Current renewable energy policy and incentives makes economically attractive the application of AD to the separated solid fraction using high solid anaerobic digester (HSAD) technology. Economic evaluation showed that energy production can reduce costs up to 60%, making sustainable the overall treatment. PMID:19135363

  1. An Experimental Examination of the Impact of Choice of Treatment Components on Treatment Integrity

    ERIC Educational Resources Information Center

    Andersen, Melissa; Daly, Edward J., III

    2013-01-01

    Although there is a growing body of research on the use of performance feedback to improve treatment integrity, antecedent interventions have received little attention. Antecedent interventions are simple to use and have a strong research base. This study examined the effects of offering teachers choice of treatment components. A choice condition…

  2. Treatment provision for gambling disorder in Britain: call for an integrated addictions treatment and commissioning model.

    PubMed

    George, Sanju; Bowden-Jones, Henrietta

    2016-06-01

    Treatment provision for individuals with gambling problems in Britain is at best inadequate. Here we call for gambling treatment provision to be integrated into mainstream drug and alcohol services, and for its commissioning responsibilities to fall under local public health departments. PMID:27280028

  3. Treatment provision for gambling disorder in Britain: call for an integrated addictions treatment and commissioning model

    PubMed Central

    George, Sanju; Bowden-Jones, Henrietta

    2016-01-01

    Treatment provision for individuals with gambling problems in Britain is at best inadequate. Here we call for gambling treatment provision to be integrated into mainstream drug and alcohol services, and for its commissioning responsibilities to fall under local public health departments. PMID:27280028

  4. The particle production at the event horizon of a black hole as gravitational Fowler-Nordheim emission in uniformly accelerated frame, in the non-relativistic scenario

    NASA Astrophysics Data System (ADS)

    De, Sanchari; Ghosh, Sutapa; Chakrabarty, Somenath

    2015-11-01

    In the conventional scenario, the Hawking radiation is believed to be a tunneling process at the event horizon of the black hole. In the quantum field theoretic approach the Schwinger's mechanism is generally used to give an explanation of this tunneling process. It is the decay of quantum vacuum into particle anti-particle pairs near the black hole surface. However, in a reference frame undergoing a uniform accelerated motion in an otherwise flat Minkowski space-time geometry, in the non-relativistic approximation, the particle production near the event horizon of a black hole may be treated as a kind of Fowler-Nordheim field emission, which is the typical electron emission process from a metal surface under the action of an external electrostatic field. This type of emission from metal surface is allowed even at extremely low temperature. It has been noticed that in one-dimensional scenario, the Schrödinger equation satisfied by the created particle (anti-particle) near the event horizon, can be reduced to a differential form which is exactly identical with that obeyed by an electron immediately after the emission from the metal surface under the action of a strong electrostatic field. The mechanism of particle production near the event horizon of a black hole is therefore identified with Schwinger process in relativistic quantum field theory, whereas in the non-relativistic scenario it may be interpreted as Fowler-Nordheim emission process, when observed from a uniformly accelerated frame.

  5. Integrative Treatment of Pediatric Obesity: Psychological and Spiritual Considerations

    PubMed Central

    Boisvert, Jennifer A.; Harrell, W. Andrew

    2015-01-01

    This article presents an integrative approach to the problem of pediatric obesity, which is a multifaceted medical condition that is epidemic in the United States and elsewhere in the world. In this article, definitions of pediatric obesity are provided, and its prevalence, etiological factors, medical complications, and comorbidities are reviewed. Psychological and spiritual factors associated with pediatric obesity are discussed, together with their importance to integrative treatment. This review suggests that the use of psychological interventions, such as cognitive behavioral therapy (CBT) and animal-assisted therapy (AAT), can be considered in conjunction with medical and educational interventions to treat pediatric obesity successfully. PMID:26770130

  6. Integrated thermal treatment system sudy: Phase 2, Results

    SciTech Connect

    Feizollahi, F.; Quapp, W.J.

    1995-08-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study, the results of which have been published as an interim report, examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 2 systems. The assumptions and methods were the same as for the Phase 1 study. The quantities, and physical and chemical compositions, of the input waste used in he Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr).

  7. Integrated thermal treatment systems study. Internal review panel report

    SciTech Connect

    Cudahy, J.; Escarda, T.; Gimpel, R.

    1995-04-01

    The U.S. Department of Energy (DOE) Office of Technology Development (OTD) commissioned two studies to evaluate nineteen thermal treatment technologies for treatment of DOE mixed low-level waste. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the help of the DOE Office of Environmental Management (EM) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel to review and comment on the ITTS studies. This Panel was composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency, the California EPA, and private experts. The Panel met from November 15-18, 1994 to review the ITTS studies and to make recommendations on the most promising thermal treatment systems for DOE mixed low-level wastes and on research and development necessary to prove the performance of the technologies. This report describes the findings and presents the recommendations of the Panel.

  8. Review of the integrated thermal and nonthermal treatment system studies

    SciTech Connect

    1996-10-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  9. Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

    PubMed Central

    Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

    2014-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

  10. Integrated modeling and heat treatment simulation of austempered ductile iron

    NASA Astrophysics Data System (ADS)

    Hepp, E.; Hurevich, V.; Schäfer, W.

    2012-07-01

    The integrated modeling and simulation of the casting and heat treatment processes for producing austempered ductile iron (ADI) castings is presented. The focus is on describing different models to simulate the austenitization, quenching and austempering steps during ADI heat treatment. The starting point for the heat treatment simulation is the simulated microstructure after solidification and cooling. The austenitization model considers the transformation of the initial ferrite-pearlite matrix into austenite as well as the dissolution of graphite in austenite to attain a uniform carbon distribution. The quenching model is based on measured CCT diagrams. Measurements have been carried out to obtain these diagrams for different alloys with varying Cu, Ni and Mo contents. The austempering model includes nucleation and growth kinetics of the ADI matrix. The model of ADI nucleation is based on experimental measurements made for varied Cu, Ni, Mo contents and austempering temperatures. The ADI kinetic model uses a diffusion controlled approach to model the growth. The models have been integrated in a tool for casting process simulation. Results are shown for the optimization of the heat treatment process of a planetary carrier casting.

  11. Integrating psychotherapy and pharmacotherapy in the treatment of premature ejaculation

    PubMed Central

    Ciocca, Giacomo; Limoncin, Erika; Mollaioli, Daniele; Gravina, Giovanni Luca; Di Sante, Stefania; Carosa, Eleonora; Lenzi, Andrea; Jannini, Emmanuele A.

    2013-01-01

    Objectives To describe the different approaches to the treatment of premature ejaculation (PE), with a final focus on integrated treatment, as conventional theories and therapies for PE are based on an organic or psychogenic dichotomy. Methods We list the principal hypotheses of the causes and therapy of PE on the basis of psychological and medical perspectives, after identifying all relevant studies available on Medline up to 2012. Results The cognitive feedback from PE can lead to a ‘performance anxiety’, which can combine with other conditions to further impair ejaculatory control. For these reasons, a psychological approach is always useful in treating PE, the most useful of which are sex therapy and behavioural therapy. For pharmacological treatment, reports suggest that dapoxetine (60 mg) significantly improves the control of the ejaculatory reflex, and it thus represents the first-line officially approved pharmacotherapy for PE. Conclusions A holistic approach which considers the biological, psychological and relational aspects is the advised treatment for PE. Integrated medical and psycho-sexological therapy requires a mutual understanding of and respect for the different disciplines involved in sexology. In this aspect two very important roles are those of the physician and the psychologist. PMID:26558097

  12. Integrated thermal treatment system study: Phase 1 results. Volume 1

    SciTech Connect

    Feizollahi, F.; Quapp, W.J.; Hempill, H.G.; Groffie, F.J.

    1994-07-01

    An integrated systems engineering approach is used for uniform comparison of widely varying thermal treatment technologies proposed for management of contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. Ten different systems encompassing several incineration design options are studied. All subsystems, including facilities, equipment, and methods needed for integration of each of the ten systems are identified. Typical subsystems needed for complete treatment of MLLW are incoming waste receiving and preparation (characterization, sorting, sizing, and separation), thermal treatment, air pollution control, primary and secondary stabilization, metal decontamination, metal melting, mercury recovery, lead recovery, and special waste and aqueous waste treatment. The evaluation is performed by developing a preconceptual design package and planning life-cycle cost (PLCC) estimates for each system. As part of the preconceptual design process, functional and operational requirements, flow sheets and mass balances, and conceptual equipment layouts are developed for each system. The PLCC components estimated are technology development, production facility construction, pre-operation, operation and maintenance, and decontamination and decommissioning. Preconceptual design data and other technology information gathered during the study are examined and areas requiring further development, testing, and evaluation are identified and recommended. Using a qualitative method, each of the ten systems are ranked.

  13. Integrated thermal treatment system study -- Phase 2 results. Revision 1

    SciTech Connect

    Feizollahi, F.; Quapp, W.J.

    1996-02-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 1 systems. The alternatives evaluated were: rotary kiln, slagging kiln, plasma furnace, plasma gasification, molten salt oxidation, molten metal waste destruction, steam gasification, Joule-heated vitrification, thermal desorption and mediated electrochemical oxidation, and thermal desorption and supercritical water oxidation. The quantities, and physical and chemical compositions, of the input waste used in the Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr). 28 refs., 88 figs., 41 tabs.

  14. Integrative Treatments to Reduce Risk for Cardiovascular Disease

    PubMed Central

    Bradley, Ryan; Oberg, Erica

    2010-01-01

    Recognizing the contribution and interrelatedness of lipoprotein risk factors is critical to prioritizing treatment strategies for cardiovascular risk reduction. Lipoprotein factors still dominate risk for developing cardiovascular disease, including myocardial infarction. Some emerging risk factors such as C-reactive protein are gaining acceptance due to recent prospective clinical trials demonstrating clinical benefit in reducing these markers. Other emerging risk factors, including lipoprotein particle size, remain to be validated. In this second article of a 2-part series, we will begin with a review of formal risk assessment, discussing the contribution of multiple “risky” and “healthy” components that play a part in overall cardiovascular health. Following risk assessment, we will discuss evidence-based integrative therapies that can be used to modify any risky lipoprotein and inflammatory patient profiles, including medications, functional foods, supplements, and lifestyle approaches. The focus is on low-density lipoproteins, high-density lipoproteins, triglycerides, and C-reactive protein. Understanding the interrelatedness of lipoprotein risk factors, and finding efficient methods of treating multiple risk factors simultaneously, will not only improve the long-term health of patients but will also save on the expenditure of healthcare dollars for unnecessary testing and ineffective treatments. Integrative practitioners who understand the contribution of lifestyle factors, and who have numerous effective treatment options at their disposal, are well positioned to counsel patients on cardiovascular disease prevention. PMID:21461347

  15. Fabrication of reproducible sub-5 nm nanogaps by a focused ion beam and observation of Fowler-Nordheim tunneling

    SciTech Connect

    Li, Hu; Wani, Ishtiaq H.; Hayat, Aqib; Leifer, Klaus; Jafri, S. Hassan M.

    2015-09-07

    Creating a stable high resistance sub-5 nm nanogap in between conductive electrodes is one of the major challenges in the device fabrication of nano-objects. Gap-sizes of 20 nm and above can be fabricated reproducibly by the precise focusing of the ion beam and careful milling of the metallic lines. Here, by tuning ion dosages starting from 4.6 × 10{sup 10} ions/cm and above, reproducible nanogaps with sub-5 nm sizes are milled with focused ion beam. The resistance as a function of gap dimension shows an exponential behavior, and Fowler-Nordheim tunneling effect was observed in nanoelectrodes with sub-5 nm nanogaps. The application of Simmon's model to the milled nanogaps and the electrical analysis indicates that the minimum nanogap size approaches to 2.3 nm.

  16. Simulation of wastewater treatment plant within integrated urban wastewater models.

    PubMed

    Heusch, S; Kamradt, B; Ostrowski, M

    2010-01-01

    In the federal state of Hesse in Germany the application of an integrated software modelling framework is becoming part of the planning process to attain legal approval for the operation of combined sewer systems. The software allows for parallel simulation of flow and water quality routing in the sewer system and in receiving rivers. It combines existing pollution load model approaches with a simplified version of the River Water Quality Model No. 1 (RWQM1). Comprehensive simulation of the wastewater treatment plant (WWTP) is not considered yet. The paper analyses alternatives for the implementation of a WWTP module to model activated sludge plants. For both primary and secondary clarifiers as well as for the activated sludge process concepts for the integration into the existing software framework were developed. The activated sludge concept which uses a linearized version of the well known ASM1 model is presented in detail. PMID:20453339

  17. The consequences of dependence between the formal area efficiency and the macroscopic electric field on linearity behavior in Fowler–Nordheim plots

    NASA Astrophysics Data System (ADS)

    de Assis, Thiago A.; Dall’Agnol, Fernando F.; Andrade, Roberto F. S.

    2016-09-01

    This work presents a theoretical explanation for a crossover in the linear behavior in Fowler–Nordheim (FN) plots based on orthodox cold field electron emission (CFE) experimental data. It is characterized by a clear change in the decay rate of usually single-slope FN plots, and has been reported when non-uniform nano-emitters are subject to high macroscopic electric field F M. We assume that the number of emitting spots, which defines an apparent formal area efficiency of CFE surfaces, depends on the macroscopic electric field. Non-uniformity is described by local enhancement factors ≤ft\\{{γj}\\right\\} , which are randomly assigned to each distinct emitter of a conducting CFE surface, from a discrete probability distribution ρ ≤ft({γj}\\right) , with j  =  1, 2. It is assumed that ρ ≤ft({γ1}\\right)<ρ ≤ft({γ2}\\right) , and that {γ1}>{γ2} . The local current density is evaluated by considering a usual Schottky–Nordheim barrier. The results reproduce the two distinct slope regimes in FN plots when {{F}\\text{M}}\\in [2, 20] V μm‑1 and are analyzed by taking into account the apparent formal area efficiency, the distribution ρ, and the slopes in the corresponding FN plot. Finally, we remark that our results from numerical solution of Laplace’s equation, for an array of conducting nano-emitters with uniform apex radii 50 nm but different local height, supports our theoretical assumptions and could used in orthodox CFE experiments to test our predictions.

  18. [Home treatment--a treatment model of integrated care in Hamburg].

    PubMed

    Schöttle, Daniel; Ruppelt, Friederike; Karow, Anne; Lambert, Martin

    2015-03-01

    Treatment models like "Crisis Resolution and Hometreatment (CRHT)" or "Assertive Community Treatment" (ACT), were found to be effective, enhancing the qualitative level of treatment for patients with severe mental disorders. In Germany, these are implemented only sporadically until today, often as part of a cross-sectoral Integrated Care (IC) treatment system. We will present the implementation of an "Assertive Community Treatment" embedded into an IC-treatment model in Hamburg and discuss the 3-year-outcomes. The IC-treatment model has been designed for severe mentally ill patients with psychotic disorders. Since May 2007 the model is financed by different health insurances as a managed-care "capitation-model" and its effectiveness gets continuously evaluated. The model proved to be effective in earlier studies were compared with standard care low rates of service disengagement were found as well as significantly improved psychopathology, psychosocial functioning, quality of life, satisfaction with care and adherence, while being cost effective. The rates of involuntary admissions declined to 10% in comparison to the years before. In 2011 the model was specified to the indication "first-episode adolescents and young adults in the age of 12-29" in a government-funded study "Integrated Care in Early Psychosis, ICEP Study". In this study an interdisciplinary team of child, adolescent and adult psychiatrists was implemented and since 2012 it is financed by the involved health insurances throughout an expansion of the §140 SGB V agreement. PMID:25485599

  19. Implementing Residential Integrated Treatment for Co-occurring Disorders

    PubMed Central

    McKee, Shari A.; Harris, Grant T.; Cormier, Catherine A.

    2013-01-01

    Objective: Much is now known about effective treatment for co-occurring substance abuse and psychiatric difficulties and many evidence-based practice recommendations have been disseminated. Implementation of these recommended interventions in daily clinical practice has been more of a struggle. This article describes successful implementation of integrated treatment for co-occurring disorders in a small residential program. Methods: A traditional 28-day addiction service was transformed into a 3-month integrated treatment program and 155 individuals with co-occurring disorders agreed to participate in its evaluation. The transformation entailed a completely new manualized service, training in a number of clinical interventions for all program clinicians, ongoing clinical supervision, and formal measurement of clients’ backgrounds, substance abuse, quality of life, mental health symptoms, self-esteem, and satisfaction with the program. We also obtained collateral informants’ reports on participants’ symptoms, substance use, and quality of life. Fidelity to the treatment model was continuously assessed, as were participants’ knowledge and skill acquisition. In addition, impact of the implementation on the program clinicians’ morale and attitudes toward evidence-based practices was assessed, as was staff turnover and per diem costs. Results: Despite very problematic clinical and sociodemographic histories, the 86 participants who completed the program showed clinically significant mental health symptom improvement, acquisition of knowledge and skill, and high self-esteem and satisfaction with the program. Program fidelity, clinician morale, commitment to the program, and attitudes toward evidence-based practice were uniformly high. These successes were achieved while maintaining the lowest per–inpatient day cost of all hospital inpatient units. Conclusions: The findings support the contention that evidence-based integrated treatment can be implemented with

  20. Treatment Integrity in Psychotherapy Research: Analysis of the Studies and Examination of the Associated Factors

    ERIC Educational Resources Information Center

    Perepletchikova, Francheska; Treat, Teresa A.; Kazdin, Alan E.

    2007-01-01

    Treatment integrity refers to the degree to which an intervention is delivered as intended. Two studies evaluated the adequacy of treatment integrity procedures (including establishing, assessing, evaluating, and reporting integrity; therapist treatment adherence; and therapist competence) implemented in psychotherapy research, as well as…

  1. Integrated Waste Treatment Unit GFSI Risk Management Plan

    SciTech Connect

    W. A. Owca

    2007-06-21

    This GFSI Risk Management Plan (RMP) describes the strategy for assessing and managing project risks for the Integrated Waste Treatment Unit (IWTU) that are specifically within the control and purview of the U.S. Department of Energy (DOE), and identifies the risks that formed the basis for the DOE contingency included in the performance baseline. DOE-held contingency is required to cover cost and schedule impacts of DOE activities. Prior to approval of the performance baseline (Critical Decision-2) project cost contingency was evaluated during a joint meeting of the Contractor Management Team and the Integrated Project Team for both contractor and DOE risks to schedule and cost. At that time, the contractor cost and schedule risk value was $41.3M and the DOE cost and schedule risk contingency value is $39.0M. The contractor cost and schedule risk value of $41.3M was retained in the performance baseline as the contractor's management reserve for risk contingency. The DOE cost and schedule risk value of $39.0M has been retained in the performance baseline as the DOE Contingency. The performance baseline for the project was approved in December 2006 (Garman 2006). The project will continue to manage to the performance baseline and change control thresholds identified in PLN-1963, ''Idaho Cleanup Project Sodium-Bearing Waste Treatment Project Execution Plan'' (PEP).

  2. Integrating electrodermal biofeedback into pharmacologic treatment of grand mal seizures

    PubMed Central

    Scrimali, Tullio; Tomasello, Damiana; Sciuto, Massimo

    2015-01-01

    Electrodermal activity (EDA) and electrodermal biofeedback, when integrated with pharmacologic treatments, indicate promising methods for the treatment of grand mal seizures. They can be used to monitor patient arousal and help patients learn new strategies to better cope with stress and anxiety. Our proposed method can possibly reduce the number of crises for patients who are dependent on pharmacologic therapy and can improve their quality of life. This article describes the scientific background of electrodermal monitoring and electrodermal biofeedback for patients affected by grand mal seizures. In this study, we have reported a clinical case study. The patient was treated for 2 years with electrodermal biofeedback to augment pharmacologic treatments. The trial has been designed in accordance with “n = 1 case study research”. Our results have shown that our methods could achieve a significant reduction in grand mal seizures and sympathetic arousal when applied. The patient under consideration was also relaxed and exhibited greater competency to cope with stress. Additionally, the patient’s sense of mastery and self-efficacy was enhanced. PMID:26029078

  3. An Integrated System for the Treatment of Coal Conversion Wastewater

    SciTech Connect

    Henry Y. Wang; Keeran R. Srinivasan

    1999-02-25

    Treatment of mixed waste from coal conversion wastewaters involves the degradation of toxic organics and the removal of heavy metals. An integrated and cost-effective treatment scheme that can implement such a process is considered essential to promote continued development and growth of coal conversion processes without any deleterious effects on our ecosystem. We have recently developed a pH-dependent, reversible heavy metal adsorption/desorption process which promises to be a cost-effective alternative to the treatment and disposal options currently in place for these inorganic contaminants. Our work shows that: (1) Polydisperse, industrial-grade surfactants can be used in the development of novel, surfactant-coated smectitic clays containing up to 50% by weight of adsorbed surfactant, (2) Reversible adsorption and resorption of cationic (CU(II) and Cd(II)) and anionic (Cr(VI)) heavy metals from their respective aqueous solutions onto these surfactant-modified smectites can be effected using pH of the medium as a switch, and (3) These surfactant-modified smectites can be repeatedly used (up to 5 times) with only a minimal loss in their adsorption potency and with very little leaching of the adsorbed surfactants.

  4. Integrating electrodermal biofeedback into pharmacologic treatment of grand mal seizures.

    PubMed

    Scrimali, Tullio; Tomasello, Damiana; Sciuto, Massimo

    2015-01-01

    Electrodermal activity (EDA) and electrodermal biofeedback, when integrated with pharmacologic treatments, indicate promising methods for the treatment of grand mal seizures. They can be used to monitor patient arousal and help patients learn new strategies to better cope with stress and anxiety. Our proposed method can possibly reduce the number of crises for patients who are dependent on pharmacologic therapy and can improve their quality of life. This article describes the scientific background of electrodermal monitoring and electrodermal biofeedback for patients affected by grand mal seizures. In this study, we have reported a clinical case study. The patient was treated for 2 years with electrodermal biofeedback to augment pharmacologic treatments. The trial has been designed in accordance with "n = 1 case study research". Our results have shown that our methods could achieve a significant reduction in grand mal seizures and sympathetic arousal when applied. The patient under consideration was also relaxed and exhibited greater competency to cope with stress. Additionally, the patient's sense of mastery and self-efficacy was enhanced. PMID:26029078

  5. Integrated flue gas treatment condensing heat exchanger for pollution control

    SciTech Connect

    Johnson, D.W.; Warchol, J.J.; Schulze, K.H.; Carrigan, J.F.

    1994-12-31

    Condensing heat exchangers recover both sensible and latent heat from flue gases. Using Teflon{reg_sign} to cover the heat exchanger tubes and inside surfaces that are exposed to the flue gas ensures adequate material lifetime in the corrosive environment encountered when the flue gas temperature drops below the acid dew point. A recent design improvement, called the integrated flue gas treatment (IFGT) concept, offers the ability to remove pollutants from the flue gas, as well as recover waste heat. It has been shown to remove SO{sub 2}, SO{sub 3}, particulates, and trace emissions. Babcock and Wilcox (B and W) is undertaking an extensive program to optimize this technology for a variety of flue gas applications. This paper summarizes the current status of IFGT technology and the development activities that are in progress.

  6. Integrating Multiscale Modeling with Drug Effects for Cancer Treatment

    PubMed Central

    Li, Xiangfang L.; Oduola, Wasiu O.; Qian, Lijun; Dougherty, Edward R.

    2015-01-01

    In this paper, we review multiscale modeling for cancer treatment with the incorporation of drug effects from an applied system’s pharmacology perspective. Both the classical pharmacology and systems biology are inherently quantitative; however, systems biology focuses more on networks and multi factorial controls over biological processes rather than on drugs and targets in isolation, whereas systems pharmacology has a strong focus on studying drugs with regard to the pharmacokinetic (PK) and pharmacodynamic (PD) relations accompanying drug interactions with multiscale physiology as well as the prediction of dosage-exposure responses and economic potentials of drugs. Thus, it requires multiscale methods to address the need for integrating models from the molecular levels to the cellular, tissue, and organism levels. It is a common belief that tumorigenesis and tumor growth can be best understood and tackled by employing and integrating a multifaceted approach that includes in vivo and in vitro experiments, in silico models, multiscale tumor modeling, continuous/discrete modeling, agent-based modeling, and multiscale modeling with PK/PD drug effect inputs. We provide an example application of multiscale modeling employing stochastic hybrid system for a colon cancer cell line HCT-116 with the application of Lapatinib drug. It is observed that the simulation results are similar to those observed from the setup of the wet-lab experiments at the Translational Genomics Research Institute. PMID:26792977

  7. An integrated biological approach for treatment of cyanidation wastewater.

    PubMed

    Mekuto, Lukhanyo; Ntwampe, S K O; Akcil, Ata

    2016-11-15

    The cyanidation process has been, and still remains, a profitable and highly efficient process for the recovery of precious metals from ores. However, this process has contributed to environmental deterioration and potable water reserve contamination due to the discharge of poorly treated, or untreated, cyanide containing wastewater. The process produces numerous cyanide complexes in addition to the gold cyanocomplex. Additionally, the discharge constituents also include hydrogen cyanide (HCN) - metallic complexes with iron, nickel, copper, zinc, cobalt and other metals; thiocyanate (SCN); and cyanate (CNO). The fate of these complexes in the environment dictates the degree to which these species pose a threat to living organisms. This paper reviews the impact that the cyanidation process has on the environment, the ecotoxicology of the cyanidation wastewater and the treatment methods that are currently utilised to treat cyanidation wastewater. Furthermore, this review proposes an integrated biological approach for the treatment of the cyanidation process wastewater using microbial consortia that is insensitive and able to degrade cyanide species, in all stages of the proposed process. PMID:27424119

  8. Integrating Tobacco Use Treatment Into Practice: Billing and Documentation.

    PubMed

    Leone, Frank T; Evers-Casey, Sarah; Mulholland, Mary A; Sachs, David P L

    2016-02-01

    Balancing population-based efforts to modify the social and environmental factors that promote tobacco dependence with efforts to improve the delivery of case-based treatments is necessary for realizing maximum reductions in the cost and consequences of the disease. Public health antismoking campaigns following the 1964 Surgeon General's report on the health risks of smoking have changed social norms, prevented initiation among youth, and promoted abstinence among the addicted. However, the rate of progress enjoyed to date is unlikely to continue into the coming decades, given that current annual unassisted cessation rates among prevalent smokers remains fairly low. With more than 1 billion patient interactions annually, there is an enormous unrealized capacity for health-care systems to have an effect on this problem. Clinicians report a perceived lack of reimbursement as a significant barrier to full integration of tobacco dependence into health care. A more complete understanding of the coding and documentation requirements for successful practice in this critically important area is a prerequisite to increasing engagement. This paper presents several case-based scenarios illustrating important practice management issues related to the treatment of tobacco dependence in health care. PMID:26426215

  9. New treatment approaches: integrating new media in the treatment of war and torture victims.

    PubMed

    Knaevelsrud, Christine; Wagner, Birgit; Karl, Ankel; Mueller, Julia

    2007-01-01

    The diagnostic process and treatment of victims of war and torture is associated with a number of difficulties. This article will provide an overview of three different approaches on how the new media may be integrated into the treatment of survivors of torture and war to face some of the challenges. Illiteracy is a common problem and makes it difficult to apply standardized psychological assessment procedures. Also, the majority of survivors of torture and war do not have access to any psychotherapeutic treatment due to geographical limitations or limitations concerning psychotherapeutic treatment capacity. Furthermore, chronic psychological disorders such as (complex) Posttraumatic Stress Disorder (PTSD) are often seen with comorbid chronic pain disorders, which present a therapeutic challenge. The Treatment Center for Torture Victims, Berlin, in cooperation with the University of Zurich, developed a number of approaches to address these challenges: 1) MultiCASI - to standardize the diagnostic process an audiovisual diagnostic tool was developed which allows illiterate individuals to answer standardized psychological questionnaires whithout the help of interpreters; 2) A virtual treatment center for posttraumatic stress disorder for traumatized patients in Iraq and other Arab speaking postconflict countries; 3) Utility of Biofeedback (BF) in chronic (somatoform) pain and in traumatized patients: to address the chronic pain syndrome presented by most survivors, a biofeedback supported cognitive-behavioral therapy approach was developed and successfully tested in a pilot study. PMID:17728484

  10. Independent peer review panel report on the integrated nonthermal treatment systems study and the comparison of integrated thermal and integrated nonthermal treatment systems for mixed low level waste

    SciTech Connect

    1996-08-01

    The US Department of Energy`s (DOE) Office of Environmental Management (EM) Office of Science and Technology (OST) has conducted studies of integrated thermal treatment systems and integrated nonthermal treatment systems (INTS) for treating contact handled, alpha and non-alpha mixed low level radioactive waste (MLLW). The MLLW in the DOE complex consists of a wide variety of organic and inorganic solids and liquids contaminated with radioactive substances. Treatment systems are needed to destroy organic material and stabilize residues prior to land disposal. In May 1996 the Deputy Assistant Secretary for OST appointed an Independent Peer Review Panel to: (1) review and comment on the INTS Study; (2) make recommendations on the most promising thermal and nonthermal treatment systems; (3) make recommendations on research and development necessary to prove the performance of nonthermal and thermal technologies; and (4) review and comment on the preliminary draft of the ITTS/INTS Comparison Report. This report presents the primary conclusions and recommendations based on the review of the INTS study and the comparison report. System selection, overviews, comparisons, cost estimations and sensitivity analyses, and recommended R and D engineering needs are then described and discussed.

  11. Portal dosimetry for VMAT using integrated images obtained during treatment

    SciTech Connect

    Bedford, James L. Hanson, Ian M.; Hansen, Vibeke Nordmark

    2014-02-15

    Purpose: Portal dosimetry provides an accurate and convenient means of verifying dose delivered to the patient. A simple method for carrying out portal dosimetry for volumetric modulated arc therapy (VMAT) is described, together with phantom measurements demonstrating the validity of the approach. Methods: Portal images were predicted by projecting dose in the isocentric plane through to the portal image plane, with exponential attenuation and convolution with a double-Gaussian scatter function. Appropriate parameters for the projection were selected by fitting the calculation model to portal images measured on an iViewGT portal imager (Elekta AB, Stockholm, Sweden) for a variety of phantom thicknesses and field sizes. This model was then used to predict the portal image resulting from each control point of a VMAT arc. Finally, all these control point images were summed to predict the overall integrated portal image for the whole arc. The calculated and measured integrated portal images were compared for three lung and three esophagus plans delivered to a thorax phantom, and three prostate plans delivered to a homogeneous phantom, using a gamma index for 3% and 3 mm. A 0.6 cm{sup 3} ionization chamber was used to verify the planned isocentric dose. The sensitivity of this method to errors in monitor units, field shaping, gantry angle, and phantom position was also evaluated by means of computer simulations. Results: The calculation model for portal dose prediction was able to accurately compute the portal images due to simple square fields delivered to solid water phantoms. The integrated images of VMAT treatments delivered to phantoms were also correctly predicted by the method. The proportion of the images with a gamma index of less than unity was 93.7% ± 3.0% (1SD) and the difference between isocenter dose calculated by the planning system and measured by the ionization chamber was 0.8% ± 1.0%. The method was highly sensitive to errors in monitor units and

  12. Inpatient Treatment of Community-Acquired Pneumonias with Integrative Medicine

    PubMed Central

    Diederich, Klas; Kusserow, Maria; Laubersheimer, Andreas; Kramer, Klaus

    2013-01-01

    Introduction. The aim of the presented observational case series was to evaluate the experience in treating patients with community-acquired pneumonia (CAP) within integrative medicine, particularly anthroposophic medicine in a well-experienced and specialized unit. Patients and Methods. Patients with proven CAP were evaluated (CAP-study group) based on a retrospective chart review. To estimate the severity of pneumonia, the pneumonia severity index (PSI) was applied. Treatment efficacy was evaluated regarding body temperature, CRP level, leukocytes blood count, the need to be treated on ICU, and mortality. Results were compared with the inpatient data of the Pneumonia PORT Validation Cohort. Results. 15/18 patients of the CAP-study group belonged to risk class groups I–III (low and moderate risk), 2 patients to risk class IV, and one patient to risk class V (severe pneumonia). 16/18 patients were treated with anthroposophic medicine only and 2/18 got additionally antibiotic therapy (both of risk class IV). A significant reduction of body temperature, CRP level, and leukocytes blood count has been obtained by applying anthroposophic medicine, while neither complications nor pneumonia-related death occurred. Compared with the control group there was no significant difference in mortality rate, whereby no patient had to be treated on the ICU, but the duration of hospital stay was significantly longer in the presented series. Conclusion. Inpatient treatment of CAP with anthroposophic medicine without the use of antibiotics may achieve reasonable results in selected cases. Additional larger sized prospective controlled trials should further clarify the role of AM in the treatment of CAP. PMID:23762145

  13. Integrating smoking cessation into substance use disorder treatment for military veterans: measurement and treatment engagement efforts.

    PubMed

    Shealy, Suzanne E; Winn, Jaime L

    2014-02-01

    Military personnel and veterans smoke at higher rates than the general population, compromising physical performance readiness and health (Committee on Smoking Cessation in Military and Veteran Populations & Institute of Medicine, 2009). While efforts are being made within both the Department of Defense and the Veterans' Administration (VA) hospitals to prevent onset, change the smoking culture, and promote smoking cessation; smoking rates are increasing among combat deployed service members, and smoking rates are particularly high among veterans with mental health and other substance use disorders (McFall, 2006). Recent research supports making smoking cessation widely available and integrated with other forms of care (Gierisch et al., 2012; McFall et al., 2010). This paper describes the efforts of one VA substance use disorder (SUD) treatment program to integrate smoking cessation in routine care, including assessment of tobacco use and motivation and intention to quit via the proposed Nic-BAM assessment. Our team was 100% successful in incorporating the Nic-BAM into our regular assessment of treatment program participants. This suggests that staff members are amenable to assessing for tobacco addiction alongside other substance addictions. Although smoking did not decrease according to the Nic-BAM, an increase in the use of nicotine-replacement products suggests that participants are willing to initiate a quit attempt during SUD treatment. The availability of new evidence-based approaches for integration of tobacco cessation with mental health and SUD treatment may help to enhance programmatic efforts. Environmental changes are needed to fully incorporate tobacco recovery into SUD programming, and additional resources may include peer support specialists. PMID:24094921

  14. Evolution of the Treatment Integrity Concept: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Gresham, Frank M.

    2009-01-01

    The concept of treatment integrity cuts across a diversity of fields involved with providing treatments or interventions to individuals. In medical treatments, the concept of "treatment compliance" or "treatment adherence" is an important and problematic issue. In the field of nutrition, the concept of "dietary adherence" is important for…

  15. The role of Hurst exponent on cold field electron emission from conducting materials: from electric field distribution to Fowler-Nordheim plots

    PubMed Central

    de Assis, T. A.

    2015-01-01

    This work considers the effects of the Hurst exponent (H) on the local electric field distribution and the slope of the Fowler-Nordheim (FN) plot when considering the cold field electron emission properties of rough Large-Area Conducting Field Emitter Surfaces (LACFESs). A LACFES is represented by a self-affine Weierstrass-Mandelbrot function in a given spatial direction. For 0.1 ≤ H < 0.5, the local electric field distribution exhibits two clear exponential regimes. Moreover, a scaling between the macroscopic current density () and the characteristic kernel current density (), , with an H-dependent exponent , has been found. This feature, which is less pronounced (but not absent) in the range where more smooth surfaces have been found (), is a consequence of the dependency between the area efficiency of emission of a LACFES and the macroscopic electric field, which is often neglected in the interpretation of cold field electron emission experiments. Considering the recent developments in orthodox field emission theory, we show that the exponent must be considered when calculating the slope characterization parameter (SCP) and thus provides a relevant method of more precisely extracting the characteristic field enhancement factor from the slope of the FN plot. PMID:26035290

  16. Treatment integrity in school-wide programs: a review of the literature (1993-2012).

    PubMed

    Bruhn, Allison L; Hirsch, Shanna E; Lloyd, John W

    2015-10-01

    We assessed the reporting of treatment integrity in school-wide prevention programs in K-12 schools. This review was designed to determine (a) the extent to which treatment integrity was reported in school-wide prevention and intervention programs and how the reporting varied by research design, year, and journal; and (b) the procedures (e.g., method, frequency, informant) used to collect treatment integrity data. Results indicated that fewer than half of the studies in the review (n = 36, 45.6 %) measured and reported treatment integrity. Those studies reporting treatment integrity often used multiple methods and informants. Reporting treatment integrity in this body of literature has increased steadily over time. PMID:26319798

  17. Integrative Treatment of Reflux and Functional Dyspepsia in Children

    PubMed Central

    Yeh, Ann Ming; Golianu, Brenda

    2014-01-01

    Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are common problems in the pediatric population, with up to 7% of school-age children and up to 8% of adolescents suffering from epigastric pain, heartburn, and regurgitation. Reflux is defined as the passage of stomach contents into the esophagus, while GERD refers to reflux symptoms that are associated with symptoms or complications—such as pain, asthma, aspiration pneumonia, or chronic cough. FD, as defined by the Rome III classification, is a persistent upper abdominal pain or discomfort, not related to bowel movements, and without any organic cause, that is present for at least two months prior to diagnosis. Endoscopic examination is typically negative in FD, whereas patients with GERD may have evidence of esophagitis or gastritis either grossly or microscopically. Up to 70% of children with dyspepsia exhibit delayed gastric emptying. Treatment of GERD and FD requires an integrative approach that may include pharmacologic therapy, treating concurrent constipation, botanicals, mind body techniques, improving sleep hygiene, increasing physical activity, and traditional Chinese medicine and acupuncture. PMID:27417471

  18. Performance Evaluation of Integrated Constructed Wetland for Domestic Wastewater Treatment.

    PubMed

    Sehar, Shama; Naz, Iffat; Khan, Sumera; Naeem, Sana; Perveen, Irum; Ali, Naeem; Ahmed, Safia

    2016-03-01

    Simple, budget friendly, laboratory-scale integrated constructed wetland (ICW) was designed to assess domestic wastewater treatment performance at a loading rate of 75 mm/d, planted with native plant species: Veronica-angallis aquatica and compared with non-vegetative control system at various residence times of 4, 8, 12, 16, 20, 24, and 28 days. Results revealed that the vegetated ICW demonstrated superior performance over non-vegetated control: 69.12 vs 17.12%, 67.77 vs 16.04%, 68 vs 16.48%, 71.19 vs 6.56%, 71.54 vs 14.80%, and 72.04 vs 11.41% for total dissolved solids, total suspended solids, phosphates (PO4(-)), sulfate (SO4(-)), nitrate (NO3(-)), and nitrite (NO2(-)), respectively, at 20 days residence times. Reduction in bacterial counts (2.79 × 10(4) CFU/mL) and fecal pathogens (345.5 MPN index/100 mL) was observed in V. aquatica at 20 days residence time. Therefore, the present study highlights not only the presence of vegetation but also appropriate residence time in constructed wetlands for better performances. PMID:26931539

  19. Integration of alternative feedstreams for biomass treatment and utilization

    DOEpatents

    Hennessey, Susan Marie; Friend, Julie; Dunson, Jr., James B.; Tucker, III, Melvin P.; Elander, Richard T.; Hames, Bonnie

    2011-03-22

    The present invention provides a method for treating biomass composed of integrated feedstocks to produce fermentable sugars. One aspect of the methods described herein includes a pretreatment step wherein biomass is integrated with an alternative feedstream and the resulting integrated feedstock, at relatively high concentrations, is treated with a low concentration of ammonia relative to the dry weight of biomass. In another aspect, a high solids concentration of pretreated biomass is integrated with an alternative feedstream for saccharifiaction.

  20. An evaluation of programmed treatment-integrity errors during discrete-trial instruction.

    PubMed

    Carroll, Regina A; Kodak, Tiffany; Fisher, Wayne W

    2013-01-01

    This study evaluated the effects of programmed treatment-integrity errors on skill acquisition for children with an autism spectrum disorder (ASD) during discrete-trial instruction (DTI). In Study 1, we identified common treatment-integrity errors that occur during academic instruction in schools. In Study 2, we simultaneously manipulated 3 integrity errors during DTI. In Study 3, we evaluated the effects of each of the 3 integrity errors separately on skill acquisition during DTI. Results showed that participants either demonstrated slower skill acquisition or did not acquire the target skills when instruction included treatment-integrity errors. PMID:24114154

  1. Integrating Surgery Into Treatment Paradigms for Organ Preservation: Tailoring Treatment to Biology Improves Outcomes

    SciTech Connect

    Wolf, Gregory T.

    2007-10-01

    Purpose: Neoadjuvant chemotherapy was introduced into treatment paradigms for curable head and neck cancer in the early 1970s in an effort to reduce the magnitude of mutilating surgery and to provide a rationale for adjuvant systemic chemotherapy in patients who responded to initial chemotherapy. The large number of trials that followed failed to demonstrate improved survival when neoadjuvant chemotherapy was added to conventional surgery or radiation. Importantly, a consistent observation in these neoadjuvant trials was the significant association of clinical tumor response to neoadjuvant therapy and favorable prognosis. Results: The findings led to development of a new treatment paradigm that was based on the hypothesis that the biology of an individual cancer is more predictive of response to specific therapy and overall outcome than is anatomic tumor site or extent, and on the corollary that matching treatment modality to biology will improve overall survival rates. Conclusions: This report identifies key findings that are important in the design and analysis of organ preservation trials and biologic markers predictive of response and outcomes. Ongoing studies incorporating biomarkers such as p53, Bcl-xL, HPV, EGFR, COX-2, and tumor promoter gene methylation are underway and will identify new targets for molecular manipulation, response monitoring, and tumor imaging that could allow real-time changes in how we integrate the various components of multi-modal therapy.

  2. Does Treatment Integrity Matter in Promoting Learning among Children with Developmental Disabilities?

    ERIC Educational Resources Information Center

    Odluyurt, Serhat; Tekin-Iftar, Elif; Adalioglu, Iclal

    2012-01-01

    The purpose of this study was to compare the effects of simultaneous prompting instruction with high and low treatment integrity on the learning of children with developmental disabilities. Low treatment integrity was defined as not delivering a controlling prompt during 30% of the teaching trials. Three preschool children with autism and…

  3. Treatment Integrity Assessment: How Estimates of Adherence, Quality, and Exposure Influence Interpretation of Implementation

    ERIC Educational Resources Information Center

    Hagermoser Sanetti, Lisa M.; Fallon, Lindsay M.

    2011-01-01

    The assessment of treatment integrity is important for determining the effectiveness of an intervention. Treatment integrity, a multidimensional construct, can be evaluated in two ways: by session or component. In this study, adherence, quality, and exposure data are estimated using permanent product data from implementation of the PAX Good…

  4. An Evaluation of Programmed Treatment-integrity Errors during Discrete-trial Instruction

    ERIC Educational Resources Information Center

    Carroll, Regina A.; Kodak, Tiffany; Fisher, Wayne W.

    2013-01-01

    This study evaluated the effects of programmed treatment-integrity errors on skill acquisition for children with an autism spectrum disorder (ASD) during discrete-trial instruction (DTI). In Study 1, we identified common treatment-integrity errors that occur during academic instruction in schools. In Study 2, we simultaneously manipulated 3…

  5. Effects of Treatment Integrity Failures during Differential Reinforcement of Alternative Behavior: A Translational Model

    ERIC Educational Resources Information Center

    Pipkin, Claire St. Peter; Vollmer, Timothy R.; Sloman, Kimberly N.

    2010-01-01

    Differential reinforcement of alternative behavior (DRA) is used frequently as a treatment for problem behavior. Previous studies on treatment integrity failures during DRA suggest that the intervention is robust, but research has not yet investigated the effects of different types of integrity failures. We examined the effects of two types of…

  6. Treatment Integrity in a Home-Based Pre-Reading Intervention Programme

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan; Veldkamp, Esther

    2006-01-01

    Treatment integrity is an underexposed issue in the phonological awareness intervention research. The current study assessed the integrity of treatment of the families (N = 32) participating in the experimental condition of a home-based pre-reading intervention study. The participating kindergartners were all genetically at risk for developing…

  7. A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

    PubMed

    Tillman, Jane G

    2008-01-01

    Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach. PMID:19113964

  8. Integrating Treatment of Posttraumatic Stress Disorder and Substance Use Disorder

    ERIC Educational Resources Information Center

    Ford, Julian D.; Russo, Eileen M.; Mallon, Sharon D.

    2007-01-01

    Historically, administrators and clinicians have been hesitant to address posttraumatic stress disorder (PTSD) in the treatment of substance use disorders (SUDs). However, research shows that SUD treatment recruitment and outcomes may be adversely affected if co-occurring PTSD is left untreated. The authors provide guidelines for screening and…

  9. Self-administered behavior modification to reduce nail biting: incorporating simple technology to ensure treatment integrity.

    PubMed

    Craig, Andrew R

    2010-01-01

    Habitual behaviors, such as problematic nail biting, are a common target for self-managed behavior-modification programs. The current self-experiment used self-monitoring in conjunction with a self-managed differential-reinforcement procedure for the treatment of problematic nail biting. A simple picture-comparison procedure allowed an independent observer to assist in monitoring treatment progress and outcomes and to ensure treatment integrity. Results provide support that the overall treatment package was successful in decreasing the occurrence of nail biting. Moreover, the treatment-integrity procedure enabled full-day monitoring to take place with limited requirement of a secondary observer. PMID:22532892

  10. Integrating Cognitive Behavioral Therapy and Pharmacotherapy in the Treatment of Adolescent Depression

    ERIC Educational Resources Information Center

    Ginsburg, Golda S.; Albano, Anne Marie; Findling, Robert L.; Kratochvil, Christopher; Walkup, John

    2005-01-01

    Recent evidence from the Treatment for Adolescents With Depression Study (TADS) suggests that combining cognitive behavioral and pharmacological treatments holds the most promise for ameliorating depression among adolescents. This article describes lessons learned during the TADS trial about how to integrate these two treatments in the care of…

  11. Policy implications of integrating buprenorphine/naloxone treatment and HIV care.

    PubMed

    Finkelstein, Ruth; Netherland, Julie; Sylla, Laurie; Gourevitch, Marc N; Cajina, Adan; Cheever, Laura

    2011-03-01

    Researchers, practitioners, and policymakers have long recognized the potential benefits of providing integrated substance abuse and medical care services, particularly for special populations such as people living with HIV/AIDS. Buprenorphine, an office-based pharmacological treatment for opioid dependence, offers new opportunities for integrating drug treatment into HIV care settings. However, the historical separation between the drug treatment and medical care systems has resulted in a host of policy barriers. The Buprenorphine and HIV Care Evaluation and Support initiative, a multisite demonstration project to assess the feasibility and effectiveness of integrating buprenorphine/naloxone into HIV care settings, provided an opportunity to evaluate if and how policy barriers affect efforts to integrate HIV care and addiction treatment. We found that financing issues, workforce and training issues, and the operational consequences of some conceptual differences between HIV care and addiction treatment are barriers to the full integration of buprenorphine into HIV care. We recommend changes to financing and reimbursement policies, programs to strengthen the addiction treatment skills of physicians, and cross training between the fields of addiction, medicine, drug treatment, and HIV medicine. By addressing some of the policy barriers to integration, this promising new treatment can help the thousands of people living with HIV/AIDS who are also opioid dependent. PMID:21317602

  12. Integrating emerging treatment options in mantle cell lymphoma.

    PubMed

    Kahl, Brad S; Fowler, Nathan H; Czuczman, Myron S

    2013-12-01

    Mantle cell lymphoma is an uncommon lymphoma subtype that is currently considered incurable and lacks a single standard of care. Choice of treatment is complicated by the disease’s clinical heterogeneity. The course of the disease may be indolent, moderately aggressive, or aggressive. A translocation between chromosomes 11 and 14 is observed in the majority of mantle cell lymphoma patients, and the diseased cells may develop a variety of other genetic aberrations. Although the disease tends to respond well to treatment, patients almost invariably relapse, with many becoming chemotherapy refractory over time. The development of new treatment strategies has improved the prognosis for these patients. Novel approaches include intensive chemotherapy, often in combination with stem cell transplantation; maintenance therapy with extended duration; and new targeted treatments such as ibrutinib, bendamustine, bortezomib, lenalidomide, and idelalisib. Many of these new agents have shown promising activity, both as single agents and in combination regimens. PMID:24893155

  13. Test Driving Interventions to Increase Treatment Integrity and Student Outcomes

    ERIC Educational Resources Information Center

    Dart, Evan H.; Cook, Clayton R.; Collins, Tai A.; Gresham, Frank M.; Chenier, Jeffrey S.

    2012-01-01

    Behavioral consultation has been shown to be an effective way for school psychologists to work with teachers in implementing interventions for student problem behavior. Some teachers are resistant to the behavioral consultation process and thereby fail to implement agreed upon interventions with integrity, which is problematic considering the…

  14. Smoking Cessation: An Integral Part of Lung Cancer Treatment

    PubMed Central

    Cataldo, Janine K.; Dubey, Sarita; Prochaska, Jodi J.

    2010-01-01

    Lung cancer is the leading cause of cancer death in the US. About 50% of lung cancer patients are current smokers at the time of diagnosis and up to 83% continue to smoke after diagnosis. A recent study suggests that people who continue to smoke after a diagnosis of early-stage lung cancer almost double their risk of dying. Despite a growing body of evidence that continued smoking by patients after a lung cancer diagnosis is linked with less effective treatment and a poorer prognosis, the belief prevails that treating tobacco dependence is useless. With improved cancer treatments and survival rates, smoking cessation among lung cancer patients has become increasingly important. There is a pressing need to clarify the role of smoking cessation in the care of lung cancer patients. Objective This paper will report on the benefits of smoking cessation for lung cancer patients and the elements of smoking cessation treatment, with consideration of tailoring to the needs of lung cancer patients. Results Given the significant benefits of smoking cessation and that tobacco dependence remains a challenge for many lung cancer patients, cancer care providers need to offer full support and intensive treatment with a smoking cessation program that is tailored to lung cancer patients’ specific needs. Conclusion A tobacco dependence treatment plan for lung cancer patients is provided. PMID:20699622

  15. Treatment of tobacco dependence: integrating recent progress into practice

    PubMed Central

    Le Foll, Bernard; George, Tony P.

    2007-01-01

    Tobacco use is one of the leading preventable causes of death in developed countries. Adoption of approaches that have demonstrated efficacy to improve the treatment of tobacco dependence are critical to reduce the health consequences of tobacco use. We summarize the latest epidemiologic data on tobacco use, the mechanisms that underlie tobacco dependence, and advances in pharmacotherapy and nonpharmacologic interventions available for the treatment of tobacco dependence. Specifically, we discuss the use of nicotine replacement therapy, bupropion and varenicline in primary care settings. PMID:18025429

  16. Tomorrow`s energy today for cities and counties -- Alternative wastewater treatment: Advanced Integrated Pond systems

    SciTech Connect

    Not Available

    1993-10-01

    This report provides a discussion of the design, construction, operation, and maintenance of the Advanced Integrated Pond System as an alternative for other more costly municipal waste water treatment plants.

  17. Integrated Passive Biological Treatment System/ Mine Waste Technology Program Report #16

    EPA Science Inventory

    This report summarizes the results of the Mine Waste Technology Program (MWTP) Activity III, Project 16, Integrated, Passive Biological Treatment System, funded by the United States Environmental Protection Agency (EPA) and jointly administered by EPA and the United States Depar...

  18. An Evaluation of the "Treatment Integrity Planning Protocol" and Two Schedules of Treatment Integrity Self-Report: Impact on Implementation and Report Accuracy

    ERIC Educational Resources Information Center

    Hagermoser Sanetti, Lisa M.; Kratochwill, Thomas R.

    2011-01-01

    The evidence-based practice movement has focused on identifying, disseminating, and promoting the adoption of evidence-based interventions. Despite advances in this movement, numerous barriers, such as the lack of treatment integrity assessment methods, remain as challenges in implementation. Accurate teacher self-report could be an efficient…

  19. An Integrated Evaluation of Nonspeech Oral Motor Treatments

    ERIC Educational Resources Information Center

    Powell, Thomas W.

    2008-01-01

    Purpose: This article functions as an epilogue to the clinical forum examining the use of nonspeech oral motor treatments (NSOMTs) to remediate speech sound disorders in children. Method: Conclusions to eight clinical questions are formed based on the findings that were reported in the clinical forum. Theoretical and clinical challenges are also…

  20. DEMONSTRATION OF AN INTEGRATED, PASSIVE BIOLOGICAL TREATMENT PROCESS FOR AMD

    EPA Science Inventory

    An innovative, cost-effective, biological treatment process has been designed by MSE Technology Applications, Inc. to treat acid mine drainage (AMD). A pilot-scale demonstration is being conducted under the Mine Waste Technology Program using water flowing from an abandoned mine ...

  1. Integrating Fieldwork into Employment Counseling for Methadone-Treatment Patients

    ERIC Educational Resources Information Center

    Blankertz, Laura; Spinelli, Michael; Magura, Stephen; Bali, Priti; Madison, Elizabeth M.; Staines, Graham L.; Horowitz, Emily; Guarino, Honoria; Grandy, Audrey; Fong, Chunki; Gomez, Augustin; Dimun, Amy; Friedman, Ellen

    2005-01-01

    An innovative employment counseling model, Customized Employment Supports, was developed for methadone-treatment patients, a population with historically low employment rates. The effectiveness of a key component of the model, "vocational fieldwork," the delivery of services in the community rather than only within the clinic, was assessed through…

  2. Integrated Self-Management System for Improved Treatment of Asthma

    PubMed Central

    NGUYEN, Kristen T.; CULJAT, Martin O.; MIERZWA, Andrzej P.; SINGH, Rahul S.; FONG, Benson; VANLANDINGHAM, Rebecca

    2016-01-01

    A mobile, affordable product that provides clinicians and patients with comprehensive asthma assessment is needed to improve asthma control. Our solution is an integrated system consisting of a portable, inexpensive, easy-to-use spirometer and a mobile application that communicates wirelessly with the spirometer. Results demonstrated that the wireless asthma management solution meets recommended American Thoracic Society (ATS) and European Respiratory Society (ERS) standards. The device is expected to empower patients to accurately self-assess their asthma for better self-management at home, work, or leisure. PMID:27046589

  3. Integrated Psychosocial and Opioid-Antagonist Treatment for Alcohol Dependence: A Systematic Review of Controlled Evaluations

    ERIC Educational Resources Information Center

    Vaughn, Michael G.; Howard, Matthew O.

    2004-01-01

    Methodological characteristics and outcomes of 14 controlled clinical investigations of integrated psychosocial and opioid-antagonist alcohol dependence treatment were evaluated. The 14 studies were identified through computerized bibliographic and manual literature searches. Clients receiving integrated psychosocial and opioid-antagonist…

  4. Treatment of Smokers with Co-Occurring Disorders: Emphasis on Integration in Mental Health and Addiction Treatment Settings

    PubMed Central

    Hall, Sharon M.; Prochaska, Judith J.

    2009-01-01

    This article reviews the research on the treatment of cigarette smoking in individuals who have comorbid mental illnesses or non-nicotinic addictions. The prevalence of smoking in mentally ill and substance-abusing populations is presented, as well as reasons for this high prevalence. The historical role of cigarettes and tobacco in mental illness and addiction is reviewed to help the reader better understand the pervasiveness of smoking in these disorders and the relative absence of intervention efforts in mental heath and addiction treatment settings. The article then discusses the several reasons for integrating smoking treatment into mental health and addiction settings. The outcome research for adult and adolescent comorbid smokers is reviewed, and barriers to treatment are discussed. The review closes with a brief discussion of models of integration and thoughts about prevention. PMID:19327035

  5. Melting down the Ice Queen: an integrative treatment of anorexia nervosa

    PubMed Central

    Hartogs, Bregje M A; Eikmans, Kirsten M; Bartels-Velthuis, Agna A

    2013-01-01

    A 23-year-old woman with anorexia nervosa (AN) and a strong need for control was offered an integrative treatment, empowering the patient to be an active participant and advocating shared decision-making. To emphasise this, both the therapist and patient describe their views on the therapy. The integrative treatment resulted in more psychological flexibility and behavioural improvements, as is evident from an increased weight, a decreased dietary restriction and an increased valued action. The strength of this integrative treatment is based on accepting and encouraging patient's self-chosen treatment method, within healthy limits, and thereby creating a flexible, supportive and empowering therapeutic alliance. More research is needed to test the efficacy of combining complementary therapies within conventional treatments of AN. PMID:23531925

  6. Integrated treatment of molasses distillery wastewater using microfiltration (MF).

    PubMed

    Basu, Subhankar; Mukherjee, Sangeeta; Kaushik, Ankita; Batra, Vidya S; Balakrishnan, Malini

    2015-08-01

    To achieve zero-liquid discharge, high pressure reverse osmosis (RO) of effluent is being employed by molasses based alcohol distilleries. Low pressure and thus less energy intensive microfiltration (MF) is well established for particulate separation but is not suitable for removal of dissolved organics and color. This work investigates two schemes incorporating MF for molasses distillery wastewater (a) chemical coagulation followed by treatment in a membrane bioreactor (MBR) using MF and (b) electrocoagulation followed by MF. The performance was assessed in terms of COD and color reduction; the conversion of the generated sludge into a zeolite desiccant was also examined. A comparison of the schemes indicates electrocoagulation followed by MF through a 0.1 μm membrane to be most effective. By hydrothermal treatment, electrocoagulated sludge can be transformed into a porous NaX zeolite with a surface area of 86 m(2)/g, which is comparable to commercial desiccants. PMID:25956444

  7. Integrated treatment to resolve a horizontal root fracture.

    PubMed

    Brandini, Daniela Atili; Poi, Wilson Roberto; Panzarini, Sônia Regina; Sonoda, Celso Koogi; de Castro, José Carlos Monteiro; Luvizuto, Eloá Rodrigues; Leal, Cláudia Resende

    2009-04-01

    Root fractures are defined as those that involve cement, dentin and pulp, comprising from 0.5 to 7% of injuries in permanent dentition. Diagnosis is made through clinical and radiographic exams, the latter frequently being limited by the position of the fracture. Treatment varies according to the displacement and vitality of the fragments. The authors present a clinical case of recurrent trauma of tooth 21 causing a horizontal root fracture in the middle third. After several attempts at endodontic treatment, the option was to remove the apical fragment by surgery. The postoperative period of 4 years shows very satisfactory results with regard to wound repair and tooth mobility, or implantation of the coronal segment. PMID:19290888

  8. Treatment Integrity Assessment of a Daily Report Card Intervention: A Preliminary Evaluation of Two Methods and Frequencies

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Chafouleas, Sandra M.; O'Keeffe, Breda V.; Kilgus, Stephen P.

    2013-01-01

    Although intuitively appealing, teacher self-report of treatment integrity is not currently recommended as a method for collecting treatment integrity data. Education researchers have not, however, evaluated features of a treatment integrity self-reporting system that may facilitate accurate self-report. In this preliminary investigation, four…

  9. Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions.

    PubMed

    Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Stangier, Ulrich

    2014-07-01

    The evaluation of treatment integrity (therapist adherence and competence) is a necessary condition to ensure the internal and external validity of psychotherapy research. However, the evaluation process is associated with high costs, because therapy sessions must be rated by experienced clinicians. It is debatable whether rating session segments is an adequate alternative to rating entire sessions. Four judges evaluated treatment integrity (i.e., therapist adherence and competence) in 84 randomly selected videotapes of cognitive-behavioral therapy for major depressive disorder, social anxiety disorder, and hypochondriasis (from three different treatment outcome studies). In each case, two judges provided ratings based on entire therapy sessions and two on session segments only (i.e., the middle third of the entire sessions). Interrater reliability of adherence and competence evaluations proved satisfactory for ratings based on segments and the level of reliability did not differ from ratings based on entire sessions. Ratings of treatment integrity that were based on entire sessions and session segments were strongly correlated (r=.62 for adherence and r=.73 for competence). The relationship between treatment integrity and outcome was comparable for ratings based on session segments and those based on entire sessions. However, significant relationships between therapist competence and therapy outcome were only found in the treatment of social anxiety disorder. Ratings based on segments proved to be adequate for the evaluation of treatment integrity. The findings demonstrate that session segments are an adequate and cost-effective alternative to entire sessions for the evaluation of therapist adherence and competence. PMID:24912466

  10. Treatment integrity in applied behavior analysis with children.

    PubMed

    Gresham, F M; Gansle, K A; Noell, G H

    1993-01-01

    Functional analysis of behavior depends upon accurate measurement of both independent and dependent variables. Quantifiable and controllable operations that demonstrate these functional relationships are necessary for a science of human behavior. Failure to implement independent variables with integrity threatens the internal and external validity of experiments. A review of all applied behavior analysis studies with children as subjects that have been published in the Journal of Applied Behavior Analysis between 1980 and 1990 found that approximately 16% of these studies measured the accuracy of independent variable implementation. Two thirds of these studies did not operationally define the components of the independent variable. Specific recommendations for improving the accuracy of independent variable implementation and for defining independent variables are discussed. PMID:8331022

  11. Treatment Integrity Enhancement via Performance Feedback Conceptualized as an Exercise in Social Influence

    ERIC Educational Resources Information Center

    Erchul, William P.

    2013-01-01

    This commentary is in response to the article "Effects of Verbal and Written Performance Feedback on Treatment Adherence" (Kaufman, Codding, Markus, Tryon, & Kyse, this issue). The overall recommendation to those who study treatment integrity using performance feedback methods is to incorporate theories and research on social…

  12. The Protected Addiction: Exploring Staff Beliefs toward Integrating Tobacco Dependence into Substance Abuse Treatment Services

    ERIC Educational Resources Information Center

    Teater, Barbra; Hammond, Gretchen Clark

    2009-01-01

    Survey research was used to explore the beliefs of 963 staff members regarding the myths to treating tobacco dependence and the integration of tobacco dependence into substance abuse treatment programs. The staff represented a mixture of residential, outpatient, and prevention-based gender-specific (women only) treatment centers throughout Ohio.…

  13. Primary Prevention Programs at the Elementary Level: Issues of Treatment Integrity, Systematic Screening, and Reinforcement

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Kalberg, Jemma Robertson; Bruhn, Allison Leigh; Mahoney, Michelle E.; Driscoll, Steven A.

    2008-01-01

    This study examined issues of treatment integrity, systematic screenings, and access to reinforcement relative to school-wide positive behavior support programs (SW-PBS) implemented in two rural elementary schools during the first year of program implementation. Results suggested that treatment fidelity, as measured by self-report and direct…

  14. The Effects of Varying Levels of Treatment Integrity on Child Compliance during Treatment with a Three-Step Prompting Procedure

    ERIC Educational Resources Information Center

    Wilder, David A.; Atwell, Julie; Wine, Byron

    2006-01-01

    The effects of three levels of treatment integrity (100%, 50%, and 0%) on child compliance were evaluated in the context of the implementation of a three-step prompting procedure. Two typically developing preschool children participated in the study. After baseline data on compliance to one of three common demands were collected, a therapist…

  15. Does Integrated Trauma-Informed Substance Abuse Treatment Increase Treatment Retention?

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Chernoff, Miriam; Brown, Vivian; Arevalo, Sandra; Gatz, Margaret

    2007-01-01

    This article presents findings from a quasi-experimental, nonrandomized group design study that explored whether trauma-enhanced substance abuse treatment results in longer residential treatment stays and improved outcomes compared with treatment-as-usual. We used a subsample (N = 461) of participants in the Women, Co-Occurring Disorders and…

  16. Integrated Treatment to Achieve Functional Recovery for First-Episode Psychosis

    PubMed Central

    Valencia, Marcelo; Juarez, Francisco; Ortega, Hector

    2012-01-01

    This study describes an integrated treatment approach that was implemented to enhance functional recovery in first-episode psychotic patients. Patients were randomized to two treatment conditions: either to an integrated treatment approach: pharmacotherapy, psychosocial treatment, and psychoeducation (experimental group: N = 39) or to medication alone (control group: N = 34). Patients were evaluated at baseline and after one year of treatment. Functional recovery was assessed according to symptomatic and functional remission. At the end of treatment, experimental patients showed a 94.9% of symptomatic remission compared to 58.8% of the control group. Functional remission was 56.4% for the experimental group and 3.6% for the control group, while 56.4% of the experimental group met both symptomatic and functional remission criteria and were considered recovered compared to 2.9% of the control group. PMID:22970366

  17. Integrity of erythrocytes of hypercholesterolemic rats during spices treatment.

    PubMed

    Kempaiah, R K; Srinivasan, K

    2002-07-01

    In rats rendered hypercholesterolemic by maintaining them on a cholesterol-enriched diet (0.5%) for 8 weeks, inclusion of spice principles--curcumin (0.2%) or capsaicin (0.015%) or the spice--garlic powder (2.0%) in the diet, produced the expected hypolipidemic effect. Plasma cholesterol which was more than 200% that of basal control in hypercholesterolemic rats, was decreased by these dietary spice principles and garlic by 25-39%. Erythrocyte membranes of hypercholesterolemic rats were relatively enriched in cholesterol, which was about 120% of basal control, while membrane phospholipid was unaffected. This resulted in a significant alteration in cholesterol to phospholipid ratio of RBC membranes. Dietary curcumin, capsaicin and garlic were observed to counter this altered lipid profile of erythrocyte membranes in hypercholesterolemic situation by producing a significant 10-14% decrease in membrane cholesterol content. As a result of alteration in membrane structural lipids, the structural integrity of RBCs was also affected. An examination of the osmotic fragility of erythrocytes in various groups, indicated that RBCs of hypercholesterolemic rats were relatively fragile compared to normal controls. Dietary curcumin, capsaicin and garlic appeared to correct this increased fragility of erythrocytes. PMID:12190115

  18. Advances in Applying Treatment Integrity Research for Dissemination and Implementation Science: Introduction to Special Issue

    PubMed Central

    Southam-Gerow, Michael A.; McLeod, Bryce D.

    2013-01-01

    This special series focuses upon the ways in which research on treatment integrity, a multidimensional construct including assessment of the content and quality of a psychosocial treatment delivered to a client as well as relational elements, can inform dissemination and implementation science. The five articles for this special series illustrate how treatment integrity concepts and methods can be applied across different levels of the mental health service system to advance dissemination and implementation science. In this introductory article, we provide an overview of treatment integrity research and describe three broad conceptual models that are relevant to the articles in the series. We conclude with a brief description of each of the five articles in the series. PMID:23970819

  19. A novel, integrated treatment systems for coal wastewaters

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-01-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and heavy metals present in coal conversion wastewaters. Hec-CBDA-DT, a modified hectorite containing a mixed bilayer of a cationic (CBDA) and a diamine (DT) type surfactants, was shown to adsorb simultaneously heavy metals such as Cu[sup 2+] and Cd[sup 2+] and toxic organics such as chlorophenols. The pH dependence of the adsorption of chlorophenols on Hec-CBDA-DT suggested hydrophobic partitioning, counterion adsorption and hydrogen-bond interaction of the phenolate ions with the surface diamine groups as the possible mechanisms of sorption. Adsorption of Cu[sup 2+] by Hec-CBDA-DT was shown to be only slightly affected by a large excess of counterions, thus indicating that Cu[sup 2+] adsorbed specifically to the surface. A second type of modified clay, Hec-CBDA-Palmitic Acid (Hec-CBDA-PA) adsorbed both Cu[sup 2+] and Cd[sup 2+] strongly. However, the pH optima for adsorption were 6.0 and 8.0 respectively in the case of Cu[sup 2+] and Cd[sup 2+]. It is inferred that the mechanisms of adsorption of these two metal ions to Hec-CBDA-PA are different, specific and counterion binding respectively in the case of Cu and Cd ions.

  20. A novel integrated treatment system for coal wastewaters

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-01-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and heavy metals present in coal conversion wastewaters. To remove and recover heavy metals from wastewaters, four different types of surfactant-clay complexes have been prepared using hectored or montmorillonite as the base clays. The adsorbent is prepared by first coating the clay surface, upto a monolayer, with a cationic surfactant, CBDA, to which an amine, (DT), or a carboxylic acid (Palmitic acid, PA) is anchored using hydrophobic effect to form a mixed bilayer. Such an arrangement is expected to locate the functional groups in metal adsorption at the solid-solution interface. Complexes based on hectored are shown to adsorb Cu{sup 2+} ions more strongly than the ones based on montmorillonite. The rate of adsorption of Cu{sup 2+} ions is quite rapid and the adsorbed amount levels off in less than 2 hrs. The optimum pH for metal adsorption is around 6.5 and the amount of metal adsorbed declines sharply on the lower pH side of the pH optimum, suggesting that removal and recovery of adsorbed metal ions can be effected by a slight pH shift.

  1. A novel, integrated treatment system for coal wastewaters

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-01-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and the heavy metals present in coal conversion wastewaters. Hec-CBDA-DT, (HCDT), a modified hectorite containing a mixed bilayer of a cationic (CBDA) and a dismine (DT) type surfactants, has been shown to adsorb Cr (VI) strongly at PH below 5.0. A second kind of a modified clay, montmorillonite-DT, (MONT-DT), in which the protonated form of the diamine is directly attached to the negative sites of clay surface, has also been found to adsorb CR(VI) as strongly as Hec-CBDA-DT at a pH of 4.5. The adsorption of Cr (VI) onto these two modified-clays is strongly inhibited by an increase in the ionic strength of the medium. It is inferred that the main mechanism of adsorption of CR(VI) onto these two clay complexes is of the counterion. Preliminary data on the partitioning of phenanthrene, a three-ringed polyaromatic hydrocarbon (PAH), reveal that organic carbon located on the external surfaces of clay complexes is more effective in partitioning nonionic, toxic organic compounds.

  2. Enhancing the Developmental Appropriateness of Treatment for Depression in Youth: Integrating the Family in Treatment

    PubMed Central

    Tompson, Martha C.; Boger, Kathryn Dingman; Asarnow, Joan R.

    2016-01-01

    Youth depression is an impairing and frequently recurrent and persistent disorder that impacts current and later development, resulting in high social and economic costs. Depression and interpersonal stress are frequently transactional, with depression powerfully negatively impacting relationships and relationship stress negatively impacting the course and outcome of depression. In this context, treatment models for youth depression that emphasize interpersonal functioning, particularly family relationships, may be particularly promising. This article has three objectives. It first reviews the current state of knowledge on the efficacy of psychosocial treatments for depression in youth, with an emphasis on the role of family involvement in treatment. Second, it discusses developmental factors that may impact the applicability and structure of family-focused treatment models for preadolescent and adolescent youth. Third, two family-based treatment models that are currently being evaluated in randomized clinical trials are described: one focusing on preadolescent depressed youth and the other on adolescents who have made a recent suicide attempt. PMID:22537731

  3. Uniting adolescent neuroimaging and treatment research: Recommendations in pursuit of improved integration

    PubMed Central

    Feldstein Ewing, Sarah W.; Tapert, Susan F.; Molina, Brooke S.G.

    2016-01-01

    Many clinicians who provide mental health treatment find developmental neuroscience discoveries to be exciting. However, the utility of these findings often seem far removed from everyday clinical care. Thus, the goal of this article is to offer a bridge to connect the fields of applied adolescent treatment and developmental neuroscience investigation. An overview of the relevance of developmental neuroscience in adolescent direct practice and a rationale for how and why this integration could benefit adolescent treatment outcomes is provided. Finally, a series of practical suggestions is generated for enhancing collaborative, interdisciplinary work that ultimately advances treatment response for this important clinical population. PMID:26748378

  4. Interpersonal, cognitive analytic and other integrative therapies versus treatment as usual for depression

    PubMed Central

    Churchill, Rachel; Davies, Philippa; Caldwell, Deborah; Moore, Theresa HM; Jones, Hannah; Lewis, Glyn; Hunot, Vivien

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all integrative therapies compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of different integrative therapies (IPT, CAT, psychodynamic-interpersonal therapy, cognitive behavioural analysis system of psychotherapy and counselling) compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of all integrative therapies compared with different types of comparator (standard care, no treatment, waiting list, attention placebo) for acute depression. PMID:25411560

  5. Patient Perspectives of an Integrated Program of Medical Care and Substance Use Treatment

    PubMed Central

    Farrell, Caitlin; Sorensen-Alawad, Amy; Palmisano, Joseph N.; Chaisson, Christine; Walley, Alexander Y.

    2014-01-01

    Abstract The benefits of integrating primary care and substance use disorder treatment are well known, yet true integration is difficult. We developed and evaluated a team-based model of integrated care within the primary care setting for HIV-infected substance users and substance users at risk for contracting HIV. Qualitative data were gathered via focus groups and satisfaction surveys to assess patients' views of the program, evaluate key elements for success, and provide recommendations for other programs. Key themes related to preferences for the convenience and efficiency of integrated care; support for a team-based model of care; a feeling that the program requirements offered needed structure; the importance of counseling and education; and how provision of concrete services improved overall well-being and quality of life. For patients who received buprenorphine/naloxone for opioid dependence, this was viewed as a major benefit. Our results support other studies that theorize integrated care could be of significant value for hard-to-reach populations and indicate that having a clinical team dedicated to providing substance use disorder treatment, HIV risk reduction, and case management services integrated into primary care clinics has the potential to greatly enhance the ability to serve a challenging population with unmet treatment needs. PMID:24428768

  6. Patient perspectives of an integrated program of medical care and substance use treatment.

    PubMed

    Drainoni, Mari-Lynn; Farrell, Caitlin; Sorensen-Alawad, Amy; Palmisano, Joseph N; Chaisson, Christine; Walley, Alexander Y

    2014-02-01

    The benefits of integrating primary care and substance use disorder treatment are well known, yet true integration is difficult. We developed and evaluated a team-based model of integrated care within the primary care setting for HIV-infected substance users and substance users at risk for contracting HIV. Qualitative data were gathered via focus groups and satisfaction surveys to assess patients' views of the program, evaluate key elements for success, and provide recommendations for other programs. Key themes related to preferences for the convenience and efficiency of integrated care; support for a team-based model of care; a feeling that the program requirements offered needed structure; the importance of counseling and education; and how provision of concrete services improved overall well-being and quality of life. For patients who received buprenorphine/naloxone for opioid dependence, this was viewed as a major benefit. Our results support other studies that theorize integrated care could be of significant value for hard-to-reach populations and indicate that having a clinical team dedicated to providing substance use disorder treatment, HIV risk reduction, and case management services integrated into primary care clinics has the potential to greatly enhance the ability to serve a challenging population with unmet treatment needs. PMID:24428768

  7. The BRENDA model: integrating psychosocial treatment and pharmacotherapy for the treatment of alcohol use disorders.

    PubMed

    Starosta, Aron N; Leeman, Robert F; Volpicelli, Joseph R

    2006-03-01

    While the U.S. Food and Drug Administration has approved several medications for the treatment of alcohol-related problems, their use has not gained wide acceptance in the United States. Typically, patients with alcohol use disorders are only referred to psychosocial support (e.g., Alcoholics Anonymous). However, the use of pharmacotherapy may complement psychosocial treatments, as evidence shows that pharmacotherapy can improve treatment outcomes. The effectiveness of pharmacotherapy depends on patient compliance with taking the medication and the context in which the medication is administered. BRENDA is a psychosocial program designed specifically to be used by many types of healthcare providers, including primary care clinicians. Designed to enhance medication and treatment compliance, BRENDA is an ideal approach for use in conjunction with pharmacotherapy. The BRENDA approach has 6 components: 1) a biopsychosocial evaluation; 2) a report of findings from the evaluation given to the patient; 3) empathy; 4) addressing patient needs; 5) providing direct advice; and 6) assessing patient reaction to advice and adjusting the treatment plan as needed. This paper describes these components and discusses how the empirical support for each component is linked to the enhancement of medication compliance and the improvement of treatment outcomes. PMID:16728904

  8. The BRENDA Model: Integrating Psychosocial Treatment and Pharmacotherapy for the Treatment of Alcohol Use Disorders

    PubMed Central

    Starosta, Aron N.; Leeman, Robert F.; Volpicelli, Joseph R.

    2009-01-01

    While the U. S. Food and Drug Administration has approved several medications for the treatment of alcohol-related problems, their use has not gained wide acceptance in the United States. Typically, patients with alcohol use disorders are only referred to psychosocial support (e.g., Alcoholics Anonymous). However, the use of pharmacotherapy may complement psychosocial treatments, as evidence shows that pharmacotherapy can improve treatment outcomes. The effectiveness of pharmacotherapy depends on patient compliance with taking the medication and the context in which the medication is administered. BRENDA is a psychosocial program designed specifically to be used by many types of healthcare providers, including primary care clinicians. Designed to enhance medication and treatment compliance, BRENDA is an ideal approach for use in conjunction with pharmacotherapy. The BRENDA approach has 6 components: 1) a biopsychosocial evaluation; 2) a report of findings from the evaluation given to the patient; 3) empathy; 4) addressing patient needs; 5) providing direct advice; and 6) assessing patient reaction to advice and adjusting the treatment plan as needed. This paper describes these components and discusses how the empirical support for each component is linked to the enhancement of medication compliance and the improvement of treatment outcomes. PMID:16728904

  9. The Urgency Of Providing Comprehensive And Integrated Treatment For Substance Abusers With HIV

    PubMed Central

    Volkow, Nora D.; Montaner, Julio

    2011-01-01

    Substance abuse is linked to many new cases of HIV infection. Barriers such as the myth that drug users cannot adhere to HIV/AIDS treatment block progress in curbing the spread of HIV in that population. In this article we explain the need to aggressively seek out high-risk, hard-to-reach substance abusers and to offer them HIV testing, access to treatment, and the necessary support to remain in treatment—both for HIV and for substance abuse. We summarize evidence showing that injection drug users can successfully undergo HIV treatment; that many substance abusers adhere to antiretroviral therapy as well as do people who don’t inject drugs; and that injection drug users who undergo substance abuse treatment are more likely to obtain and stay in treatment for their HIV infection. This evidence makes a strong case for integrating substance abuse treatment with HIV treatment programs and providing substance abusers with universal access to HIV treatment. But an integrated strategy will require changes in the health care system to overcome lingering obstacles that inhibit the merging of substance abuse treatment with HIV programs. PMID:21821558

  10. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    ERIC Educational Resources Information Center

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  11. The possible introduction of anti-osteoporosis drugs as an integrated treatment in total hip arthroplasty.

    PubMed

    Marchese, Marcella; Zarattini, Guido; Pazzaglia, Ugo E

    2011-04-01

    The anchorage of cementless total hip arthroplasty relies on a direct bone to implant bonding. Several factors including material properties and surface treatment determine the interfacial response of the host bone to a foreign material. Another factor that must be taken into account is the bone remodeling after the prosthesis introduction. Considering this bone remodeling, in the last few years the possibility of using anti-osteoporotic drugs has been introduced as a supplementary and integrated treatment in total hip replacement. PMID:21970916

  12. [Integration of drug treatment in the management concept of prostate cancer].

    PubMed

    Cathomas, R

    2013-10-01

    The drug treatment of prostate cancer was for many years based on androgen deprivation with luteinizing hormone-releasing hormone (LHRH) analogues.This treatment still represents the standard first line treatment for advanced prostate cancer. In cases of progression to metastatic castration-resistant prostate cancer (mCRPC) further treatment options used to be limited. Only the chemotherapy drug docetaxel could demonstrate a significant overall survival benefit. Within the last few years, however, five new treatments for patients with mCRCP have achieved significant results in large phase III trials. Interestingly they have different mechanisms of action: abiraterone is a testosterone synthesis inhibitor, enzalutamide is a novel antiandrogen, cabazitaxel is a cytotoxic drug, radium-223 is a radionuclide and sipuleucel-T an immunotherapy. Further new drugs are under investigation. The integration of these new treatment options as well as an optimal sequence and combination is the main focus of current research. PMID:23896735

  13. A simple method of independent treatment time verification in gamma knife radiosurgery using integral dose

    SciTech Connect

    Jin Jianyue; Drzymala, Robert; Li Zuofeng

    2004-12-01

    The purpose of this study is to develop a simple independent dose calculation method to verify treatment plans for Leksell Gamma Knife radiosurgery. Our approach uses the total integral dose within the skull as an end point for comparison. The total integral dose is computed using a spreadsheet and is compared to that obtained from Leksell GammaPlan registered . It is calculated as the sum of the integral doses of 201 beams, each passing through a cylindrical volume. The average length of the cylinders is estimated from the Skull-Scaler measurement data taken before treatment. Correction factors are applied to the length of the cylinder depending on the location of a shot in the skull. The radius of the cylinder corresponds to the collimator aperture of the helmet, with a correction factor for the beam penumbra and scattering. We have tested our simple spreadsheet program using treatment plans of 40 patients treated with Gamma Knife registered in our center. These patients differ in geometry, size, lesion locations, collimator helmet, and treatment complexities. Results show that differences between our calculations and treatment planning results are typically within {+-}3%, with a maximum difference of {+-}3.8%. We demonstrate that our spreadsheet program is a convenient and effective independent method to verify treatment planning irradiation times prior to implementation of Gamma Knife radiosurgery.

  14. An Integrated Model for Identifying Linkages Between the Management of Fuel Treatments, Fire and Ecosystem Services

    NASA Astrophysics Data System (ADS)

    Bart, R. R.; Anderson, S.; Moritz, M.; Plantinga, A.; Tague, C.

    2015-12-01

    Vegetation fuel treatments (e.g. thinning, prescribed burning) are a frequent tool for managing fire-prone landscapes. However, predicting how fuel treatments may affect future wildfire risk and associated ecosystem services, such as forest water availability and streamflow, remains a challenge. This challenge is in part due to the large range of conditions under which fuel treatments may be implemented, as response is likely to vary with species type, rates of vegetation regrowth, meteorological conditions and physiographic properties of the treated site. It is also due to insufficient understanding of how social factors such as political pressure, public demands and economic constraints affect fuel management decisions. To examine the feedbacks between ecological and social dimensions of fuel treatments, we present an integrated model that links a biophysical model that simulates vegetation and hydrology (RHESSys), a fire spread model (WMFire) and an empirical fuel treatment model that accounts for agency decision-making. We use this model to investigate how management decisions affect landscape fuel loads, which in turn affect fire severity and ecosystem services, which feedback to management decisions on fuel treatments. We hypothesize that this latter effect will be driven by salience theory, which predicts that fuel treatments are more likely to occur following major wildfire events. The integrated model provides a flexible framework for answering novel questions about fuel treatments that span social and ecological domains, areas that have previously been treated separately.

  15. Family-Based Cognitive-Behavioral Treatments for Suicidal Adolescents and their Integration with Individual Treatment

    ERIC Educational Resources Information Center

    Wells, Karen C.; Heilbron, Nicole

    2012-01-01

    A considerable research base underscores the importance of family functioning in the risk for and treatment of adolescent suicidal thoughts and behaviors. This paper reviews the extant empirical literature documenting associations between features of the family context and adolescent suicidal thoughts and behaviors. A case example is provided to…

  16. Implementation Planning to Promote Parents' Treatment Integrity of Behavioral Interventions for Children with Autism

    ERIC Educational Resources Information Center

    Fallon, Lindsay M.; Collier-Meek, Melissa A.; Sanetti, Lisa M. H.; Feinberg, Adam B.; Kratochwill, Thomas R.

    2016-01-01

    Behavioral interventions delivered across home and school settings can promote positive outcomes for youth with autism spectrum disorders (ASD). Yet, stakeholders who deliver these interventions may struggle to implement interventions as intended. Low levels of treatment integrity can undermine potentially positive intervention outcomes. One way…

  17. Increasing Teacher Treatment Integrity through Performance Feedback Provided by School Personnel

    ERIC Educational Resources Information Center

    Hagermoser Sanetti, Lisa M.; Fallon, Lindsay M.; Collier-Meek, Melissa A.

    2013-01-01

    When implementing behavioral interventions in educational settings, some implementers need support to maintain high levels of treatment integrity. Performance feedback has a large body of research supporting it as a strategy for improving teachers' implementation of classroom interventions. However, in most prior studies, performance feedback has…

  18. Treatment Integrity of Interventions with Children in the School Psychology Literature from 1995 to 2008

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Gritter, Katie L.; Dobey, Lisa M.

    2011-01-01

    Increased accountability in education has resulted in a focus on implementing interventions with strong empirical support. Both student outcome and treatment integrity data are needed to draw valid conclusions about intervention effectiveness. Reviews of the literature in other fields (e.g., applied behavior analysis, prevention science) suggest…

  19. Effects of Varied Levels of Treatment Integrity on Appropriate Toy Manipulation in Children with Autism

    ERIC Educational Resources Information Center

    Groskreutz, Nicole C.; Groskreutz, Mark P.; Higbee, Thomas S.

    2011-01-01

    We assessed the effects of varying the treatment integrity of a prompting procedure on appropriate toy manipulation in two preschool-aged children with autism. Following an assessment to identify toys with high levels of inappropriate toy manipulation, each of three toys was associated with implementation of the prompting procedure at a different…

  20. A Randomized, Controlled Trial of Integrated Home-School Behavioral Treatment for ADHD, Predominantly Inattentive Type

    ERIC Educational Resources Information Center

    Pfiffner, Linda J.; Mikami, Amori Yee; Huang-Pollock, Cynthia; Easterlin, Barbara; Zalecki, Christine; McBurnett, Keith

    2007-01-01

    Objective: To evaluate the efficacy of a behavioral psychosocial treatment integrated across home and school (Child Life and Attention Skills Program) with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I). Method: Sixty-nine children ages 7 to 11 years were randomized to the Child Life and Attention Skills…

  1. The Effect of Sensory Integration Treatment on Children with Multiple Disabilities.

    ERIC Educational Resources Information Center

    Din, Feng S.; Lodato, Donna M.

    Six children with multiple disabilities (ages 5 to 8) participated in this evaluation of the effect of sensory integration treatment on sensorimotor function and academic learning. The children had cognitive abilities ranging from sub-average to significantly sub-average, three were non-ambulatory, one had severe behavioral problems, and each…

  2. K West Basin Integrated Water Treatment System (IWTS) E-F Annular Filter Vessel Accident Calculations

    SciTech Connect

    RITTMANN, P.D.

    1999-10-07

    Three bounding accidents postdated for the K West Basin integrated water treatment system are evaluated against applicable risk evaluation guidelines. The accidents are a spray leak during fuel retrieval, spray leak during backflushing, and a hydrogen explosion. Event trees and accident probabilities are estimated. In all cases, the unmitigated dose consequences are below the risk evaluation guidelines.

  3. Preliminary design report for the K basins integrated water treatment system

    SciTech Connect

    Pauly, T.R., Westinghouse Hanford

    1996-08-12

    This Preliminary Design Report (PDR) provides a revised concept for the K Basins Integrated Water Treatment Systems (IWTS). This PDR incorporates the 11 recommendations made in a May 1996 Value Engineering session into the Conceptual Design, and provides new flow diagrams, hazard category assessment, cost estimate, and schedule for the IWTS Subproject.

  4. Project TEAMS: Integrating Treatment and Education To Improve Outcomes for Delinquent Youth.

    ERIC Educational Resources Information Center

    Huffty, Judy; Fitzsimons-Lovett, Ann

    1999-01-01

    Describes and evaluates a holistic resocialization program used by the Texas Youth Commission that has been integrated into the state's education, treatment, and correctional programs for incarcerated youth. Goals of the program are to help ensure that the youth can generalize the skills they gain through these processes to situations outside the…

  5. K West Basin Integrated Water Treatment System (IWTS) E-F Annular Filter Vessel Accident Calculations

    SciTech Connect

    PIEPHO, M.G.

    2000-01-10

    Four bounding accidents postulated for the K West Basin integrated water treatment system are evaluated against applicable risk evaluation guidelines. The accidents are a spray leak during fuel retrieval, spray leak during backflushing a hydrogen explosion, and a fire breaching filter vessel and enclosure. Event trees and accident probabilities are estimated. In all cases, the unmitigated dose consequences are below the risk evaluation guidelines.

  6. MONITORING INTEGRATED ENERGY SYSTEMS AT A WASTEWATER TREATMENT PLANT IN MAINE

    EPA Science Inventory

    A project was undertaken to monitor the performance of an integrated energy system at the Wilton, Maine, wastewater treatment plant. These systems included active and passive solar heating, effluent heat recovery, digester gas generation, air-to-air heat recovery, and electricity...

  7. Examining the Influence of Treatment Integrity: Accuracy of Daily Report Card Intervention Implementation and Student Outcome

    ERIC Educational Resources Information Center

    Vujnovic, Rebecca Kate

    2010-01-01

    Given the deficits associated with ADHD and the significant prevalence, it is important to explore evidence based treatments for ADHD in the classroom and the efficacy with which the classroom teachers implement such interventions. The current investigation is a secondary analysis to investigate the integrity of a Daily Report Card (DRC)…

  8. Assessing Treatment Integrity in Acceptance and Commitment Therapy: Strategies and Suggestions

    ERIC Educational Resources Information Center

    Plumb, Jennifer C.; Vilardaga, Roger

    2010-01-01

    In this paper, we briefly review the current literature on treatment integrity and discuss the relevance of this procedure for detecting, measuring and ensuring that the proposed mechanisms of change in cognitive behavior therapy, in this case of acceptance and commitment therapy (ACT; S.C. Hayes, Strosahl, & Wilson, 1999), take place. We discuss…

  9. Treatment Integrity: A Review of Intervention Studies Conducted with Children with Autism

    ERIC Educational Resources Information Center

    Wheeler, John J.; Baggett, Bob A.; Fox, James; Blevins, Leia

    2006-01-01

    The purpose of this study was to assess the degree to which behavioral intervention studies conducted with children diagnosed with autism operationally defined the independent variables (IVs) and evaluated treatment integrity (TI). The study replicated the criteria from Gresham, Gansle, and Noell (1993) and focused exclusively on research studies…

  10. A Comparison of Sensory Integrative and Behavioral Therapies as Treatment for Pediatric Feeding Disorders

    ERIC Educational Resources Information Center

    Addison, Laura R.; Piazza, Cathleen C.; Patel, Meeta R.; Bachmeyer, Melanie H.; Rivas, Kristi M.; Milnes, Suzanne M.; Oddo, Jackie

    2012-01-01

    We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory…

  11. An Assessment of Treatment Integrity in Behavioral Intervention Studies Conducted with Persons with Mental Retardation

    ERIC Educational Resources Information Center

    Wheeler, John J.; Mayton, Michael R.; Carter, Stacy L.; Chitiyo, Morgan; Menendez, Anthony L.; Huang, Ann

    2009-01-01

    The purpose of this study was to assess the degree to which behavioral intervention studies conducted with persons with mental retardation operationally defined the independent variables and evaluated and reported measures of treatment integrity. The study expands the previous work in this area reported by Gresham, Gansle, and Noell (1993) and…

  12. Integrated trauma treatment in correctional health care and community-based treatment upon reentry.

    PubMed

    Wallace, Barbara C; Conner, Latoya C; Dass-Brailsford, Priscilla

    2011-10-01

    Given the crisis of mass incarceration in the United States and the high prevalence of trauma histories among those incarcerated, it is imperative to improve service delivery to inmates in correctional facilities and to those undergoing reentry in community-based treatment settings. This article provides trauma definitions and categories, describes the sequelae of trauma, reviews research on the high prevalence of incarceration in this nation, and reviews research on the high prevalence of trauma among the incarcerated. This article also provides a menu of evidence-based and promising treatment approaches to address the overlap among trauma, mental illness, substance abuse, and behavioral problems. A synthesis of research via seven points is meant to guide practitioner and policy responses to the national challenge of meeting the needs of those undergoing reentry. PMID:21948808

  13. A Pathway to Personalization of Integrated Treatment: Informatics and Decision Science in Psychiatric Rehabilitation

    PubMed Central

    Spaulding, William; Deogun, Jitender

    2011-01-01

    Personalization of treatment is a current strategic goal for improving health care. Integrated treatment approaches such as psychiatric rehabilitation benefit from personalization because they involve matching diverse arrays of treatment options to individually unique profiles of need. The need for personalization is evident in the heterogeneity of people with severe mental illness and in the findings of experimental psychopathology. One pathway to personalization lies in analysis of the judgments and decision making of human experts and other participants as they respond to complex circumstances in pursuit of treatment and rehabilitation goals. Such analysis is aided by computer simulation of human decision making, which in turn informs development of computerized clinical decision support systems. This inspires a research program involving concurrent development of databases, domain ontology, and problem-solving algorithms, toward the goal of personalizing psychiatric rehabilitation through human collaboration with intelligent cyber systems. The immediate hurdle is to demonstrate that clinical decisions beyond diagnosis really do affect outcome. This can be done by supporting the hypothesis that a human treatment team with access to a reasonably comprehensive clinical database that tracks patient status and treatment response over time achieves better outcome than a treatment team without such access, in a controlled experimental trial. Provided the hypothesis can be supported, the near future will see prototype systems that can construct an integrated assessment, formulation, and rehabilitation plan from clinical assessment data and contextual information. This will lead to advanced systems that collaborate with human decision makers to personalize psychiatric rehabilitation and optimize outcome. PMID:21860042

  14. Human health benefits and burdens of a pharmaceutical treatment: Discussion of a conceptual integrated approach.

    PubMed

    Debaveye, Sam; De Soete, Wouter; De Meester, Steven; Vandijck, Dominique; Heirman, Bert; Kavanagh, Shane; Dewulf, Jo

    2016-01-01

    The effects of a pharmaceutical treatment have until now been evaluated by the field of Health Economics on the patient health benefits, expressed in Quality-Adjusted Life Years (QALYs) versus the monetary costs. However, there is also a Human Health burden associated with this process, resulting from emissions that originate from the pharmaceutical production processes, Use Phase and End of Life (EoL) disposal of the medicine. This Human Health burden is evaluated by the research field of Life Cycle Assessment (LCA) and expressed in Disability-Adjusted Life Years (DALYs), a metric similar to the QALY. The need for a new framework presents itself in which both the positive and negative health effects of a pharmaceutical treatment are integrated into a net Human Health effect. To do so, this article reviews the methodologies of both Health Economics and the area of protection Human Health of the LCA methodology and proposes a conceptual framework on which to base an integration of both health effects. Methodological issues such as the inclusion of future costs and benefits, discounting and age weighting are discussed. It is suggested to use the structure of an LCA as a backbone to cover all methodological challenges involved in the integration. The possibility of monetizing both Human Health benefits and burdens is explored. The suggested approach covers the main methodological aspects that should be considered in an integrated assessment of the health effects of a pharmaceutical treatment. PMID:26544901

  15. White Matter Integrity and Executive Abilities Following Treatment with Tetrahydrobiopterin (BH4) in Individuals with Phenylketonuria

    PubMed Central

    White, Desirée A.; Antenor-Dorsey, Jo Ann V.; Grange, Dorothy K.; Hershey, Tamara; Rutlin, Jerrel; Shimony, Joshua S.; McKinstry, Robert C.; Christ, Shawn E.

    2013-01-01

    Tetrahydrobiopterin (BH4) lowers blood phenylalanine (Phe) in individuals with PKU who are responders, but its effects on the brain and cognition have not been explored thoroughly. We examined blood Phe, microstructural white matter integrity, and executive abilities in 12 BH4 responders before (i.e., baseline) and after (i.e., follow-up) six months of treatment with BH4. Compared with baseline, Phe in these responders decreased by 51% during a 4 week screening period after initiation of treatment and remained lowered by 37% over the 6 month follow-up period. Significant improvements in white matter integrity, evaluated by mean diffusivity from diffusion tensor imaging, were also found following six months of treatment. Improvements in executive abilities were not identified, although six months may have been a period too brief for changes in cognition to follow changes in brain. To our knowledge, our study is the first to explore relationships among Phe, white matter integrity, executive abilities, and BH4 treatment within a single study. PMID:23928118

  16. White matter integrity and executive abilities following treatment with tetrahydrobiopterin (BH4) in individuals with phenylketonuria.

    PubMed

    White, Desirée A; Antenor-Dorsey, Jo Ann V; Grange, Dorothy K; Hershey, Tamara; Rutlin, Jerrel; Shimony, Joshua S; McKinstry, Robert C; Christ, Shawn E

    2013-11-01

    Tetrahydrobiopterin (BH(4)) lowers blood phenylalanine (Phe) in individuals with PKU who are responders, but its effects on the brain and cognition have not been explored thoroughly. We examined blood Phe, microstructural white matter integrity, and executive abilities in 12 BH(4) responders before (i.e., baseline) and after (i.e., follow-up) six months of treatment with BH(4). Compared with baseline, Phe in these responders decreased by 51% during a 4 week screening period after initiation of treatment and remained lowered by 37% over the 6 month follow-up period. Significant improvements in white matter integrity, evaluated by mean diffusivity from diffusion tensor imaging, were also found following six months of treatment. Improvements in executive abilities were not identified, although six months may have been a period too brief for changes in cognition to follow changes in the brain. To our knowledge, our study is the first to explore relationships among Phe, white matter integrity, executive abilities, and BH(4) treatment within a single study. PMID:23928118

  17. Integrated municipal solid waste treatment using a grate furnace incinerator: The Indaver case

    SciTech Connect

    Vandecasteele, C. Wauters, G.; Arickx, S.; Jaspers, M.; Van Gerven, T.

    2007-07-01

    An integrated installation for treatment of municipal solid waste and comparable waste from industrial origin is described. It consists of three grate furnace lines with flue gas treatment by half-wet scrubbing followed by wet scrubbing, and an installation for wet treatment of bottom ash. It is demonstrated that this integrated installation combines high recovery of energy (40.8% net) with high materials recovery. The following fractions were obtained after wet treatment of the bottom ash: ferrous metals, non-ferrous metals, three granulate fractions with different particle sizes, and sludge. The ferrous and non-ferrous metal fractions can both be recycled as high quality raw materials; the two larger particle size particle fractions can be applied as secondary raw materials in building applications; the sand fraction can be used for applications on a landfill; and the sludge is landfilled. For all components of interest, emissions to air are below the limit values. The integrated grate furnace installation is characterised by zero wastewater discharge and high occupational safety. Moreover, with the considered installation, major pollutants, such as PCDD/PCDF, Hg and iodine-136 are to a large extent removed from the environment and concentrated in a small residual waste stream (flue gas cleaning residue), which can be landfilled after stabilisation.

  18. Integrated municipal solid waste treatment using a grate furnace incinerator: the Indaver case.

    PubMed

    Vandecasteele, C; Wauters, G; Arickx, S; Jaspers, M; Van Gerven, T

    2007-01-01

    An integrated installation for treatment of municipal solid waste and comparable waste from industrial origin is described. It consists of three grate furnace lines with flue gas treatment by half-wet scrubbing followed by wet scrubbing, and an installation for wet treatment of bottom ash. It is demonstrated that this integrated installation combines high recovery of energy (40.8% net) with high materials recovery. The following fractions were obtained after wet treatment of the bottom ash: ferrous metals, non-ferrous metals, three granulate fractions with different particle sizes, and sludge. The ferrous and non-ferrous metal fractions can both be recycled as high quality raw materials; the two larger particle size particle fractions can be applied as secondary raw materials in building applications; the sand fraction can be used for applications on a landfill; and the sludge is landfilled. For all components of interest, emissions to air are below the limit values. The integrated grate furnace installation is characterised by zero wastewater discharge and high occupational safety. Moreover, with the considered installation, major pollutants, such as PCDD/PCDF, Hg and iodine-136 are to a large extent removed from the environment and concentrated in a small residual waste stream (flue gas cleaning residue), which can be landfilled after stabilisation. PMID:17049223

  19. Integration of advanced oxidation processes at mild conditions in wet scrubbers for odourous sulphur compounds treatment.

    PubMed

    Vega, Esther; Martin, Maria J; Gonzalez-Olmos, Rafael

    2014-08-01

    The effectiveness of different advanced oxidation processes on the treatment of a multicomponent aqueous solution containing ethyl mercaptan, dimethyl sulphide and dimethyl disulphide (0.5 mg L(-1) of each sulphur compound) was investigated with the objective to assess which one is the most suitable treatment to be coupled in wet scrubbers used in odour treatment facilities. UV/H2O2, Fenton, photo-Fenton and ozone treatments were tested at mild conditions and the oxidation efficiency obtained was compared. The oxidation tests were carried out in magnetically stirred cylindrical quartz reactors using the same molar concentration of oxidants (hydrogen peroxide or ozone). The results show that ozone and photo-Fenton are the most efficient treatments, achieving up to 95% of sulphur compounds oxidation and a mineralisation degree around 70% in 10 min. Furthermore, the total costs of the treatments taking into account the capital and operational costs were also estimated for a comparative purpose. The economic analysis revealed that the Fenton treatment is the most economical option to be integrated in a wet scrubber to remove volatile organic sulphur compounds, as long as there are no space constraints to install the required reactor volume. In the case of reactor volume limitation or retrofitting complexities, the ozone and photo-Fenton treatments should be considered as viable alternatives. PMID:24873715

  20. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    PubMed Central

    Wolever, Ruth Q.; Price, Rebecca; Hazelton, A. Garrett; Dmitrieva, Natalia O.; Bechard, Elizabeth M.; Shaffer, Janet K.; Tucci, Debara L.

    2015-01-01

    Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE) therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life) and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1) conventional tinnitus treatments and (2) promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs. PMID:26457113

  1. Using Enhanced and Integrated Services to Improve Response to Standard Methadone Treatment: Changing the Clinical Infrastructure of Treatment Networks

    PubMed Central

    Neufeld, Karin; Kidorf, Michael; King, Van; Stoller, Ken; Clark, Michael; Peirce, Jessica; Brooner, Robert K.

    2009-01-01

    Outcomes are presented from opioid-dependent outpatients (N = 81) participating in a new community-based initiative designed to improve access to enhanced substance abuse and psychiatric services in the publicly-supported methadone maintenance treatment network in Baltimore, Maryland. The initiative, entitled Community Access to Specialized Treatment (CAST), is located at the Addiction Treatment Services (ATS), a program within this network. Network programs referred patients engaged in unremitting drug use and at risk for discharge to CAST, where they received methadone substitution, individual and group counseling within an adaptive platform, behavioral contingencies to reinforce adherence, and on-site psychiatric evaluation and care. Patients returned to their referring program after producing at least two consecutive weeks of drug-negative urine samples and full counseling adherence. CAST was well-utilized by the community. Patients had high rates of adherence to scheduled individual and group counseling services (93% and 73%, respectively); 43% of referrals successfully completed the program in an average of 101 days. This community-wide service delivery approach is a novel alternative to integrating intensive substance abuse and psychiatric care at each program within a treatment network. PMID:19717272

  2. A Two-site Randomized Clinical Trial of Integrated Psychosocial Treatment for ADHD-Inattentive Type

    PubMed Central

    Pfiffner, Linda J.; Hinshaw, Stephen P.; Owens, Elizabeth; Zalecki, Christine; Kaiser, Nina M.; Villodas, Miguel; McBurnett, Keith

    2014-01-01

    Objective This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with Attention Deficit Hyperactivity Disorder-Inattentive Type (ADHD-I). Method In a two-site randomized controlled trial, 199 children (ages 7-11) were randomized to CLAS (N=74), parent-focused treatment (PFT, N=74), or treatment as usual (TAU, N=51). We compared groups on parent and teacher ratings of inattention symptoms, organizational skills, social skills, and global improvement at post-treatment, and also at follow-up during the subsequent school year. Results CLAS resulted in greater improvements in teacher-reported inattention, organizational skills, social skills, and global functioning relative to both PFT and TAU at post-treatment. Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at post-treatment. Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes. Conclusions These findings extend support for CLAS across two study sites, revealing that integrating parent, teacher, and child treatment components, specifically adapted for ADHD-I, is superior to parent training alone and to usual care. Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent, teacher, and child treatment components for cross-setting effects on symptoms and impairment associated with ADHD-I. PMID:24865871

  3. Integrated constructed wetland systems: design, operation, and performance of low-cost decentralized wastewater treatment systems.

    PubMed

    Behrends, L L; Bailey, E; Jansen, P; Houke, L; Smith, S

    2007-01-01

    Several different types of constructed wetland systems are being used as decentralized treatment systems including surface-flow, subsurface-flow, vertical-flow, and hybrid systems. Archetypical wetland systems have design strengths and weaknesses, and therefore it should be possible to design combined (integrated) systems to optimize a number of important treatment processes. This study provides comparative efficacy data for two integrated wetland treatment systems (IWTS) designed to enhance treatment of medium strength wastewater generated from a pilot-scale intensive fish farm. Results from the twenty eight months study included consistently high removal of COD (84% +) and ammonia nitrogen (93%) in both systems. Initially, phosphorus removal was also high (>90%) in both systems, but removal efficacy declined significantly over time. Nitrate removal was significantly better in the system that provided sequential aerobic and anoxic environments. Short hydraulic retention times coupled with sustained removal of COD and ammonia indicate that the ReCip components could be a least-cost wastewater treatment technology in the decentralized market sector. PMID:17506433

  4. Two Models of Integrating Buprenorphine Treatment and Medical Staff within Formerly "Drug-Free" Outpatient Programs.

    PubMed

    Monico, Laura; Schwartz, Robert P; Gryczynski, Jan; O'Grady, Kevin E; Mitchell, Shannon Gwin

    2016-01-01

    "Drug-free" outpatient programs deliver treatment to the largest number of patients of all treatment modalities in the U.S., providing a significant opportunity to expand access to medication treatments for substance use disorders. This analysis examined staff perceptions of organizational dynamics associated with the delivery of buprenorphine maintenance within three formerly "drug-free" outpatient treatment programs. Semi-structured interviews (N = 15) were conducted with counseling and medical staff, and respondents were predominantly African American (n = 11) and female (n = 12). Themes and concepts related to medical staff integration emerged through an inductive and iterative coding process using Atlas.ti qualitative analysis software. Two treatment clinics incorporated buprenorphine maintenance into their programs using a co-located model of care. Their staff generally reported greater intra-organizational discord regarding the best ways to combine medication and counseling compared to the clinic using an integrated model of care. Co-located program staff reported less communication between medical and clinical staff, which contributed to some uncertainty about proper dosing and concerns about the potential for medication diversion. Clinics that shift from "drug-free" to incorporating buprenorphine maintenance should consider which model of care they wish to adapt and how to train staff and structure staff communication. PMID:26940870

  5. Oral antioxidant treatment partly improves integrity of human sperm DNA in infertile grade I varicocele patients.

    PubMed

    Gual-Frau, Josep; Abad, Carlos; Amengual, María J; Hannaoui, Naim; Checa, Miguel A; Ribas-Maynou, Jordi; Lozano, Iris; Nikolaou, Alexandros; Benet, Jordi; García-Peiró, Agustín; Prats, Juan

    2015-09-01

    Infertile males with varicocele have the highest percentage of sperm cells with damaged DNA, compared to other infertile groups. Antioxidant treatment is known to enhance the integrity of sperm DNA; however, there are no data on the effects in varicocele patients. We thus investigated the potential benefits of antioxidant treatment specifically in grade I varicocele males. Twenty infertile patients with grade I varicocele were given multivitamins (1500 mg L-Carnitine, 60 mg vitamin C, 20 mg coenzyme Q10, 10 mg vitamin E, 200 μg vitamin B9, 1 μg vitamin B12, 10 mg zinc, 50 μg selenium) daily for three months. Semen parameters including total sperm count, concentration, progressive motility, vitality, and morphology were determined before and after treatment. In addition, sperm DNA fragmentation and the amount of highly degraded sperm cells were analyzed by Sperm Chromatin Dispersion. After treatment, patients showed an average relative reduction of 22.1% in sperm DNA fragmentation (p = 0.02) and had 31.3% fewer highly degraded sperm cells (p = 0.07). Total numbers of sperm cells were increased (p = 0.04), but other semen parameters were unaffected. These data suggest that sperm DNA integrity in grade I varicocele patients may be improved by oral antioxidant treatment. PMID:26090928

  6. A computational tool integrating host immunity with antibiotic dynamics to study tuberculosis treatment

    PubMed Central

    Pienaar, Elsje; Cilfone, Nicholas A.; Lin, Philana Ling; Dartois, Véronique; Mattila, Joshua T.; Butler, Russ; Flynn, JoAnne L.; Kirschner, Denise E.; Linderman, Jennifer J.

    2014-01-01

    While active tuberculosis (TB) is a treatable disease, many complex factors prevent its global elimination. Part of the difficulty in developing optimal therapies is the large design space of antibiotic doses, regimens and combinations. Computational models that capture the spatial and temporal dynamics of antibiotics at the site of infection can aid in reducing the design space of costly and time-consuming animal pre-clinical and human clinical trials. The site of infection in TB is the granuloma, a collection of immune cells and bacteria that form in the lung, and new data suggest that penetration of drugs throughout granulomas is problematic. Here we integrate our computational model of granuloma formation and function with models for plasma pharmacokinetics, lung tissue pharmacokinetics and pharmacodynamics for two first line anti-TB antibiotics. The integrated model is calibrated to animal data. We make four predictions. First, antibiotics are frequently below effective concentrations inside granulomas, leading to bacterial growth between doses and contributing to the long treatment periods required for TB. Second, antibiotic concentration gradients form within granulomas, with lower concentrations toward their centers. Third, during antibiotic treatment, bacterial subpopulations are similar for INH and RIF treatment: mostly intracellular with extracellular bacteria located in areas non-permissive for replication (hypoxic areas), presenting a slowly increasing target population over time. Finally, we find that on an individual granuloma basis, pre-treatment infection severity (including bacterial burden, host cell activation and host cell death) is predictive of treatment outcome. PMID:25497475

  7. An integrated prediction and optimization model of biogas production system at a wastewater treatment facility.

    PubMed

    Akbaş, Halil; Bilgen, Bilge; Turhan, Aykut Melih

    2015-11-01

    This study proposes an integrated prediction and optimization model by using multi-layer perceptron neural network and particle swarm optimization techniques. Three different objective functions are formulated. The first one is the maximization of methane percentage with single output. The second one is the maximization of biogas production with single output. The last one is the maximization of biogas quality and biogas production with two outputs. Methane percentage, carbon dioxide percentage, and other contents' percentage are used as the biogas quality criteria. Based on the formulated models and data from a wastewater treatment facility, optimal values of input variables and their corresponding maximum output values are found out for each model. It is expected that the application of the integrated prediction and optimization models increases the biogas production and biogas quality, and contributes to the quantity of electricity production at the wastewater treatment facility. PMID:26295443

  8. Epidermal growth factor treatment decreases mortality and is associated with improved gut integrity in sepsis

    PubMed Central

    Clark, Jessica A.; Clark, Andrew T.; Hotchkiss, Richard S.; Buchman, Timothy G.; Coopersmith, Craig M.

    2007-01-01

    Epidermal growth factor (EGF) is a cytoprotective peptide that has healing effects on the intestinal mucosa. We sought to determine whether systemic administration of EGF following the onset of sepsis improved intestinal integrity and decreased mortality. FVB/N mice were subjected to either sham laparotomy or 2×23 cecal ligation and puncture (CLP). Septic mice were further randomized to receive intraperitoneal injection of either 150 μg/kg/day EGF or 0.9% saline. Circulating EGF levels were decreased following CLP compared to sham animals but were unaffected by giving exogenous EGF treatment. In contrast, intestinal EGF levels increased following CLP, and were further augmented by exogenous EGF treatment. Intestinal EGF-receptor (EGF-R) was increased following CLP whether assayed by immunohistochemistry, real-time PCR or western blot, and exogenous EGF treatment decreased intestinal EGF-R. Villus length decreased 2-fold between sham and septic animals, and EGF treatment resulted in near total restitution of villus length. Sepsis decreased intestinal proliferation and increased intestinal apoptosis. This was accompanied by increased expression of the pro-apoptotic proteins Bid and FADD, as well as the cyclin-dependent kinase inhibitor p21cip1/waf. EGF treatment after the onset of sepsis restored both proliferation and apoptosis to levels seen in sham animals and normalized expression of Bid, FADD, and p21cip1/waf. To determine whether improvements in gut homeostasis were associated with a decrease in sepsis-induced mortality, septic mice with or without EGF treatment after CLP were followed seven days for survival. Mortality decreased from 60% to 30% in mice treated with EGF after the onset of sepsis (p<0.05). EGF may thus be a potential therapeutic agent for the treatment of sepsis, in part due to its ability to protect intestinal integrity. PMID:18004230

  9. Epidermal growth factor treatment decreases mortality and is associated with improved gut integrity in sepsis.

    PubMed

    Clark, Jessica A; Clark, Andrew T; Hotchkiss, Richard S; Buchman, Timothy G; Coopersmith, Craig M

    2008-07-01

    Epidermal growth factor (EGF) is a cytoprotective peptide that has healing effects on the intestinal mucosa. We sought to determine whether systemic administration of EGF after the onset of sepsis improved intestinal integrity and decreased mortality. FVB/N mice were subjected to either sham laparotomy or 2 x 23 cecal ligation and puncture (CLP). Septic mice were further randomized to receive injection of either 150 microg kg(-1) d(-1) (i.p.) EGF or 0.9% saline (i.p.). Circulating EGF levels were decreased after CLP compared with sham animals but were unaffected by giving exogenous EGF treatment. In contrast, intestinal EGF levels increased after CLP and were further augmented by exogenous EGF treatment. Intestinal EGF receptor was increased after CLP, whether assayed by immunohistochemistry, real-time polymerase chain reaction, or Western blot, and exogenous EGF treatment decreased intestinal EGF receptor. Villus length decreased 2-fold between sham and septic animals, and EGF treatment resulted in near total restitution of villus length. Sepsis decreased intestinal proliferation and increased intestinal apoptosis. This was accompanied by increased expression of the proapoptotic proteins Bid and Fas-associated death domain, as well as the cyclin-dependent kinase inhibitor p21 cip1/waf Epidermal growth factor treatment after the onset of sepsis restored both proliferation and apoptosis to levels seen in sham animals and normalized expression of Bid, Fas-associated death domain, and p21 cip1/waf . To determine whether improvements in gut homeostasis were associated with a decrease in sepsis-induced mortality, septic mice with or without EGF treatment after CLP were followed 7 days for survival. Mortality decreased from 60% to 30% in mice treated with EGF after the onset of sepsis (P < 0.05). Thus, EGF may be a potential therapeutic agent for the treatment of sepsis in part due to its ability to protect intestinal integrity. PMID:18004230

  10. Integrated demonstration of molten salt oxidation with salt recycle for mixed waste treatment

    SciTech Connect

    Hsu, P.C.

    1997-11-01

    Molten Salt Oxidation (MSO) is a thermal, nonflame process that has the inherent capability of completely destroying organic constituents of mixed wastes, hazardous wastes, and energetic materials while retaining inorganic and radioactive constituents in the salt. For this reason, MSO is considered a promising alternative to incineration for the treatment of a variety of organic wastes. Lawrence Livermore National Laboratory (LLNL) has prepared a facility and constructed an integrated pilot-scale MSO treatment system in which tests and demonstrations are performed under carefully controlled (experimental) conditions. The system consists of a MSO processor with dedicated off-gas treatment, a salt recycle system, feed preparation equipment, and equipment for preparing ceramic final waste forms. This integrated system was designed and engineered based on laboratory experience with a smaller engineering-scale reactor unit and extensive laboratory development on salt recycle and final forms preparation. In this paper we present design and engineering details of the system and discuss its capabilities as well as preliminary process demonstration data. A primary purpose of these demonstrations is identification of the most suitable waste streams and waste types for MSO treatment.

  11. An integrated anaerobic digestion and UV photocatalytic treatment of distillery wastewater.

    PubMed

    Apollo, Seth; Onyango, Maurice S; Ochieng, Aoyi

    2013-10-15

    Anaerobic up-flow fixed bed reactor and annular photocatalytic reactor were used to study the efficiency of integrated anaerobic digestion (AD) and ultraviolet (UV) photodegradation of real distillery effluent and raw molasses wastewater (MWW). It was found that UV photodegradation as a stand-alone technique achieved colour removal of 54% and 69% for the distillery and MWW, respectively, with a COD reduction of <20% and a negligible BOD reduction. On the other hand, AD as a single treatment technique was found to be effective in COD and BOD reduction with efficiencies of above 75% and 85%, respectively, for both wastewater samples. However, the AD achieved low colour removal efficiency, with an increase in colour intensity of 13% recorded when treating MWW while a colour removal of 51% was achieved for the distillery effluent. The application of UV photodegradation as a pre-treatment method to the AD process reduced the COD removal and biogas production efficiency. However, an integration in which UV photodegradation was employed as a post-treatment to the AD process achieved high COD removal of above 85% for both wastewater samples, and colour removal of 88% for the distillery effluent. Thus, photodegradation can be employed as a post-treatment technique to an AD system treating distillery effluent for complete removal of the biorecalcitrant and colour imparting compounds. PMID:23974530

  12. Integrated radwaste treatment system lessons learned from 2{1/2} years of operation

    SciTech Connect

    Baker, M.N.; Fussner, R.J.

    1997-05-01

    The Integrated Radwaste Treatment System (IRTS) at the West Valley Demonstration Project (WVDP) is a pretreatment scheme to reduce the amount of salts in the high-level radioactive waste (vitrification) stream. Following removal of cesium-137 (Cs-137) by ion-exchange in the Supernatant Treatment System (STS), the radioactive waste liquid is volume-reduced by evaporation. Trace amounts of Cs-137 in the resulting distillate are removed by ion-exchange, then the distillate is discharged to the existing plant water treatment system. The concentrated product, 37 to 41 percent solids by weight, is encapsulated in cement producing a stable, low-level waste form. The Integrated Radwaste Treatment System (IRTS) operated in this mode from May 1988 through November 1990, decontaminating 450,000 gallons of high-level waste liquid; evaporating and encapsulating the resulting concentrates into 10,393 71-gallon square drums. A number of process changes and variations from the original operating plan were required to increase the system flow rate and minimize waste volumes. This report provides a summary of work performed to operate the IRTS, including system descriptions, process highlights, and lessons learned.

  13. Service Utilization Patterns as Predictors of Response to Trauma-Informed Integrated Treatment for Women With Co-occurring Disorders.

    PubMed

    Gilbert, Allison R; Morrissey, Joseph P; Domino, Marisa E

    2011-07-01

    OBJECTIVE: The current study examined whether clinical responses to an integrated treatment intervention among women with co-occurring disorders and histories of abuse varied according to their service use patterns at baseline. METHODS: Data were from a national, multi-site, integrated treatment intervention study in 1998-2003. Analyses included 999 study participants assigned to the integrated treatment group and who were symptomatic at baseline. Participants' baseline service use activity was characterized according to five distinct baseline service use clusters. Logistic regression models estimated study participants' odds of good clinical responses to integrated treatment at 12 months across the five service clusters. RESULTS: Participants with high levels of psychotropic medication and medical care use at baseline had significantly lower odds than low-intensity service users of having a good response to integrated treatment at 12 months on mental health, alcohol addiction, and posttraumatic stress measures. A majority of women in this group had serious medical illness or disability and were more likely than their counterparts with other service use patterns to have used homeless or domestic violence shelters. CONCLUSIONS: Women who used high levels of medication and medical services appear to have faced especially difficult barriers in responding well to integrated treatment. Careful assessments of their mental health, trauma, and medical treatment needs may be required as part of integrated treatment in an effort to improve their response to integrated treatment, clinical outcomes and well-being. This information can also be used to target integrated treatment to women who are likely to respond positively and achieve meaningful improvements in their functioning. PMID:22368532

  14. Integrated Thermal Treatment Systems study: US Department of Energy Internal Review Panel report

    SciTech Connect

    Cudahy, J.; Escarda, T.; Gimpel, R.

    1995-04-01

    The U.S. Department of Energy`s (DOE) Office of Technology Development (OTD) commissioned two studies to uniformly evaluate nineteen thermal treatment technologies. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the advice and guidance of the DOE Office of Environmental Management`s (EM`s) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel, composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency (EPA), the California EPA, and private experts. The Panel met from November 15-18, 1994, to review and comment on the ITTS studies, to make recommendations on the most promising thermal treatment systems for DOE mixed low level wastes (MLLW), and to make recommendations on research and development necessary to prove the performance of the technologies on MLLW.

  15. [Training model for integral treatment of patients with eating disorders resistant to change].

    PubMed

    Calvo Sagardoy, R; Gallego Morales, L T; García de Lorenzo y Mateos, A

    2012-01-01

    The need to find effective treatments for patients with Anorexia or Bulimia nervosa has led to the professionals who care for them to develop new forms of treatment that take into account the variables that cause resistance to change. Patients in this study (2006-2009) have the following characteristics: 340 patients who have 7 or more years of evolution and/or have tried numerous previous treatments without having succeeded in starting and / or maintaining the desired changes, that allowed them to recover steadily. As the proposed treatment, the patient-treatment team is based on the principles of the training model. It considers the patient holistically, it informs and provides him with resources to increase its commitment to change. Teaches the patient to take care physically and mentally as a way to regain their health and leave the disorder in a stable way. Includes family members as essential support in the recovery of their closest. Therapists require extensive experience in the treatment of ED, flexibility, ability to integrate with other team members even if they use different theoretical models, skills for group sessions, ability to handle negative emotions and frustration tolerance. Finally, the model presented below has been implemented, recovered patients whose stay in the disorder exceeded 15 years of development and led to permanent occupational disability. PMID:23114941

  16. Integrated Next-Generation Sequencing and Avatar Mouse Models for Personalized Cancer Treatment

    PubMed Central

    Garralda, Elena; Paz, Keren; López-Casas, Pedro P.; Jones, Siân; Katz, Amanda; Kann, Lisa M.; López-Rios, Fernando; Sarno, Francesca; Al-Shahrour, Fátima; Vasquez, David; Bruckheimer, Elizabeth; Angiuoli, Samuel V.; Calles, Antonio; Diaz, Luis A.; Velculescu, Victor E.; Valencia, Alfonso; Sidransky, David; Hidalgo, Manuel

    2015-01-01

    Background Current technology permits an unbiased massive analysis of somatic genetic alterations from tumor DNA as well as the generation of individualized mouse xenografts (Avatar models). This work aimed to evaluate our experience integrating these two strategies to personalize the treatment of patients with cancer. Methods We performed whole-exome sequencing analysis of 25 patients with advanced solid tumors to identify putatively actionable tumor-specific genomic alterations. Avatar models were used as an in vivo platform to test proposed treatment strategies. Results Successful exome sequencing analyses have been obtained for 23 patients. Tumor-specific mutations and copy-number variations were identified. All samples profiled contained relevant genomic alterations. Tumor was implanted to create an Avatar model from 14 patients and 10 succeeded. Occasionally, actionable alterations such as mutations in NF1, PI3KA, and DDR2 failed to provide any benefit when a targeted drug was tested in the Avatar and, accordingly, treatment of the patients with these drugs was not effective. To date, 13 patients have received a personalized treatment and 6 achieved durable partial remissions. Prior testing of candidate treatments in Avatar models correlated with clinical response and helped to select empirical treatments in some patients with no actionable mutations. Conclusion The use of full genomic analysis for cancer care is encouraging but presents important challenges that will need to be solved for broad clinical application. Avatar models are a promising investigational platform for therapeutic decision making. While limitations still exist, this strategy should be further tested. PMID:24634382

  17. Evaluating integrated strategies for robust treatment of high saline piggery wastewater.

    PubMed

    Kim, Hyun-Chul; Choi, Wook Jin; Chae, A Na; Park, Joonhong; Kim, Hyung Joo; Song, Kyung Guen

    2016-02-01

    In this study, we integrated physicochemical and biological strategies for the robust treatment of piggery effluent in which high levels of organic constituents, inorganic nutrients, color, and salts remained. Piggery effluent that was stabilized in an anaerobic digester was sequentially coagulated, micro-filtered, and air-stripped prior to biological treatment with mixotrophic algal species that showed tolerance to high salinity (up to 4.8% as Cl(-)). The algae treatment was conducted with continuous O2 supplementation instead of using the combination of high lighting and CO2 injection. The microalga Scenedesmus quadricauda employed as a bio-agent was capable of assimilating both nitrogen (222 mg N g cell(-1) d(-1)) and phosphorus (9.3 mg P g cell(-1) d(-1)) and utilizing dissolved organics (2053 mg COD g cell(-1) d(-1)) as a carbon source in a single treatment process under the heterotrophic growth conditions. The heterotrophic growth of S. quadricauda proceeded rapidly by directly incorporating organic substrate in the oxidative assimilation process, which coincided with the high productivity of algal biomass, accounting for 2.4 g cell L(-1) d(-1). The algae-treated wastewater was subsequently ozonated to comply with discharge permits that limit color in the effluent, which also resulted in improved biodegradability of residual organics. The integrated treatment scheme proposed in this study also achieved 89% removal of COD, 88% removal of TN, and 60% removal of TP. The advantage of using the hybrid configuration suggests that this would be a promising strategy in full-scale treatment facilities for piggery effluent. PMID:26689659

  18. The outcome of treatment of chronic osteomyelitis according to an integrated approach.

    PubMed

    Marais, Leonard C; Ferreira, Nando; Aldous, Colleen; Le Roux, Theo L B

    2016-08-01

    Previous classification systems of chronic osteomyelitis have failed to provide objective and pragmatic guidelines for selection of the appropriate treatment strategy. In this study, we assessed the short-term treatment outcome in adult patients with long-bone chronic osteomyelitis prospectively where a modified host classification system was integrated with treatment strategy selection through a novel management algorithm. Twenty-six of the 28 enrolled patients were available for follow-up at a minimum of 12 months. The median patient age of was 36.5 years (range 18-72 years). Fourteen patients (54 %) were managed palliatively, and 11 patients (42 %) were managed through the implementation of a curative treatment strategy. One patient required alternative treatment in the form of an amputation. The overall success rate was 96.2 % (95 % CI 80.4-99.9 %) at a minimum of 12-months follow-up. Remission was achieved in all [11/11] patients treated curatively (one-sided 95 % CI 73.5-100.0 %). Palliative treatment was successful in 92.9 % [13/14] of cases (95 % CI 66.1-99.9 %). In patients with lower limb involvement, there was a statistically significant improvement of 28.3 (95 % CI 21.0-35.7; SD 17.0) in the AAOS Lower Limb Outcomes Instrument score (p value < 0.001). The integrated approach proposed in this study appears a useful guideline to the management of chronic osteomyelitis of long bones in adult patients in the developing world. Further investigation is required to validate the approach, and additional development of the algorithm may be required in order to render it useful in other clinical environments. PMID:27369868

  19. Integrating Motivational Interviewing and Cognitive Behavioral Therapy in the Treatment of Eating Disorders: Tailoring Interventions to Patient Readiness for Change

    ERIC Educational Resources Information Center

    Geller, Josie; Dunn, Erin C.

    2011-01-01

    This paper focuses on the integration of Motivational Interviewing (MI) and cognitive behavioral therapy (CBT) in the treatment of eating disorders. Although CBT is regarded as the treatment of choice in this population, it nevertheless has limitations: some patients fail to engage, drop out from treatment prematurely, or simply do not improve.…

  20. Integrated omics for the identification of key functionalities in biological wastewater treatment microbial communities

    PubMed Central

    Narayanasamy, Shaman; Muller, Emilie E L; Sheik, Abdul R; Wilmes, Paul

    2015-01-01

    Biological wastewater treatment plants harbour diverse and complex microbial communities which prominently serve as models for microbial ecology and mixed culture biotechnological processes. Integrated omic analyses (combined metagenomics, metatranscriptomics, metaproteomics and metabolomics) are currently gaining momentum towards providing enhanced understanding of community structure, function and dynamics in situ as well as offering the potential to discover novel biological functionalities within the framework of Eco-Systems Biology. The integration of information from genome to metabolome allows the establishment of associations between genetic potential and final phenotype, a feature not realizable by only considering single ‘omes’. Therefore, in our opinion, integrated omics will become the future standard for large-scale characterization of microbial consortia including those underpinning biological wastewater treatment processes. Systematically obtained time and space-resolved omic datasets will allow deconvolution of structure–function relationships by identifying key members and functions. Such knowledge will form the foundation for discovering novel genes on a much larger scale compared with previous efforts. In general, these insights will allow us to optimize microbial biotechnological processes either through better control of mixed culture processes or by use of more efficient enzymes in bioengineering applications. PMID:25678254

  1. Integrated forward osmosis-membrane distillation process for human urine treatment.

    PubMed

    Liu, Qianliang; Liu, Caihong; Zhao, Lei; Ma, Weichao; Liu, Huiling; Ma, Jun

    2016-03-15

    This study demonstrated a forward osmosis-membrane distillation (FO-MD) hybrid system for real human urine treatment. A series of NaCl solutions at different concentrations were adopted for draw solutions in FO process, which were also the feed solutions of MD process. To establish a stable and continuous integrated FO-MD system, individual FO process with different NaCl concentrations and individual direct contact membrane distillation (DCMD) process with different feed temperatures were firstly investigated separately. Four stable equilibrium conditions were obtained from matching the water transfer rates of individual FO and MD processes. It was found that the integrated system is stable and sustainable when the water transfer rate of FO subsystem is equal to that of MD subsystem. The rejections to main contaminants in human urine were also investigated. Although individual FO process had relatively high rejection to Total Organic Carbon (TOC), Total Nitrogen (TN) and Ammonium Nitrogen (NH4(+)-N) in human urine, these contaminants could also accumulate in draw solution after long term performance. The MD process provided an effective rejection to contaminants in draw solution after FO process and the integrated system revealed nearly complete rejection to TOC, TN and NH4(+)-N. This work provided a potential treatment process for human urine in some fields such as water regeneration in space station and water or nutrient recovery from source-separated urine. PMID:26773483

  2. [Integration of burn treatment and rehabilitation for a child with extremely severe burn].

    PubMed

    Li, Hongming; Zhang, Jiaping; Chen, Jian; Song, Huapei; Liu, Qiushi; Fan, Xin; Peng, Yizhi; Wu, Jun

    2015-04-01

    This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and

  3. Integrated process control for recirculating cooling water treatment in the coal chemical industry.

    PubMed

    Pei, Y S; Guo, W; Yang, Z F

    2011-01-01

    This work focused on the integrated process of the recirculating cooling water (RCW) treatment to achieve approximate zero emission in the coal chemical industry. The benefits of fractional and comprehensive RCW treatment were quantified and qualified by using a water and mass balance approach. Limits of cycle of concentrations and some encountered bottlenecks were used to ascertain set target limits for different water sources. Makeup water was mixed with water produced from reverse osmosis (RO) in the proportion of 6:4, which notably reduced salts discharge. Side infiltration, which settled down suspended solids, can reduce energy consumption by over 40%. An automated on-line monitoring organic phosphorus inhibitor feed maintains the RCW system stability in comparison to the manual feed. Two-step electrosorb technology (EST) instead of an acid feed can lead cycle of concentration of water to reach 7.0. The wastewater from RO, EST and filter was transferred into a concentration treatment system where metallic ions were adsorbed by permanent magnetic materials. Separation of water and salts was completed by using a magnetic disc separator. Applying the integrated process in a coal chemical industry, a benefit of 1.60 million Yuan annually in 2 years was gained and approximate zero emission was achieved. Moreover, both technical and economic feasibility were demonstrated in detail. PMID:21977648

  4. How Does Scale of Implementation Impact the Environmental Sustainability of Wastewater Treatment Integrated with Resource Recovery?

    PubMed

    Cornejo, Pablo K; Zhang, Qiong; Mihelcic, James R

    2016-07-01

    Energy and resource consumptions required to treat and transport wastewater have led to efforts to improve the environmental sustainability of wastewater treatment plants (WWTPs). Resource recovery can reduce the environmental impact of these systems; however, limited research has considered how the scale of implementation impacts the sustainability of WWTPs integrated with resource recovery. Accordingly, this research uses life cycle assessment (LCA) to evaluate how the scale of implementation impacts the environmental sustainability of wastewater treatment integrated with water reuse, energy recovery, and nutrient recycling. Three systems were selected: a septic tank with aerobic treatment at the household scale, an advanced water reclamation facility at the community scale, and an advanced water reclamation facility at the city scale. Three sustainability indicators were considered: embodied energy, carbon footprint, and eutrophication potential. This study determined that as with economies of scale, there are benefits to centralization of WWTPs with resource recovery in terms of embodied energy and carbon footprint; however, the community scale was shown to have the lowest eutrophication potential. Additionally, technology selection, nutrient control practices, system layout, and topographical conditions may have a larger impact on environmental sustainability than the implementation scale in some cases. PMID:27001077

  5. Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program

    PubMed Central

    2013-01-01

    Background Changes in Quality of Life (QOL) measures over time with treatment of obesity have not previously been described for youth. We describe the changes from baseline through two follow up visits in youth QOL (assessed by the Pediatric Quality Life Inventory, PedsQL4.0), teen depression (assessed by the Patient Health Questionnaire, PHQ9A), Body Mass Index (BMI) and BMI z-score. We also report caregiver proxy ratings of youth QOL. Methods A sample of 267 pairs of youth and caregiver participants were recruited at their first visit to an outpatient weight-treatment clinic that provides care integrated between a physician, dietician, and mental health provider; of the 267, 113 attended a visit two (V2) follow-up appointment, and 48 attended visit three (V3). We investigated multiple factors longitudinally experienced by youth who are overweight and their caregivers across up to three different integrated care visits. We determined relationships at baseline in QOL, PHQ9A, and BMI z-score, as well as changes in variables over time using linear mixed models with time as a covariate. Results Overall across three visits the results indicate that youth had slight declines in relative BMI, significant increases in their QOL and improvements in depression. Conclusions We encourage clinicians and researchers to track youth longitudinally throughout treatment to investigate not only youth’s BMI changes, but also psychosocial changes including QOL. PMID:23837620

  6. Integrated basic treatment of activated carbon for enhanced CO2 selectivity

    NASA Astrophysics Data System (ADS)

    Adelodun, Adedeji Adebukola; Jo, Young-Min

    2013-12-01

    We attempted the use of three chemical agents viz nitric acid (HN), calcium nitrate (CaN) and calcium ethanoate (CaEt) to achieve enhanced CO2 selective adsorption by activated carbon (AC). In dry phase treatment, microporous coconut shell-based carbon (CS) exhibits higher CO2 capacity than coal-based. However, upon wet-phase pre-treatment, modified CS samples showed lesser CO2 adsorption efficiency. Surface characterization with X-ray photoelectron spectroscopy confirms the presence of calcium and amine species on the samples with integrated treatment (A-CaN). These samples recorded the highest low-level CO2 capture despite calcinated CaEt-doped samples (C-CaEt) showing the highest value for pure and high level CO2 adsorption capacities. The slope and linearity values of isobaric desorption were used to estimate the proportion of CO2 chemisorbed and heterogeneity of the adsorbents’ surfaces respectively. Consequently, integrated basic impregnation provides the most efficient adsorbents for selective adsorption of both indoor and outdoor CO2 levels.

  7. A membrane-integrated advanced scheme for treatment of industrial wastewater: dynamic modeling towards scale up.

    PubMed

    Kumar, Ramesh; Pal, Parimal

    2013-08-01

    Modeling and simulation was carried out for an advanced membrane-integrated hybrid treatment process that ensures reuse of water with conversion and recovery of ammoniacal nitrogen as value-added struvite fertilizer from coke wastewater. While toxic cyanide was largely removed in a pre-chemical treatment unit using Fenton's reagents under optimized conditions, more than 95% of NH4(+)-N could be recovered as a valuable by-product called struvite through addition of appropriate doses of magnesium and phosphate salts. Water could be turned reusable through a polishing treatment by nanofiltration membranes in a largely fouling free membrane module following a biodegradation step. Mathematical modeling of such an integrated process was done with Haldane-Andrew approach for the associated microbial degradation of phenol by Pseudomonas putida. Residual NH4(+) was degraded by nitrification and denitrification following the modified Monod kinetics. The model could successfully predict the plant performance as reflected in reasonably low relative error (0.03-0.18) and high Willmott d-index (>0.98). PMID:23735488

  8. Personalized psychotherapy: a treatment approach based on Theodore Millon's integrated model of clinical science.

    PubMed

    Strack, Stephen; Millon, Theodore

    2013-12-01

    In this article we present personalized psychotherapy, a treatment approach for people with a wide range of personality problems and clinical syndromes that is a central part of Theodore Millon's unified clinical science model of personality and psychopathology. Because the intervention strategy is fully integrated with an evolutionary perspective on human development, we offer it in this context. We begin with a historical overview of Millon's model and its relationship to the Diagnostic and Statistical Manual of Mental Disorders (DSM). We then present his basic theoretical principles and personality taxonomy, and discuss variations in personality functioning across the normal-abnormal continuum. We move on to describe assessment measures that were developed to operationalize his concepts and ideas, and which are used as the basis for creating treatment plans. The premises and principles of personalized psychotherapy are described to show how the intervention model is squarely focused on the integrated unity of the person. We look at presenting problems of all kinds from the point of view of how they emanate from, and are related to, the individual's unique combination of temperament, traits, preferences, behavioral patterns, and coping strategies. We then specify multimodal interventions (e.g., a combination of pharmacologic, cognitive, behavioral, phenomenological, interpersonal, and/or intrapsychic treatments) and apply them in a particular sequence to maximize their impact, not only on the target symptoms, but on the underlying personality elements believed to be their primary cause. PMID:23072423

  9. Inhibitors of HIV-1 entry and integration: recent developments and impact on treatment.

    PubMed

    Sharma, Anil K; George, Varghese; Valiathan, Ranjini; Pilakka-Kanthikeel, Sudheesh; Pallikkuth, Suresh

    2013-05-01

    Advances in the drug development against HIV-1 have lead to the identification of new compounds which could be used to target cellular entry and nuclear integration of virus in addition to drugs that commonly target reverse transcriptase and protease. These additional targets have added a new dimension to fight against HIV. Cellular entry of HIV is a multistep procedure involving a range of cellular and molecular interactions between virus envelope protein and receptors expressed on the surface of the target cells, thus providing many opportunities to block infection. Some of these entry inhibitors are currently being used in the clinic and more compounds are under various stages of development. Integration of the HIV-1 DNA is required and essential to maintain the viral DNA in the infected cell. The design and discovery of integrase inhibitors were first focused at targeting the catalytic site of integrase that selectively acting on strand transfer and thus inhibits integration of virus DNA with host cell genome. Thus, entry and integrase inhibitors present a real added value in combined treatment against HIV infection. This review discusses the recent development in the discovery of inhibitors of HIV entry and integration along with some of recent patents in the field. PMID:23578097

  10. Integrated process analysis of treatment systems for mixed low level waste

    SciTech Connect

    Cooley, C.R.; Schwinkendorf, W.E. |; Bechtold, T.E.

    1997-10-01

    Selection of technologies to be developed for treatment of DOE`s mixed low level waste (MLLW) requires knowledge and understanding of the expected costs, schedules, risks, performance, and reliability of the total engineered systems that use these technologies. Thus, an integrated process analysis program was undertaken to identify the characteristics and needs of several thermal and nonthermal systems. For purposes of comparison, all systems were conceptually designed for a single facility processing the same amount of waste at the same rate. Thirty treatment systems were evaluated ranging from standard incineration to innovative thermal systems and innovative nonthermal chemical treatment. Treating 236 million pounds of waste in 20 years through a central treatment was found to be the least costly option with total life cycle cost ranging from $2.1 billion for a metal melting system to $3.9 billion for a nonthermal acid digestion system. Little cost difference exists among nonthermal systems or among thermal systems. Significant cost savings could be achieved by working towards maximum on line treatment time per year; vitrifying the final waste residue; decreasing front end characterization segregation and sizing requirements; using contaminated soil as the vitrifying agent; and delisting the final vitrified waste form from Resource Conservation and Recovery Act (RCRA) Land Disposal Restriction (LDR) requirements.

  11. Hybrid Processing: the Impact of Mechanical and Surface Thermal Treatment Integration onto the Machine Parts Quality

    NASA Astrophysics Data System (ADS)

    Skeeba, V. Yu; Ivancivsky, V. V.; Kutyshkin, A. V.; Parts, K. A.

    2016-04-01

    The comparative analysis of the two hybrid process technologies, which are based on the integration of mechanical treatment (abrasive grinding or turning) and a surface heat strengthening by high frequency current on the same processing equipment, is given in the paper. The acquired results demonstrate that the suggested integrating approach allows carrying out the processing on the one technological base, which leads to the increase in the quality of the machine parts surface layer. The conducted experimental research proves that a minor stock allowance value for the final mechanical processing (sparking out or diamond smoothing) ensures the absence of defects such as local abatement zones and provides strain hardening of the work piece surface. This leads to the formation of the work-hardened layer of 0.01 - 0.03 mm, increase in microhardness value by 12 - 17% and the level of residual compressive stress in the surface layer by 10 - 21 % respectively.

  12. Patient-centered care in cancer treatment programs: the future of integrative oncology through psychoeducation.

    PubMed

    Garchinski, Christina M; DiBiase, Ann-Marie; Wong, Raimond K; Sagar, Stephen M

    2014-12-01

    The reciprocal relationship between the mind and body has been a neglected process for improving the psychosocial care of cancer patients. Emotions form an important link between the mind and body. They play a fundamental role in the cognitive functions of decision-making and symptom control. Recognizing this relationship is important for integrative oncology. We define psychoeducation as the teaching of self-evaluation and self-regulation of the mind-body process. A gap exists between research evidence and implementation into clinical practice. The patients' search for self-empowerment through the pursuit of complementary therapies may be a surrogate for inadequate psychoeducation. Integrative oncology programs should implement psychoeducation that helps patients to improve both emotional and cognitive intelligence, enabling them to better negotiate cancer treatment systems. PMID:25531048

  13. An Integrated Water Treatment Technology Solution for Sustainable Water Resource Management in the Marcellus Shale

    SciTech Connect

    Matthew Bruff; Ned Godshall; Karen Evans

    2011-04-30

    This Final Scientific/ Technical Report submitted with respect to Project DE-FE0000833 titled 'An Integrated Water Treatment Technology Solution for Sustainable Water Resource Management in the Marcellus Shale' in support of final reporting requirements. This final report contains a compilation of previous reports with the most current data in order to produce one final complete document. The goal of this research was to provide an integrated approach aimed at addressing the increasing water resource challenges between natural gas production and other water stakeholders in shale gas basins. The objective was to demonstrate that the AltelaRain{reg_sign} technology could be successfully deployed in the Marcellus Shale Basin to treat frac flow-back water. That objective has been successfully met.

  14. Integrated Biomarker Responses of Effluents from Municipal Sewage Treatment Works in Goldfish

    NASA Astrophysics Data System (ADS)

    Lu, G. H.; Xia, J.; Zhang, H. Z.; Wang, C.

    2010-11-01

    The organic toxicants were extracted from the effluents from municipal sewage treatment works (STWs) in Nanjing (Chengbei, Suojincun and Jiangxinzhou STWs) by using solid phase extraction. AChE, GST, EROD, GPx and Na+/K+-ATPase activities in goldfish (Carassius auratus) were determmed after exposure of the extracted components. The extracts of water samples from the three STWs induced AChE, GST, EROD and Na+/K+-ATPase activities. The responses of enzymatic activities were mostly significant for those exposures of intermediate polar components, weakly polar components and/or nonpolar hexane extracts. Integrated biomarker response (IBR) index were calculated and used to evaluate an integrated impact of organic toxicants from different sampling sites. The order of negative biological effects of the three STWs was Jiangxinzhou>Chengbei>Suojincun.

  15. Coke oven gas treatment and by-product plant of Magnitogorsk Integrated Iron and Steel Works

    SciTech Connect

    Egorov, V.N.; Anikin, G.J.; Gross, M.

    1995-12-01

    Magnitogorsk Integrated Iron and Steel Works, Russia, decided to erect a new coke oven gas treatment and by-product plant to replace the existing obsolete units and to improve the environmental conditions of the area. The paper deals with the technological concept and the design requirements. Commissioning is scheduled at the beginning of 1996. The paper describes H{sub 2}S and NH{sub 3} removal, sulfur recovery and ammonia destruction, primary gas cooling and electrostatic tar precipitation, and the distributed control system that will be installed.

  16. Integrated ozonation and biomethanization treatments of vinasse derived from ethanol manufacturing.

    PubMed

    Siles, J A; García-García, I; Martín, A; Martín, M A

    2011-04-15

    Anaerobic digestion of vinasse derived from bioethanol manufacturing, in which total COD was found to be 68.56 ± 8.17 g/L, was studied in batch laboratory-scale reactors at mesophilic temperature (35 °C). The vinasse was subjected to a short ozonation pre-treatment (15 min) in which more than 50% reduction of phenols was observed, although the total organic carbon concentration remained approximately stable, indicating that the phenols were transformed into other simpler forms. The anaerobic biodegradability of raw and pre-treated vinasse was similar, reaching values close to 80% (COD). However, the methane yield coefficient and methane production rate enhanced by around 13.6% and 41.16%, respectively, when the ozonized vinasse was fed. These results indicate that the integration of chemical-biological treatments could be a viable option for the purification of this hazardous wastewater. PMID:21330053

  17. Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study

    PubMed Central

    2014-01-01

    Background Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Methods/Design Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers’s diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods — pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance — with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation

  18. Potential integration of wetland wastewater treatment with space life support systems.

    PubMed

    Nelson, M; Alling, A; Dempster, W F; Van Thillo, M; Allen, J P

    2002-01-01

    Subsurface-flow constructed wetlands for wastewater treatment and nutrient recycling have a number of advantages in planetary exploration scenarios: they are odorless, relatively low labor and low energy, assist in purification of water and recycling of atmospheric CO2, and can directly grow some food crops. This article presents calculations for integration of wetland wastewater treatment with a prototype ground-based experimental facility ("Mars on Earth") supporting four people showing that an area of 4-6 m2 may be sufficient to accomplish wastewater treatment and recycling. Discharge water from the wetland system can be used as irrigation water for the agricultural crop area, thus ensuring complete reclamation and utilization of nutrients within the bioregenerative life support system. Because the primary requirements for wetland treatment systems are warm temperatures and lighting, such bioregenerative systems can be integrated into space life support systems because heat from the lights may be used for temperature maintenance in the human living environment. Subsurface-flow wetlands can be modified for space habitats to lower space and mass requirements. Many of its construction requirements can eventually be met with use of in situ materials, such as gravel from the Mars surface. Because the technology does not depend on machinery and chemicals, and relies more on natural ecological mechanisms (microbial and plant metabolism), maintenance requirements (e.g., pumps, aerators, and chemicals) are minimized, and systems may have long operating lifetimes. Research needs include suitability of Martian soil and gravel for wetland systems, system sealing and liner options in a Mars base, and determination of wetland water quality efficiency under varying temperature and light regimes. PMID:12481806

  19. Integrating membrane filtration into bioelectrochemical systems as next generation energy-efficient wastewater treatment technologies for water reclamation: A review.

    PubMed

    Yuan, Heyang; He, Zhen

    2015-11-01

    Bioelectrochemical systems (BES) represent an energy-efficient approach for wastewater treatment, but the effluent still requires further treatment for direct discharge or reuse. Integrating membrane filtration in BES can achieve high-quality effluents with additional benefits. Three types of filtration membranes, dynamic membrane, ultrafiltration membrane and forward osmosis membrane that are grouped based on pore size, have been studied for integration in BES. The integration can be accomplished either in an internal or an external configuration. In an internal configuration, membranes can act as a separator between the electrodes, or be immersed in the anode/cathode chamber as a filtration component. The external configuration allows BES and membrane module to be operated independently. Given much progress and interest in the integration of membrane filtration into BES, this paper has reviewed the past studies, described various integration methods, discussed the advantages and limitations of each integration, and presented challenges for future development. PMID:26026232

  20. Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

    PubMed Central

    Heinz, Jürgen; Fiori, Wolfgang; Heusser, Peter

    2013-01-01

    Background. Much work has been done to evaluate the outcome of integrative inpatient treatment but scarcely the costs. This paper evaluates the costs for inpatient treatment in three anthroposophic hospitals (AHs). Material and Methods. Cost and performance data from a total of 23,180 cases were analyzed and compared to national reference data. Subgroup analysis was performed between the cases with and without anthroposophic medical complex (AMC) treatment. Results. Costs and length of stay in the cases without AMC displayed no relevant differences compared to the national reference data. In contrast the inlier cases with AMC caused an average of € 1,394 more costs. However costs per diem were not higher than those in the national reference data. Hence, the delivery of AMC was associated with a prolonged length of stay. 46.6% of the cases with AMC were high outliers. Only 10.6% of the inlier cases with AMC were discharged before reaching the mean length of stay of each DRG. Discussion. Treatment in an AH is not generally associated with an increased use of resources. However, the provision of AMC leads to a prolonged length of stay and cannot be adequately reimbursed by the current G-DRG system. Due to the heterogeneity of the patient population, an additional payment should be negotiated individually. PMID:23431346

  1. An integrated Monte Carlo dosimetric verification system for radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Yamamoto, T.; Mizowaki, T.; Miyabe, Y.; Takegawa, H.; Narita, Y.; Yano, S.; Nagata, Y.; Teshima, T.; Hiraoka, M.

    2007-04-01

    An integrated Monte Carlo (MC) dose calculation system, MCRTV (Monte Carlo for radiotherapy treatment plan verification), has been developed for clinical treatment plan verification, especially for routine quality assurance (QA) of intensity-modulated radiotherapy (IMRT) plans. The MCRTV system consists of the EGS4/PRESTA MC codes originally written for particle transport through the accelerator, the multileaf collimator (MLC), and the patient/phantom, which run on a 28-CPU Linux cluster, and the associated software developed for the clinical implementation. MCRTV has an interface with a commercial treatment planning system (TPS) (Eclipse, Varian Medical Systems, Palo Alto, CA, USA) and reads the information needed for MC computation transferred in DICOM-RT format. The key features of MCRTV have been presented in detail in this paper. The phase-space data of our 15 MV photon beam from a Varian Clinac 2300C/D have been developed and several benchmarks have been performed under homogeneous and several inhomogeneous conditions (including water, aluminium, lung and bone media). The MC results agreed with the ionization chamber measurements to within 1% and 2% for homogeneous and inhomogeneous conditions, respectively. The MC calculation for a clinical prostate IMRT treatment plan validated the implementation of the beams and the patient/phantom configuration in MCRTV.

  2. Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

    PubMed Central

    Gielen, Nele; Krumeich, Anja; Havermans, Remco C.; Smeets, Feikje; Jansen, Anita

    2014-01-01

    Background Healthcare providers working in addiction facilities do not often implement integrated treatment of comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD) while there is empirical evidence to do so. Objective This study aims to get insight into the views of clinicians with regard to the diagnosis and treatment of PTSD in SUD patients. Method A qualitative research method was chosen. Fourteen treatment staff members of different wards of an addiction care facility were interviewed by an independent interviewer. Results Despite acknowledging adverse consequences of trauma exposure on SUD, severe underdiagnosis of PTSD was mentioned and treatment of PTSD during SUD treatment was not supported. Obstacles related to the underestimation of PTSD among SUD patients and to the perceptions of SUD clinicians concerning the treatment of comorbid SUD/PTSD were reported. Conclusions It is concluded that SUD facilities should train their clinicians to enable them to provide for integrated treatment of SUD/PTSD. PMID:24511368

  3. An integrated system for the online monitoring of particle therapy treatment accuracy

    NASA Astrophysics Data System (ADS)

    Fiorina, E.

    2016-07-01

    Quality assurance in hadrontherapy remains an open issue that can be addressed with reliable monitoring of treatment accuracy. The INSIDE (INnovative SolutIons for DosimEtry in hadrontherapy) project aims to develop an integrated online monitoring system based on two dedicated PET panels and a tracking system, called Dose Profiler. The proposed solution is designed to operate in-beam and provide an immediate feedback on the particle range acquiring both photons produced by β+ decays and prompt secondary particle signals. Monte Carlo simulations cover an important role both in the system development, by confirming the design feasibility, and in the system operation, by understanding data. A FLUKA-based integrated simulation was developed taking into account the hadron beam structure, the phantom/patient features and the PET detector and Dose Profiler specifications. In addition, to reduce simulation time in signal generation on PET detectors, a two-step technique has been implemented and validated. The first PET modules were tested in May 2015 at the Centro Nazionale Adroterapia Oncologica (CNAO) in Pavia (Italy) with very satisfactory results: in-spill, inter-spill and post-treatment PET images were reconstructed and a quantitative agreement between data and simulation was found.

  4. Decentralized peri-urban wastewater treatment technologies assessment integrating sustainability indicators.

    PubMed

    Mena-Ulecia, Karel; Hernández, Heykel Hernández

    2015-01-01

    Selection of treatment technologies without considering the environmental, economic and social factors associated with each geographical context risks the occurrence of negative impacts that were not properly foreseen, working against the sustainable performance of the technology. The principal aim of this study was to evaluate 12 technologies for decentralized treatment of domestic wastewater applicable to peri-urban communities using sustainability approaches and, at the same time, continuing a discussion about how to address a more integrated assessment of overall sustainability. For this, a set of 13 indicators that embody the environmental, economic and social approach for the overall sustainability assessment were used by means of a target plot diagram as a tool for integrating indicators that represent a holistic analysis of the technologies. The obtained results put forward different degrees of sustainability, which led to the selection of: septic tank+land infiltration; up-flow anaerobic reactor+high rate trickling filter and septic tank+anaerobic filter as the most sustainable and attractive technologies to be applied in peri-urban communities, according to the employed indicators. PMID:26177403

  5. Effectiveness of a Novel Integrative Online Treatment for Depression (Deprexis): Randomized Controlled Trial

    PubMed Central

    Berger, Thomas; Caspar, Franz; Beevers, Christopher G; Andersson, Gerhard; Weiss, Mario

    2009-01-01

    Background Depression is associated with immense suffering and costs, and many patients receive inadequate care, often because of the limited availability of treatment. Web-based treatments may play an increasingly important role in closing this gap between demand and supply. We developed the integrative, Web-based program Deprexis, which covers therapeutic approaches such as behavioral activation, cognitive restructuring, mindfulness/acceptance exercises, and social skills training. Objective To evaluate the effectiveness of the Web-based intervention in a randomized controlled trial. Methods There were 396 adults recruited via Internet depression forums in Germany, and they were randomly assigned in an 80:20 weighted randomization sequence to either 9 weeks of immediate-program-access as an add-on to treatment-as-usual (N = 320), or to a 9-week delayed-access plus treatment-as-usual condition (N = 76). At pre- and post-treatment and 6-month follow-up, we measured depression (Beck Depression Inventory) as the primary outcome measure and social functioning (Work and Social Adjustment Scale) as the secondary outcome measure. Completer analyses and intention-to-treat analyses were performed. Results Of 396 participants, 216 (55%) completed the post-measurement 9 weeks later. Available case analyses revealed a significant reduction in depression severity (BDI), Cohen’s d = .64 (CI 95% = 0.33 - 0.94), and significant improvement in social functioning (WSA), Cohen’s d = .64, 95% (CI 95% = 0.33 - 0.95). These improvements were maintained at 6-month follow-up. Intention-to-treat analyses confirmed significant effects on depression and social functioning improvements (BDI: Cohen’s d = .30, CI 95% = 0.05 - 0.55; WSA: Cohen’s d = .36, CI 95% = 0.10 - 0.61). Moreover, a much higher percentage of patients in the intervention group experienced a significant reduction of depression symptoms (BDI: odds ratio [OR] = 6.8, CI 95% = 2.90 - 18.19) and recovered more often (OR

  6. Integration of microalgae systems at municipal wastewater treatment plants: implications for energy and emission balances.

    PubMed

    Menger-Krug, Eve; Niederste-Hollenberg, Jutta; Hillenbrand, Thomas; Hiessl, Harald

    2012-11-01

    Integrating microalgae systems (MAS) at municipal wastewater treatment plants (WWTPs) to produce of bioenergy offers many potential synergies. Improved energy balances provide a strong incentive for WWTPs to integrate MAS, but it is crucial that WWTPs maintain their barrier function to protect water resources. We perform a prospective analysis of energy and emission balances of a WWTP with integrated MAS, based on a substance flow analysis of the elements carbon (C), nitrogen (N), and phosphorus (P). These elements are the main ingredients of wastewater, and the key nutrients for algae growth. We propose a process design which relies solely on resources from wastewater with no external input of water, fertilizer or CO(2). The whole process chain, from cultivation to production of bioelectricity, takes place at the WWTP. Our results show that MAS can considerably improve energy balances of WWTPs without any external resource input. With optimistic assumptions, they can turn WWTPs into net energy producers. While intensive C recycling in MAS considerably improves the energy balance, we show that it also impacts on effluent quality. We discuss the importance of nonharvested biomass for effluent quality and highlight harvesting efficiency as key factor for energy and emission balances of MAS at WWTP. PMID:23050661

  7. Structural elucidation of sorghum lignins from an integrated biorefinery process based on hydrothermal and alkaline treatments.

    PubMed

    Sun, Shao-Long; Wen, Jia-Long; Ma, Ming-Guo; Sun, Run-Cang

    2014-08-13

    An integrated process based on hydrothermal pretreatment (HTP) (i.e., 110-230 °C, 0.5-2.0 h) and alkaline post-treatment (2% NaOH at 90 °C for 2.0 h) has been performed for the production of xylooligosaccharide, lignin, and digestible substrate from sweet sorghum stems. The yield, purity, dissociation mechanisms, structural features, and structural transformations of alkali lignins obtained from the integrated process were investigated. It was found that the HTP process facilitated the subsequent alkaline delignification, releasing lignin with the highest yield (79.3%) and purity from the HTP residue obtained at 190 °C for 0.5 h. All of the results indicated that the cleavage of the β-O-4 linkages and degradation of β-β and β-5 linkages occurred under the harsh HTP conditions. Depolymerization and condensation reactions simultaneously occurred at higher temperatures (≥ 170 °C). Moreover, the thermostability of lignin was positively related to its molecular weight, but was also affected by the inherent structures, such as β-O-4 linkages and condensed units. These findings will enhance the understanding of structural transformations of the lignins during the integrated process and maximize the potential utilizations of the lignins in a current biorefinery process. PMID:25090032

  8. An integrated approach to energy recovery from biomass and waste: Anaerobic digestion-gasification-water treatment.

    PubMed

    Milani, M; Montorsi, L; Stefani, M

    2014-07-01

    The article investigates the performance of an integrated system for the energy recovery from biomass and waste based on anaerobic digestion, gasification and water treatment. In the proposed system, the organic fraction of waste of the digestible biomass is fed into an anaerobic digester, while a part of the combustible fraction of the municipal solid waste is gasified. Thus, the obtained biogas and syngas are used as a fuel for running a cogeneration system based on an internal combustion engine to produce electric and thermal power. The waste water produced by the integrated plant is recovered by means of both forward and inverse osmosis. The different processes, as well as the main components of the system, are modelled by means of a lumped and distributed parameter approach and the main outputs of the integrated plant such as the electric and thermal power and the amount of purified water are calculated. Finally, the implementation of the proposed system is evaluated for urban areas with a different number of inhabitants and the relating performance is estimated in terms of the main outputs of the system. PMID:24946772

  9. Integrating Field Spectra and Worldview-2 Data for Grapevine Productivity in Different Irrigation Treatments

    NASA Astrophysics Data System (ADS)

    Maimaitiyiming, M.; Bozzolo, A.; Wulamu, A.; Wilkins, J. L.

    2015-12-01

    Precision farming requires high spectral, spatial and temporal resolution remote sensing data to detect plant physiological changes. The higher spatial resolution is particularly as important as the spectral resolution for crop monitoring. It is important to develop data integration techniques between field or airborne hyperspectral data with spaceborne broad band multispectral images for plant productivity monitoring. To investigate varying rootstock and irrigation interactions, different irrigation treatments are implemented in a vineyard experimental site either i) unirrigated ii) full replacement of evapotranspiration (ET) iii) irrigated at 50 % of the potential ET. In summer 2014, we collected leaf and canopy spectra of the vineyard using field spectroscopy along with other plant physiological and nutritional variables. In this contribution, we integrate the field spectra and the spectral wavelengths of WorldView-2 to develop a predictive model for plant productivity,i.e., fruit quality and yield. First, we upscale field and canopy spectra to WorldView-2 spectral bands using radiative transfer simulations (e.g., MODTRAN). Then we develop remote sensing techniques to quantify plant productivity in different scenarios water stress by identifying the most effective and sensitive wavelengths, and indices that are capable of early detection of plant health and estimation of crop nutrient status. Finally we present predictive models developed from partial least square regression (PLSR) for plant productivity using spectral wavelengths and indices derived from integrated field and satellite remote sensing data.

  10. One System Integrated Project Team Progress in Coordinating Hanford Tank Farms and the Waste Treatment Plant

    SciTech Connect

    Skwarek, Raymond J.; Harp, Ben J.; Duncan, Garth M.

    2013-12-18

    The One System Integrated Project Team (IPT) was formed at the Hanford Site in late 2011 as a way to improve coordination and itegration between the Hanford Tank Waste Treatment and Immobilization Plant (WTP) and the Tank Operations Contractor (TOC) on interfaces between the two projects, and to eliminate duplication and exploit opportunities for synergy. The IPT is composed of jointly staffed groups that work on technical issues of mutal interest, front-end design and project definition, nuclear safety, plant engineering system integration, commissioning, planning and scheduling, and environmental, safety, health and quality (ESH&Q) areas. In the past year important progress has been made in a number of areas as the organization has matured and additional opportunities have been identified. Areas covered in this paper include: Support for development of the Office of Envirnmental Management (EM) framework document to progress the Office of River Protection's (ORP) River Protection Project (RPP) mission; Stewardship of the RPP flowsheet; Collaboration with Savannah River Site (SRS), Savannah River National Laboratory (SRNL), and Pacific Northwest National Laboratory (PNNL); Operations programs integration; and, Further development of the waste acceptance criteria.

  11. Integrated Treatment and Storage Solutions for Solid Radioactive Waste at the Russian Shipyard Near Polyarny

    SciTech Connect

    Griffith, A.; Engoy, T.; Endregard, M.; Busmundrud, O.; Schwab, P.; Nazarian, A.; Krumrine, P.; Backe, S.; Gorin, S.; Evans, B.

    2002-02-27

    Russian Navy Yard No. 10 (Shkval), near the city of Murmansk, has been designated as the recipient for Solid Radioactive Waste (SRW) pretreatment and storage facilities under the Arctic Military Environmental Cooperation (AMEC) Program. This shipyard serves the Northern Fleet by servicing, repairing, and dismantling naval vessels. Specifically, seven nuclear submarines of the first and second generation and Victor class are laid up at this shipyard, awaiting defueling and dismantlement. One first generation nuclear submarine has already been dismantled there, but recently progress on dismantlement has slowed because all the available storage space is full. SRW has been placed in metal storage containers, which have been moved outside of the actual storage site, which increases the environmental risks. AMEC is a cooperative effort between the Russian Federation, Kingdom of Norway and the United States. AMEC Projects 1.3 and 1.4 specifically address waste treatment and storage issues. Various waste treatment options have been assessed, technologies selected, and now integrated facilities are being designed and constructed to address these problems. Treatment technologies that are being designed and constructed include a mobile pretreatment facility comprising waste assay, segregation, size reduction, compaction and repackaging operations. Waste storage technologies include metal and concrete containers, and lightweight modular storage buildings. This paper focuses on the problems and challenges that are and will be faced at the Polyarninsky Shipyard. Specifically, discussion of the waste quantities, types, and conditions and various site considerations versus the various technologies that are to be employed will be provided. A systems approach at the site is being proposed by the Russian partners, therefore integration with other ongoing and planned operations at the site will also be discussed.

  12. Integrating HIV care and treatment into primary healthcare: Are clinics equipped?

    PubMed Central

    Stellenberg, Ethelwynn L.

    2014-01-01

    Abstract Background The demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC) is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Conversely, the PHC system is fraught with the current burden of disease. Setting The study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal. Aim The objectives of the study were to assess whether PHC clinics were equipped to deliver integrated HIV services and to evaluate the availability of resources as well as support systems for HIV care and treatment in PHC clinics. Methods A quantitative, cross-sectional descriptive study was undertaken in 20 randomly-selected, eligible clinics in the uMgungundlovu district, KwaZulu-Natal, South Africa. An evaluation instrument was completed through observations and review of the clinic data records. Criteria were based on the World Health Organization's guide to indicators for antiretroviral programmes as well as South African HIV standards for PHC facilities. Results None of the clinics were equipped adequately. Clinics with a higher patient load had poorer scores, whilst clinics providing antiretroviral therapy were better equipped in terms of human resources and infrastructure. Conclusion HIV services are an essential part of primary healthcare and clinics need to be equipped adequately in order to render this service. It is unlikely that the over-burdened health system would be able to cope with an increased number of patients on antiretroviral therapy in the long term, whilst maintaining quality of services, without support being given to PHC clinics. PMID:26245407

  13. Integrated chemical treatment of municipal wastewater using waste hydrogen peroxide and ultraviolet light

    NASA Astrophysics Data System (ADS)

    Bhatti, Zulfiqar Ahmed; Mahmood, Qaisar; Raja, Iftikhar Ahmad; Malik, Amir Haider; Rashid, Naim; Wu, Donglei

    Dilemmas like water shortage, rapid industrialization, growing human population and related issues have seriously affected human health and environmental sustainability. For conservation and sustainable use of our water resources, innovative methods for wastewater treatment are continuously being explored. Advance Oxidation Processes (AOPs) show a promising approach to meet specific objectives of municipal wastewater treatment (MWW). The MWW samples were pretreated with Al 2(SO 4) 4·8H 2O (Alum) at different doses 4, 8, 12-50 mg/L to enhance the sedimentation. The maximum COD removal was observed at alum treatments in range of 28-32 mg/L without increasing total dissolved solids (TDS). TDS were found to increase when the alum dose was increased from 32-40 mg/L. In the present study, the optimum alum dose of 30 mg/L for 3 h of sedimentation and subsequent integrated H 2O 2/UV treatment was applied (using 2.5 mL/L of 40% waste H 2O 2 and 35% fresh H 2O 2 separately). Organic and inorganic pollutants, contributing towards chemical oxygen demand (COD), biological oxygen demand (BOD), turbidity and total dissolved solids were degraded by H 2O 2/UV. About 93% COD, 90% BOD and 83% turbidity reduction occurred when 40% waste H 2O 2 was used. When using fresh H 2O 2, 63% COD, 68% BOD and 86% turbidity reduction was detected. Complete disinfection of coliform bacteria occurred by using 40% H 2O 2/UV. The most interesting part of this research was to compare the effectiveness of waste H 2O 2 with fresh H 2O 2. Waste H 2O 2 generated from an industrial process of disinfection was found more effective in the treatment of MWW than fresh 35% H 2O 2.

  14. Nutrient removal and biogas upgrading by integrating freshwater algae cultivation with piggery anaerobic digestate liquid treatment.

    PubMed

    Xu, Jie; Zhao, Yongjun; Zhao, Guohua; Zhang, Hui

    2015-08-01

    An integrated approach that combined freshwater microalgae Scenedesmus obliquus (FACHB-31) cultivation with piggery anaerobic digestate liquid treatment was investigated in this study. The characteristics of algal growth, biogas production, and nutrient removal were examined using photobioreactor bags (PBRbs) to cultivate S. obliquus (FACHB-31) in digestate with various digestate dilutions (the concentration levels of 3200, 2200, 1600, 1200, 800, and 400 mg L(-1) chemical oxygen demand (COD)) during 7-day period. The effects of the level of pollutants on nutrient removal efficiency and CO2 removal process were investigated to select the optimum system for effectively upgrade biogas and simultaneously reduce the nutrient content in digestate. The treatment performance displayed that average removal rates of COD, total nitrogen (TN), total phosphorous (TP), and CO2 were 61.58-75.29, 58.39-74.63, 70.09-88.79, and 54.26-73.81 %, respectively. All the strains grew well under any the dilution treatments. With increased initial nutrient concentration to a certain range, the CO4 content (v/v) of raw biogas increased. Differences in the biogas enrichment of S. obliquus (FACHB-31) in all treatments mainly resulted from variations in biomass productivity and CO2 uptake. Notably, the diluted digestate sample of 1600 mg L(-1) COD provided an optimal nutrient concentration for S. obliquus (FACHB-31) cultivation, where the advantageous nutrient and CO2 removals, as well as the highest productivities of biomass and biogas upgrading, were revealed. Results showed that microalgal biomass production offered real opportunities to address issues such as CO2 sequestration, wastewater treatment, and biogas production. PMID:25808519

  15. Integrating Theory and Research: The Development of a Research-Based Treatment Program for Juvenile Male Sex Offenders

    ERIC Educational Resources Information Center

    Calley, Nancy G.

    2007-01-01

    A research-based treatment model designed to effectively address identified factors related to juvenile sexual offending behaviors is presented. Current research, theory, and national standards related to juvenile sexual offending are each explored with the treatment model reflecting an integration of these 3 components. The use of counseling…

  16. Integrated system for the treatment of oxides of nitrogen from flue gases

    SciTech Connect

    Sanjoy Barman; Ligy Philip

    2006-02-01

    A novel and effective system was developed for the complete treatment of NOx from flue gases. The system consisted of photocatalytic or ozone oxidation of NOx, followed by scrubbing and biological denitrification. Maximum photocatalytic oxidation of NOx was achieved while using powdered TiO{sub 2} at a catalytic loading rate of 10 g/h, relative humidity of 50%, and a space time of 10 s. The used catalyst was regenerated and reused. A total of 72% of oxidized NO was recovered as HNO{sub 3}/HNO{sub 2} in the regeneration process. Stoichiometrically, 10% excess ozone was able to affect 100% oxidation of NO to NO{sub 2}. Presence of SO{sub 2} adversely influenced the oxidation of NO by ozone. The scrubbing of NO was effective with distilled water. Heterotrophic denitrifiers were able to denitrify the leachate with an efficiency of 90%, using sewage (COD 450 mg/L) as electron donor. The new integrated treatment system seems to be a promising alternative for complete treatment of NOx from flue gases. 29 refs., 7 figs., 2 tabs.

  17. Performance evaluation of vinasse treatment plant integrated with physico-chemical methods.

    PubMed

    Ojha, Sanjay Kumar; Mishra, Snehasish; Kumar, Satish; Mohanty, Shakti Shankar; Sarkar, Biplab; Singh, Monika; Chaudhury, Gautam Roy

    2015-11-01

    With an objective to assess environmental management criteria of a vinasse treatment plant (VTP) and to evaluate the critical environmental parameters, a study was undertaken in a multi-product (packaged apple juice, distillery, brewery, packaged drinking water) brewery-cum-distillery unit. The facility with a volumetric loading rate of 11-15 kg COD m(-3).day, 3.6-4.5 h hydraulic retention time and 20 g l(-1) VSS had a scientifically managed technically sound effluent treatment system. While the water quality parameters were found within the acceptable limits, there was 99.07% reduction in BOD, from 43140.0 to 398.0 mg l(-1) and 98.61% reduction in COD from 98003.0 to 1357.0 mg l(-1). There was appreciable improvement in mixed liquor suspended solids (MLSS), mixed liquorvolatile suspended solids (MLVSS) and sludge volume index (SVI). A striking feature was the integrated aerobic-anaerobic highly efficient Up-flow Anaerobic Sludge Blanket (UASB) treatment for biodegradation and energy production that reduced energy and space needs, producing utilisable end-products and net savings on the operational cost. The end-point waste management included terminal products such as fertile sludge, cattle feed supplement, recyclable water and biogas. Vast lagoons with combined aerobic-anaerobic approaches, biogasification unit, sludge recovery, remediated irrigable water were the notable attributes. PMID:26688960

  18. [Research on integrated application of tumor magnetic induction hyperthermia treatment planning system and modern medical information systems].

    PubMed

    Zhuo, Zihan; Zhai, Weiming; Cai, Dongyang; Wang, Jie; Zhang, Xiaodong; Tang, Jintian

    2014-02-01

    Magnetic induction hyperthermia becomes a very important tumor treatment method at present. In order to ensure a successful operation, doctors should make hyperthermia treatment planning before surgery. Based on Integration Healthcare Enterprise (IHE) framework and Digital Imaging and Communications in Medcine (DICOM) standard, we proposed and carried out a network workflow integrated with modern medical information systems for the dissemination of information in magnetic induction hyperthermia like accurate accessing patient information and radiology image data, storing processed images, sharing and verifying hyperthermia reports. The results proved that our system could not only improve the efficiency of magnetic induction hyperthermia treatment planning, but also save medical resources and reduce labor costs. PMID:24804509

  19. Integrated monitoring technologies for the management of a Soil-Aquifer-Treatment (SAT) system

    NASA Astrophysics Data System (ADS)

    Kallioras, Andreas; Kofakis, Petros; Bumberger, Jan; Athanasiou, Georgios; Schimdt, Felix; Apostolopoulos, Georgios; Uzunoglou, Nikolaos; Dietrich, Peter; Schuth, Christoph

    2015-04-01

    Artificial recharge of groundwater has an important role to play in water reuse as treated wastewater effluent can be infiltrated into the ground for aquifer recharge. As the effluent moves through the soil and the aquifer, it undergoes significant quality improvements through physical, chemical, and biological processes in the underground environment. Collectively, these processes and the water quality improvement obtained are called soil-aquifer-treatment (SAT) or geopurification. The pilot site of Lavrion Technological & Cultural Park (LTCP) of the National Technical University of Athens (NTUA), involves the employment of plot infiltration basins at experimental scale, which will be using waters of impaired quality as a recharge source, and hence acting as a Soil-Aquifer-Treatment, SAT, system. Τhe LTCP site will be employed as a pilot SAT system complemented by new technological developments, which will be providing continuous monitoring of the quantitative and qualitative characteristics of infiltrating groundwater through all hydrologic zones (i.e. surface, unsaturated and saturated zone). This will be achieved by the development and installation of an integrated system of prototype sensing technologies, installed on-site, and offering a continuous evaluation of the performance of the SAT system. An integrated approach of the performance evaluation of any operating SAT system should aim at parallel monitoring of all hydrologic zones, proving the sustainability of all involved water quality treatment processes within unsaturated and saturated zone. Hence a prototype system of Time and Frequency Domain Reflectometry (TDR & FDR) sensors is developed and will be installed, in order to achieve continuous quantitative monitoring of the unsaturated zone through the entire soil column down to significant depths below the SAT basin. Additionally, the system contains two different radar-based sensing systems that will be offering (i) identification of preferential

  20. Integrated monitoring technologies for the management of a Soil-Aquifer-Treatment (SAT) system.

    NASA Astrophysics Data System (ADS)

    Papadopoulos, Alexandros; Kallioras, Andreas; Kofakis, Petros; Bumberger, Jan; Schmidt, Felix; Athanasiou, Georgios; Uzunoglou, Nikolaos; Amditis, Angelos; Dietrich, Peter

    2016-04-01

    Artificial recharge of groundwater has an important role to play in water reuse as treated wastewater effluent can be infiltrated into the ground for aquifer recharge. As the effluent moves through the soil and the aquifer, it undergoes significant quality improvements through physical, chemical, and biological processes in the underground environment. Collectively, these processes and the water quality improvement obtained are called soil-aquifer-treatment (SAT) or geopurification. The pilot site of Lavrion Technological & Cultural Park (LTCP) of the National Technical University of Athens (NTUA), involves the employment of plot infiltration basins at experimental scale, which will be using waters of impaired quality as a recharge source, and hence acting as a Soil-Aquifer-Treatment, SAT, system. Τhe LTCP site will be employed as a pilot SAT system complemented by new technological developments, which will be providing continuous monitoring of the quantitative and qualitative characteristics of infiltrating groundwater through all hydrologic zones (i.e. surface, unsaturated and saturated zone). This will be achieved by the development and installation of an integrated system of prototype sensing technologies, installed on-site, and offering a continuous evaluation of the performance of the SAT system. An integrated approach of the performance evaluation of any operating SAT system should aim at parallel monitoring of all hydrologic zones, proving the sustainability of all involved water quality treatment processes within unsaturated and saturated zone. Hence a prototype system of Time and Frequency Domain Reflectometry (TDR & FDR) sensors is developed and will be installed, in order to achieve continuous quantitative monitoring of the unsaturated zone through the entire soil column down to significant depths below the SAT basin. Additionally, the system contains two different radar-based sensing systems that will be offering (i) identification of preferential

  1. Hole injection and dielectric breakdown in 6H-SiC and 4H-SiC metal-oxide-semiconductor structures during substrate electron injection via Fowler-Nordheim tunneling

    NASA Astrophysics Data System (ADS)

    Samanta, Piyas; Mandal, Krishna C.

    2015-12-01

    Hole injection into silicon dioxide (SiO2) films (8-40 nm thick) is investigated for the first time during substrate electron injection via Fowler-Nordheim (FN) tunneling in n-type 4H- and 6H-SiC (silicon carbide) based metal-oxide-semiconductor (MOS) structures at a wide range of temperatures (T) between 298 and 598 K and oxide electric fields Eox from 6 to 10 MV/cm. Holes are generated in heavily doped n-type polycrystalline silicon (n+ -polySi) gate serving as the anode as well as in the bulk silicon dioxide (SiO2) film via hot-electron initiated band-to-band ionization (BTBI). In absence of oxide trapped charges, it is shown that at a given temperature, the hole injection rates from either of the above two mechanisms are higher in n-4H-SiC MOS devices than those in n-6H-SiC MOS structures when compared at a given Eox and SiO2 thickness (tox). On the other hand, relative to n-4H-SiC devices, n-6H-SiC structures exhibit higher hole injection rates for a given tox during substrate electron injection at a given FN current density je,FN throughout the temperature range studied here. These two observations clearly reveal that the substrate material (n-6H-SiC and n-4H-SiC) dependencies on time-to-breakdown (tBD) or injected charge (electron) to breakdown (QBD) of the SiO2 film depend on the mode of FN injections (constant field/voltage and current) from the substrate which is further verified from the rigorous device simulation as well.

  2. Integrated modelling of transitions in mechanical conditions during casting and heat treatment

    NASA Astrophysics Data System (ADS)

    Thorborg, J.; Klinkhammer, J.; Heitzer, M.

    2015-06-01

    The mechanical material behaviour of a cast component changes significantly during casting and heat treatment. The big difference in temperature levels during the different process steps causes different deformation mechanisms to be active. The thermal gradients promote transient stresses that can lead to inelastic deformations, residual stresses and in some cases to defects in the final part. It is a big challenge to make a reasonable transition in the mechanical model, and hence material data, when modelling several different coupled process steps. It is important to use an integrated approach where the transition is included in the full load history of the part. When industrial examples are considered, the sequence of process steps typically also changes the thermal and mechanical boundary conditions significantly e.g. going from being mechanically constrained during casting to being supported point-wise during the heat treatment process. This change includes mapping of results and obtaining equilibrium in a new global system, where the further reaction forces from the supports must be handled with contact conditions to e.g. predict deformations due to gravity during solution heat treatment. The work presented in this paper is focused on modelling the mechanical fields, taking into account the changes in the mechanical material model at different temperature levels, and the transition in mechanical behaviour when the microstructure is changing during the different steps of the heat treatment process. The approach used is based on a unified model where creep effects are considered at high temperature and rate effects are included in general during cooling. Proposals are made to include cooling rate sensitivity, annealing and precipitation hardening via modification of mechanical properties in the different process steps.

  3. Designing a concept for an IT-infrastructure for an integrated research and treatment center.

    PubMed

    Stäubert, Sebastian; Winter, Alfred; Speer, Ronald; Löffler, Markus

    2010-01-01

    Healthcare and medical research in Germany are heading to more interconnected systems. New initiatives are funded by the German government to encourage the development of Integrated Research and Treatment Centers (IFB). Within an IFB new organizational structures and infrastructures for interdisciplinary, translational and trans-sectoral working relationship between existing rigid separated sectors are intended and needed. This paper describes how an IT-infrastructure of an IFB could look like, what major challenges have to be solved and what methods can be used to plan such a complex IT-infrastructure in the field of healthcare. By means of project management, system analyses, process models, 3LGM2-models and resource plans an appropriate concept with different views is created. This concept supports the information management in its enterprise architecture planning activities and implies a first step of implementing a connected healthcare and medical research platform. PMID:20841898

  4. Integrated bacterial process for the treatment of a spent nickel catalyst.

    PubMed

    Bosio, V; Viera, M; Donati, E

    2008-06-15

    Integrated biological processes involving the dissolution and subsequent precipitation have been used for the treatment of the spent material from the hydrogenation of vegetable oil containing a high-level of nickel. Our results show that nickel was successfully leached using Acidithiobacillus thiooxidans. The percentages of nickel leached using A. thiooxidans were higher than those obtained with dilute sulphuric acid solutions. Due to the physical characteristics of the residue, the best results were obtained when the leaching process was carried out using sulphuric acid biogenerated by an A. thiooxidans biofilm. The recovery of nickel from the leachates was performed at room temperature by precipitating with sulphide generated by Desulfovibrio cells. Indirect precipitation using sulphide generated in Desulfovibrio sp. cultures allowed the recovery of nickel as the very insoluble nickel sulphide. PMID:18079054

  5. An endoscope with integrated transparent bioelectronics and theranostic nanoparticles for colon cancer treatment

    PubMed Central

    Lee, Hyunjae; Lee, Youngsik; Song, Changyeong; Cho, Hye Rim; Ghaffari, Roozbeh; Choi, Tae Kyu; Kim, Kyung Hoon; Lee, Young Bum; Ling, Daishun; Lee, Hyuk; Yu, Su Jong; Choi, Seung Hong; Hyeon, Taeghwan; Kim, Dae-Hyeong

    2015-01-01

    The gastrointestinal tract is a challenging anatomical target for diagnostic and therapeutic procedures for bleeding, polyps and cancerous growths. Advanced endoscopes that combine imaging and therapies within the gastrointestinal tract provide an advantage over stand-alone diagnostic or therapeutic devices. However, current multimodal endoscopes lack the spatial resolution necessary to detect and treat small cancers and other abnormalities. Here we present a multifunctional endoscope-based interventional system that integrates transparent bioelectronics with theranostic nanoparticles, which are photoactivated within highly localized space near tumours or benign growths. These advanced electronics and nanoparticles collectively enable optical fluorescence-based mapping, electrical impedance and pH sensing, contact/temperature monitoring, radio frequency ablation and localized photo/chemotherapy, as the basis of a closed-loop solution for colon cancer treatment. In vitro, ex vivo and in vivo experiments highlight the utility of this technology for accurate detection, delineation and rapid targeted therapy of colon cancer or precancerous lesions. PMID:26616435

  6. Integrated surgical protocol for the treatment of the infected diabetic foot.

    PubMed

    Caravaggi, C

    2012-02-01

    Diabetes is a chronic disease with a worldwide increasing trend. Feet complication, closely related to neuropathy and obstructive peripheral vascular disease, are responsible for more than 1 million of leg amputations every year. Foot infection can dramatically improve the risk of amputation. Although many ulcer classification systems have been proposed to stratify the severity of infectious process the problem of the definition of a correct therapeutic approach to different clinical pictures still remains unresolved. A diabetic foot triage and an integrated surgical protocol are proposed to try identifying a diagnostic flowchart and a step-by-step surgical protocol that can be applied in the treatment of diabetic foot infection. Goals and technical aspects of emergent and elective surgical procedures in diabetic foot are analysed to evaluate critical aspects and to suggest proper surgical choices. PMID:22231526

  7. Tracing pharmaceuticals in a municipal plant for integrated wastewater and organic solid waste treatment.

    PubMed

    Jelic, Aleksandra; Fatone, Francesco; Di Fabio, Silvia; Petrovic, Mira; Cecchi, Franco; Barcelo, Damia

    2012-09-01

    The occurrence and removal of 42 pharmaceuticals, belonging to different therapeutic groups (analgesics and anti-inflammatory drugs, anti-ulcer agent, psychiatric drugs, antiepileptic drug, antibiotics, ß-blockers, diuretics, lipid regulator and cholesterol lowering statin drugs and anti-histamines), were studied in the wastewater and sewage sludge trains of a full scale integrated treatment plant. The plant employs a biological nutrient removal (BNR) process for the treatment of municipal wastewater, and a single-stage mesophilic anaerobic co-digestion for the treatment of wasted activated sludge mixed with the organic fraction of municipal solid waste (OFMSW), followed by a short-cut nitrification-denitrification of the anaerobic supernatant in a sequential batch reactor. Influent and effluent wastewater, as well as thickened, digested and treated sludge were sampled and analyzed for the selected pharmaceuticals in order to study their presence and fate during the treatment. Twenty three compounds were detected in influent and effluent wastewater and eleven in sludge. Infiltration of groundwater in the sewer system led to a dilution of raw sewage, resulting in lower concentrations in wastewater (up to 0.7 μg/L in influent) and sludge (70 ng/g d.w.). Due to the dilution, overall risk quotient for the mixture of pharmaceuticals detected in effluent wastewater was less than one, indicating no direct risk for the aquatic environment. A wide range of removal efficiencies during the treatment was observed, i.e. <20% to 90%. The influent concentrations of the target pharmaceuticals, as polar compounds, were undoubtedly mostly affected by BNR process in the wastewater train, and less by anaerobic-co-digestion. Mass balance calculations showed that less than 2% of the total mass load of the studied pharmaceuticals was removed by sorption. Experimentally estimated distribution coefficients (<500 L/kg) also indicated that the selected pharmaceuticals preferably remain in

  8. Systems Pharmacology Dissection of the Integrated Treatment for Cardiovascular and Gastrointestinal Disorders by Traditional Chinese Medicine

    PubMed Central

    Zhang, Wenjuan; Tao, Qin; Guo, Zihu; Fu, Yingxue; Chen, Xuetong; Shar, Piar Ali; Shahen, Mohamed; Zhu, Jinglin; Xue, Jun; Bai, Yaofei; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Wang, Yonghua

    2016-01-01

    Though cardiovascular diseases (CVDs) and gastrointestinal disorders (GIDs) are different diseases associated with different organs, they are highly correlated clinically. Importantly, in Traditional Chinese Medicine (TCM), similar treatment strategies have been applied in both diseases. However, the etiological mechanisms underlying them remain unclear. Here, an integrated systems pharmacology approach is presented for illustrating the molecular correlations between CVDs and GIDs. Firstly, we identified pairs of genes that are associated with CVDs and GIDs and found that these genes are functionally related. Then, the association between 115 heart meridian (HM) herbs and 163 stomach meridian (SM) herbs and their combination application in Chinese patent medicine was investigated, implying that both CVDs and GIDs can be treated by the same strategy. Exemplified by a classical formula Sanhe Decoration (SHD) treating chronic gastritis, we applied systems-based analysis to introduce a drug-target-pathway-organ network that clarifies mechanisms of different diseases being treated by the same strategy. The results indicate that SHD regulated several pathological processes involved in both CVDs and GIDs. We experimentally confirmed the predictions implied by the effect of SHD for myocardial ischemia. The systems pharmacology suggests a novel integrated strategy for rational drug development for complex associated diseases. PMID:27597117

  9. [Optoelectronic PCB Wastewater Treatment by Partial Nitrification-ANAMMOX Integrative Reactor].

    PubMed

    Yuan, Yan; Li, Xiang; Zhou, Cheng; Chen, Zong-heng

    2015-07-01

    The feasibility and operating characteristics of treatment of printed circuit board (PCB) wastewater by using autotrophic nitrogen removal process in partial nitrification and ANAMMOX integrative reactor were investigated. The reactor had startup successfully and achieved the stable nitrogen removal efficiency. The results showed that, after 80d operation, the nitrogen removal rate increased and was up to 1. 29 kg . (m3 . d)-1, the effluent NH4+-N and NO2- -N were decreased and stabilized at 4. 0 mg . L -1, 9. 8 mg . L-1 respectively, when the influent concentration of NH4+-N maintained at 220 mg . L -1. At the same time, the concentration of total nitrogen was less than 50 mg . L-1 in effluent, which meet the quality emissions requirements. The NO2- -N production rate was up to 2. 05 kg . (m3 . d)-1 by nitrite bacteria in aerobic zone, and the highest nitrogen removal rate was 2. 91 kg . (m3 . d) -1 by ANAMMOX. bacteria in anaerobic zone, which illuminated functional bacteria were steadily grown in the corresponding region. The inorganic ammmonia in PCB wastewater could be removed by autotrophic nitrogen removal process in nitrification and ANAMMOX integrative reactor. PMID:26489329

  10. Integrated hybrid treatment for the remediation of 2,3,7,8-tetrachlorodibenzo-p-dioxin.

    PubMed

    Bokare, Varima; Murugesan, Kumarasamy; Kim, Jae-Hwan; Kim, Eun-Ju; Chang, Yoon-Seok

    2012-10-01

    The dioxin isomer 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TeCDD) has been reported as the deadliest compound known to science. Due to its highly recalcitrant nature and low bioavailability, it is stubborn toward bioremediation and chemical treatment. Efforts to degrade it using one single technique have not accomplished the desired results. In this study, we have tried to develop an integrated 2,3,7,8-TeCDD removal process using palladized iron nanoparticles (Pd/nFe) for initial reductive dechlorination under anoxic conditions and subsequent oxidative biomineralization. Using laboratory synthesized Pd/nFe, 2,3,7,8-TeCDD was completely dechlorinated to form the end product dibenzo-p-dioxin (DD). Oxidative degradation of DD was successfully achieved by growing active cells of a dioxin-degrading microorganism Sphingomonas wittichii RW1 (DSM 6014) under aerobic culture conditions. Metabolite identification was done by high performance liquid chromatography (HPLC) and whole cell protein was measured as the indicator for cell growth. To the best of our knowledge, this is the first report on integrated hybrid degradation method for 2,3,7,8-TeCDD. PMID:22909785

  11. An integrated approach for establishing dosing recommendations: paliperidone for the treatment of adolescent schizophrenia.

    PubMed

    Younis, Islam Rasem; Laughren, Thomas P; Wang, Yaning; Mathis, Mitchell; Gobburu, Jogarao V

    2013-04-01

    The Food and Drug Administration recently approved Invega for the treatment of schizophrenia in adolescents 12 to 17 years. If dosing recommendations for this population would have been based only on the results of the single efficacy trial included in this program, paliperidone dosing in adolescents might have been limited to 3 mg/d in adolescents less than 51 kg and to 6 mg/d in adolescents greater than or equal to 51 kg. This article provides an illustration of a more integrated approach to arrive at dosing recommendation that included practical considerations, modeling and simulation of data from the clinical trial, and the totality of evidence for both paliperidone and the parent drug, risperidone. On the basis of this integrated approach, the agency approved a starting dose of 3 mg/d in both adolescent weight groups and subsequent dosing in a range of 3 to 6 mg/d for adolescents less than 51 kg and 3 to 12 mg/d for adolescents greater than 51 kg, although the 3-mg dose was not evaluated in the greater than or equal to 51-kg group. PMID:23422374

  12. Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility.

    PubMed

    Leblanc, R J; Allain, C J; Laughton, P J; Henry, J G

    2004-01-01

    The Greater Moncton Sewerage Commission's 115,000 m3/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Université de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and "cumulative effects" as part of the overall biosolids management strategy are also discussed. PMID:15259950

  13. Acupuncture in Uganda: A Research Letter on the Integration of Acupuncture With Conventional Biomedical Treatments

    PubMed Central

    Kirschner, Kathia; Mandell, Richard; Knowlton, Janelle; Romeo, Melissa J.

    2014-01-01

    The PanAfrican Acupuncture Project (PAAP) was created in 2001 and is a volunteer-based not-for-profit training organization. It encourages community empowerment and wellness through training local healthcare providers how to use simple, effective acupuncture protocols to treat the symptoms of HIV/ AIDS, malaria, tuberculosis, and other chronic conditions. A manual explains the theory of acupuncture and the techniques associated with it in clear and simple terms with specific acupuncture protocols associated with the signs and symptoms of illnesses commonly seen in Uganda. PAAP maintains contact with the trainees to provide ongoing support through: (1) three week-long meetings per year, (2) ongoing contact with the PAAP local coordinator, and (3) electronic communications including email, text messaging, and Facebook communication. A primary focus is to help integrate acupuncture into the local context and current public-health system. This is accomplished by working with local governmental and nongovernmental agencies and healthcare facilities to improve access to and effectiveness of care through collaboration with Western and traditional healthcare modalities. The integration of acupuncture and other traditional complementary and alternative medicines (TCAMs) in the international public health sector at the level of local health workers can increase access to treatment in a sustainable manner while also building the confidence and self-worth of the public health-care practitioners. PMID:25105080

  14. Acupuncture in Uganda: a research letter on the integration of acupuncture with conventional biomedical treatments.

    PubMed

    Kirschner, Kathia; Mandell, Richard; Knowlton, Janelle; Romeo, Melissa J; Conboy, Lisa

    2014-07-01

    The PanAfrican Acupuncture Project (PAAP) was created in 2001 and is a volunteer-based not-for-profit training organization. It encourages community empowerment and wellness through training local healthcare providers how to use simple, effective acupuncture protocols to treat the symptoms of HIV/ AIDS, malaria, tuberculosis, and other chronic conditions. A manual explains the theory of acupuncture and the techniques associated with it in clear and simple terms with specific acupuncture protocols associated with the signs and symptoms of illnesses commonly seen in Uganda. PAAP maintains contact with the trainees to provide ongoing support through: (1) three week-long meetings per year, (2) ongoing contact with the PAAP local coordinator, and (3) electronic communications including email, text messaging, and Facebook communication. A primary focus is to help integrate acupuncture into the local context and current public-health system. This is accomplished by working with local governmental and nongovernmental agencies and healthcare facilities to improve access to and effectiveness of care through collaboration with Western and traditional healthcare modalities. The integration of acupuncture and other traditional complementary and alternative medicines (TCAMs) in the international public health sector at the level of local health workers can increase access to treatment in a sustainable manner while also building the confidence and self-worth of the public health-care practitioners. PMID:25105080

  15. Systems Pharmacology Dissection of the Integrated Treatment for Cardiovascular and Gastrointestinal Disorders by Traditional Chinese Medicine.

    PubMed

    Zhang, Wenjuan; Tao, Qin; Guo, Zihu; Fu, Yingxue; Chen, Xuetong; Shar, Piar Ali; Shahen, Mohamed; Zhu, Jinglin; Xue, Jun; Bai, Yaofei; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Wang, Yonghua

    2016-01-01

    Though cardiovascular diseases (CVDs) and gastrointestinal disorders (GIDs) are different diseases associated with different organs, they are highly correlated clinically. Importantly, in Traditional Chinese Medicine (TCM), similar treatment strategies have been applied in both diseases. However, the etiological mechanisms underlying them remain unclear. Here, an integrated systems pharmacology approach is presented for illustrating the molecular correlations between CVDs and GIDs. Firstly, we identified pairs of genes that are associated with CVDs and GIDs and found that these genes are functionally related. Then, the association between 115 heart meridian (HM) herbs and 163 stomach meridian (SM) herbs and their combination application in Chinese patent medicine was investigated, implying that both CVDs and GIDs can be treated by the same strategy. Exemplified by a classical formula Sanhe Decoration (SHD) treating chronic gastritis, we applied systems-based analysis to introduce a drug-target-pathway-organ network that clarifies mechanisms of different diseases being treated by the same strategy. The results indicate that SHD regulated several pathological processes involved in both CVDs and GIDs. We experimentally confirmed the predictions implied by the effect of SHD for myocardial ischemia. The systems pharmacology suggests a novel integrated strategy for rational drug development for complex associated diseases. PMID:27597117

  16. Measuring the Integration of Tobacco Policy and Treatment into the Behavioral Health Care Delivery System: How Are We Doing?

    PubMed

    Christiansen, Bruce A; Macmaster, David R; Heiligenstein, Eric L; Glysch, Randal L; Riemer, Donna M; Adsit, Robert T; Hayden, Kristine A; Hollenback, Christopher P; Fiore, Michael C

    2016-01-01

    People with a mental illness and/or drug use disorder have a higher rate of smoking than adults in general. To address this challenge, recommendations include integrating tobacco-free policies and tobacco dependency treatment into the behavioral health care delivery system. Currently, little is known regarding levels of such integration. A 65-item Internet survey measuring integration assessed three areas: a) policies addressing the use of tobacco products; b) provision of evidence-based tobacco dependence treatment; and, c) capacity to help employees/volunteers quit tobacco use. The survey was distributed to representatives of all behavioral health programs in Wisconsin. The survey response rate was 27.1%. Programs, on average, were 40% integrated. A significant proportion of programs (20%) were less than 20% integrated. A few programs (4.3%) exceeded 80% integration. Integration of tobacco policies and treatment into the behavioral health care delivery system remains limited and there is a need for technical assistance and training. PMID:27180692

  17. Operator decision support system for integrated wastewater management including wastewater treatment plants and receiving water bodies.

    PubMed

    Kim, Minsoo; Kim, Yejin; Kim, Hyosoo; Piao, Wenhua; Kim, Changwon

    2016-06-01

    An operator decision support system (ODSS) is proposed to support operators of wastewater treatment plants (WWTPs) in making appropriate decisions. This system accounts for water quality (WQ) variations in WWTP influent and effluent and in the receiving water body (RWB). The proposed system is comprised of two diagnosis modules, three prediction modules, and a scenario-based supporting module (SSM). In the diagnosis modules, the WQs of the influent and effluent WWTP and of the RWB are assessed via multivariate analysis. Three prediction modules based on the k-nearest neighbors (k-NN) method, activated sludge model no. 2d (ASM2d) model, and QUAL2E model are used to forecast WQs for 3 days in advance. To compare various operating alternatives, SSM is applied to test various predetermined operating conditions in terms of overall oxygen transfer coefficient (Kla), waste sludge flow rate (Qw), return sludge flow rate (Qr), and internal recycle flow rate (Qir). In the case of unacceptable total phosphorus (TP), SSM provides appropriate information for the chemical treatment. The constructed ODSS was tested using data collected from Geumho River, which was the RWB, and S WWTP in Daegu City, South Korea. The results demonstrate the capability of the proposed ODSS to provide WWTP operators with more objective qualitative and quantitative assessments of WWTP and RWB WQs. Moreover, the current study shows that ODSS, using data collected from the study area, can be used to identify operational alternatives through SSM at an integrated urban wastewater management level. PMID:26893178

  18. Integration of photocatalysis and biological treatment for azo dye removal--application to AR183.

    PubMed

    Chebli, Derradji; Fourcade, Florence; Brosillon, Stephan; Nacef, Saci; Amrane, Abdeltif

    2011-04-01

    The feasibility of coupling photocatalysis with biological treatment to treat effluents containing azo dyes was examined in this work. With this aim, the degradation of Acid Red 183 was investigated. The very low biodegradability of AR183 was confirmed beforehand by measuring the biological oxygen demand (BOD5). Photocatalysis experiments were carried out in a closed-loop step photoreactor. The reactor walls were covered by TiO2 catalyst coated on non-woven paper, and the effluent flowed over the photocatalyst as a thin falling film. The removal of the dye was 82.7% after 4 h, and a quasi-complete decolorization (98.5%) was obtained for 10 h of irradiation (initial concentration 100 mg L(-1)). The decrease in concentration followed pseudo-first-order kinetics, with a constant k of 0.47 h(-1). Mineralization and oxidation yields were 80% and 75%, respectively, after 10 h of pretreatment. Therefore, even if target compound oxidation occurs (COD removal), indicating a modification to the chemical structure, the concomitant high mineralization was not in favour of subsequent microbial growth. The BOD5 measurement confirmed the non-biodegradability of the irradiated solution, which remained toxic since the EC50 decreased from 35 to 3 mg L(-1). The proposed integrated process appeared, therefore, to be not relevant for the treatment of AR183. However, this result should be confirmed for other azo dyes. PMID:21877531

  19. An Integrated Human/Murine Transcriptome and Pathway Approach To Identify Prenatal Treatments For Down Syndrome.

    PubMed

    Guedj, Faycal; Pennings, Jeroen LA; Massingham, Lauren J; Wick, Heather C; Siegel, Ashley E; Tantravahi, Umadevi; Bianchi, Diana W

    2016-01-01

    Anatomical and functional brain abnormalities begin during fetal life in Down syndrome (DS). We hypothesize that novel prenatal treatments can be identified by targeting signaling pathways that are consistently perturbed in cell types/tissues obtained from human fetuses with DS and mouse embryos. We analyzed transcriptome data from fetuses with trisomy 21, age and sex-matched euploid controls, and embryonic day 15.5 forebrains from Ts1Cje, Ts65Dn, and Dp16 mice. The new datasets were compared to other publicly available datasets from humans with DS. We used the human Connectivity Map (CMap) database and created a murine adaptation to identify FDA-approved drugs that can rescue affected pathways. USP16 and TTC3 were dysregulated in all affected human cells and two mouse models. DS-associated pathway abnormalities were either the result of gene dosage specific effects or the consequence of a global cell stress response with activation of compensatory mechanisms. CMap analyses identified 56 molecules with high predictive scores to rescue abnormal gene expression in both species. Our novel integrated human/murine systems biology approach identified commonly dysregulated genes and pathways. This can help to prioritize therapeutic molecules on which to further test safety and efficacy. Additional studies in human cells are ongoing prior to pre-clinical prenatal treatment in mice. PMID:27586445

  20. An Integrated Human/Murine Transcriptome and Pathway Approach To Identify Prenatal Treatments For Down Syndrome

    PubMed Central

    Guedj, Faycal; Pennings, Jeroen LA; Massingham, Lauren J.; Wick, Heather C.; Siegel, Ashley E.; Tantravahi, Umadevi; Bianchi, Diana W.

    2016-01-01

    Anatomical and functional brain abnormalities begin during fetal life in Down syndrome (DS). We hypothesize that novel prenatal treatments can be identified by targeting signaling pathways that are consistently perturbed in cell types/tissues obtained from human fetuses with DS and mouse embryos. We analyzed transcriptome data from fetuses with trisomy 21, age and sex-matched euploid controls, and embryonic day 15.5 forebrains from Ts1Cje, Ts65Dn, and Dp16 mice. The new datasets were compared to other publicly available datasets from humans with DS. We used the human Connectivity Map (CMap) database and created a murine adaptation to identify FDA-approved drugs that can rescue affected pathways. USP16 and TTC3 were dysregulated in all affected human cells and two mouse models. DS-associated pathway abnormalities were either the result of gene dosage specific effects or the consequence of a global cell stress response with activation of compensatory mechanisms. CMap analyses identified 56 molecules with high predictive scores to rescue abnormal gene expression in both species. Our novel integrated human/murine systems biology approach identified commonly dysregulated genes and pathways. This can help to prioritize therapeutic molecules on which to further test safety and efficacy. Additional studies in human cells are ongoing prior to pre-clinical prenatal treatment in mice. PMID:27586445

  1. Integration of Treatment Innovation Planning and Implementation: Strategic Process Models and Organizational Challenges

    PubMed Central

    Lehman, Wayne E. K.; Simpson, D. Dwayne; Knight, Danica K.; Flynn, Patrick M.

    2015-01-01

    Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A 2-phase procedural approach is therefore presented based on the integration of TCU models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. PMID:21443294

  2. Integrated, Home-based Treatment for MDR-TB and HIV in Rural South Africa: An Alternate Model of Care

    PubMed Central

    Brust, James C.M.; Shah, N. Sarita; Scott, Michelle; Chaiyachati, Krisda; Lygizos, Melissa; van der Merwe, Theo L.; Bamber, Sheila; Radebe, Zanele; Loveday, Marian; Moll, Anthony P.; Margot, Bruce; Lalloo, Umesh G.; Friedland, Gerald H.; Gandhi, Neel R.

    2012-01-01

    SUMMARY Treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) in South Africa have suffered as centralized, inpatient treatment programs struggle to cope with rising prevalence and HIV co-infection rates. A new treatment model is needed to expand treatment capacity and improve MDR-TB and HIV outcomes. We describe the design and preliminary results of an integrated, home-based MDR-TB/HIV treatment program created in rural KwaZulu-Natal. In 2008, a decentralized center was established to provide outpatient MDR-TB and HIV treatment. Nurses, community health workers, and family supporters have been trained to administer injections, provide adherence support, and monitor adverse reactions in patients’ homes. Physicians assess clinical response, adherence, and adverse reaction severity to MDR-TB and HIV therapy at monthly follow-up visits. Treatment outcomes are assessed by monthly cultures and CD4 and viral load every 6 months. Eighty patients initiated MDR-TB therapy from 2/2008–4/2010; 66 were HIV co-infected. Retention has been high (only 5% defaults, 93% of visits attended) and preliminary outcomes have been favorable (77% cured/still on treatment, 82% undetectable viral load). Few patients have required escalation of care (9%), had severe adverse events (8%), or died (6%). Integrated, home-based treatment for MDR-TB and HIV is a promising treatment model to expand capacity and achieve improved outcomes in rural, resource-poor, and high-HIV prevalent settings. PMID:22668560

  3. Towards integration of PET/MR hybrid imaging into radiation therapy treatment planning

    SciTech Connect

    Paulus, Daniel H.; Thorwath, Daniela; Schmidt, Holger; Quick, Harald H.

    2014-07-15

    Purpose: Multimodality imaging has become an important adjunct of state-of-the-art radiation therapy (RT) treatment planning. Recently, simultaneous PET/MR hybrid imaging has become clinically available and may also contribute to target volume delineation and biological individualization in RT planning. For integration of PET/MR hybrid imaging into RT treatment planning, compatible dedicated RT devices are required for accurate patient positioning. In this study, prototype RT positioning devices intended for PET/MR hybrid imaging are introduced and tested toward PET/MR compatibility and image quality. Methods: A prototype flat RT table overlay and two radiofrequency (RF) coil holders that each fix one flexible body matrix RF coil for RT head/neck imaging have been evaluated within this study. MR image quality with the RT head setup was compared to the actual PET/MR setup with a dedicated head RF coil. PET photon attenuation and CT-based attenuation correction (AC) of the hardware components has been quantitatively evaluated by phantom scans. Clinical application of the new RT setup in PET/MR imaging was evaluated in anin vivo study. Results: The RT table overlay and RF coil holders are fully PET/MR compatible. MR phantom and volunteer imaging with the RT head setup revealed high image quality, comparable to images acquired with the dedicated PET/MR head RF coil, albeit with 25% reduced SNR. Repositioning accuracy of the RF coil holders was below 1 mm. PET photon attenuation of the RT table overlay was calculated to be 3.8% and 13.8% for the RF coil holders. With CT-based AC of the devices, the underestimation error was reduced to 0.6% and 0.8%, respectively. Comparable results were found within the patient study. Conclusions: The newly designed RT devices for hybrid PET/MR imaging are PET and MR compatible. The mechanically rigid design and the reproducible positioning allow for straightforward CT-based AC. The systematic evaluation within this study provides the

  4. Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men.

    PubMed

    Wolff, Nancy; Huening, Jessica; Shi, Jing; Frueh, B Christopher; Hoover, Donald R; McHugo, Gregory

    2015-03-01

    A controlled trial of Seeking Safety (SS) and Male-Trauma Recovery Empowerment Model (M-TREM) examined implementation and effectiveness of integrated group therapy for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) on PTSD and mental health symptoms plus self-esteem and efficacy for incarcerated men. The study sample (n=230) was male inmates 18 years or older who were primarily non-white, high school graduates or equivalents, had childhood trauma histories, committed violent crimes, had serious mental illnesses, and resided in a maximum security prison. Incarcerated men, who screened positive for PTSD and SUD, were assigned randomly (n=142) or by preference (n=88) to receive SS or M-TREM, with a waitlist group of (n=93). Manualized interventions were group-administered for 14 weeks. Primary outcomes were PTSD and other mental health symptoms. Secondary outcomes were self-esteem, coping, and self-efficacy. SUD outcomes cannot be measured in a correctional setting. Implementation feasibility was exhibited by the ability to recruit, screen, assign, and retain participants. Effectiveness findings depended on sample, design, and method for analysis. Using a waitlist control group and no follow-up period, we found no aggregate effect of treatment on PTSD symptoms, although, when disaggregated, M-TREM was found to improve PTSD severity and SS improved general mental health symptoms and psychological functioning. Using intent-to-treat and completer analyses, no significant differences were found in the relative performance between SS and M-TREM on primary or secondary outcomes. When longitudinal data were maximized and modeled in ways that reflect the hierarchical nature of the data, we found that SS and M-TREM performed better than no treatment on PTSD severity and secondary outcomes, and that treatment benefits endured. Findings cautiously support implementing either Seeking Safety or M-TREM to treat incarcerated men with co-morbid PTSD

  5. Simulation of integrated pollutant removal (IPR) water-treatment system using ASPEN Plus

    SciTech Connect

    Harendra, Sivaram; Oryshcyhn, Danylo [U.S. DOE Ochs, Thomas [U.S. DOE Gerdemann, Stephen; Clark, John

    2013-01-01

    Capturing CO2 from fossil fuel combustion provides an opportunity for tapping a significant water source which can be used as service water for a capture-ready power plant and its peripherals. Researchers at the National Energy Technology Laboratory (NETL) have patented a process—Integrated Pollutant Removal (IPR®)—that uses off-the-shelf technology to produce a sequestration ready CO2 stream from an oxy-combustion power plant. Water condensed from oxy-combustion flue gas via the IPR system has been analyzed for composition and an approach for its treatment—for in-process reuse and for release—has been outlined. A computer simulation model in ASPEN Plus has been developed to simulate water treatment of flue gas derived wastewater from IPR systems. At the field installation, water condensed in the IPR process contains fly ash particles, sodium (largely from spray-tower buffering) and sulfur species as well as heavy metals, cations, and anions. An IPR wastewater treatment system was modeled using unit operations such as equalization, coagulation and flocculation, reverse osmosis, lime softening, crystallization, and pH correction. According to the model results, 70% (by mass) of the inlet stream can be treated as pure water, the other 20% yields as saleable products such as gypsum (CaSO4) and salt (NaCl) and the remaining portion is the waste. More than 99% of fly ash particles are removed in the coagulation and flocculation unit and these solids can be used as filler materials in various applications with further treatment. Results discussed relate to a slipstream IPR installation and are verified experimentally in the coagulation/flocculation step.

  6. Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men

    PubMed Central

    Wolff, Nancy; Huening, Jessica; Shi, Jing; Frueh, B. Christopher; Hoover, Donald R.; McHugo, Gregory

    2015-01-01

    A controlled trial of Seeking Safety (SS) and Male-Trauma Recovery Empowerment Model (M-TREM) examined implementation and effectiveness of integrated group therapy for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) on PTSD and mental health symptoms plus self-esteem and efficacy for incarcerated men. The study sample (n = 230) was male inmates 18 years or older who were primarily non-white, high school graduates or equivalents, had childhood trauma histories, committed violent crimes, had serious mental illnesses, and resided in a maximum security prison. Incarcerated men, who screened positive for PTSD and SUD, were assigned randomly (n = 142) or by preference (n = 88) to receive SS or M-TREM, with a waitlist group of (n = 93). Manualized interventions were group-administered for 14 weeks. Primary outcomes were PTSD and other mental health symptoms. Secondary outcomes were self-esteem, coping, and self-efficacy. SUD outcomes cannot be measured in a correctional setting. Implementation feasibility was exhibited by the ability to recruit, screen, assign, and retain participants. Effectiveness findings depended on sample, design, and method for analysis. Using a waitlist control group and no follow-up period, we found no aggregate effect of treatment on PTSD symptoms, although, when disaggregated, M-TREM was found to improve PTSD severity and SS improved general mental health symptoms and psychological functioning. Using intent-to-treat and completer analyses, no significant differences were found in the relative performance between SS and M-TREM on primary or secondary outcomes. When longitudinal data were maximized and modeled in ways that reflect the hierarchical nature of the data, we found that SS and M-TREM performed better than no treatment on PTSD severity and secondary outcomes, and that treatment benefits endured. Findings cautiously support implementing either Seeking Safety or M-TREM to treat incarcerated men with co

  7. Effective cancer laser-therapy design through the integration of nanotechnology and computational treatment planning models

    NASA Astrophysics Data System (ADS)

    Fisher, Jessica W.; Rylander, Marissa Nichole

    2008-02-01

    Laser therapies can provide a minimally invasive treatment alternative to surgical resection of tumors. However, the effectiveness of these therapies is limited due to nonspecific heating of target tissue which often leads to healthy tissue injury and extended treatment durations. These therapies can be further compromised due to heat shock protein (HSP) induction in tumor regions where non-lethal temperature elevation occurs, thereby imparting enhanced tumor cell viability and resistance to subsequent chemotherapy and radiation treatments. Introducing multi-walled nanotubes (MWNT) into target tissue prior to laser irradiation increases heating selectivity permitting more precise thermal energy delivery to the tumor region and enhances thermal deposition thereby increasing tumor injury and reducing HSP expression induction. This study investigated the impact of MWNT inclusion in untreated and laser irradiated monolayer cell culture and cell phantom model. Cell viability remained high for all samples with MWNT inclusion and cells integrated into alginate phantoms, demonstrating the non-toxic nature of both MWNTs and alginate phantom models. Following, laser irradiation samples with MWNT inclusion exhibited dramatic temperature elevations and decreased cell viability compared to samples without MWNT. In the cell monolayer studies, laser irradiation of samples with MWNT inclusion experienced up-regulated HSP27, 70 and 90 expression as compared to laser only or untreated samples due to greater temperature increases albeit below the threshold for cell death. Further tuning of laser parameters will permit effective cell killing and down-regulation of HSP. Due to optimal tuning of laser parameters and inclusion of MWNT in phantom models, extensive temperature elevations and cell death occurred, demonstrating MWNT-mediated laser therapy as a viable therapy option when parameters are optimized. In conclusion, MWNT-mediated laser therapies show great promise for effective

  8. Abnormal functional integration of thalamic low frequency oscillation in the BOLD signal after acute heroin treatment.

    PubMed

    Denier, Niklaus; Schmidt, André; Gerber, Hana; Vogel, Marc; Huber, Christian G; Lang, Undine E; Riecher-Rossler, Anita; Wiesbeck, Gerhard A; Radue, Ernst-Wilhelm; Walter, Marc; Borgwardt, Stefan

    2015-12-01

    Heroin addiction is a severe relapsing brain disorder associated with impaired cognitive control, including deficits in attention allocation. The thalamus has a high density of opiate receptors and is critically involved in orchestrating cortical activity during cognitive control. However, there have been no studies on how acute heroin treatment modulates thalamic activity. In a cross-over, double-blind, vehicle-controlled study, 29 heroin-maintained outpatients were studied after heroin and placebo administration, while 20 healthy controls were included for the placebo condition only. Resting-state functional magnetic resonance imaging was used to analyze functional integration of the thalamus by three different resting state analysis techniques. Thalamocortical functional connectivity (FC) was analyzed by seed-based correlation, while intrinsic thalamic oscillation was assessed by analysis of regional homogeneity (ReHo) and the fractional amplitude of low frequency fluctuations (fALFF). Relative to the placebo treatment and healthy controls, acute heroin administration reduced thalamocortical FC to cortical regions, including the frontal cortex, while the reductions in FC to the mediofrontal cortex, orbitofrontal cortex, and frontal pole were positively correlated with the plasma level of morphine, the main psychoactive metabolite of heroin. Furthermore, heroin treatment was associated with increased thalamic ReHo and fALFF values, whereas fALFF following heroin exposure correlated negatively with scores of attentional control. The heroin-associated increase in fALFF was mainly dominated by slow-4 (0.027-0.073 Hz) oscillations. Our findings show that there are acute effects of heroin within the thalamocortical system and may shed new light on the role of the thalamus in cognitive control in heroin addiction. Future research is needed to determine the underlying physiological mechanisms and their role in heroin addiction. PMID:26441146

  9. Advanced treatment of biologically pretreated coal gasification wastewater by a novel integration of catalytic ultrasound oxidation and membrane bioreactor.

    PubMed

    Jia, Shengyong; Han, Hongjun; Zhuang, Haifeng; Xu, Peng; Hou, Baolin

    2015-01-01

    Laboratorial scale experiments were conducted to investigate a novel system integrating catalytic ultrasound oxidation (CUO) with membrane bioreactor (CUO-MBR) on advanced treatment of biologically pretreated coal gasification wastewater. Results indicated that CUO with catalyst of FeOx/SBAC (sewage sludge based activated carbon (SBAC) which loaded Fe oxides) represented high efficiencies in eliminating TOC as well as improving the biodegradability. The integrated CUO-MBR system with low energy intensity and high frequency was more effective in eliminating COD, BOD5, TOC and reducing transmembrane pressure than either conventional MBR or ultrasound oxidation integrated MBR. The enhanced hydroxyl radical oxidation, facilitation of substrate diffusion and improvement of cell enzyme secretion were the mechanisms for CUO-MBR performance. Therefore, the integrated CUO-MBR was the promising technology for advanced treatment in engineering applications. PMID:25936898

  10. Integrative Families and Systems Treatment: A Middle Path toward Integrating Common and Specific Factors in Evidence-Based Family Therapy

    ERIC Educational Resources Information Center

    Fraser, J. Scott; Solovey, Andrew D.; Grove, David; Lee, Mo Yee; Greene, Gilbert J.

    2012-01-01

    A moderate common factors approach is proposed as a synthesis or middle path to integrate common and specific factors in evidence-based approaches to high-risk youth and families. The debate in family therapy between common and specific factors camps is reviewed and followed by suggestions from the literature for synthesis and creative flexibility…

  11. Integration of biopolymer production with process water treatment at a sugar factory.

    PubMed

    Anterrieu, Simon; Quadri, Luca; Geurkink, Bert; Dinkla, Inez; Bengtsson, Simon; Arcos-Hernandez, Monica; Alexandersson, Tomas; Morgan-Sagastume, Fernando; Karlsson, Anton; Hjort, Markus; Karabegovic, Lamija; Magnusson, Per; Johansson, Peter; Christensson, Magnus; Werker, Alan

    2014-06-25

    The present investigation has focused on generating a surplus denitrifying biomass with high polyhydroxyalkanoate (PHA) producing potential while maintaining water treatment performance in biological nitrogen removal. The motivation for the study was to examine integration of PHA production into the water treatment and residuals management needs at the Suiker Unie sugar beet factory in Groningen, the Netherlands. At the factory, process waters are treated in nitrifying-denitrifying sequencing batch reactors (SBRs) to remove nitrogen found in condensate. Organic slippage (COD) in waters coming from beet washing is the substrate used for denitrification. The full-scale SBR was mimicked at laboratory scale. In two parallel laboratory scale SBRs, a mixed-culture biomass selection strategy of anoxic-feast and aerobic-famine was investigated using the condensate and wash water from Suiker Unie. One laboratory SBR was operated as conventional activated sludge with long solids retention time similar to the full-scale (SRT >16 days) while the other SBR was a hybrid biofilm-activated sludge (IFAS) process with short SRT (4-6 days) for the suspended solids. Both SBRs were found to produce biomass with augmented PHA production potential while sustaining process water treatment for carbon, nitrogen and phosphorus for the factory process waters. PHA producing potential in excess of 60 percent g-PHA/g-VSS was achieved with the lab scale surplus biomass. Surplus biomass of low (4-6 days) and high (>16 days) solids retention time yielded similar results in PHA accumulation potential. However, nitrification performance was found to be more robust for the IFAS SBR. Assessment of the SBR microbial ecology based on 16sDNA and selected PHA synthase genes at full-scale in comparison to biomass from the laboratory scale SBRs suggested that the full-scale process was enriched with a PHA storing microbial community. However, structure-function relationships based on RNA levels for the

  12. Integration of Three-Dimensional Rotational Angiography in Radiosurgical Treatment Planning of Cerebral Arteriovenous Malformations

    SciTech Connect

    Conti, Alfredo; Pontoriero, Antonio; Farago, Giuseppe; Midili, Federica; Siragusa, Carmelo; Granata, Francesca; Pitrone, Antonio; De Renzis, Costantino; Longo, Marcello; Tomasello, Francesco

    2011-11-01

    Purpose: Accuracy in delineating the target volume is a major issue for successful stereotactic radiosurgery for arteriovenous malformations. The aim of the present study was to describe a method to integrate three-dimensional (3D) rotational angiography ( (3DRA)) into CyberKnife treatment planning and to investigate its potential advantages compared with computed tomography angiography (CTA) and magnetic resonance angiography. Methods and Materials: A total of 20 patients with a diagnosis of cerebral arteriovenous malformation were included in the present study. All patients underwent multislice computed tomography and 3D-volumetric CTA, (3DRA), and 3D magnetic resonance angiography. The contouring of the target and critical volumes was done separately using CTA and thereafter directly using (3DRA). The composite, conjoint, and disjoint volumes were measured. Results: The use of CTA or (3DRA) resulted in significant differences in the target and critical volumes. The target volume averaged 3.49 {+-} 3.01 mL measured using CTA and 3.26 {+-} 2.93 mL measured using (3DRA), for a difference of 8% (p < .05). The conjoint and disjoint volume analysis showed an 88% volume overlap. The qualitative evaluation showed that the excess volume obtained using CTA was mostly tissue surrounding the nidus and venous structures. The mean contoured venous volume was 0.67 mL measured using CTA and 0.88 mL (range, 0.1-2.7) measured using (3DRA) (p < .05). Conclusions: (3DRA) is a volumetric angiographic study that can be integrated into computer-based treatment planning. Although whether (3DRA) provides superior accuracy has not yet been proved, its high spatial resolution is attractive and offers a superior 3D view. This allows a better 3D understanding of the target volume and distribution of the radiation doses within the volume. Additional technical efforts to improve the temporal resolution and the development of software tools aimed at improving the performance of 3D contouring

  13. Integrated Pre-Antiretroviral Therapy Screening and Treatment for Tuberculosis and Cryptococcal Antigenemia

    PubMed Central

    Pac, Lincoln; Horwitz, Mara; Namutebi, Anne Marion; Auerbach, Brandon J.; Semeere, Aggrey; Namulema, Teddy; Schwarz, Miriam; Bbosa, Robert; Muruta, Allan; Meya, David; Manabe, Yukari C.

    2015-01-01

    Objective To demonstrate the feasibility of integrated screening for cryptococcal antigenemia and tuberculosis (TB) prior to antiretroviral therapy (ART) initiation and to assess disease specific and all-cause mortality in the first 6 months of follow-up. Methods We enrolled a cohort of HIV-infected, ART-naïve adults with CD4 counts ≤ 250 cells/µL in rural Uganda who were followed for 6 months after ART initiation. All subjects underwent screening for TB; those with CD4 ≤ 100 cells/µL also had cryptococcal antigen (CrAg) screening. For those who screened positive, standard treatment for TB or preemptive treatment for cryptococcal infection was initiated, followed by ART two weeks later. Results Of 540 participants enrolled, pre-ART screening detected 10.6% (57/540) with prevalent TB and 6.8% (12/177 with CD4 count ≤ 100 cells/µL) with positive serum CrAg. After ART initiation, 13 (2.4%) patients were diagnosed with TB and one patient developed cryptococcal meningitis. Overall 7.2% of participants died (incidence rate 15.6 per 100 person years at risk). Death rates were significantly higher among subjects with TB and cryptococcal antigenemia compared to subjects without these diagnoses. In multivariate analysis, significant risk factors for mortality were male sex, baseline anemia of hemoglobin ≤ 10 mg/dL, wasting defined as body mass index ≤ 15.5 kg/m2, and opportunistic infections (TB, positive serum CrAg). Conclusion Pre-ART screening for opportunistic infections detects many prevalent cases of TB and cryptococcal infection. However, severely immunosuppressed and symptomatic HIV patients continue to experience high mortality after ART initiation. PMID:25761234

  14. TH-A-BRF-09: Integration of High-Resolution MRSI Into Glioblastoma Treatment Planning

    SciTech Connect

    Schreibmann, E; Cordova, J; Shu, H; Crocker, I; Curran, W; Holder, C; Shim, H

    2014-06-15

    Purpose: Identification of a metabolite signature that shows significant tumor cell infiltration into normal brain in regions that do not appear abnormal on standard MRI scans would be extremely useful for radiation oncologists to choose optimal regions of brain to treat, and to quantify response beyond the MacDonald criteria. We report on integration of high-resolution magnetic resonance spectroscopic imaging (HR-MRSI) with radiation dose escalation treatment planning to define and target regions at high risk for recurrence. Methods: We propose to supplement standard MRI with a special technique performed on an MRI scanner to measure the metabolite levels within defined volumes. Metabolite imaging was acquired using an advanced MRSI technique combining 3D echo-planar spectroscopic imaging (EPSI) with parallel acquisition (GRAPPA) using a multichannel head coil that allows acquisition of whole brain metabolite maps with 108 μl resolution in 12 minutes implemented on a 3T MR scanner. Elevation in the ratio of two metabolites, choline (Cho, elevated in proliferating high-grade gliomas) and N-acetyl aspartate (NAA, a normal neuronal metabolite), was used to image infiltrating high-grade glioma cells in vivo. Results: The metabolite images were co-registered with standard contrast-enhanced T1-weighted MR images using in-house registration software and imported into the treatment-planning system. Regions with tumor infiltration are identified on the metabolic images and used to create adaptive IMRT plans that deliver a standard dose of 60 Gy to the standard target volume and an escalated dose of 75 Gy (or higher) to the most suspicious regions, identified as areas with elevated Cho/NAA ratio. Conclusion: We have implemented a state-of-the-art HR-MRSI technology that can generate metabolite maps of the entire brain in a clinically acceptable scan time, coupled with introduction of an imaging co-registration/ analysis program that combines MRSI data with standard imaging

  15. Probabilistic evaluation of integrating resource recovery into wastewater treatment to improve environmental sustainability.

    PubMed

    Wang, Xu; McCarty, Perry L; Liu, Junxin; Ren, Nan-Qi; Lee, Duu-Jong; Yu, Han-Qing; Qian, Yi; Qu, Jiuhui

    2015-02-01

    Global expectations for wastewater service infrastructure have evolved over time, and the standard treatment methods used by wastewater treatment plants (WWTPs) are facing issues related to problem shifting due to the current emphasis on sustainability. A transition in WWTPs toward reuse of wastewater-derived resources is recognized as a promising solution for overcoming these obstacles. However, it remains uncertain whether this approach can reduce the environmental footprint of WWTPs. To test this hypothesis, we conducted a net environmental benefit calculation for several scenarios for more than 50 individual countries over a 20-y time frame. For developed countries, the resource recovery approach resulted in ∼154% net increase in the environmental performance of WWTPs compared with the traditional substance elimination approach, whereas this value decreased to ∼60% for developing countries. Subsequently, we conducted a probabilistic analysis integrating these estimates with national values and determined that, if this transition was attempted for WWTPs in developed countries, it would have a ∼65% probability of attaining net environmental benefits. However, this estimate decreased greatly to ∼10% for developing countries, implying a substantial risk of failure. These results suggest that implementation of this transition for WWTPs should be studied carefully in different temporal and spatial contexts. Developing countries should customize their approach to realizing more sustainable WWTPs, rather than attempting to simply replicate the successful models of developed countries. Results derived from the model forecasting highlight the role of bioenergy generation and reduced use of chemicals in improving the sustainability of WWTPs in developing countries. PMID:25605884

  16. Probabilistic evaluation of integrating resource recovery into wastewater treatment to improve environmental sustainability

    PubMed Central

    Wang, Xu; McCarty, Perry L.; Liu, Junxin; Ren, Nan-Qi; Lee, Duu-Jong; Yu, Han-Qing; Qian, Yi; Qu, Jiuhui

    2015-01-01

    Global expectations for wastewater service infrastructure have evolved over time, and the standard treatment methods used by wastewater treatment plants (WWTPs) are facing issues related to problem shifting due to the current emphasis on sustainability. A transition in WWTPs toward reuse of wastewater-derived resources is recognized as a promising solution for overcoming these obstacles. However, it remains uncertain whether this approach can reduce the environmental footprint of WWTPs. To test this hypothesis, we conducted a net environmental benefit calculation for several scenarios for more than 50 individual countries over a 20-y time frame. For developed countries, the resource recovery approach resulted in ∼154% net increase in the environmental performance of WWTPs compared with the traditional substance elimination approach, whereas this value decreased to ∼60% for developing countries. Subsequently, we conducted a probabilistic analysis integrating these estimates with national values and determined that, if this transition was attempted for WWTPs in developed countries, it would have a ∼65% probability of attaining net environmental benefits. However, this estimate decreased greatly to ∼10% for developing countries, implying a substantial risk of failure. These results suggest that implementation of this transition for WWTPs should be studied carefully in different temporal and spatial contexts. Developing countries should customize their approach to realizing more sustainable WWTPs, rather than attempting to simply replicate the successful models of developed countries. Results derived from the model forecasting highlight the role of bioenergy generation and reduced use of chemicals in improving the sustainability of WWTPs in developing countries. PMID:25605884

  17. Dosimetric evaluation of integrated IMRT treatment of the chest wall and supraclavicular region for breast cancer after modified radical mastectomy

    SciTech Connect

    Yang, Bo; Wei, Xian-ding; Zhao, Yu-tian; Ma, Chang-Ming

    2014-07-01

    To investigate the dosimetric characteristics of irradiation of the chest wall and supraclavicular region as an integrated volume with intensity-modulated radiation therapy (IMRT) after modified radical mastectomy. This study included 246 patients who received modified radical mastectomy. The patients were scanned with computed tomography, and the chest wall (with or without the internal mammary lymph nodes) and supraclavicular region were delineated. For 143 patients, the chest wall and supraclavicular region were combined as an integrated planning volume and treated with IMRT. For 103 patients, conventional treatments were employed with 2 tangential fields for the chest wall, abutting a mixed field of 6-MV x-rays (16 Gy) and 9-MeV electrons (34 Gy) for the upper supraclavicular region. The common prescription dose was 50 Gy/25 Fx/5 W to 90% of the target volume. The dosimetric characteristics of the chest wall, the supraclavicular region, and normal organs were compared. For the chest wall target, compared with conventional treatments, the integrated IMRT plans lowered the maximum dose, increased the minimum dose, and resulted in better conformity and uniformity of the target volume. There was an increase in minimum, average, and 95% prescription dose for the integrated IMRT plans in the supraclavicular region, and conformity and uniformity were improved. The V{sub 30} of the ipsilateral lung and V{sub 10}, V{sub 30}, and mean dose of the heart on the integrated IMRT plans were lower than those of the conventional plans. The V{sub 5} and V{sub 10} of the ipsilateral lung and V{sub 5} of the heart were higher on the integrated IMRT plans (p < 0.05) than on conventional plans. Without an increase in the radiation dose to organs at risk, the integrated IMRT treatment plans improved the dose distribution of the supraclavicular region and showed better dose conformity and uniformity of the integrated target volume of the chest wall and supraclavicular region.

  18. The SCIDOTS Project: Evidence of benefits of an integrated tobacco cessation intervention in tuberculosis care on treatment outcomes

    PubMed Central

    2011-01-01

    Background There is substantial evidence to support the association between tuberculosis (TB) and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. Methods An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS) providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group) or conventional TB DOTS alone (comparison or DOTS group). At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. Results A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when compared with those who

  19. Integration of Substance Abuse Treatment Organizations into Accountable Care Organizations: Results from a National Survey

    PubMed Central

    D’Aunno, Thomas; Friedmann, Peter D.; Chen, Qixuan; Wilson, Donna M.

    2016-01-01

    To meet their aims of managing population health to improve the quality and cost of health care in the United States, accountable care organizations (ACOs) will need to focus on coordinating care for individuals with substance abuse disorders. The prevalence of these disorders is high, and these individuals often suffer from comorbid chronic medical and social conditions. This article examines the extent to which the nation’s fourteen thousand specialty substance abuse treatment (SAT) organizations, which have a daily census of more than 1 million patients, are contracting with ACOs across the country; we also examine factors associated with SAT organization involvement with ACOs. We draw on data from a recent (2014) nationally representative survey of executive directors and clinical supervisors from 635 SAT organizations. Results show that only 15 percent of these organizations had signed contracts with ACOs. Results from multivariate analyses show that directors’ perceptions of market competition, organizational ownership, and geographic location are significantly related to SATinvolvement with ACOs. We discuss implications for integrating the SAT specialty system with the mainstream health care system. PMID:26124307

  20. Organizational factors influencing implementation of evidence-based practices for integrated treatment in behavioral health agencies.

    PubMed

    Bonham, Caroline A; Sommerfeld, David; Willging, Cathleen; Aarons, Gregory A

    2014-01-01

    Objective. In recent years, New Mexico has prioritized integrated treatment for cooccurring mental health and substance use disorders within its public behavioral health system. This report describes factors likely to be important when implementing evidence-based practices (EBPs) in community agencies. Methods. Our mixed-method research design consisted of observations, semistructured interviews, and surveys undertaken with employees at 14 agencies at baseline and after 18 months. We developed four-agency typologies based on iterative coding and analysis of observations and interviews. We then examined survey data from employees at the four exemplar agencies to validate qualitative findings. Results. Financial resources and strong leadership impacted agency capacity to train providers and implement EBPs. Quantitative analysis of service provider survey responses from these agencies (N = 38) supported qualitative findings and demonstrated significant mean score differences in leadership, organizational climate, and attitudes toward EBPs in anticipated directions. Conclusion. The availability of strong leadership and financial resources were key components to initial implementation success in this study of community agencies in New Mexico. Reliance only on external funding poses risks for sustainment when demoralizing work climates precipitate employee turnover. Strong agency leadership does not always compensate for deficient financial resources in vulnerable communities. PMID:24772411

  1. Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment

    PubMed Central

    Goedert, Kelly M.; Shah, Priyanka; Foundas, Anne L.; Barrett, A. M.

    2013-01-01

    Prism adaptation treatment (PAT) is a promising rehabilitative method for functional recovery in persons with spatial neglect. Previous research suggests that PAT improves motor-intentional “aiming” deficits that frequently occur with frontal lesions. To test whether presence of frontal lesions predicted better improvement of spatial neglect after PAT, the current study evaluated neglect-specific improvement in functional activities (assessment with the Catherine Bergego Scale) over time in 21 right-brain-damaged stroke survivors with left-sided spatial neglect. The results demonstrated that neglect patients' functional activities improved after two weeks of PAT and continued improving for four weeks. Such functional improvement did not occur equally in all of the participants: Neglect patients with lesions involving the frontal cortex (n=13) experienced significantly better functional improvement than did those without frontal lesions (n=8). More importantly, voxel-based lesion-behavior mapping (VLBM) revealed that in comparison to the group of patients without frontal lesions, the frontal-lesioned neglect patients had intact regions in the medial temporal areas, the superior temporal areas, and the inferior longitudinal fasciculus. The medial cortical and subcortical areas in the temporal lobe were especially distinguished in the “frontal lesion” group. The findings suggest that the integrity of medial temporal structures may play an important role in supporting functional improvement after PAT. PMID:22941243

  2. Sewage treatment in integrated system of UASB reactor and duckweed pond and reuse for aquaculture.

    PubMed

    Mohapatra, D P; Ghangrekar, M M; Mitra, A; Brar, S K

    2012-06-01

    The performance of a laboratory-scale upflow anaerobic sludge blanket (UASB) reactor and a duckweed pond containing Lemna gibba was investigated for suitability for treating effluent for use in aquaculture. While treating low-strength sewage having a chemical oxygen demand (COD) of typically less than 200 mg/L, with an increase in hydraulic retention time (HRT) from 10.04 to 33.49 h, COD removal efficiency of the UASB reactor decreased owing to a decrease in organic loading rate (OLR) causing poor mixing in the reactor. However, even at the lower OLR (0.475 kg COD/(m3 x d)), the UASB reactor gave a removal efficiency of 68% for COD and 74% for biochemical oxygen demand (BOD). The maximum COD, BOD, ammonia-nitrogen and phosphate removal efficiencies of the duckweed pond were 40.77%, 38.01%, 61.87% and 88.57%, respectively. Decreasing the OLR by increasing the HRT resulted in an increase in efficiency of the duckweed pond for removal of ammonia-nitrogen and phosphate. The OLR of 0.005 kg COD/(m2 x d) and HRT of 108 h in the duckweed pond satisfied aquaculture quality requirements. A specific growth rate of 0.23% was observed for tilapia fish fed with duckweed harvested from the duckweed pond. The economic analysis proved that it was beneficial to use the integrated system of a UASB reactor and a duckweed pond for treatment of sewage. PMID:22856320

  3. The advanced EctoSys electrolysis as an integral part of a ballast water treatment system.

    PubMed

    Echardt, J; Kornmueller, A

    2009-01-01

    A full-scale 500 m(3)/h ballast water treatment system was tested according to the landbased type approval procedure of the International Maritime Organization (IMO). The system consists of disc filters followed by the advanced EctoSys electrolysis as an integral part for disinfection. The test water quality exceeded by far the minimum requirements for type approval testing. Due to the properties of the special electrodes used together with the striking disinfection effect, the disinfectants assumed to be produced inline by the EctoSys cell in river water were hydroxyl radicals, while in brackish water additionally chlorine and consequently the more stable bromine were formed. In river water, no residual oxidants could be detected in accordance with the assumed production of not responding, highly-reactive and short-living hydroxyl radicals. Accordingly, disinfection byproduct (DBP) formation was very low and close to the limit of quantification in river water. While in brackish water, initial residual oxidant concentrations were maximum 2 mg/L as chlorine and mostly brominated DBP (especially bromoform and bromate) were found. Overall considering this worst case test approach, the DBP concentrations of the treated effluents were below or in the range of the WHO Drinking Water Guideline values and therefore evaluated as acceptable for discharge to the environment. The stringent discharge standard by IMO concerning viable organisms was fully met in river and brackish water, proving the disinfection efficiency of the EctoSys electrolysis against smaller plankton and bacteria. PMID:19901453

  4. An innovative integrated system utilizing solar energy as power for the treatment of decentralized wastewater.

    PubMed

    Han, Changfu; Liu, Junxin; Liang, Hanwen; Guo, Xuesong; Li, Lin

    2013-02-01

    This article reports an innovative integrated system utilizing solar energy as power for decentralized wastewater treatment, which consists of an oxidation ditch with double channels and a photovoltaic (PV) system without a storage battery. Because the system operates without a storage battery, which can reduce the cost of the PV system, the solar radiation intensity affects the amount of power output from the PV system. To ensure that the power output is sufficient in all different weather conditions, the solar radiation intensity of 78 W/m2 with 95% confidence interval was defined as a threshold of power output for the PV system according to the monitoring results in this study, and a step power output mode was used to utilize the solar energy as well as possible. The oxidation ditch driven by the PV system without storage battery ran during the day and stopped at night. Therefore, anaerobic, anoxic and aerobic conditions could periodically appear in the oxidation ditch, which was favorable to nitrogen and phosphate removal from the wastewater. The experimental results showed that the system was efficient, achieving average removal efficiencies of 88% COD, 98% NH4+-N, 70% TN and 83% TP, under the loading rates of 140 mg COD/(g MLSS x day), 32 mg NH4+-N/(g MLSS x day), 44 mg TN/(g MLSS x day) and 5 mg TP/(g MLSS x day). PMID:23596946

  5. Integrated physicochemical and biological treatment process for fluoride and phosphorus removal from fertilizer plant wastewater.

    PubMed

    Gouider, Mbarka; Mlaik, Najwa; Feki, Mongi; Sayadi, Sami

    2011-08-01

    The phosphate fertilizer industry produces highly hazardous and acidic wastewaters. This study was undertaken to develop an integrated approach for the treatment of wastewaters from the phosphate industry. Effluent samples were collected from a local phosphate fertilizer producer and were characterized by their high fluoride and phosphate content. First, the samples were pretreated by precipitation of phosphate and fluoride ions using hydrated lime. The resulting low- fluoride and phosphorus effluent was then treated with the enhanced biological phosphorus removal (EBPR) process to monitor the simultaneous removal of carbon, nitrogen, and phosphorus. Phosphorus removal included a two-stage anaerobic/aerobic system operating under continuous flow. Pretreated wastewater was added to the activated sludge and operated for 160 days in the reactor. The operating strategy included increasing the organic loading rate (OLR) from 0.3 to 1.2 g chemical oxygen demand (COD)/L.d. The stable and high removal rates of COD, NH4(+)-N, and PO4(3-)-P were then recorded. The mean concentrations of the influent were approximately 3600 mg COD/L, 60 mg N/L, and 14 mg P/L, which corresponded to removal efficiencies of approximately 98%, 86%, and 92%, respectively. PMID:21905410

  6. Integrated production of polyhydroxyalkanoates (PHAs) with municipal wastewater and sludge treatment at pilot scale.

    PubMed

    Morgan-Sagastume, F; Hjort, M; Cirne, D; Gérardin, F; Lacroix, S; Gaval, G; Karabegovic, L; Alexandersson, T; Johansson, P; Karlsson, A; Bengtsson, S; Arcos-Hernández, M V; Magnusson, P; Werker, A

    2015-04-01

    A pilot-scale process was operated over 22 months at the Brussels North Wastewater Treatment Plant (WWTP) in order to evaluate polyhydroxyalkanoate (PHA) production integration with services of municipal wastewater and sludge management. Activated sludge was produced with PHA accumulation potential (PAP) by applying feast-famine selection while treating the readily biodegradable COD from influent wastewater (average removals of 70% COD, 60% CODsol, 24% nitrogen, and 46% phosphorus). The biomass PAP was evaluated to be in excess of 0.4gPHA/gVSS. Batch fermentation of full-scale WWTP sludge at selected temperatures (35, 42 and 55 °C) produced centrate (6-9.4 gCODVFA/L) of consistent VFA composition, with optimal fermentation performance at 42 °C. Centrate was used to accumulate PHA up to 0.39 gPHA/gVSS. The centrate nutrients are a challenge to the accumulation process but producing a biomass with 0.5 gPHA/gVSS is considered to be realistically achievable within the typically available carbon flows at municipal waste management facilities. PMID:25638407

  7. Organizational Factors Influencing Implementation of Evidence-Based Practices for Integrated Treatment in Behavioral Health Agencies

    PubMed Central

    Bonham, Caroline A.; Sommerfeld, David; Willging, Cathleen; Aarons, Gregory A.

    2014-01-01

    Objective. In recent years, New Mexico has prioritized integrated treatment for cooccurring mental health and substance use disorders within its public behavioral health system. This report describes factors likely to be important when implementing evidence-based practices (EBPs) in community agencies. Methods. Our mixed-method research design consisted of observations, semistructured interviews, and surveys undertaken with employees at 14 agencies at baseline and after 18 months. We developed four-agency typologies based on iterative coding and analysis of observations and interviews. We then examined survey data from employees at the four exemplar agencies to validate qualitative findings. Results. Financial resources and strong leadership impacted agency capacity to train providers and implement EBPs. Quantitative analysis of service provider survey responses from these agencies (N = 38) supported qualitative findings and demonstrated significant mean score differences in leadership, organizational climate, and attitudes toward EBPs in anticipated directions. Conclusion. The availability of strong leadership and financial resources were key components to initial implementation success in this study of community agencies in New Mexico. Reliance only on external funding poses risks for sustainment when demoralizing work climates precipitate employee turnover. Strong agency leadership does not always compensate for deficient financial resources in vulnerable communities. PMID:24772411

  8. Evaluation of an integrated continuous stirred microbial electrochemical reactor: Wastewater treatment, energy recovery and microbial community.

    PubMed

    Wang, Haiman; Qu, Youpeng; Li, Da; Zhou, Xiangtong; Feng, Yujie

    2015-11-01

    A continuous stirred microbial electrochemical reactor (CSMER) was developed by integrating anaerobic digestion (AD) and microbial electrochemical system (MES). The system was capable of treating high strength artificial wastewater and simultaneously recovering electric and methane energy. Maximum power density of 583±9, 562±7, 533±10 and 572±6 mW m(-2) were obtained by each cell in a four-independent circuit mode operation at an OLR of 12 kg COD m(-3) d(-1). COD removal and energy recovery efficiency were 87.1% and 32.1%, which were 1.6 and 2.5 times higher than that of a continuous stirred tank reactor (CSTR). Larger amount of Deltaproteobacteria (5.3%) and hydrogenotrophic methanogens (47%) can account for the better performance of CSMER, since syntrophic associations among them provided more degradation pathways compared to the CSTR. Results demonstrate the CSMER holds great promise for efficient wastewater treatment and energy recovery. PMID:26094049

  9. An integrated anaerobic--physico-chemical treatment concept for wool scouring wastewater.

    PubMed

    Peláez, H; Gutiérrez, S; Castro, G; Hernández, A; Viñas, M

    2001-01-01

    The strong flow wastewater from a wool scouring industry is treated by a combination of anaerobic digestion and physico-chemical postreatment. Based on previous laboratory results (Gutiérrez et al., 1999), three anaerobic baffled reactors (ABR) of 300 m3 each were built, processing 60% of the strong flow of a wool scouring mill for about two years. COD and grease removal in the anaerobic reactors were 47-50% and 50-55% respectively, with an organic load between 8.9 and 6.7 kg COD/m3 d. The effluent of the anaerobic reactors was assayed with additives in an industrial decanter centrifuge. As results of these assays, all the effluent of the three reactors was sent to the decanter centrifuge after dosing additives. Overall COD and grease removal of the integrated system were 87% and 93% respectively. Dosage of coagulation-flocculation additives was optimized in a continuous flocculation device. The proposed treatment is cheaper and easier to control than others alternatives with COD removal higher than 93%. PMID:11575099

  10. Culturally Informed and Flexible Family-Based Treatment for Adolescents: A Tailored and Integrative Treatment for Hispanic Youth

    PubMed Central

    Santisteban, Daniel; Mena, Maite P.

    2009-01-01

    The increasing utilization of evidence-based treatments has highlighted the need for interventions that are effective with Hispanic substance abusing youth and families. The list of evidence-based treatments is limited in its inclusion of interventions that are responsive to the unique characteristics and treatment needs of young Hispanics and that have been tested with this population. Some treatments that have been tested with Hispanics do not articulate the manner in which cultural characteristics and therapy processes interact. Other treatments have emphasized the important role of culture but have not been tested rigorously. The value of well designed interventions built upon an appreciation for unique patient characteristics was highlighted by Beutler et al.,1996 when they argued that “psychotherapy is comprised of a set of complex tasks, and practitioners need comprehensive knowledge of how different processes used in psychotherapy interact with patient characteristics in order to make treatment decisions that will maximize and optimize therapeutic power” (page 30). A focus on how treatment processes interact with patient characteristics is particularly relevant in the Hispanic population because of the considerable heterogeneity beneath the Hispanic umbrella. Our new program of clinical research focuses on articulating how the varied profiles with regard to immigration stressors, acculturation processes, values clashes, sense of belonging to the community, discrimination, and knowledge about issues important to adolescent health, can be more effectively addressed by a culturally informed treatment. PMID:19579908

  11. Family Assessment/Treatment/Evaluation Methods Integrated for Helping Teen Suicide Attempters/Families in Short Term Psychiatric Hospitalization Programs.

    ERIC Educational Resources Information Center

    Shepard, Suzanne

    The assessment process can be integrated with treatment and evaluation for helping teenage suicide attempters and families in short term psychiatric hospitalization programs. The method is an extremely efficient way for the therapist to work within a given time constraint. During family assessment sufficient information can be gathered to…

  12. Errors of Omission and Commission during Alternative Reinforcement of Compliance: The Effects of Varying Levels of Treatment Integrity

    ERIC Educational Resources Information Center

    Leon, Yanerys; Wilder, David A.; Majdalany, Lina; Myers, Kristin; Saini, Valdeep

    2014-01-01

    We conducted two experiments to evaluate the effects of errors of omission and commission during alternative reinforcement of compliance in young children. In Experiment 1, we evaluated errors of omission by examining two levels of integrity during alternative reinforcement (20 and 60%) for child compliance following no treatment (baseline) versus…

  13. The Effect of Performance Feedback on Teachers' Treatment Integrity: A Meta-Analysis of the Single-Case Literature

    ERIC Educational Resources Information Center

    Solomon, Benjamin G.; Klein, Suzanne A.; Politylo, Bethany C.

    2012-01-01

    Performance feedback (PF) has become popular in the school-based literature as a method to increase the treatment integrity of prescribed interventions. The current study extracted and aggregated data from single-case studies that used PF in school settings to increase teachers' use of classroom-based interventions. Results suggest PF is…

  14. A Guiding Framework for Integrating the Consultation Process and Behavior Analytic Practice in Schools: The Treatment Validation Consultation Model

    ERIC Educational Resources Information Center

    Andersen, Melissa N.; Hofstadter, Kristi L.; Kupzyk, Sara; Daly, Edward J., III; Bleck, Amanda A.; Collaro, Alyssa L.; Jones, Kristin E.; Clure, Lynne F.; Blevins, Carrie A.

    2010-01-01

    Since behavioral consultation (BC) was introduced over 30 years ago, the core procedures and assumptions of the model have remained largely unchanged in spite of its widespread popularity in practice. This article presents the Treatment Validation Consultation (TVC) model, which addresses limitations of BC and integrates recent technological…

  15. Treatment Integrity of Literacy Interventions for Students with Emotional and/or Behavioral Disorders: A Review of Literature

    ERIC Educational Resources Information Center

    Griffith, Annette K.; Hurley, Kristin Duppong; Hagaman, Jessica L.

    2009-01-01

    This review examines the treatment integrity data of literacy interventions for students with emotional and/or behavioral disorders (EBD). Forty-four studies published between 1977 and 2005 were examined. Findings indicate that studies focusing on literacy interventions for students with EBD included clear operational definitions and data on…

  16. The Effects of Self-Monitoring and Performance Feedback on the Treatment Integrity of Behavior Intervention Plan Implementation and Generalization

    ERIC Educational Resources Information Center

    Mouzakitis, Angela; Codding, Robin S.; Tryon, Georgiana

    2015-01-01

    Accurate implementation of individualized behavior intervention plans (BIPs) is a critical aspect of evidence-based practice. Research demonstrates that neither training nor consultation is sufficient to improve and maintain high rates of treatment integrity (TI). Therefore, evaluation of ongoing support strategies is needed. The purpose of this…

  17. Effect of patient setup errors on simultaneously integrated boost head and neck IMRT treatment plans

    SciTech Connect

    Siebers, Jeffrey V. . E-mail: jsiebers@vcu.edu; Keall, Paul J.; Wu Qiuwen; Williamson, Jeffrey F.; Schmidt-Ullrich, Rupert K.

    2005-10-01

    Purpose: The purpose of this study is to determine dose delivery errors that could result from random and systematic setup errors for head-and-neck patients treated using the simultaneous integrated boost (SIB)-intensity-modulated radiation therapy (IMRT) technique. Methods and Materials: Twenty-four patients who participated in an intramural Phase I/II parotid-sparing IMRT dose-escalation protocol using the SIB treatment technique had their dose distributions reevaluated to assess the impact of random and systematic setup errors. The dosimetric effect of random setup error was simulated by convolving the two-dimensional fluence distribution of each beam with the random setup error probability density distribution. Random setup errors of {sigma} = 1, 3, and 5 mm were simulated. Systematic setup errors were simulated by randomly shifting the patient isocenter along each of the three Cartesian axes, with each shift selected from a normal distribution. Systematic setup error distributions with {sigma} = 1.5 and 3.0 mm along each axis were simulated. Combined systematic and random setup errors were simulated for {sigma} = {sigma} = 1.5 and 3.0 mm along each axis. For each dose calculation, the gross tumor volume (GTV) received by 98% of the volume (D{sub 98}), clinical target volume (CTV) D{sub 90}, nodes D{sub 90}, cord D{sub 2}, and parotid D{sub 50} and parotid mean dose were evaluated with respect to the plan used for treatment for the structure dose and for an effective planning target volume (PTV) with a 3-mm margin. Results: Simultaneous integrated boost-IMRT head-and-neck treatment plans were found to be less sensitive to random setup errors than to systematic setup errors. For random-only errors, errors exceeded 3% only when the random setup error {sigma} exceeded 3 mm. Simulated systematic setup errors with {sigma} = 1.5 mm resulted in approximately 10% of plan having more than a 3% dose error, whereas a {sigma} = 3.0 mm resulted in half of the plans having

  18. Nuclear-interaction correction of integrated depth dose in carbon-ion radiotherapy treatment planning.

    PubMed

    Inaniwa, T; Kanematsu, N; Hara, Y; Furukawa, T

    2015-01-01

    In treatment planning of charged-particle therapy, tissue heterogeneity is conventionally modeled as water with various densities, i.e. stopping effective densities ρ(S), and the integrated depth dose measured in water (IDD) is applied accordingly for the patient dose calculation. Since the chemical composition of body tissues is different from that of water, this approximation causes dose calculation errors, especially due to difference in nuclear interactions. Here, we propose and validate an IDD correction method for these errors in patient dose calculations. For accurate handling of nuclear interactions, ρ(S) of the patient is converted to nuclear effective density ρ(N), defined as the ratio of the probability of nuclear interactions in the tissue to that in water using a recently formulated semi-empirical relationship between the two. The attenuation correction factor Φ(w)(p), defined as the ratio of the attenuation of primary carbon ions in a patient to that in water, is calculated from a linear integration of ρ(N) along the beam path. In our treatment planning system, a carbon-ion beam is modeled to be composed of three components according to their transverse beam sizes: primary carbon ions, heavier fragments, and lighter fragments. We corrected the dose contribution from primary carbon ions to IDD as proportional to Φ(w)(p), and corrected that from lighter fragments as inversely proportional to Φ(w)(p). We tested the correction method for some non-water materials, e.g. milk, lard, ethanol and water solution of potassium phosphate (K2HPO4), with un-scanned and scanned carbon-ion beams. In un-scanned beams, the difference in IDD between a beam penetrating a 150 mm-thick layer of lard and a beam penetrating water of the corresponding thickness amounted to -4%, while it was +6% for a 150 mm-thick layer of 40% K2HPO4. The observed differences were accurately predicted by the correction method. The corrected IDDs agreed with the measurements within

  19. Challenges in treatment of posttraumatic stress disorder in refugees: towards integration of evidence-based treatments with contextual and culture-sensitive perspectives

    PubMed Central

    Drožđek, Boris

    2015-01-01

    Background Research shows that trauma-focused therapy and multimodal interventions are the two most often used strategies in treatment of refugees suffering from posttraumatic stress disorder (PTSD). While preliminary evidence suggests that trauma-focused approaches may have some efficacy, this could not be established for multimodal interventions. However, it may be that multimodal interventions have been studied in more treatment-resistant refugees with very high levels of psychopathology, disability, and chronicity. In the past decades, various models for understanding of the complex relationship between mental health problems and well-being have emerged. They aim at framing mental health problems in individualized, contextual, epigenetic, and culturally sensitive ways, and may be useful in tailoring content and timing of multimodal interventions. Objective To draw clinicians’ attention to the possibility of using the Integrative Contextual Model for understanding and assessment of posttrauma mental health sequelae while tailoring multimodal interventions; to present a possible way of combining multimodal with evidence-based trauma-focused approaches; and to improve the understanding and treatment of PTSD and other mental health problems in refugee survivors of prolonged and repeated trauma. Method Based on literature, clinical experience, and presentation of a fictional case, the use of the Integrative Contextual Model in tailoring the treatment of severe PTSD in a refugee patient is presented and discussed. Results The Integrative Contextual Model for understanding and assessing factors, which may play a role in causing and maintaining of PTSD and comorbidity in refugees, may help tailoring of multimodal interventions. These interventions can be combined with evidence-based trauma-focused treatments. Conclusion The field of refugee mental health intervention and clinical practice with traumatized refugees may be enriched with the use of contextual and

  20. An Integrative View of Mechanisms Underlying Generalized Spike-and-Wave Epileptic Seizures and Its Implication on Optimal Therapeutic Treatments

    PubMed Central

    Yan, Boyuan; Li, Peng

    2011-01-01

    Many types of epileptic seizures are characterized by generalized spike-and-wave discharges. In the past, notable effort has been devoted to understanding seizure dynamics and various hypotheses have been proposed to explain the underlying mechanisms. In this paper, by taking an integrative view of the underlying mechanisms, we demonstrate that epileptic seizures can be generated by many different combinations of synaptic strengths and intrinsic membrane properties. This integrative view has important medical implications: the specific state of a patient characterized by a set of biophysical characteristics ultimately determines the optimal therapeutic treatment. Through the same view, we further demonstrate the potentiation effect of rational polypharmacy in the treatment of epilepsy and provide a new angle to resolve the debate on polypharmacy. Our results underscore the need for personalized medicine and demonstrate that computer modeling and simulation may play an important role in assisting the clinicians in selecting the optimal treatment on an individual basis. PMID:21811612

  1. Integrating services for injection drug users infected with hepatitis C virus with methadone maintenance treatment: challenges and opportunities.

    PubMed

    Litwin, Alain H; Soloway, Irene; Gourevitch, Marc N

    2005-04-15

    Despite the high prevalence of hepatitis C virus (HCV) infection among drug users enrolled in methadone maintenance treatment programs, few drug users are being treated with combination therapy. The most significant barrier to treatment is lack of access to comprehensive HCV-related care. We describe a pilot program to integrate care for HCV infection with substance abuse treatment in a setting of maintenance treatment with methadone. This on-site, multidisciplinary model of care includes comprehensive screening and treatment for HCV infection, assessment of eligibility, counseling with regard to substance abuse, psychiatric services, HCV support groups, directly observed therapy, and enhanced linkages to a tertiary care system for diagnostic procedures. Our approach has led to high levels of adherence, with liver biopsy and substantial rates of initiation of antiviral therapy. Two cases illustrate the successful application of this model to patients with HCV infection complicated by active substance abuse and psychiatric comorbidity. PMID:15768345

  2. Performance evaluation of a full-scale coke oven wastewater treatment plant in an integrated steel plant.

    PubMed

    Kumar, M Suresh; Vaidya, A N; Shivaraman, N; Bal, A S

    2003-01-01

    Wastewater generated during coke-oven gas cleaning operations in the integrated steel plant contains phenol, cyanide, thiocyanate, and also oil and grease. Although the activated sludge process is widely practiced for biological treatment of coke-oven wastewater, it was observed during the evaluation of performance of full scale coke-oven wastewater treatment plant that oil contamination and poor sludge settleability had resulted in poor maintenance of the activated sludge process. Keeping these aspects in view, treatability studies were conducted and an alternative treatment process is proposed. With these corrective measures the coke-oven wastewater treatment plant will give desired performance. In this paper we present results of the performance evaluation, data on treatability studies and alternative treatment process scheme. PMID:14723281

  3. The Integration of Family-Based Treatment and Dialectical Behavior Therapy for Adolescent Bulimia Nervosa: Philosophical and Practical Considerations.

    PubMed

    Anderson, Leslie K; Murray, Stuart B; Ramirez, Ana L; Rockwell, Roxanne; Le Grange, Daniel; Kaye, Walter H

    2015-01-01

    Dialectical behavior therapy (DBT) and family-based treatment (FBT) are two evidence-based interventions that have been applied in the treatment of bulimia nervosa (BN) in adolescents. While DBT focuses on providing skills for coping with emotion dysregulation that often co-occurs with BN, FBT targets the normalization of eating patterns. The purpose of the current article is to introduce an integration of both treatments to provide a more comprehensive approach that targets the full scope of the disorder. We provide a review of the conceptual similarities and differences between FBT-BN and DBT along with strategies to guide a blended treatment approach. Given the strengths and limitations of either independent treatment, DBT and FBT-BN complement one another and together can address the range of symptoms and behaviors typically seen in adolescent BN. PMID:26009868

  4. Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis

    PubMed Central

    2010-01-01

    Background The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services) have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment. Methods We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies) of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (d) effect size estimates. Results In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (d = -0.09 and 0.22, respectively). Conclusions Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not significantly more effective than non-integrated

  5. Integration of an innovative biological treatment with physical or chemical disinfection for wastewater reuse.

    PubMed

    De Sanctis, Marco; Del Moro, Guido; Levantesi, Caterina; Luprano, Maria Laura; Di Iaconi, Claudio

    2016-02-01

    In the present paper, the effectiveness of a Sequencing Batch Biofilter Granular Reactor (SBBGR) and its integration with different disinfection strategies (UV irradiation, peracetic acid) for producing an effluent suitable for agricultural use was evaluated. The plant treated raw domestic sewage, and its performances were evaluated in terms of the removal efficiency of a wide group of physical, chemical and microbiological parameters. The SBBGR resulted really efficient in removing suspended solids, COD and nitrogen with an average effluent concentration of 5, 32 and 10 mg/L, respectively. Lower removal efficiency was observed for phosphorus with an average concentration in the effluent of 3 mg/L. Plant effluent was also characterized by an average electrical conductivity and sodium adsorption ratio of 680 μS/cm and 2.9, respectively. Therefore, according to these gross parameters, the SBBGR effluent was conformed to the national standards required in Italy for agricultural reuse. Moreover, disinfection performances of the SBBGR was higher than that of conventional municipal wastewater treatment plants and met the quality criteria suggested by WHO (Escherichia coli<1000 CFU/100 mL) for agricultural reuse. In particular, the biological treatment by SBBGR removed 3.8±0.4 log units of Giardia lamblia, 2.8±0.8 log units of E. coli, 2.5±0.7 log units of total coliforms, 2.0±0.3 log units of Clostridium perfringens, 2.0±0.4 log units of Cryptosporidium parvum and 1.7±0.7 log units of Somatic coliphages. The investigated disinfection processes (UV and peracetic acid) resulted very effective for total coliforms, E. coli and somatic coliphages. In particular, a UV radiation and peracetic acid doses of 40 mJ/cm(2) and 1 mg/L respectively reduced E. coli content in the effluent below the limit for agricultural reuse in Italy (10 CFU/100 mL). Conversely, they were both ineffective on C.perfringens spores. PMID:26584070

  6. Fixed capital investments for the uranium soils integrated demonstration soil treatment technologies

    SciTech Connect

    Douthat, D.M.; Armstrong, A.Q.; Stewart, R.N.

    1995-05-01

    The development of a nuclear industry in the United States required mining, milling, and fabricating a large variety of uranium products. One of these products was purified uranium metal which was used in the Savannah River and Hanford Site reactors. Most of this feed material was produced at the United States Department of Energy (DOE) facility formerly called the Feed Materials Production Center at Fernald, Ohio. During operation of this facility, soils became contaminated with uranium from a variety of sources. To address remediation and management of uranium-contaminated soils at sites owned by DOE, the Uranium Soils Integrated Demonstration (USID) Program was formed to evaluate and compare the versatility, efficiency, and economics of various technologies that may be combined into systems designed to characterize and remediate uranium contaminated soils. The USID Program has five major tasks in developing and demonstrating these technologies. Each must be able to (1) characterize the uranium in soil, (2) decontaminate or remove uranium from soil, (3) treat or dispose of resulting waste streams, (4) meet necessary state and federal regulations, and (5) meet performance assessment objectives. The role of the performance assessment objectives is to provide the information necessary to conduct evaluations of the technologies. These performance assessments provide the basis for selecting the optimum system for remediation of large areas contaminated with uranium. One of the performance assessment tasks is to address the economics of full-scale implementation of soil treatment technologies developed by the USID Program. The cost of treating contaminated soil is one of the criteria used in the decision-making process for selecting remedial alternatives.

  7. Integrated flue gas treatment for simulataneous emission control and heat rate improvement - demonstration project at Ravenswood

    SciTech Connect

    Heaphy, J.; Carbonara, J.; Cressner, A.

    1995-06-01

    Results are presented for electric-utility, residual-oil fired, field demonstration testing of advanced-design, heat-recovery type, flue gas sub-coolers that incorporate sulfite-alkali-based wet scrubbing for efficient removal of volatile and semi-volatile trace elements, sub-micron solid particulate matter, SO{sub 2} and SO{sub 3}. By innovative adaptation of wet collector system operation with methanol injection into the rear boiler cavity to convert flue-gas NO to No{sub 2}, simultaneous removal of NO{sub x} is also achieved. The focus of this integrated flue gas treatment (IFGT) technology development and demonstration-scale, continuous performance testing is an upward-gas-flow, indirectly water-cooled, condensing heat exchanger fitted with acid-proof, teflon-covered tubes and tubesheets and that provides a unique condensing (non-evaporative) wet-scrubbing mode to address air toxics control objectives of new Clean Air Act, Title III. Advantageous trace-metal condensation/nucleation/agglomeration along with substantially enhanced boiler efficiency is accomplished in the IFGT system by use of boiler makeup water as a heat sink in indirectly cooling boiler flue gas to a near-ambient-temperature, low-absolute-humidity, water-saturated state. Moreover, unique, innocuous, stack systems design encountered with conventional high-humidity, wet-scrubber operations. The mechanical design of this advanced flue-gas cooling/scrubbing equipment is based on more than ten years of commercial application of such units is downward-gas-flow design/operation for energy recovery, e.g. in preheating of makeup water, in residual-oil and natural-gas fired boiler operations.

  8. Electrophoretic Behavior in Relation to the Structural Integrity of Codfish Parvalbumin upon Heat Treatment.

    PubMed

    de Jongh, Harmen H J; de los Reyes Jimenez, Marta; Baumert, Joseph L; Taylor, Steve L; Koppelman, Stef J

    2015-05-13

    This work evaluates the impact of heat processing of parvalbumin, a major fish allergen, on the consequences for quantitative analysis of this protein embedded in different matrices during heating (either isolated, in an aqueous extract, or in whole fillets) to assess potential health risks. It is shown that oligomerization of parvalbumin does occur, but only upon heat treatment above 80 °C. This coincides with the ability of the isolated protein to refold up to this temperature in a fully reversible way, as demonstrated by circular dichroism analysis. In autoclaved samples a disintegration of the protein structure is observed. The situation becomes different when parvalbumin is embedded in a matrix with other constituents, as in fish extracts or whole fillets. The electrophoretic analysis of parvalbumin (SDS-PAGE and immunoblotting) is largely determined by complexation with other proteins resulting in insoluble materials caused by the partial unfolding of the parvalbumin at elevated temperatures. This effect is more strongly observed for cod fish extract, compared to whole cod fillets, as in the latter situation the integrity of the tissue hampers this interprotein complexation. Moreover, it is shown by ELISA analysis of heat-treated samples that using blotting procedures where disintegration of complexes may be promoted, restoring some of the IgG-binding propensity, may provide false outcomes. It was concluded that antibody binding to parvalbumin is dominated by the potential to form heat-induced complexes with other proteins. The possibly less-soluble or extractable character of these complexes may provide confusing information regarding potential health risks of fish and fish protein-containing food composites when such heat-treated samples are analyzed by immunochemical assays. PMID:25880570

  9. Process engineering design of pathological waste incinerator with an integrated combustion gases treatment unit.

    PubMed

    Shaaban, A F

    2007-06-25

    Management of medical wastes generated at different hospitals in Egypt is considered a highly serious problem. The sources and quantities of regulated medical wastes have been thoroughly surveyed and estimated (75t/day from governmental hospitals in Cairo). From the collected data it was concluded that the most appropriate incinerator capacity is 150kg/h. The objective of this work is to develop the process engineering design of an integrated unit, which is technically and economically capable for incinerating medical wastes and treatment of combustion gases. Such unit consists of (i) an incineration unit (INC-1) having an operating temperature of 1100 degrees C at 300% excess air, (ii) combustion-gases cooler (HE-1) generating 35m(3)/h hot water at 75 degrees C, (iii) dust filter (DF-1) capable of reducing particulates to 10-20mg/Nm(3), (iv) gas scrubbers (GS-1,2) for removing acidic gases, (v) a multi-tube fixed bed catalytic converter (CC-1) to maintain the level of dioxins and furans below 0.1ng/Nm(3), and (vi) an induced-draft suction fan system (SF-1) that can handle 6500Nm(3)/h at 250 degrees C. The residence time of combustion gases in the ignition, mixing and combustion chambers was found to be 2s, 0.25s and 0.75s, respectively. This will ensure both thorough homogenization of combustion gases and complete destruction of harmful constituents of the refuse. The adequate engineering design of individual process equipment results in competitive fixed and operating investments. The incineration unit has proved its high operating efficiency through the measurements of different pollutant-levels vented to the open atmosphere, which was found to be in conformity with the maximum allowable limits as specified in the law number 4/1994 issued by the Egyptian Environmental Affairs Agency (EEAA) and the European standards. PMID:17166659

  10. Nonsurgical Korean Integrative Treatments for Symptomatic Lumbar Spinal Stenosis: A Three-Armed Randomized Controlled Pilot Trial Protocol

    PubMed Central

    Kim, Kiok; Shin, Kyung-Min; Lee, Jun-Hwan; Seo, Bok-Nam; Jung, So-Young; Youn, Yousuk; Lee, Sang Ho; Kim, Jaehong; Qu, Wenchun

    2016-01-01

    This is a study protocol for a pilot three-armed randomized controlled trial on nonsurgical integrative Korean medicinal treatment for symptomatic lumbar spinal stenosis (LSS). Thirty-six participants who have been diagnosed with (LSS) and recommended for spinal surgery by neurosurgeons or orthopedics and have had spinal symptoms such as severe low back pain and neurological claudication regardless of at least three months of conservative treatments will be recruited. Participants will be randomly assigned to be one of the three intervention groups, including the Mokhuri treatment program group 1 or 2 or usual care group. All treatments will be administered in inpatient units over a period of 4 weeks. The primary outcomes are 0 to 100 Visual Analogue Scales for low back pain and leg pain and the secondary outcomes are Oswestry Disability Index; EQ-5D; Roland-Morris Disability Questionnaire; Oxford Claudication Score; physical function test, including treadmill test, walking duration, and distance assessment for free leg pain; radiologic testing; and adverse events which will be assessed during the 4-week treatment period as well as after 3 and 6 months of follow-up. Then, we will assess the feasibility of the clinical trial design as well as a nonsurgical integrative treatment program. This trial is registered with CRIS registration number: KCT0001218. PMID:26941823

  11. Nonsurgical Korean Integrative Treatments for Symptomatic Lumbar Spinal Stenosis: A Three-Armed Randomized Controlled Pilot Trial Protocol.

    PubMed

    Kim, Kiok; Shin, Kyung-Min; Lee, Jun-Hwan; Seo, Bok-Nam; Jung, So-Young; Youn, Yousuk; Lee, Sang Ho; Kim, Jaehong; Qu, Wenchun; Kim, Tae-Hun

    2016-01-01

    This is a study protocol for a pilot three-armed randomized controlled trial on nonsurgical integrative Korean medicinal treatment for symptomatic lumbar spinal stenosis (LSS). Thirty-six participants who have been diagnosed with (LSS) and recommended for spinal surgery by neurosurgeons or orthopedics and have had spinal symptoms such as severe low back pain and neurological claudication regardless of at least three months of conservative treatments will be recruited. Participants will be randomly assigned to be one of the three intervention groups, including the Mokhuri treatment program group 1 or 2 or usual care group. All treatments will be administered in inpatient units over a period of 4 weeks. The primary outcomes are 0 to 100 Visual Analogue Scales for low back pain and leg pain and the secondary outcomes are Oswestry Disability Index; EQ-5D; Roland-Morris Disability Questionnaire; Oxford Claudication Score; physical function test, including treadmill test, walking duration, and distance assessment for free leg pain; radiologic testing; and adverse events which will be assessed during the 4-week treatment period as well as after 3 and 6 months of follow-up. Then, we will assess the feasibility of the clinical trial design as well as a nonsurgical integrative treatment program. This trial is registered with CRIS registration number: KCT0001218. PMID:26941823

  12. Religiously integrated cognitive behavioral therapy: a new method of treatment for major depression in patients with chronic medical illness.

    PubMed

    Pearce, Michelle J; Koenig, Harold G; Robins, Clive J; Nelson, Bruce; Shaw, Sally F; Cohen, Harvey J; King, Michael B

    2015-03-01

    Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients' spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive-behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155

  13. Religiously Integrated Cognitive Behavioral Therapy: A New Method of Treatment for Major Depression in Patients With Chronic Medical Illness

    PubMed Central

    Pearce, Michelle J.; Koenig, Harold G.; Robins, Clive J.; Nelson, Bruce; Shaw, Sally F.; Cohen, Harvey J.; King, Michael B.

    2015-01-01

    Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients’ spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive–behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155

  14. The Impact of Lifetime Drug Use on Hepatitis C Treatment Outcomes in Insured Members of an Integrated Health Care Plan

    PubMed Central

    Pauly, Mary Patricia; Moore, Charles Denton; Chia, Constance; Dorrell, Jennifer Mary; Cunanan, Renee Junko; Witt, Gayle

    2013-01-01

    Background The relation of drug use to HCV treatment outcome in an insured household population has not been previously reported. Methods Lifetime frequencies of marijuana use and non-medical use of stimulants, sedatives, and opioids; hallucinogens; and inhalants were retrospectively assessed in 259 privately insured members of an integrated health care plan treated for chronic hepatitis C virus infection (HCV+) with pegylated interferon alpha and ribavirin and examined with respect to rates of sustained virological response (SVR). Results The majority of patients reported chronic use of multiple illegal drugs; 61.6% reported injection drug use (IDU); 79.5% abstained from drug use during the six months prior to HCV treatment. Total frequency of individual drugs, multiple drugs, and length of abstention from drugs prior to HCV treatment were not related to impaired SVR rates. Sustained viral responses were obtained in 80.2% of patients with HCV genotype 2/3 and 45.1% of patients with genotype 1/4/6. Marijuana use during HCV treatment, reported by 8.5% of patients, was associated with higher treatment adherence (95.5% compared with 78.9%, p=0.045), but lower SVR rates (40.9% compared with 62.5%, p=0.041). In addition, drug use during HCV treatment was associated with significantly higher relapse rates, 18.8% compared with 7.7% (p=.053). Conclusion A history of chronic illegal drug use should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are motivated to seek treatment and closely monitored, but drug use during HCV treatment, including marijuana use, should be discouraged. PMID:24262649

  15. The BHIVES collaborative: organization and evaluation of a multisite demonstration of integrated buprenorphine/naloxone and HIV treatment.

    PubMed

    Weiss, Linda; Egan, James E; Botsko, Michael; Netherland, Julie; Fiellin, David A; Finkelstein, Ruth

    2011-03-01

    Substance abuse is associated with poor medical and quality-of-life outcomes among HIV-infected individuals. Although drug treatment may reduce these negative consequences, for many patients, options are limited. Buprenorphine/naloxone, an opioid agonist treatment that can be prescribed in the United States in office-based settings, can be used to expand treatment capacity and integrate substance abuse services into HIV care. Recognizing this potential, the US Health Resources and Services Administration funded the development and implementation of demonstration projects that integrated HIV care and buprenorphine/naloxone treatment at 10 sites across the country. An Evaluation and Technical Assistance Center provided programmatic and clinical support as well as oversight for an evaluation that examined the processes for and outcomes of integrated care. The evaluation included patient-level self-report and chart abstractions as well as provider and site level data collected through surveys and in-depth interviews. Although multisite demonstrations pose implementation and evaluation challenges, our experience demonstrates that these can, in part, be addressed through ongoing communication and technical assistance as well as a comprehensive evaluation design that incorporates multiple research methods and data sources. Although limitations to evaluation findings persist, they may be balanced by the scope and "real-world" context of the initiative. PMID:21317598

  16. Integrating Antiretroviral Strategies for Human Immunodeficiency Virus Prevention: Post- and Pre-Exposure Prophylaxis and Early Treatment

    PubMed Central

    Grant, Robert M.; Smith, Dawn K.

    2015-01-01

    Best practices for integrating human immunodeficiency virus (HIV) testing and antiretroviral interventions for prevention and treatment are suggested based on research evidence and existing normative guidance. The goal is to provide high-impact prevention services during periods of substantial risk. Antiretroviral medications are recommended for postexposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), and treatment of HIV infection. We reviewed research evidence and current normative guidelines to identify best practices for integrating these high-impact prevention strategies. More sensitive HIV tests used for screening enable earlier diagnosis and treatment of HIV infection, more appropriate counseling, and help limit drug resistance. A fully suppressive PEP regimen should be initiated based on exposure history or physical findings when sensitive diagnostic testing is delayed or not available and antibody tests are negative. Transitions from PEP to PrEP are often warranted because HIV exposure events may continue to occur. This algorithmic approach to integrating PEP, PrEP, and early treatment decisions may increase the uptake of these interventions by a greater number and diversity of knowledgeable healthcare providers. PMID:26512356

  17. Selection of forward osmosis draw solutes for subsequent integration with anaerobic treatment to facilitate resource recovery from wastewater.

    PubMed

    Ansari, Ashley J; Hai, Faisal I; Guo, Wenshan; Ngo, Hao H; Price, William E; Nghiem, Long D

    2015-09-01

    Forward osmosis (FO) can be used to extract clean water and pre-concentrate municipal wastewater to make it amenable to anaerobic treatment. A protocol was developed to assess the suitability of FO draw solutes for pre-concentrating wastewater for potential integration with anaerobic treatment to facilitate resource recovery from wastewater. Draw solutes were evaluated in terms of their ability to induce osmotic pressure, water flux, and reverse solute flux. The compatibility of each draw solute with subsequent anaerobic treatment was assessed by biomethane potential analysis. The effect of each draw solute (at concentrations corresponding to the reverse solute flux at ten-fold pre-concentration of wastewater) on methane production was also evaluated. The results show that ionic organic draw solutes (e.g., sodium acetate) were most suitable for FO application and subsequent anaerobic treatment. On the other hand, the reverse solute flux of inorganic draw solutions could inhibit methane production from FO pre-concentrated wastewater. PMID:25978854

  18. An Integrated, Multidimensional Treatment Model for Individuals Living with HIV, Mental Illness, and Substance Abuse

    ERIC Educational Resources Information Center

    Bouis, Stephanie; Reif, Susan; Whetten, Kathryn; Scovil, Janet; Murray, Andrea; Swartz, Marvin

    2007-01-01

    The challenge of providing effective treatment services for the growing population of HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV treatment and prevention. This article describes a treatment model that was…

  19. Dual Treatments as Starting Point for Integrative Perceptions in Teaching Mathematics

    ERIC Educational Resources Information Center

    Kërënxhi, Svjetllana; Gjoci, Pranvera

    2015-01-01

    In this paper, we recommend mathematical teaching through dual treatments. The dual treatments notion, classified in dual interpretations, dual analyses, dual solutions, and dual formulations, is explained through concrete examples taken from mathematical textbooks of elementary education. Dual treatments provide opportunities for creating…

  20. Integrating Religion and Spirituality into Treatment for Late-Life Anxiety: Three Case Studies

    ERIC Educational Resources Information Center

    Barrera, Terri L.; Zeno, Darrell; Bush, Amber L.; Barber, Catherine R.; Stanley, Melinda A.

    2012-01-01

    Generalized anxiety disorder (GAD) is common in older adults and, although cognitive behavioral therapy (CBT) is an efficacious treatment for late-life GAD, effect sizes are only moderate and attrition rates are high. One way to increase treatment acceptability and enhance current cognitive behavioral treatments for GAD in older adults might be to…

  1. The energy trilogy: An integrated sustainability model to bridge wastewater treatment plant energy and emissions gaps

    NASA Astrophysics Data System (ADS)

    Al-Talibi, A. Adhim

    An estimated 4% of national energy consumption is used for drinking water and wastewater services. Despite the awareness and optimization initiatives for energy conservation, energy consumption is on the rise owing to population and urbanization expansion and to commercial and industrial business advancement. The principal concern is since energy consumption grows, the higher will be the energy production demand, leading to an increase in CO2 footprints and the contribution to global warming potential. This research is in the area of energy-water nexus, focusing on wastewater treatment plant (WWTP) energy trilogy -- the group of three related entities, which includes processes: (1) consuming energy, (2) producing energy, and (3) the resulting -- CO2 equivalents. Detailed and measurable energy information is not readily obtained for wastewater facilities, specifically during facility preliminary design phases. These limitations call for data-intensive research approach on GHG emissions quantification, plant efficiencies and source reduction techniques. To achieve these goals, this research introduced a model integrating all plant processes and their pertinent energy sources. In a comprehensive and "Energy Source-to-Effluent Discharge" pattern, this model is capable of bridging the gaps of WWTP energy, facilitating plant designers' decision-making for meeting energy assessment, sustainability and the environmental regulatory compliance. Protocols for estimating common emissions sources are available such as for fuels, whereas, site-specific emissions for other sources have to be developed and are captured in this research. The dissertation objectives were met through an extensive study of the relevant literature, models and tools, originating comprehensive lists of processes and energy sources for WWTPs, locating estimation formulas for each source, identifying site specific emissions factors, and linking the sources in a mathematical model for site specific CO2 e

  2. Integrating precision medicine in the study and clinical treatment of a severely mentally ill person

    PubMed Central

    O’Rawe, Jason A.; Fang, Han; Rynearson, Shawn; Robison, Reid; Kiruluta, Edward S.; Higgins, Gerald; Eilbeck, Karen; Reese, Martin G.

    2013-01-01

    .Glu429Ala allele in methylenetetrahydrofolate reductase (MTHFR) and the p.Asp7Asn allele in ChAT, encoding choline O-acetyltransferase, with both alleles having been shown to confer an elevated susceptibility to psychoses. We have found thousands of other variants in his genome, including pharmacogenetic and copy number variants. This information has been archived and offered to this person alongside the clinical sequencing data, so that he and others can re-analyze his genome for years to come. Conclusions. To our knowledge, this is the first study in the clinical neurosciences that integrates detailed neuropsychiatric phenotyping, deep brain stimulation for OCD and clinical-grade WGS with management of genetic results in the medical treatment of one person with severe mental illness. We offer this as an example of precision medicine in neuropsychiatry including brain-implantable devices and genomics-guided preventive health care. PMID:24109560

  3. Integrating precision medicine in the study and clinical treatment of a severely mentally ill person.

    PubMed

    O'Rawe, Jason A; Fang, Han; Rynearson, Shawn; Robison, Reid; Kiruluta, Edward S; Higgins, Gerald; Eilbeck, Karen; Reese, Martin G; Lyon, Gholson J

    2013-01-01

    .Glu429Ala allele in methylenetetrahydrofolate reductase (MTHFR) and the p.Asp7Asn allele in ChAT, encoding choline O-acetyltransferase, with both alleles having been shown to confer an elevated susceptibility to psychoses. We have found thousands of other variants in his genome, including pharmacogenetic and copy number variants. This information has been archived and offered to this person alongside the clinical sequencing data, so that he and others can re-analyze his genome for years to come. Conclusions. To our knowledge, this is the first study in the clinical neurosciences that integrates detailed neuropsychiatric phenotyping, deep brain stimulation for OCD and clinical-grade WGS with management of genetic results in the medical treatment of one person with severe mental illness. We offer this as an example of precision medicine in neuropsychiatry including brain-implantable devices and genomics-guided preventive health care. PMID:24109560

  4. Integration of Research and Practice in Substance Use Disorder Treatment: Findings from Focus Groups of Clinicians, Researchers, Educators, Administrators, and Policy Makers

    ERIC Educational Resources Information Center

    Campbell, Todd C.; Daood, Christopher; Catlin, Lynn; Abelson, Alissa

    2005-01-01

    Clinicians, researchers, educators, administrators, and policy makers, who represented stakeholders in the substance abuse treatment field, participated in 5 focus groups. Four general areas regarding integration of research and practice were investigated: definition of research, training/education, current integration, and future integration.…

  5. Integrating screening, brief intervention and referral to treatment (SBIRT) into an abortion clinic: an exploratory study of acceptability.

    PubMed

    Appel, Lindsay; Ramanadhan, Shaalini; Hladky, Katherine; Welsh, Chris; Terplan, Mishka

    2015-04-01

    Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an effective means of identifying problematic substance use. We evaluated the acceptability of SBIRT in an abortion clinic via an anonymous survey of 100 participants. Clients were comfortable being asked about their substance use, receiving counseling, and treatment referral (mean Likert 1.1, 1.5, and 1.6, respectively) and were only minimally embarrassed when asked about substance use (mean Likert 3.6). These findings suggest that integrating SBIRT into an abortion clinic may be feasible. However, future studies are needed to assess the efficacy of abortion clinic SBIRT in reducing risky substance use. PMID:25596511

  6. Integration of surgery with fractionated stereotactic radiotherapy for treatment of nonfunctioning pituitary macroadenomas

    SciTech Connect

    Paek, Sun Ha; Downes, M. Beverly; Bednarz, Greg; Keane, William M.; Werner-Wasik, Maria; Curran, Walter J.; Andrews, David W. . E-mail: david.andrews@jefferson.edu

    2005-03-01

    FSRT as a safe, effective, and integrated treatment for nonfunctioning pituitary adenomas. Additional follow-up is needed to document the long-term tumor control rates, preservation rates for vision and pituitary function, and neurocognitive outcomes.

  7. Efficient treatment of phenolic wastewater with high salinity using a novel integrated system of magnetically immobilized cells coupling with electrodes.

    PubMed

    Jiang, Bei; Shi, Shengnan; Song, Lun; Tan, Liang; Li, Meidi; Liu, Jiaxin; Xue, Lanlan

    2016-10-01

    A novel integrated system in which magnetically immobilized cells coupled with a pair of stainless iron meshes-graphite plate electrodes has been designed and operated to enhance the treatment performance of phenolic wastewater under high salinity. With NaCl concentration increased, phenol, o-cresol, m-cresol, p-cresol and COD removal rates by integrated system increased significantly, which were obviously higher than the sum of removal rates by single magnetically immobilized cells and electrode reaction. This integrated system exhibited higher removal rates for all the compounds than that by single magnetically immobilized cells during six cycles for reuse, and it still performed better, even when the voltage was cut off. These results indicated that there was a coupling effect between biodegradation and electrode reaction. The investigation of phenol hydroxylase activity and cells concentration confirmed that electrode reaction played an important role in this coupling effect. PMID:27347805

  8. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    PubMed

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too. PMID:26775496

  9. Advanced treatment of biologically pretreated coal gasification wastewater by a novel integration of heterogeneous Fenton oxidation and biological process.

    PubMed

    Xu, Peng; Han, Hongjun; Zhuang, Haifeng; Hou, Baolin; Jia, Shengyong; Xu, Chunyan; Wang, Dexin

    2015-04-01

    Laboratorial scale experiments were conducted in order to investigate a novel system integrating heterogeneous Fenton oxidation (HFO) with anoxic moving bed biofilm reactor (ANMBBR) and biological aerated filter (BAF) process on advanced treatment of biologically pretreated coal gasification wastewater (CGW). The results indicated that HFO with the prepared catalyst (FeOx/SBAC, sewage sludge based activated carbon (SBAC) which loaded Fe oxides) played a key role in eliminating COD and COLOR as well as in improving the biodegradability of raw wastewater. The surface reaction and hydroxyl radicals (OH) oxidation were the mechanisms for FeOx/SBAC catalytic reaction. Compared with ANMBBR-BAF process, the integrated system was more effective in abating COD, BOD5, total phenols (TPs), total nitrogen (TN) and COLOR and could shorten the retention time. Therefore, the integrated system was a promising technology for engineering applications. PMID:25724695

  10. Feasibility of laser-integrated high intensity focused ultrasound (HIFU) treatment for bladder tumors: in vitro study (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Nguyen, Van Phuc; Park, Suhyun; Oh, Junghwan; Kang, Hyun Wook

    2016-02-01

    Previous studies have shown that photothemal therapy combined with high intensity focused ultrasound (HIFU) can provide a promising method to achieve rapid thermal coagulation during surgical procedures. The current study investigated the feasibility of the laser-integrated high intensity focused ultrasound (HIFU) application to treat bladder tumors by enhancing thermal effects and therapeutic depth in vitro. To generate thermal coagulation, a single element HIFU transducer with a central frequency of 2.0 MHz was used to transmit acoustic energy to 15 fresh porcine bladders injected with an artificial tumor (100 µl gelatin and hemoglobin solution) in vitro. Simultaneously, an 80-W 532-nm laser system was also implemented to induce thermal necrosis in the targeted tissue. The intensity of 570 W/cm2 at the focus of HIFU and laser energy of 0.9 W were applied to all the samples for 40 s. The temperature rise increased up to about 1.6 or 3 folds (i.e., ΔT=32±3.8 K for laser-integrated HIFU, ΔT=20±6.5 K for HIFU only, and ΔT=11±5.6 K for laser only). The estimated lesion depth also increased by 1.3 and 2 folds during the dual-thermal treatment, in comparison with the treatment by either HIFU or laser. The results indicated that the laser-integrated HIFU treatment can be an efficient hyperthermic method for tumor coagulation.

  11. Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors.

    PubMed

    Kienle, Gunver S; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

    2016-01-01

    Background. Mistletoe therapy (MT) is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients' general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients' emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations. PMID:27239209

  12. Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors

    PubMed Central

    Kienle, Gunver S.; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

    2016-01-01

    Background. Mistletoe therapy (MT) is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients' general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients' emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations. PMID:27239209

  13. Fate of As, Se, and Hg in a Passive Integrated System for Treatment of Fossil Plant Wastewater

    SciTech Connect

    Terry Yost; Paul Pier; Gregory Brodie

    2007-12-31

    TVA is collaborating with EPRI and DOE to demonstrate a passive treatment system for removing SCR-derived ammonia and trace elements from a coal-fired power plant wastewater stream. The components of the integrated system consist of trickling filters for ammonia oxidation, reaction cells containing zero-valent iron (ZVI) for trace contaminant removal, a settling basin for storage of iron hydroxide floc, and anaerobic vertical-flow wetlands for biological denitrification. The passive integrated treatment system will treat up to 0.25 million gallons per day (gpd) of flue gas desulfurization (FGD) pond effluent, with a configuration requiring only gravity flow to obviate the need for pumps. The design of the system will enable a comparative evaluation of two parallel treatment trains, with and without the ZVI extraction trench and settling/oxidation basin components. One of the main objectives is to gain a better understanding of the chemical transformations that species of trace elements such as arsenic, selenium, and mercury undergo as they are treated in passive treatment system components with differing environmental conditions. This progress report details the design criteria for the passive integrated system for treating fossil power plant wastewater as well as performance results from the first several months of operation. Engineering work on the project has been completed, and construction took place during the summer of 2005. Monitoring of the passive treatment system was initiated in October 2005 and continued until May 18 2006. The results to date indicate that the treatment system is effective in reducing levels of nitrogen compounds and trace metals. Concentrations of both ammonia and trace metals were lower than expected in the influent FGD water, and additions to increase these concentrations will be done in the future to further test the removal efficiency of the treatment system. In May 2006, the wetland cells were drained of FGD water, refilled with

  14. A new treatment of boltzmann-like collision integrals in nuclear kinetic equations

    SciTech Connect

    Lang, A.; Babovsky, H.; Cassing, W.; Mosel, U.; Reusch, H.G.; Weber, K. )

    1993-06-01

    The authors present a new method to solve the collision-integrals in BUU- type simulations of heavy-ion reactions and compare it to the two currently used full- and parallel-ensemble schemes. 25 refs., 8 figs.

  15. Gauge-invariant treatment of the integrated Sachs-Wolfe effect on general spherically symmetric spacetimes

    SciTech Connect

    Tomita, Kenji

    2010-03-15

    On the basis of the Gerlach-Sengupta theory of gauge-invariant perturbations, a formula of the integrated Sachs-Wolfe effect for a central observer is derived on general spherically symmetric spacetimes. It will be useful for comparative studies of theoretical and observational aspects of the integrated Sachs-Wolfe effect in the Lemaitre-Tolman-Bondi cosmological models which have been noticed by explaining the apparent acceleration without cosmological constant.

  16. Non-partial wave treatment of reactive and non-reactive scattering Coupled integral equation formalism.

    NASA Technical Reports Server (NTRS)

    Hayes, E. F.; Kouri, D. J.

    1971-01-01

    Coupled integral equations are derived for the full scattering amplitudes for both reactive and nonreactive channels. The equations do not involve any partial wave expansion and are obtained using channel operators for reactive and nonreactive collisions. These coupled integral equations are similar in nature to equations derived for purely nonreactive collisions of structureless particles. Using numerical quadrature techniques, these equations may be reduced to simultaneous algebraic equations which may then be solved.

  17. Long-term Impact of Integration of Household Water Treatment and Hygiene Promotion with Antenatal Services on Maternal Water Treatment and Hygiene Practices in Malawi

    PubMed Central

    Loharikar, Anagha; Russo, Elizabeth; Sheth, Anandi; Menon, Manoj; Kudzala, Amose; Tauzie, Blessius; Masuku, Humphreys D.; Ayers, Tracy; Hoekstra, Robert M.; Quick, Robert

    2013-01-01

    A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010. Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus 2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants. PMID:23243106

  18. Long-term impact of integration of household water treatment and hygiene promotion with antenatal services on maternal water treatment and hygiene practices in Malawi.

    PubMed

    Loharikar, Anagha; Russo, Elizabeth; Sheth, Anandi; Menon, Manoj; Kudzala, Amose; Tauzie, Blessius; Masuku, Humphreys D; Ayers, Tracy; Hoekstra, Robert M; Quick, Robert

    2013-02-01

    A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010. Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus 2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants. PMID:23243106

  19. A method for integrating computed tomography into radiotherapy planning and treatment.

    PubMed

    Ash, D V; Andrews, B; Stubbs, B

    1983-01-01

    A technique is described for accurate localisation and radiotherapy treatment planning for a wide range of intrathoracic, abdominal and pelvic tumours. It allows the patient to proceed in one step from a single examination by computed tomography (CT) to treatment and avoids the need for separate treatment simulation. Compatible laser-beam positioning systems between the CT scanner and treatment-machine rooms ensure accurate reproduction of patient position, so that CT data are directly applicable to treatment. The use of appropriate skin markers, which appear on the CT scan, allows accurate measurements of the distance of the centre of the planned volume from a tattoo placed on the patient at the time of the scan, and ensures that the planned treatment fields are accurately directed. PMID:6822045

  20. Integrating Antimicrobial Therapy with Host Immunity to Fight Drug-Resistant Infections: Classical vs. Adaptive Treatment

    PubMed Central

    Gjini, Erida; Brito, Patricia H.

    2016-01-01

    Antimicrobial resistance of infectious agents is a growing problem worldwide. To prevent the continuing selection and spread of drug resistance, rational design of antibiotic treatment is needed, and the question of aggressive vs. moderate therapies is currently heatedly debated. Host immunity is an important, but often-overlooked factor in the clearance of drug-resistant infections. In this work, we compare aggressive and moderate antibiotic treatment, accounting for host immunity effects. We use mathematical modelling of within-host infection dynamics to study the interplay between pathogen-dependent host immune responses and antibiotic treatment. We compare classical (fixed dose and duration) and adaptive (coupled to pathogen load) treatment regimes, exploring systematically infection outcomes such as time to clearance, immunopathology, host immunization, and selection of resistant bacteria. Our analysis and simulations uncover effective treatment strategies that promote synergy between the host immune system and the antimicrobial drug in clearing infection. Both in classical and adaptive treatment, we quantify how treatment timing and the strength of the immune response determine the success of moderate therapies. We explain key parameters and dimensions, where an adaptive regime differs from classical treatment, bringing new insight into the ongoing debate of resistance management. Emphasizing the sensitivity of treatment outcomes to the balance between external antibiotic intervention and endogenous natural defenses, our study calls for more empirical attention to host immunity processes. PMID:27078624

  1. Integrating Estimates of the Social and Individual Costs of Caregiving into Dementia Treatment Trials

    PubMed Central

    Phillips, Charles D.

    2016-01-01

    A variety of new treatments for dementia are awaiting or undergoing randomized clinical trails. These trials focus on outcomes such as changes in cognitive function, physical function, or amyloid plaques. What is quite important and is too often missing from these trials are estimates of the impact of these treatments on the social and individual costs of providing care for those facing dementia. Until outcomes such as family caregiver time and caregiver burden are included in trails of dementia treatments, the picture of how well these treatments work will be distressingly incomplete. PMID:26997869

  2. Optimizing fracture stimulation using treatment-well tiltmeters and integrated fracture modeling

    SciTech Connect

    Mayerhofer, M.; Stutz, L.; Davis, E.; Wolhart, S.

    2006-05-15

    This paper covers the optimization of hydraulic fracture treatments in a new coalbed methane (CBM) reservoir in Wyoming. A multiwell pilot project was conducted in the Copper Ridge (CR) field to assess future development potential. Hydraulic fracture mapping was successfully performed with treatment-well tiltmeters on six wells including the first-ever used on propped treatments. The mapped fracture height was then used to calibrate the fracture model, perform on-site fracture-design changes, and optimize future fracture treatments. This paper shows how early use of fracture diagnostics can assist in the development of a new reservoir.

  3. Development and validation of a novel modeling framework integrating ion exchange and resin regeneration for water treatment.

    PubMed

    Zhang, Jie; Amini, Adib; O'Neal, Jeremy A; Boyer, Treavor H; Zhang, Qiong

    2015-11-01

    Models have been developed to simulate the process of ion exchange for water treatment. However the modeling of resin regeneration process, which can predict regeneration efficiency and residual stream for determining technology sustainability, was not incorporated into previous models. Therefore a model integrating both ion exchange and resin regeneration considering regeneration efficiency is needed for evaluating and improving ion exchange technology. This study developed an integrated model aiming to simulate ion exchange and resin regeneration in different configurations (fixed bed, fluidized bed) for the first time. The integrated model has been validated via comparing model predictions with experimental data. The impacts of dimensionless groups (i.e. the Péclet number, the diffusion modulus, and the Biot number) on ion exchange breakthrough curve have been analyzed using this model. In addition, this integrated model has been used to optimize the regeneration frequency to improve the overall performance of ion exchange. It demonstrated this integrated model could be a useful tool for further studies in ion exchange technology. PMID:26253896

  4. Advanced treatment of oilfield production wastewater by an integration of coagulation/flotation, catalytic ozonation and biological processes.

    PubMed

    Chen, Ke-Yong; Zhang, Xiao-Bing; Li, Jun

    2016-10-01

    In this study, advanced treatment of heavily polluted oilfield production wastewater (OPW) was investigated employing the combination of coagulation/dissolved air flotation, heterogeneous catalytic ozonation and sequencing batch reactor (SBR) processes. Two SBR reactors were separately set up before and after the ozonation unit. The results show that microbubble flotation was more efficient than macrobubble flotation in pollutant removal. Catalytic ozonation with the prepared Fe/activated carbon catalyst significantly enhanced pollutant removal in the second SBR by improving wastewater biodegradability and reducing wastewater microtoxicity. The treatment technique decreased oil, chemical oxygen demand and NH3-N by about 97%, 88% and 91%, respectively, allowing the discharge limits to be met. Therefore, the integrated process with efficient, economical and sustainable advantages was suitable for advanced treatment of real OPW. PMID:26936286

  5. Effects of Conversational versus Technical Language on Treatment Preference and Integrity

    ERIC Educational Resources Information Center

    Jarmolowicz, David P.; Kahng, SungWoo; Ingvarsson, Einar T.; Goysovich, Richard; Heggemeyer, Rebecca; Gregory, Meagan K.

    2008-01-01

    Problem behaviors present a significant challenge for individuals with developmental disabilities and their caregivers. Interventions based on behavioral principles are effective in treating problem behaviors; however, some caregivers have difficulty adhering to treatment recommendations. Treatment adherence may be affected by the technical nature…

  6. Treatment of Sexual Disorders in the 1990s: An Integrated Approach.

    ERIC Educational Resources Information Center

    Rosen, Raymond C.; Leiblum, Sandra R.

    1995-01-01

    Reviews existing data regarding the etiology and treatment of male and female sexual dysfunctions. Discusses the use of multidimensional assessment models, especially in the evaluation of erectile dysfunction and sexual pain disorders. Despite the conceptual and technological sophistication of current approaches, treatment outcomes are…

  7. Integrated Waste Treatment Unit (IWTU) Input Coal Analyses and Off-Gass Filter (OGF) Content Analyses

    SciTech Connect

    Jantzen, Carol M.; Missimer, David M.; Guenther, Chris P.; Shekhawat, Dushyant; VanEssendelft, Dirk T.; Means, Nicholas C.

    2015-04-23

    A full engineering scale Fluidized Bed Steam Reformer (FBSR) system is being used at the Idaho Nuclear Technology and Engineering Center (INTEC) to stabilize acidic Low Activity Waste (LAW) known as Sodium Bearing Waste (SBW). The INTEC facility, known as the Integrated Waste Treatment Unit (IWTU), underwent an Operational Readiness Review (ORR) and a Technology Readiness Assessment (TRA) in March 2014. The IWTU began non-radioactive simulant processing in late 2014 and by January, 2015 ; the IWTU had processed 62,000 gallons of simulant. The facility is currently in a planned outage for inspection of the equipment and will resume processing simulated waste feed before commencing to process 900,000 gallons of radioactive SBW. The SBW acidic waste will be made into a granular FBSR product (carbonate based) for disposal in the Waste Isolation Pilot Plant (WIPP). In the FBSR process calcined coal is used to create a CO2 fugacity to force the waste species to convert to carbonate species. The quality of the coal, which is a feed input, is important because the reactivity, moisture, and volatiles (C,H,N,O, and S) in the coal impact the reactions and control of the mineralizing process in the primary steam reforming vessel, the Denitration and Mineralizing Reformer (DMR). Too much moisture in the coal can require that additional coal be used. However since moisture in the coal is only a small fraction of the moisture from the fluidizing steam this can be self-correcting. If the coal reactivity or heating value is too low then the coal feedrate needs to be adjusted to achieve the desired heat generation. Too little coal and autothermal heat generation in the DMR cannot be sustained and/or the carbon dioxide fugacity will be too low to create the desired carbonate mineral species. Too much coal and excess S and hydroxide species can form. Excess sulfur from coal that (1) is too rich in sulfur or (2) from overfeeding coal can promote wall scale and contribute to corrosion

  8. Integral dose investigation of non-coplanar treatment beam geometries in radiotherapy

    SciTech Connect

    Nguyen, Dan; Dong, Peng; Ruan, Dan; Low, Daniel A.; Sheng, Ke; Long, Troy; Romeijn, Edwin

    2014-01-15

    Purpose: Automated planning and delivery of non-coplanar plans such as 4π radiotherapy involving a large number of fields have been developed to take advantage of the newly available automated couch and gantry on C-arm gantry linacs. However, there is an increasing concern regarding the potential changes in the integral dose that needs to be investigated. Methods: A digital torso phantom and 22 lung and liver stereotactic body radiation therapy (SBRT) patients were included in the study. The digital phantom was constructed as a water equivalent elliptical cylinder with a major axis length of 35.4 cm and minor axis of 23.6 cm. A 4.5 cm diameter target was positioned at varying depths along the major axis. Integral doses from intensity modulated, non-coplanar beams forming a conical pattern were compared against the equally spaced coplanar beam plans. Integral dose dependence on the phantom geometry and the beam number was also quantified. For the patient plans, the non-coplanar and coplanar beams and fluences were optimized using a column generation and pricing approach and compared against clinical VMAT plans using two full (lung) or partial coplanar arcs (liver) entering at the side proximal to the tumor. Both the average dose to the normal tissue volume and the total volumes receiving greater than 2 Gy (V2) and 5 Gy (V5) were evaluated and compared. Results: The ratio of integral dose from the non-coplanar and coplanar plans depended on the tumor depth for the phantom; for tumors shallower than 10 cm, the non-coplanar integral doses were lower than coplanar integral doses for non-coplanar angles less than 60°. Similar patterns were observed in the patient plans. The smallest non-coplanar integral doses were observed for tumor 6–8 cm deep. For the phantom, the integral dose was independent of the number of beams, consistent with the liver SBRT patients but the lung SBRT patients showed slight increase in the integral dose when more beams were used. Larger

  9. Evaluating the Role of Seed Treatments in Canola/Oilseed Rape Production: Integrated Pest Management, Pollinator Health, and Biodiversity.

    PubMed

    Sekulic, Gregory; Rempel, Curtis B

    2016-01-01

    The use patterns and role of insecticide seed treatments, with focus on neonicotinoid insecticides, were examined for canola/oilseed rape production in Canada and the EU. Since nearly all planted canola acres in Western Canada and, historically, a majority of planted oilseed acres in the EU, use seed treatments, it is worth examining whether broad use of insecticidal seed treatments (IST) is compatible with principles of integrated pest management (IPM). The neonicotinoid insecticide (NNI) seed treatment (NNI ST) use pattern has risen due to effective control of several early season insect pests, the most destructive being flea beetles (Phyllotreta sp.). Negative environmental impact and poor efficacy of foliar applied insecticides on flea beetles led growers to look for better alternatives. Due to their biology, predictive models have been difficult to develop for flea beetles, and, therefore, targeted application of seed treatments, as part of an IPM program, has contributed to grower profitability and overall pollinator success for canola production in Western Canada. Early evidence suggests that the recent restriction on NNI may negatively impact grower profitability and does not appear to be having positive impact on pollinator health. Further investigation on impact of NNI on individual bee vs. hive health need to be conducted. Predictive models for flea beetle emergence/feeding activity in canola/oilseed rape need to be developed, as broad acre deployment of NNI seed treatments may not be sustainable due to concerns about resistance/tolerance in flea beetles and other pest species. PMID:27527233

  10. A path-integral Langevin equation treatment of low-temperature doped helium clusters

    NASA Astrophysics Data System (ADS)

    Ing, Christopher; Hinsen, Konrad; Yang, Jing; Zeng, Toby; Li, Hui; Roy, Pierre-Nicholas

    2012-06-01

    We present an implementation of path integral molecular dynamics for sampling low temperature properties of doped helium clusters using Langevin dynamics. The robustness of the path integral Langevin equation and white-noise Langevin equation [M. Ceriotti, M. Parrinello, T. E. Markland, and D. E. Manolopoulos, J. Chem. Phys. 133, 124104 (2010)], 10.1063/1.3489925 sampling methods are considered for those weakly bound systems with comparison to path integral Monte Carlo (PIMC) in terms of efficiency and accuracy. Using these techniques, convergence studies are performed to confirm the systematic error reduction introduced by increasing the number of discretization steps of the path integral. We comment on the structural and energetic evolution of HeN-CO2 clusters from N = 1 to 20. To quantify the importance of both rotations and exchange in our simulations, we present a chemical potential and calculated band origin shifts as a function of cluster size utilizing PIMC sampling that includes these effects. This work also serves to showcase the implementation of path integral simulation techniques within the molecular modelling toolkit [K. Hinsen, J. Comp. Chem. 21, 79 (2000)], 10.1002/(SICI)1096-987X(20000130)21:2<79::AID-JCC1>3.0.CO;2-B, an open-source molecular simulation package.

  11. Integrative Psychotherapy for Schizophrenia: Its Potential for a Central Role in Recovery Oriented Treatment.

    PubMed

    Lysaker, Paul H; Roe, David

    2016-02-01

    Research has affirmed that recovery from serious mental illnesses (SMI), such as schizophrenia, is a common outcome and often involves subjective changes in the experience of self, one's identity, and one's sense of agency in the world. Although many different interventions have been developed and validated, efforts to consider how those interventions should be integrated to assist people to direct their own recovery have been limited. This article considers the 5 case reports of psychotherapy presented in this special issue that have sought to integrate scientifically valid approaches within a recovery frame work. Exploring shared themes, this article suggests that a common set of processes exists between these examples of integrative work. These include therapist acceptance of a vulnerable stance in the face of uncertainty, which rejects stigma and remains open to knowing the person. This ultimately allows the kinds of meaning to be made jointly between the therapist and client that promote recovery. PMID:26641411

  12. Integration of microbial fuel cell techniques into activated sludge wastewater treatment processes to improve nitrogen removal and reduce sludge production.

    PubMed

    Gajaraj, Shashikanth; Hu, Zhiqiang

    2014-12-01

    Bioelectrochemical systems are emerging for wastewater treatment, yet little is known about how well they can be integrated with current wastewater treatment processes. In this bench-scale study, the microbial fuel cell (MFC) technique was incorporated into the Modified Ludzack-Ettinger (MLE) process (phase I) and later with the membrane bioreactor (MBR) process (phase II) to evaluate the performance of MFC assisted wastewater treatment systems (i.e., MLE-MFC and MBR-MFC). There was no significant difference in the effluent NH4(+)-N concentration between the systems integrating MFC and the open circuit controls. The average effluent COD concentration was significantly lower in the MLE-MFC, but it did not change much in the MBR-MFC because of the already low COD concentrations in MBR operation. The MLE-MFC and MBR-MFC systems increased the NO3(-)-N removal efficiencies by 31% (±12%) and 20% (±12%), respectively, and reduced sludge production by 11% and 6%, respectively, while generating an average voltage of 0.13 (±0.03) V in both systems. Analysis of the bacterial specific oxygen uptake rate, the sludge volume index, and ammonia-oxidizing bacterial population (dominated by Nitrosomonas through terminal restriction fragment length polymorphism analysis) indicated that there was no significant difference in sludge activity, settling property, and nitrifying community structure between the MFC assisted systems and the open circuit controls. The results suggest that the wastewater treatment systems could achieve higher effluent water quality and lower sludge production if it is integrated well with MFC techniques. PMID:25014565

  13. Integrating Fasciolosis Control in the Dry Cow Management: The Effect of Closantel Treatment on Milk Production

    PubMed Central

    Charlier, Johannes; Hostens, Miel; Jacobs, Jos; Van Ranst, Bonny; Duchateau, Luc; Vercruysse, Jozef

    2012-01-01

    The liver fluke Fasciola hepatica is a parasite of ruminants with a worldwide distribution and an apparent increasing incidence in EU member states. Effective control in dairy cattle is hampered by the lack of flukicides with a zero-withdrawal time for milk, leaving the dry period as the only time that preventive treatment can be applied. Here, we present the results of a blinded, randomized and placebo-controlled trial on 11 dairy herds (402 animals) exposed to F. hepatica to 1) assess the effect of closantel treatment at dry-off (or 80–42 days before calving in first-calving heifers) on milk production parameters and 2) evaluate if a number of easy-to-use animal parameters is related to the milk production response after treatment. Closantel treatment resulted in a noticeable decrease of anti-F. hepatica antibody levels from 3–6 months after treatment onwards, a higher peak production (1.06 kg) and a slightly higher persistence (9%) of the lactation, resulting in a 305-day milk production increase of 303 kg. No effects of anthelmintic treatment were found on the average protein and fat content of the milk. Milk production responses after treatment were poor in meagre animals and clinically relevant higher milk production responses were observed in first-lactation animals and in cows with a high (0.3–0.5 optical density ratio (ODR)), but not a very high (≥0.5 ODR) F. hepatica ELISA result on a milk sample from the previous lactation. We conclude that in dairy herds exposed to F. hepatica, flukicide treatment at dry-off is a useful strategy to reduce levels of exposure and increase milk production in the subsequent lactation. Moreover, the results suggest that treatment approaches that only target selected animals within a herd can be developed based on easy-to-use parameters. PMID:22916226

  14. The treatment of climate science in Integrated Assessment Modelling: integration of climate step function response in an energy system integrated assessment model.

    NASA Astrophysics Data System (ADS)

    Dessens, Olivier

    2016-04-01

    Integrated Assessment Models (IAMs) are used as crucial inputs to policy-making on climate change. These models simulate aspect of the economy and climate system to deliver future projections and to explore the impact of mitigation and adaptation policies. The IAMs' climate representation is extremely important as it can have great influence on future political action. The step-function-response is a simple climate model recently developed by the UK Met Office and is an alternate method of estimating the climate response to an emission trajectory directly from global climate model step simulations. Good et al., (2013) have formulated a method of reconstructing general circulation models (GCMs) climate response to emission trajectories through an idealized experiment. This method is called the "step-response approach" after and is based on an idealized abrupt CO2 step experiment results. TIAM-UCL is a technology-rich model that belongs to the family of, partial-equilibrium, bottom-up models, developed at University College London to represent a wide spectrum of energy systems in 16 regions of the globe (Anandarajah et al. 2011). The model uses optimisation functions to obtain cost-efficient solutions, in meeting an exogenously defined set of energy-service demands, given certain technological and environmental constraints. Furthermore, it employs linear programming techniques making the step function representation of the climate change response adapted to the model mathematical formulation. For the first time, we have introduced the "step-response approach" method developed at the UK Met Office in an IAM, the TIAM-UCL energy system, and we investigate the main consequences of this modification on the results of the model in term of climate and energy system responses. The main advantage of this approach (apart from the low computational cost it entails) is that its results are directly traceable to the GCM involved and closely connected to well-known methods of

  15. Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG): toward integrated treatment of symptoms related to traumatic loss

    PubMed Central

    Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.

    2015-01-01

    Background Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components. PMID:26154434

  16. Integrated water quality, emergy and economic evaluation of three bioremediation treatment systems for eutrophic water

    EPA Science Inventory

    This study was targeted at finding one or more environmentally efficient, economically feasible and ecologically sustainable bioremediation treatment modes for eutrophic water. Three biological species, i.e. water spinach (Ipomoea aquatica), loach (Misgurus anguillicaudatus) and ...

  17. An integrated system to remote monitor and control anaerobic wastewater treatment plants through the internet.

    PubMed

    Bernard, O; Chachuat, B; Hélias, A; Le Dantec, B; Sialve, B; Steyer, J-P; Lardon, L; Neveu, P; Lambert, S; Gallop, J; Dixon, M; Ratini, P; Quintabà, A; Frattesi, S; Lema, J M; Roca, E; Ruiz, G; Rodriguez, J; Franco, A; Vanrolleghem, P; Zaher, U; De Pauw, D J W; De Neve, K; Lievens, K; Dochaine, D; Schoefs, O; Fibrianto, H; Farina, R; Alcaraz Gonzalez, V; Gonzalez Alvarez, V; Lemaire, P; Martinez, J A; Esandi, F; Duclaud, O; Lavigne, J F

    2005-01-01

    The TELEMAC project brings new methodologies from the Information and Science Technologies field to the world of water treatment. TELEMAC offers an advanced remote management system which adapts to most of the anaerobic wastewater treatment plants that do not benefit from a local expert in wastewater treatment. The TELEMAC system takes advantage of new sensors to better monitor the process dynamics and to run automatic controllers that stabilise the treatment plant, meet the depollution requirements and provide a biogas quality suitable for cogeneration. If the automatic system detects a failure which cannot be solved automatically or locally by a technician, then an expert from the TELEMAC Control Centre is contacted via the internet and manages the problem. PMID:16180464

  18. Integrated Chemical and Toxicological Investigation of UV-Chlorine/Chloramine Drinking Water Treatment

    EPA Science Inventory

    As the use of alternative drinking water treatment increases, it is important to understand potential public health•implications associated with these processes. The objective of this study was to evaluate the formation of disinfection byproducts (DBPs) and cytotoxicity of ...

  19. Integrated fungal biomass and activated sludge treatment for textile wastewaters bioremediation.

    PubMed

    Anastasi, Antonella; Spina, Federica; Romagnolo, Alice; Tigini, Valeria; Prigione, Valeria; Varese, Giovanna Cristina

    2012-11-01

    A combined biological process was investigated for effective textile wastewater treatment. The process consisted of a first step performed by selected fungal biomasses, mainly devoted to the effluent decolourisation, and of a subsequent stage by means of activated sludge, in order to reduce the remaining COD and toxicity. In particular, the treatment with Trametes pubescens MUT 2400, selected over nine strains, achieved very good results in respect to all parameters. The final scale-up phase in a moving bed bioreactor with the supported biomass of the fungus allowed to verify the effectiveness of the treatment with high volumes. Despite promising results, further steps must be taken in order to optimize the use of these biomasses for a full exploitation of their oxidative potential in textile wastewater treatment. PMID:22940306

  20. Juvenile Drug Court: Enhancing Outcomes by Integrating Evidence-Based Treatments

    ERIC Educational Resources Information Center

    Henggeler, Scott W.; Halliday-Boykins, Colleen A.; Cunningham, Phillippe B.; Randall, Jeff; Shapiro, Steven B.; Chapman, Jason E.

    2006-01-01

    Evaluated the effectiveness of juvenile drug court for 161 juvenile offenders meeting diagnostic criteria for substance abuse or dependence and determined whether the integration of evidence-based practices enhanced the outcomes of juvenile drug court. Over a 1-year period, a four-condition randomized design evaluated outcomes for family court…

  1. Violence Survivors with Posttraumatic Stress Disorder: Treatment by Integrating Existential and Narrative Therapies

    ERIC Educational Resources Information Center

    Day, Kristen W.

    2009-01-01

    In this article, the author proposes an integration of existential and narrative therapies with current evidence-supported approaches to treating the aforementioned population. First, she briefly defines interpersonal violence, then provides a history and review of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), which frequently…

  2. K East Basin sludge volume estimates for integrated water treatment system

    SciTech Connect

    Pitner, A.L.

    1998-08-12

    Estimates were made of the volume of sludge expected from Integrated Process Strategy (IPS) processing fuel elements and in the fuel storage canisters in K East Basin, These were based on visual observations of fuel element condition in the basin and laboratory measurements of canister sludge density. The estimates, made in early 1997, are reviewed and the basic assumptions used discussed.

  3. Integrating Positive Peer Culture into the Residential Treatment Center and Public School Curriculum: Suggestions for Practice.

    ERIC Educational Resources Information Center

    Donlevy, James G.; Weissman, Geraldine

    1992-01-01

    A school-based approach to Positive Peer Culture (PPC) is most successful if integrated into academic curriculum. Examples of incorporating PPC into English, math, social studies, and science show how students can learn to think analytically about PPC's 12 problem areas. (SK)

  4. Comparison of Behavioral Intervention and Sensory-Integration Therapy in the Treatment of Challenging Behavior

    ERIC Educational Resources Information Center

    Devlin, Sarah; Healy, Olive; Leader, Geraldine; Hughes, Brian M.

    2011-01-01

    The objective of the current study was to compare the effects of sensory-integration therapy (SIT) and a behavioral intervention on rates of challenging behavior (including self-injurious behavior) in four children diagnosed with Autism Spectrum Disorder. For each of the participants a functional assessment was conducted to identify the variables…

  5. An integrative review of attention biases and their contribution to treatment for anxiety disorders

    PubMed Central

    Barry, Tom J.; Vervliet, Bram; Hermans, Dirk

    2015-01-01

    Models of exposure therapy, one of the key components of cognitive behavioral therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians. PMID:26217284

  6. Optimized matching modes of bioelectrochemical module and anaerobic sludge in the integrated system for azo dye treatment.

    PubMed

    Kong, Fanying; Wang, Aijie; Ren, Hong-Yu

    2015-09-01

    In this work, three matching modes (relative positions, catholyte flow sequences, and flow regimes) of bioelectrochemical module and anaerobic sludge were evaluated and optimized for azo dye treatment in the integrated system with embedding modular bioelectrochemical system into anaerobic sludge reactor. Results showed that it was favorable to operate this integrated system under the condition of 1/4 cathode soaking into sludge with spiral distributor in down-flow direction. Current, electrochemical impedance spectroscopy and pH clearly demonstrated the important role of 1/4 soaking in electron/proton transfer. The down-flow direction flowed through electrode zone and then sludge zone could benefit to the efficient use of cathode and improve AO7 treatment. Furthermore, the positive effect of spiral catholyte distributor might be due to its promoting role in mixing and creating a spiral flow channel around the cathode electrode-microbes-solution interface. These results exhibited great potential for matching modular bioelectrochemical system with anaerobic treatment process. PMID:26080106

  7. Integrating Family-Based Treatment and Dialectical Behavior Therapy for Adolescent Bulimia Nervosa: Preliminary Outcomes of an Open Pilot Trial.

    PubMed

    Murray, Stuart B; Anderson, Leslie K; Cusack, Anne; Nakamura, Tiffany; Rockwell, Roxanne; Griffiths, Scott; Kaye, Walter H

    2015-01-01

    Adolescent bulimia nervosa (BN) remains relatively understudied, and the complex interaction between core eating psychopathology and emotional regulation difficulties provides ongoing challenges for full symptom remission. In an open pilot trial, we aimed to investigate the efficacy of a program integrating family-based treatment (FBT) and dialectical behavior therapy (DBT) in treating adolescent BN, without exclusion criteria. Participants were 35 adolescents who underwent partial hospital treatment for BN, and outcomes included measures of core BN pathology and emotional regulation difficulties, as well as parental measures of self-efficacy, completed at intake and discharge. Results indicate significant improvements in overall eating disorder pathology, t(68) = 4.52, p = .002, and in core BN symptoms, including objective binge episodes, t(68) = 2.01, p = .041, and self-induced vomiting, t(68) = 2.90, p = .005. Results also illustrated a significant increase in parental efficacy throughout the course of treatment, t(20) = .081, p = .001, although no global improvement in difficulties in emotion regulation was noted, t(68) = 1.12, p = .285. These preliminary findings support the utility of this integration of FBT and DBT, although raise interesting questions as to the mechanism of symptom remission. PMID:26009971

  8. Risk assessment of Giardia from a full scale MBR sewage treatment plant caused by membrane integrity failure.

    PubMed

    Zhang, Yu; Chen, Zhimin; An, Wei; Xiao, Shumin; Yuan, Hongying; Zhang, Dongqing; Yang, Min

    2015-04-01

    Membrane bioreactors (MBR) are highly efficient at intercepting particles and microbes and have become an important technology for wastewater reclamation. However, many pathogens can accumulate in activated sludge due to the long residence time usually adopted in MBR, and thus may pose health risks when membrane integrity problems occur. This study presents data from a survey on the occurrence of water-borne Giardia pathogens in reclaimed water from a full-scale wastewater treatment plant with MBR experiencing membrane integrity failure, and assessed the associated risk for green space irrigation. Due to membrane integrity failure, the MBR effluent turbidity varied between 0.23 and 1.90 NTU over a period of eight months. Though this turbidity level still met reclaimed water quality standards (≤5 NTU), Giardia were detected at concentrations of 0.3 to 95 cysts/10 L, with a close correlation between effluent turbidity and Giardia concentration. All β-giardin gene sequences of Giardia in the WWTP influents were genotyped as Assemblages A and B, both of which are known to infect humans. An exponential dose-response model was applied to assess the risk of infection by Giardia. The risk in the MBR effluent with chlorination was 9.83×10(-3), higher than the acceptable annual risk of 1.0×10(-4). This study suggested that membrane integrity is very important for keeping a low pathogen level, and multiple barriers are needed to ensure the biological safety of MBR effluent. PMID:25872734

  9. An integrated modelling concept for immission-based management of sewer system, wastewater treatment plant and river.

    PubMed

    Erbe, V; Schütze, M

    2005-01-01

    Today's planning standards deal with the individual urban drainage components (sewer system, wastewater treatment plant and receiving water) separately, i.e. they are often designed and operated as single components. As opposed to this, an integral handling considers the drainage components jointly. This novel approach allows a holistic and more sustainable planning of urban drainage systems. This paper presents an integrated modelling concept. The aim is to analyse fluxes through the total wastewater system and to integrate pollution-based control in the upstream direction, that is, e.g., managing the combined water retention tanks as a function of state variables in the WWTP or the receiving water. All models of the different subsystems are based on the Activated Sludge Model (ASM) concept of IWA, including River Water Quality Model No. 1 (RWOM). Simulations can be done in truly parallel mode using the simulation environment SIMBA. The integrated modelling concept is applied to the river Dhuenn and the urban wastewater system of the municipality of Odenthal (Germany). An optimised operation of the system using RTC proves to be a very effective measure. PMID:16248185

  10. Going beyond the BCS level in the superfluid path integral: A consistent treatment of electrodynamics and thermodynamics

    NASA Astrophysics Data System (ADS)

    Anderson, Brandon M.; Boyack, Rufus; Wu, Chien-Te; Levin, K.

    2016-05-01

    In this Rapid Communication we derive the full gauge-invariant electromagnetic response beyond the BCS level using the fermionic superfluid path integral. In the process we identify and redress a failure to satisfy the compressibility sum rule; this shortcoming is associated with the conventional path-integral formulation of BCS-level electrodynamics. The approach in this paper builds on an alternative saddle point scheme. At the mean field level, this leads to the well known gauge-invariant electrodynamics of BCS theory and to the satisfaction of the compressibility sum rule. Moreover, this scheme can be readily extended to address arbitrary higher order fluctuation theories (for example, at the Gaussian level.) At any level this approach will lead to a gauge invariant and compressibility sum rule consistent treatment of electrodynamics and thermodynamics.

  11. Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach

    PubMed Central

    Taw, Lawrence

    2015-01-01

    A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptoms are consistent with damage to the visceral parasympathetic nervous system. Interestingly, many studies evaluating the mechanisms of acupuncture point to restoration of parasympathetic tone as a mechanism of action. In this article, we describe a case of complex functional gastrointestinal disorders associated with posttraumatic autonomic neuropathy that was refractory to pharmacotherapy and was successfully treated with an integrative East-West approach PMID:26331105

  12. Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach.

    PubMed

    Shubov, Andrew; Taw, Lawrence

    2015-07-01

    A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptoms are consistent with damage to the visceral parasympathetic nervous system. Interestingly, many studies evaluating the mechanisms of acupuncture point to restoration of parasympathetic tone as a mechanism of action. In this article, we describe a case of complex functional gastrointestinal disorders associated with posttraumatic autonomic neuropathy that was refractory to pharmacotherapy and was successfully treated with an integrative East-West approach. PMID:26331105

  13. The integration of constructed wetlands into a treatment system for airport runoff.

    PubMed

    Revitt, D M; Worral, P; Brewer, D

    2001-01-01

    A new surface runoff treatment system has been designed for London Heathrow Airport, which incorporates separate floating constructed wetlands or reedbeds and sub-surface flow constructed wetlands as major pollutant removal systems. The primary requirement of the newly developed treatment system is to control the concentrations of glycols following their use as de-icers and anti-icers within the airport. The ability of reedbeds to contribute to this treatment role was fully tested through pilot scale, on-site experiments over a 2 year period. The average reductions in runoff BOD concentrations achieved by pilot scale surface flow and sub-surface flow reedbeds were 30.9% and 32.9%, respectively. The corresponding average glycol removal efficiencies were 54.2% and 78.3%, following shock dosing inputs. These treatment performances are used to predict the required full scale constructed wetland surface areas needed to attain the desired effluent water quality. The treatment system also incorporates aeration, storage and, combined with reedbed technology, has been designed to reduce a mixed inlet BOD concentration of 240 mg/l to less than 40 mg/l for water temperatures varying between 6 degrees C and 20 degrees C. PMID:11804136

  14. An integrated approach for monitoring efficiency and investments of activated sludge-based wastewater treatment plants at large spatial scale.

    PubMed

    De Gisi, Sabino; Sabia, Gianpaolo; Casella, Patrizia; Farina, Roberto

    2015-08-01

    WISE, the Water Information System for Europe, is the web-portal of the European Commission (EU) that disseminates the quality state of the receiving water bodies and the efficiency of the municipal wastewater treatment plants (WWTPs) in order to monitor advances in the application of both the Water Framework Directive (WFD) as well as the Urban Wastewater Treatment Directive (UWWTD). With the intention to develop WISE applications, the aim of the work was to define and apply an integrated approach capable of monitoring the efficiency and investments of activated sludge-based WWTPs located in a large spatial area, providing the following outcomes useful to the decision-makers: (i) the identification of critical facilities and their critical processes by means of a Performance Assessment System (PAS), (ii) the choice of the most suitable upgrading actions, through a scenario analysis. (iii) the assessment of the investment costs to upgrade the critical WWTPs and (iv) the prioritization of the critical facilities by means of a multi-criteria approach which includes the stakeholders involvement, along with the integration of some technical, environmental, economic and health aspects. The implementation of the proposed approach to a high number of municipal WWTPs highlighted how the PAS developed was able to identify critical processes with a particular effectiveness in identifying the critical nutrient removal ones. In addition, a simplified approach that considers the cost related to a basic-configuration and those for the WWTP integration, allowed to link the critical processes identified and the investment costs. Finally, the questionnaire for the acquisition of data such as that provided by the Italian Institute of Statistics, the PAS defined and the database on the costs, if properly adapted, may allow for the extension of the integrated approach on an EU-scale by providing useful information to water utilities as well as institutions. PMID:25863511

  15. (+/-)-3,4-Methylenedioxymethamphetamine treatment in adult rats impairs path integration learning: a comparison of single vs once per week treatment for 5 weeks.

    PubMed

    Skelton, Matthew R; Able, Jessica A; Grace, Curtis E; Herring, Nicole R; Schaefer, Tori L; Gudelsky, Gary A; Vorhees, Charles V; Williams, Michael T

    2008-12-01

    3,4-Methlylenedioxymethamphetamine (MDMA) administration (4 x 15 mg/kg) on a single day has been shown to cause path integration deficits in rats. While most animal experiments focus on single binge-type models of MDMA use, many MDMA users take the drug on a recurring basis. The purpose of this study was to compare the effects of repeated single-day treatments with MDMA (4 x 15 mg/kg) once weekly for 5 weeks to animals that only received MDMA on week 5 and saline on weeks 1-4. In animals treated with MDMA for 5 weeks, there was an increase in time spent in the open area of the elevated zero maze suggesting a decrease in anxiety or increase in impulsivity compared to the animals given MDMA for 1 week and saline treated controls. Regardless of dosing regimen, MDMA treatment produced path integration deficits as evidenced by an increase in latency to find the goal in the Cincinnati water maze. Animals treated with MDMA also showed a transient hypoactivity that was not present when the animals were re-tested at the end of cognitive testing. In addition, both MDMA-treated groups showed comparable hyperactive responses to a later methamphetamine challenge. No differences were observed in spatial learning in the Morris water maze during acquisition or reversal but MDMA-related deficits were seen on reduced platform-size trials. Taken together, the data show that a single-day regimen of MDMA induces deficits similar to that of multiple weekly treatments. PMID:18674550

  16. Integration of cancer genomics with treatment selection: from the genome to predictive biomarkers

    PubMed Central

    Ow, Thomas J.; Sandulache, Vlad C.; Skinner, Heath D.; Myers, Jeffrey N.

    2013-01-01

    The field of cancer genomics is rapidly advancing as new technology provides detailed genetic and epigenetic profiling of human cancers. The amount of new data available describing the genetic make-up of tumors is paralleled by rapid advances in drug discovery and molecular therapy currently under investigation to treat these diseases. This review summarizes the challenges and approaches associated with the integration of genomic data into the development of new biomarkers in the management of cancer. PMID:24037788

  17. Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

    PubMed

    Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

    2016-01-01

    The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa. PMID:26467107

  18. [Towards an integrated approach to cardiovascular toxicities related to the treatments of breast cancer].

    PubMed

    Tanz, Rachid; Magne, Nicolas; Annede, Pierre; Mery, Benoite; Jacob, Julian; Bauduceau, Olivier; Trone, Jane-Chloé; Guichard, Jean-Baptiste; Meillan, Nicolas; Kirova, Youlia; Vedrine, Lionel; Chargari, Cyrus

    2014-01-01

    There is an increasing number of therapeutic options in breast cancer management. While prognosis improves, the cardiac toxicity related to treatments remains a significant issue. This toxicity has several clinical presentations and can be explained by complex and diverse molecular mechanisms. Systemic treatments (anthracyclines, inhibitors of HER2 signaling pathway, hormone therapy, antiangiogenic agents) and radiotherapy have their own cardiac toxicity. However, the toxicities associated with these treatments may potentiate together and the existence of pre-existing cardiovascular risk factors should be taken into account. The assessment of cardiac hazard evolves toward a multifactorial approach. Several possibilities exist to minimize the incidence of cardiac complications. Those include pharmacological and technological innovations, but also a more accurate selection of patients and a growing involvement of practitioners in the field of cardiac toxicity, which is prerequisite for an early management of cardiac events. PMID:25091656

  19. Software Configuration Management Plan for the K West Basin Integrated Water Treatment System (IWTS) Project A.9

    SciTech Connect

    GREEN, J.W.

    2000-05-01

    This document provides a configuration control plan for the software associated with the operation and control of the Integrated Water Treatment System (IWTS). It establishes requirements for ensuring configuration item identification, configuration control, configuration status accounting, defect reporting and resolution of computer software. It is written to comply with HNF-SD-SNF-CM-001, Spent Nuclear Fuel Configuration Management Plan (Forehand 1998) and HNF-PRO-309 Computer Software Quality Assurance Requirements, and applicable sections of administrative procedure CM-6-037-00, SNF Project Process Automation Software and Equipment.

  20. Evaluation of Family Impairment Following an Integrative Treatment Program for Children with Autism

    ERIC Educational Resources Information Center

    Lambert, Ashley Nehrt

    2012-01-01

    Research has shown that behaviors associated with Autism Spectrum Disorder (ASD) are a consistent source of stress on the family unit. Given the increased amount of stress that families endure and the importance of the family unit to the child with ASD, treatment programs should not only take the child with ASD's needs into account, but also…

  1. Treatment of Childhood and Adolescent Obesity: An Integrative Review of Recent Recommendations from Five Expert Groups

    ERIC Educational Resources Information Center

    Kirschenbaum, Daniel S.; Gierut, Kristen

    2013-01-01

    Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity. Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and…

  2. Integrated chemical and toxicological investigation of UV-chlorine/chloramine drinking water treatment.

    PubMed

    Lyon, Bonnie A; Milsk, Rebecca Y; DeAngelo, Anthony B; Simmons, Jane Ellen; Moyer, Mary P; Weinberg, Howard S

    2014-06-17

    As the use of alternative drinking water treatment increases, it is important to understand potential public health implications associated with these processes. The objective of this study was to evaluate the formation of disinfection byproducts (DBPs) and cytotoxicity of natural organic matter (NOM) concentrates treated with chlorine, chloramine, and medium pressure ultraviolet (UV) irradiation followed by chlorine or chloramine, with and without nitrate or iodide spiking. The use of concentrated NOM conserved volatile DBPs and allowed for direct analysis of the treated water. Treatment with UV prior to chlorine in ambient (unspiked) samples did not affect cytotoxicity as measured using an in vitro normal human colon cell (NCM460) assay, compared to chlorination alone when toxicity is expressed on the basis of dissolved organic carbon (DOC). Nitrate-spiked UV+chlorine treatment produced greater cytotoxicity than nitrate-spiked chlorine alone or ambient UV+chlorine samples, on both a DOC and total organic halogen basis. Samples treated with UV+chloramine were more cytotoxic than those treated with only chloramine using either dose metric. This study demonstrated the combination of cytotoxicity and DBP measurements for process evaluation in drinking water treatment. The results highlight the importance of dose metric when considering the relative toxicity of complex DBP mixtures formed under different disinfection scenarios. PMID:24840005

  3. Production integrated treatment of textile wastewater by closing raw material cycles.

    PubMed

    Krull, R

    2005-01-01

    A method for the in-house treatment of partial wastewater flows and the recycling of treated process water into the textile finishing process was developed in order to recycle effluents from textile finishing industry and feed them back into the production process. The method is based on a two-stage biological anaerobic-aerobic process to split colouring wastewater agents and to degrade organic substances contained in the water as well as a chemical stage to remove the remaining color of the water with the help of ozone. In the framework of a research and development project a demonstration plant for a treatment capacity of 1440 m3 per working day was installed and started in a textile finishing company. At the plant, a wastewater flow and a recycling flow are treated separately in two different treatment lanes. Approximately 40% of the total wastewater flows, i.e. 576 m3/d are treated in the wastewater lane, and a maximum of 60% of total wastewater, i.e. 864 m3/d are treated in the recycling lane. Thanks to the preliminary treatment of wastewater flows, which are discharged into the municipal sewage works, a reduction of average COD levels in the sewage works effluents could be achieved. PMID:16459804

  4. The Substance Abuse Treatment Needs of Prisoners: Implementation of an Integrated Statewide Approach

    ERIC Educational Resources Information Center

    Kubiak, Sheryl Pimlott; Boyd, Carol J.; Slayden, Janie; Young, Amy

    2005-01-01

    Studies have demonstrated that treatment for drug-involved offenders can reduce relapse and recidivism. However, few institutions utilize validated assessments of drug dependence, limiting the ability to determine and prioritize services. Toward this goal, we explain an assessment method implemented statewide using a sample of 22,069 prisoners.…

  5. Perspectives--Talking with Practitioners: How to Integrate Best Practices with Evidence-Based Treatment

    ERIC Educational Resources Information Center

    Cohen, Richard

    2012-01-01

    Evidence-based treatments are increasingly important and necessary parts of many disciplines when working with very young children and their families. In using them, it is advantageous to be grounded in the principles and practices that research has shown are critical to children's healthy development, particularly the importance of supporting the…

  6. Policy Issues for Integrating Parenting Interventions and Addiction Treatment for Women.

    ERIC Educational Resources Information Center

    VanBremen, Jane R.; Chasnoff, Ira J.

    1994-01-01

    This article addresses the rationale for linking addiction treatment programs and parenting education interventions in substance-abusing families. Specific components of a parenting program for women in recovery are detailed, including parenting classes and support groups, mother-child play groups, and family literacy activities. Program…

  7. Integrated and Holistic Treatment Approach to PTSD and SUD: A Synergy

    ERIC Educational Resources Information Center

    Weis, Melanie

    2010-01-01

    Individuals living with posttraumatic stress disorder (PTSD) and addiction experience a complex and dynamic interaction of symptoms from both diagnoses. However, heretofore, each diagnosis has been approached as if it were a separate treatment consideration. Therefore, an individual may be treated for either a substance use disorder (SUD) or PTSD,…

  8. Neuromodulation integrating rTMS and neurofeedback for the treatment of autism spectrum disorder: An exploratory study

    PubMed Central

    Sokhadze, Estate M.; El-Baz, Ayman S.; Tasman, Allan; Sears, Lonnie L.; Wang, Yao; Lamina, Eva V.; Casanova, Manuel F.

    2014-01-01

    Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social interaction, language, stereotyped behaviors, and restricted range of interests. In previous studies low frequency repetitive transcranial magnetic stimulation (rTMS) has been used, with positive behavioral and electrophysiological results, for the experimental treatment in ASD. In this study we combined prefrontal rTMS sessions with electroencephalographic (EEG) neurofeedback (NFB) to prolong and reinforce TMS-induced EEG changes. The pilot trial recruited 42 children with ASD (~14.5 yrs). Outcome measures included behavioral evaluations and reaction time test with event-related potential (ERP) recording. For the main goal of this exploratory study we used rTMS-neurofeedback combination (TMS-NFB, N=20) and waitlist (WTL, N=22) groups to examine effects of 18 sessions of integrated rTMS-NFB treatment or wait period) on behavioral responses, stimulus and response-locked ERPs, and other functional and clinical outcomes. The underlying hypothesis was that combined TMS-NFB will improve executive functions in autistic patients as compared to the waitlist group. Behavioral and ERP outcomes were collected in pre- and post-treatment tests in both groups. Results of the study supported our hypothesis by demonstration of positive effects of combined TMS-NFB neurotherapy in active treatment group as compared to control waitlist group, as the TMS-NFB group showed significant improvements in behavioral and functional outcomes as compared to the waitlist group. PMID:25267414

  9. Neuromodulation integrating rTMS and neurofeedback for the treatment of autism spectrum disorder: an exploratory study.

    PubMed

    Sokhadze, Estate M; El-Baz, Ayman S; Tasman, Allan; Sears, Lonnie L; Wang, Yao; Lamina, Eva V; Casanova, Manuel F

    2014-12-01

    Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social interaction, language, stereotyped behaviors, and restricted range of interests. In previous studies low frequency repetitive transcranial magnetic stimulation (rTMS) has been used, with positive behavioral and electrophysiological results, for the experimental treatment in ASD. In this study we combined prefrontal rTMS sessions with electroencephalographic (EEG) neurofeedback (NFB) to prolong and reinforce TMS-induced EEG changes. The pilot trial recruited 42 children with ASD (~14.5 years). Outcome measures included behavioral evaluations and reaction time test with event-related potential (ERP) recording. For the main goal of this exploratory study we used rTMS-neurofeedback combination (TMS-NFB, N = 20) and waitlist (WTL, N = 22) groups to examine effects of 18 sessions of integrated rTMS-NFB treatment or wait period) on behavioral responses, stimulus and response-locked ERPs, and other functional and clinical outcomes. The underlying hypothesis was that combined TMS-NFB will improve executive functions in autistic patients as compared to the WTL group. Behavioral and ERP outcomes were collected in pre- and post-treatment tests in both groups. Results of the study supported our hypothesis by demonstration of positive effects of combined TMS-NFB neurotherapy in active treatment group as compared to control WTL group, as the TMS-NFB group showed significant improvements in behavioral and functional outcomes as compared to the WTL group. PMID:25267414

  10. Advances in Integrative Nanomedicine for Improving Infectious Disease Treatment in Public Health

    PubMed Central

    Bell, Iris R.; Schwartz, Gary E.; Boyer, Nancy N.; Koithan, Mary; Brooks, Audrey J.

    2012-01-01

    Introduction Infectious diseases present public health challenges worldwide. An emerging integrative approach to treating infectious diseases is using nanoparticle (NP) forms of traditional and alternative medicines. Advantages of nanomedicine delivery methods include better disease targeting, especially for intracellular pathogens, ability to cross membranes and enter cells, longer duration drug action, reduced side effects, and cost savings from lower doses. Methods We searched Pubmed articles in English with keywords related to nanoparticles and nanomedicine. Nanotechnology terms were also combined with keywords for drug delivery, infectious diseases, herbs, antioxidants, homeopathy, and adaptation. Results NPs are very small forms of material substances, measuring 1–100 nanometers along at least one dimension. Compared with bulk forms, NPs’ large ratio of surface-area-to-volume confers increased reactivity and adsorptive capacity, with unique electromagnetic, chemical, biological, and quantum properties. Nanotechnology uses natural botanical agents for green manufacturing of less toxic NPs. Discussion Nanoparticle herbs and nutriceuticals can treat infections via improved bioavailability and antiinflammatory, antioxidant, and immunomodulatory effects. Recent studies demonstrate that homeopathic medicines may contain source and/or silica nanoparticles because of their traditional manufacturing processes. Homeopathy, as a form of nanomedicine, has a promising history of treating epidemic infectious diseases, including malaria, leptospirosis and HIV/AIDS, in addition to acute upper respiratory infections. Adaptive changes in the host’s complex networks underlie effects. Conclusions Nanomedicine is integrative, blending modern technology with natural products to reduce toxicity and support immune function. Nanomedicine using traditional agents from alternative systems of medicine can facilitate progress in integrative public health approaches to infectious

  11. Research on soybean protein wastewater treatment by the integrated two-phase anaerobic reactor

    PubMed Central

    Yu, Yaqin

    2015-01-01

    The start-up tests of treating soybean protein wastewater by the integrated two-phase anaerobic reactor were studied. The results showed that the soybean protein wastewater could be successfully processed around 30 days when running under the situation of dosing seed sludge with the influent of approximately 2000 mg/L and an HRT of 40 h. When the start-up was finished, the removal rate of COD by the reactor was about 80%. In the zone I, biogas mainly revealed carbon dioxide (CO2) and hydrogen (H2). Methane was the main component in the zone 2 which ranged from 53% to 59% with an average of 55%. The methane content in biogas increased from the zone I to II. It indicated that the methane-producing capacity of the anaerobic sludge increased. It was found that the uniquely designed two-phase integrated anaerobic reactor played a key role in treating soybean protein wastewater. The acidogenic fermentation bacteria dominated in the zone I, while methanogen became dominant in the zone II. It realized the relatively effective separation of hydrolysis acidification and methanogenesis process in the reactor, which was benefit to promote a more reasonable space distribution of the microbial communities in the reactor. There were some differences between the activities of the sludge in the two reaction zones of the integrated two-phase anaerobic reactor. The activity of protease was higher in the reaction zone I. And the coenzyme F420 in the reaction zone II was twice than that in the reaction zone I, which indicated that the activity of the methanogens was stronger in the reaction zone II. PMID:26288554

  12. K West Basin sludge volume estimates for integrated water treatment system

    SciTech Connect

    Pitner, A.L.

    1998-08-19

    This document provides estimates of the volume of sludge (1) expected from Integrated Process Strategy (IPS) processing of the fuel elements and (2) in the fuel storage canisters in K West Basin. The original estimates were based on visual observations of fuel element condition in the basin and laboratory measurements of KE canister sludge density. Revision 1 revised the volume estimates of sludge based on additional data from evaluations of material from the KW Basin fuel subsurface examinations and KW canister sludge characterization data. A nominal Working Estimate and an upper level Working Bound is developed for the canister sludge and the fuel wash sludge components in the KW Basin.

  13. K East basin sludge volume estimates for integrated water treatment system

    SciTech Connect

    Pearce, K.L.

    1998-08-19

    This document provides estimates of the volume of sludge expected from Integrated Process Strategy (IPS) processing of the fuel elements and in the fuel storage canisters in K East Basin. The original estimates were based on visual observations of fuel element condition in the basin and laboratory measurements of canister sludge density. Revision 1 revised the volume estimates of sludge from processing of the fuel elements based on additional data from evaluations of material from the KE Basin fuel subsurface examinations. A nominal Working Estimate and an upper level Working Bound is developed for the canister sludge and the fuel wash sludge components in the KE Basin.

  14. Time-dependent treatment of scattering. II - Novel integral equation approach to quantum wave packets

    NASA Technical Reports Server (NTRS)

    Sharafeddin, Omar A.; Judson, Richard S.; Kouri, Donald J.; Hoffman, David K.

    1990-01-01

    The novel wave-packet propagation scheme presented is based on the time-dependent form of the Lippman-Schwinger integral equation and does not require extensive matrix inversions, thereby facilitating application to systems in which some degrees of freedom express the potential in a basis expansion. The matrix to be inverted is a function of the kinetic energy operator, and is accordingly diagonal in a Bessel function basis set. Transition amplitudes for various orbital angular momentum quantum numbers are obtainable via either Fourier transform of the amplitude density from the time to the energy domain, or the direct analysis of the scattered wave packet.

  15. Performance Improvement in Behavioral Health Care: Collateral Effects of Planned Treatment Integrity Observations as an Applied Example of Schedule-Induced Responding

    ERIC Educational Resources Information Center

    Reed, Derek D.; Fienup, Daniel M.; Luiselli, James K.; Pace, Gary M.

    2010-01-01

    With rising interest in the role of treatment integrity on student outcomes, research has primarily focused on isolating the techniques and procedures necessary to improve staff's acquisition and maintenance of adequate levels of integrity. Despite increasing numbers of publications on this topic, there has been little discussion of the variables…

  16. Nanotechnology for a safe and sustainable water supply: enabling integrated water treatment and reuse.

    PubMed

    Qu, Xiaolei; Brame, Jonathon; Li, Qilin; Alvarez, Pedro J J

    2013-03-19

    Ensuring reliable access to clean and affordable water is one of the greatest global challenges of this century. As the world's population increases, water pollution becomes more complex and difficult to remove, and global climate change threatens to exacerbate water scarcity in many areas, the magnitude of this challenge is rapidly increasing. Wastewater reuse is becoming a common necessity, even as a source of potable water, but our separate wastewater collection and water supply systems are not designed to accommodate this pressing need. Furthermore, the aging centralized water and wastewater infrastructure in the developed world faces growing demands to produce higher quality water using less energy and with lower treatment costs. In addition, it is impractical to establish such massive systems in developing regions that currently lack water and wastewater infrastructure. These challenges underscore the need for technological innovation to transform the way we treat, distribute, use, and reuse water toward a distributed, differential water treatment and reuse paradigm (i.e., treat water and wastewater locally only to the required level dictated by the intended use). Nanotechnology offers opportunities to develop next-generation water supply systems. This Account reviews promising nanotechnology-enabled water treatment processes and provides a broad view on how they could transform our water supply and wastewater treatment systems. The extraordinary properties of nanomaterials, such as high surface area, photosensitivity, catalytic and antimicrobial activity, electrochemical, optical, and magnetic properties, and tunable pore size and surface chemistry, provide useful features for many applications. These applications include sensors for water quality monitoring, specialty adsorbents, solar disinfection/decontamination, and high performance membranes. More importantly, the modular, multifunctional and high-efficiency processes enabled by nanotechnology provide a

  17. Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs

    PubMed Central

    KILLEEN, THERESE K.; BACK, SUDIE E.; BRADY, KATHLEEN T.

    2016-01-01

    Issues The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. Approach The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Key Findings Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Implications and Conclusions Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. PMID:25737377

  18. Development of an Integrated Leachate Treatment Solution for the Port Granby Waste Management Facility - 12429

    SciTech Connect

    Conroy, Kevin W.; Vandergaast, Gerald

    2012-07-01

    The Port Granby Project (the Project) is located near the north shore of Lake Ontario in the Municipality of Clarington, Ontario, Canada. The Project consists of relocating approximately 450,000 m{sup 3} of historic Low-Level Radioactive Waste (LLRW) and contaminated soil from the existing Port Granby Waste Management Facility (WMF) to a proposed Long-Term Waste Management Facility (LTWMF) located adjacent to the WMF. The LTWMF will include an engineered waste containment facility, a Wastewater Treatment Plant (WTP), and other ancillary facilities. A series of bench- and pilot-scale test programs have been conducted to identify preferred treatment processes to be incorporated into the WTP to treat wastewater generated during the construction, closure and post-closure periods at the WMF/LTWMF. (authors)

  19. Integral approaches to wastewater treatment plant upgrading for odor prevention: Activated Sludge and Oxidized Ammonium Recycling.

    PubMed

    Estrada, José M; Kraakman, N J R; Lebrero, R; Muñoz, R

    2015-11-01

    Traditional physical/chemical end-of-the-pipe technologies for odor abatement are relatively expensive and present high environmental impacts. On the other hand, biotechnologies have recently emerged as cost-effective and environmentally friendly alternatives but are still limited by their investment costs and land requirements. A more desirable approach to odor control is the prevention of odorant formation before being released to the atmosphere, but limited information is available beyond good design and operational practices of the wastewater treatment process. The present paper reviews two widely applicable and economic alternatives for odor control, Activated Sludge Recycling (ASR) and Oxidized Ammonium Recycling (OAR), by discussing their fundamentals, key operating parameters and experience from the available pilot and field studies. Both technologies present high application potential using readily available plant by-products with a minimum plant upgrading, and low investment and operating costs, contributing to the sustainability and economic efficiency of odor control at wastewater treatment facilities. PMID:26316402

  20. Environmental and economic assessment of integrated systems for dairy manure treatment coupled with algae bioenergy production.

    PubMed

    Zhang, Yongli; White, Mark A; Colosi, Lisa M

    2013-02-01

    Life cycle assessment (LCA) and life cycle costing (LCC) are used to investigate integrated algae bioenergy production and nutrient management on small dairy farms. Four cases are considered: a reference land-application scenario (REF), anaerobic digestion with land-application of liquid digestate (AD), and anaerobic digestion with recycling of liquid digestate to either an open-pond algae cultivation system (OPS) or an algae turf scrubber (ATS). LCA indicates that all three "improved" scenarios (AD, OPS, and ATS) are environmentally favorable compared to REF, exhibiting increases in net energy output up to 854GJ/yr, reductions in net eutrophication potential up to 2700kg PO(4)-eq/yr, and reductions in global warming potential up to 196Mg CO(2)-eq/yr. LCC reveals that the integrated algae systems are much more financially attractive than either AD or REF, whereby net present values (NPV) are as follows: $853,250 for OPS, $790,280 for ATS, -$62,279 for REF, and -$211,126 for AD. However, these results are highly dependent on the sale price for nutrient credits. Comparison of LCA and LCC results indicates that robust nutrient credit markets or other policy tools are required to align financial and environmental preferability of energy production systems and foster widespread adoption of sustainable nutrient management systems. PMID:23313697

  1. Pollutant removal from municipal wastewater employing baffled subsurface flow and integrated surface flow-floating treatment wetlands.

    PubMed

    Saeed, Tanveer; Al-Muyeed, Abdullah; Afrin, Rumana; Rahman, Habibur; Sun, Guangzhi

    2014-04-01

    This article reports pollutant removal performances of baffled subsurface flow, and integrated surface flow-floating treatment wetland units, when arranged in series for the treatment of municipal wastewater in Bangladesh. The wetland units (of the hybrid system) included organic, inorganic media, and were planted with nineteen types of macrophytes. The wetland train was operated under hydraulic loading fluctuation and seasonal variation. The performance analyses (across the wetland units) illustrated simultaneous denitrification and organics removal rates in the first stage vertical flow wetland, due to organic carbon leaching from the employed organic media. Higher mean organics removal rates (656.0 g COD/(m(2)·day)) did not completely inhibit nitrification in the first stage vertical flow system; such pattern could be linked to effective utilization of the trapped oxygen, as the flow was directed throughout the media by the baffle walls. Second stage horizontal flow wetland showed enhanced biodegradable organics removal, which depleted organic carbon availability for denitrification. The final stage integrated wetland system allowed further nitrogen removal from wastewater, via nutrient uptake by plant roots (along with nitrification), and generation of organic carbon (by the dead macrophytes) to support denitrification. The system achieved higher E. coli mortality through protozoa predation, E. coli oxidation, and destruction by UV radiation. In general, enhanced pollutant removal efficiencies as demonstrated by the structurally modified hybrid wetland system signify the necessity of such modification, when operated under adverse conditions such as: substantial input organics loading, hydraulic loading fluctuation, and seasonal variation. PMID:25079402

  2. A Preliminary Study of an Integrated and Culturally Attuned Cognitive Behavioral Group Treatment for Chinese Problem Gamblers in Hong Kong.

    PubMed

    Wong, Daniel Fu Keung; Chung, Catherine Lai Ping; Wu, Janet; Tang, Joe; Lau, Patrick; Wan, Jennie Po Ching

    2015-09-01

    Chinese people may have a higher rate of gambling problems than other cultural groups. However, there are very few clinical outcome studies that have demonstrated the effectiveness of clinical interventions for helping Chinese gamblers. Cognitive behavioural therapy (CBT) has been found to be effective for helping problem gamblers to significantly reduce their gambling problems in western countries. Very few CBT clinical trials have been conducted with the Chinese populations, and the results were masked by methodological limitations. This preliminary study attempted to test the effectiveness of an integrated and culturally attuned CBT group treatment for Chinese problem gamblers in Hong Kong. This study adopted a randomized control design and 38 participants were allocated randomly to the experimental condition (n = 18) and control condition (n = 20). The experimental group received 10 weekly CBT group sessions and individual counseling services while control group only received the individual counseling services. Significant decreases in gambling severity and frequencies of gambling were found in the experimental group. The findings also showed that a change in gambling cognitions predicted the changes in gambling severity and gambling urge while a change in gambling severity was also linked to a change in depression. Preliminary evidence highlights the potential benefits of an integrated and culturally attuned CBT group treatment for Chinese problem gamblers in Hong Kong. However, a more vigorous research design with a larger sample is needed to provide solid evidence of the effectiveness of the model for Chinese problem gamblers. PMID:24699943

  3. Membrane-integrated physico-chemical treatment of coke-oven wastewater: transport modelling and economic evaluation.

    PubMed

    Kumar, Ramesh; Chakrabortty, Sankha; Pal, Parimal

    2015-04-01

    A modelling and simulation study with economic evaluation was carried out for an advanced membrane-integrated hybrid treatment process that ensures reuse of water with recovery of ammoniacal nitrogen as struvite from coke-oven wastewater. Linearized transport model was developed based on extended Nernst-Plank and concentration polarization modulus equation. Effects of pH, transmembrane pressure and cross-flow rate of interest on membrane charge density, solute rejection and solvent flux were investigated. The membrane module was successful in yielding a pure water flux as high as 120 L m(-2) h(-1) removing more than 95 and 96% of the cyanide and phenol, respectively, while permeating more than 90% NH4 (+)-N at a transmembrane pressure of only 15 × 10(2) KPa and at a pH of 10 for a volumetric cross-flow rate of 800 L h(-1). The Fenton's reagents were used to degrade more than 99% of pollutants present in the concentrated stream. The developed model could successfully predict the plant performance as reflected in the very low relative error (0.01-0.12) and overall high correlation coefficient (R(2) > 0.96). Economic analysis indicated that such a membrane-integrated hybrid system could be quite promising in coke wastewater treatment at low cost i.e. $0.934/m(2) of wastewater. PMID:25380632

  4. The integrated melter off-gas treatment systems at the West Valley Demonstration Project

    SciTech Connect

    Vance, R.F.

    1991-12-01

    The West Valley Demonstration project was established by an act of Congress in 1980 to solidify the high level radioactive liquid wastes produced from operation of the Western New York Nuclear Services Center from 1966 to 1972. The waste will be solidified as borosilicate glass. This report describes the functions, the controlling design criteria, and the resulting design of the melter off-gas treatment systems.

  5. [Integrated care in pain therapy: innovations and coordinated treatment offers from the "Techniker Krankenkasse"].

    PubMed

    Brunkhorst, J; Schwarz, F; Klein, S

    2013-04-01

    Sectorally segregated healthcare structures are seen as a major reason for deficits in quality and efficiency. With the introduction of §§ 140 a ff. SGB V, the sectoral splitting into outpatient, inpatient and rehabilitative services will be eliminated. This is especially true for the requirements of state-of-the-art multidisciplinary and comprehensive pain therapy. Through this form of contract competition and competition for the best idea, incentives shall be created for economic behaviour of market participants, above all the efficient use of limited resources and allocation of healthcare resources based on need. Selective contracts are essential competition parameters for continued innovative development of the healthcare system. They enable statutory healthcare providers to offer their insurants innovative treatments which are not available in standard care. Agreements can be made concerning higher levels of quality and healthcare services, incentives for economical behaviour and success-based payment models. The key idea is the orientation on the needs of the insurant. The successful realisation of innovation in pain therapy is described using a practical example. Professional contractual partners, high quality information and communication, the taking over of responsibility for treatment and cost effectiveness are factors essential the success of innovative treatment concepts. PMID:23539274

  6. An integrated wastewater treatment system using a BAS reactor with biomass attached to tubular supports.

    PubMed

    Luciano, Antonella; Viotti, Paolo; Mancini, Giuseppe; Torretta, Vincenzo

    2012-12-30

    This paper describes laboratory experiments aimed to develop a new wastewater treatment system as an alternative to a conventional domestic wastewater plant. A modified Biofilm Airlift Suspension reactor (BAS), with biomass attached to tubular supports, is proposed to address low organic loads (typical of domestic sewage) and low residence time (typical of compact reactors technology). Attached and suspended biomasses, coupled to the high dissolved oxygen (DO), allow high removal efficiencies (90% and 56% for COD and N-NH(4)(+) removal respectively) and high effluent quality to be reached. The experimental activity, divided into three parts, demonstrates the good efficiency of the process, and the reduction of the removal kinetics for the high operating pressure used in the technology. The occurrence of simultaneous nitrification-denitrification (SND) was also observed. When compared with the conventional BAS system, the present treatment shows comparable removal efficiencies and higher specific removal rates (80 mg COD/g VSS and 2.60 mg N-NH(4)(+)/g VSS). The experimental results were coupled with the development of a numerical model to aid in designing a full-scale treatment plant in Italy. PMID:23000503

  7. Process Integrated Heat Treatment of a Microalloyed Medium Carbon Steel: Microstructure and Mechanical Properties

    NASA Astrophysics Data System (ADS)

    Herbst, Sebastian; Schledorn, Mareike; Maier, Hans Jürgen; Milenin, Andrij; Nürnberger, Florian

    2016-04-01

    Air-water spray cooling was employed during a heat treatment to enhance the mechanical properties of microalloyed medium carbon steel test cylinders (38MnVS6, 88 mm diameter). Using appropriate cooling times and intensities, the test cylinders' surfaces could be quenched and subsequently self-tempered by the residual heat of the core. Simultaneously, it was possible to keep the core regions of the cylinders in the bainitic regime and carry out a quasi-isothermal holding. The resulting microstructures consisted of tempered martensite (near-surface) and bainite with pearlite and ferrite (core). Compared to the standard heat treatment (controlled air cooling), the tensile properties (proof stress and ultimate tensile strength) could be improved for both near-surface and core regions with the adapted spray cooling. A hardness profile with 450 HV10 surface hardness and a hardening depth of more than 11 mm could be realized. In addition, an increase of the impact toughness for the core was achieved, resulting in approximately 25 J charpy impact energy. This is a substantial improvement compared to standard heat treatment procedure and values reported in the literature and can be attributed to the reduced pearlite volume fraction and the increased amount of fine bainite.

  8. Integrating Recent Data in Managing Adverse Events in the Treatment of Hepatocellular Carcinoma

    PubMed Central

    Gish, Robert G.; Abou-Alfa, Ghassan K.; Tong, Myron J.

    2010-01-01

    Hepatocellular carcinoma (HCC) is a major cause of cancer-related morbidity and mortality worldwide. In the United States, HCC is the main cause of death in patients with cirrhosis, and the incidence of this malignancy is on the rise. Because HCC is associated with a particularly poor prognosis, emphasis is placed on surveillance of high-risk patients. Early detection allows a greater chance of diagnosing HCC before it has spread, thus increasing the chances that the patient can be potentially cured with surgical techniques such as resection and transplantation. However, most cases of HCC are not diagnosed until at least some of the cancer has spread or multiple nodules exist. For these patients, treatment options include percutaneous and transarterial ablation, as well as systemic chemotherapy. Systemic therapy is now considered the standard of care for patients with advanced tumors. Traditional treatment was based on cytotoxic chemotherapeutic agents, such as doxorubicin. This approach was associated with minimal benefit and a high rate of toxicity. Recently, targeted agents have proven more effective and safer in this setting. The oral multikinase inhibitor sorafenib is now approved for the treatment of unresectable HCC and is currently the only approved agent for advanced HCC. In order to maximize the benefit of sorafenib and other investigational agents for patients with advanced disease, effective interventions have been designed to mitigate their associated adverse events, such as hand-foot skin reactions and hypertension. PMID:22423222

  9. Biodegradation characteristics and size fractionation of landfill leachate for integrated membrane treatment.

    PubMed

    Insel, Güçlü; Dagdar, Mina; Dogruel, Serdar; Dizge, Nadir; Ubay Cokgor, Emine; Keskinler, Bülent

    2013-09-15

    The fate of organics and nitrogen during the biological treatment with MBR and subsequent membrane filtration processes (nano filtration, NF; reverse osmosis, RO) were investigated for a landfill leachate. The chemical oxygen demand (COD) and total Kjeldahl nitrogen (TKN) removal performances of membrane bioreactor (MBR) were obtained to be around 89% and 85%, respectively. The effluent COD of MBR was measured to be 1935 mg/L (30 kDa) which is much lower than experimentally determined soluble inert COD of 3200 mg/L using 0.45 μm filter. The readily and slowly biodegradable COD fractions were estimated to be 17% and 52% of raw influent COD, respectively. The respirometry based modeling test performed on raw leachate exhibited much slower degradation kinetics compared to municipal wastewater. A unique subset of model parameters was extracted from batch respirometry by using acclimated MBR sludge. The sequential ultrafiltration (UF) experiments (particle size distribution, PSD) revealed that most of the organics was below 2 nm filter mesh size. In addition, NF/RO post treatment after MBR system was required to increase COD and total nitrogen (TN) removal performances up to 99%. Relatively lower salt rejection rates around 94% was obtained for RO system as a post treatment of MBR system. PMID:23856313

  10. A 12-month controlled trial of methadone medical maintenance integrated into an adaptive treatment model.

    PubMed

    King, Van L; Kidorf, Michael S; Stoller, Kenneth B; Schwartz, Robert; Kolodner, Kenneth; Brooner, Robert K

    2006-12-01

    Methadone medical maintenance (MMM) reduces the reporting schedule for stable and well-functioning methadone maintenance patients to once a month, with counseling provided by medical staff. We report on the 12-month outcomes of 92 highly stable methadone maintenance patients randomly assigned to one of three study conditions: routine care, MMM at the methadone maintenance program, and MMM at a physician's office. Methadone medical maintenance patients received a 28-day supply of methadone, whereas routine care patients received five or six take-home methadone doses each week. All patients performed a medication recall once a month and submitted two urine samples each month. An adaptive stepped-care system of treatment intensification was used for patients who failed recall or who had drug-positive urine specimens. Seventy-seven patients completed the 12-month study period. Dropout was caused primarily by problems with handling methadone and disliking the recall frequency. There were low rates of drug use or failed medication recall. Treatment satisfaction was high in all groups, but the MMM patients initiated more new employment or family/social activities than did routine care patients over the study period. The stepped-care approach was well tolerated and matched patients to an appropriate step of service within a continuum of treatment intensity. PMID:17084792

  11. One System Integrated Project Team: Retrieval And Delivery Of The Hanford Tank Wastes For Vitrification In The Waste Treatment Plant

    SciTech Connect

    Harp, Benton J.; Kacich, Richard M.; Skwarek, Raymond J.

    2012-12-20

    The One System Integrated Project Team (IPT) was formed in late 2011 as a way for improving the efficiency of delivery and treatment of highly radioactive waste stored in underground tanks at the U.S. Department of Energy's (DOE's) 586-square-mile Hanford Site in southeastern Washington State. The purpose of the One System IPT is to improve coordination and integration between the Hanford's Waste Treatment Plant (WTP) contractor and the Tank Operations Contractor (TOC). The vision statement is: One System is a WTP and TOC safety conscious team that, through integrated management and implementation of risk-informed decision and mission-based solutions, will enable the earliest start of safe and efficient treatment of Hanford's tank waste, to protect the Columbia River, environment and public. The IPT is a formal collaboration between Bechtel National, Inc. (BNI), which manages design and construction of the WTP for the U.S. Department of Energy's Office of River Protection (DOEORP), and Washington River Protection Solutions (WRPS), which manages the TOC for ORP. More than fifty-six (56) million gallons of highly radioactive liquid waste are stored in one hundred seventy-seven (177) aging, underground tanks. Most of Hanford's waste tanks - one hundred forty-nine (149) of them - are of an old single-shell tank (SST) design built between 1944 and 1964. More than sixty (60) of these tanks have leaked in the past, releasing an estimated one million gallons of waste into the soil and threatening the nearby Columbia River. There are another twenty-eight (28) new double-shelled tanks (DSTs), built from 1968 to 1986, that provide greater protection to the environment. In 1989, DOE, the U.S. Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) signed a landmark agreement that required Hanford to comply with federal and state environmental standards. It also paved the way for agreements that set deadlines for retrieving the tank

  12. One System Integrated Project Team: Retrieval and Delivery of Hanford Tank Wastes for Vitrification in the Waste Treatment Plant - 13234

    SciTech Connect

    Harp, Benton J.; Kacich, Richard M.; Skwarek, Raymond J.

    2013-07-01

    The One System Integrated Project Team (IPT) was formed in late 2011 as a way for improving the efficiency of delivery and treatment of highly radioactive waste stored in underground tanks at the U.S. Department of Energy's (DOE's) 586-square-mile Hanford Site in southeastern Washington State. The purpose of the One System IPT is to improve coordination and integration between the Hanford's Waste Treatment Plant (WTP) contractor and the Tank Operations Contractor (TOC). The vision statement is: One System is a WTP and TOC safety-conscious team that, through integrated management and implementation of risk-informed decision and mission-based solutions, will enable the earliest start of safe and efficient treatment of Hanford's tank waste, to protect the Columbia River, environment and public. The IPT is a formal collaboration between Bechtel National, Inc. (BNI), which manages design and construction of the WTP for the U.S. Department of Energy's Office of River Protection (DOEORP), and Washington River Protection Solutions (WRPS), which manages the TOC for ORP. More than fifty-six (56) million gallons of highly radioactive liquid waste are stored in one hundred seventy-seven (177) aging, underground tanks. Most of Hanford's waste tanks - one hundred forty-nine (149) of them - are of an old single-shell tank (SST) design built between 1944 and 1964. More than sixty (60) of these tanks have leaked in the past, releasing an estimated one million gallons of waste into the soil and threatening the nearby Columbia River. There are another twenty-eight (28) new double-shelled tanks (DSTs), built from 1968 to 1986, that provide greater protection to the environment. In 1989, DOE, the U.S. Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) signed a landmark agreement that required Hanford to comply with federal and state environmental standards. It also paved the way for agreements that set deadlines for retrieving the tank

  13. The Positive Impact of Integrative Medicine in the Treatment of Recalcitrant Chronic daily Headache: A Series of Case Reports.

    PubMed

    Amoils, Steve; Amoils, Sandi; Lester, Tiffany; Woolford, Liz; Gallagher, Lisa

    2014-07-01

    People who suffer from recalcitrant chronic daily headache (CDH)-a primary, episodic headache occurring at least 15 days per month, and lasting four or more hours per day for at least three consecutive months(1)-have generally tried many pain relief medications with few positive results. These patients often continue to add more and more medications and travel from clinician to clinician seeking help, without relief. Patients with recalcitrant CDH are often caught in a vicious cycle of increasing pain which results in a substantial impact from their disease on productivity and quality of life. Studies in the United States and Europe indicate that four to five percent of the general population has recalcitrant CDH,(2) which encompasses transformed migraine and chronic tension-type headache.(3) The disability associated with recalcitrant CDH is substantial, as patients have a significantly diminished quality of life and mental health, as well as impaired physical, social, and occupational functioning.(4,5) Research shows that CDH may not be treated effectively with conventional medicine (CM). Integrative medicine (IM) offers a complex, personalized intervention necessary to treat CDH. Many integrative therapies have shown benefit, effectiveness, cost effectiveness and low side effect profile in patients with both chronic headache and chronic pain.(6-17) Yet even within the IM community, clinicians often struggle with the balance between providing evidence-based therapy and patient-centered, complex, personalized integrative approaches, which may use popular but unproven therapies. In this article, we present a series of cases comprising patients with CDH who had previously been recalcitrant to CM approaches. In each case, employing a five-pronged treatment algorithm resulted in the successful IM treatment of CDH. By using this five-pronged approach, clinicians can offer the standardized protocols and scientific rationale they are accustomed to when employing CM

  14. The Positive Impact of Integrative Medicine in the Treatment of Recalcitrant Chronic daily Headache: A Series of Case Reports

    PubMed Central

    Amoils, Sandi; Lester, Tiffany; Woolford, Liz; Gallagher, Lisa

    2014-01-01

    People who suffer from recalcitrant chronic daily headache (CDH)—a primary, episodic headache occurring at least 15 days per month, and lasting four or more hours per day for at least three consecutive months1—have generally tried many pain relief medications with few positive results. These patients often continue to add more and more medications and travel from clinician to clinician seeking help, without relief. Patients with recalcitrant CDH are often caught in a vicious cycle of increasing pain which results in a substantial impact from their disease on productivity and quality of life. Studies in the United States and Europe indicate that four to five percent of the general population has recalcitrant CDH,2 which encompasses transformed migraine and chronic tension-type headache.3 The disability associated with recalcitrant CDH is substantial, as patients have a significantly diminished quality of life and mental health, as well as impaired physical, social, and occupational functioning.4,5 Research shows that CDH may not be treated effectively with conventional medicine (CM). Integrative medicine (IM) offers a complex, personalized intervention necessary to treat CDH. Many integrative therapies have shown benefit, effectiveness, cost effectiveness and low side effect profile in patients with both chronic headache and chronic pain.6-17 Yet even within the IM community, clinicians often struggle with the balance between providing evidence-based therapy and patient-centered, complex, personalized integrative approaches, which may use popular but unproven therapies. In this article, we present a series of cases comprising patients with CDH who had previously been recalcitrant to CM approaches. In each case, employing a five-pronged treatment algorithm resulted in the successful IM treatment of CDH. By using this five-pronged approach, clinicians can offer the standardized protocols and scientific rationale they are accustomed to when employing CM options

  15. Time-dependent treatment of scattering - Integral equation approaches using the time-dependent amplitude density

    NASA Technical Reports Server (NTRS)

    Hoffman, David K.; Sharafeddin, Omar; Judson, Richard S.; Kouri, Donald J.

    1990-01-01

    The time-dependent form of the Lippmann-Schwinger integral equation is used as the basis of several new wave packet propagation schemes. These can be formulated in terms of either the time-dependent wave function or a time-dependent amplitude density. The latter is nonzero only in the region of configuratiaon space for which the potential is nonzero, thereby in principle obviating the necessity of large grids or the use of complex absorbing potentials when resonances cause long collision times (leading, consequently, to long propagation times). Transition amplitudes are obtained in terms of Fourier transforms of the amplitude density from the time to the energy domain. The approach is illustrated by an application to a standard potential scattering model problem where, as in previous studies, the action of the kinetic energy operator is evaluated by fast Fourier transform (FFT) techniques.

  16. Definition and compositions of standard wastestreams for evaluation of Buried Waste Integrated Demonstration treatment technologies

    SciTech Connect

    Bates, S.O.

    1993-06-01

    The Buried Waste Integrated Demonstration (BWID) Project was organized at the Idaho National Engineering Laboratory to support research, development, demonstration, testing, and evaluation of emerging technologies that offer promising solutions to remediation of buried waste. BWID will identify emerging technologies, screen them for applicability to the identified needs, select technologies for demonstration, and then evaluate the technologies based on prescribed performance objectives. The technical objective of the project is to establish solutions to Environmental Restoration and Waste Management`s technological deficiencies and improve baseline remediation systems. This report establishes a set of standard wastestream compositions that will be used by BWID to evaluate the emerging technologies. Five wastestreams are proposed that use four types of waste and a nominal case that is a homogenized combination of the four wastes. The five wastestreams will provide data on the compositional extremes and indicate the technologies` effectiveness over the complete range of expected wastestream compositions.

  17. Prevention of hepatotoxicity due to anti tuberculosis treatment: A novel integrative approach

    PubMed Central

    Adhvaryu, Meghna R; Reddy, Narsimha M; Vakharia, Bhasker C

    2008-01-01

    AIM: To evaluate the ability of Curcuma longa (CL) and Tinospora cordifolia (TC) formulation to prevent anti-tuberculosis (TB) treatment (ATT) induced hepatotoxicity. METHODS: Patients with active TB diagnosis were randomized to a drug control group and a trial group on drugs plus an herbal formulation. Isoniazid, rifampicin, pyrazinamide and ethambutol for first 2 mo followed by continuation phase therapy excluding Pyrazinamide for 4 mo comprised the anti-tuberculous treatment. Curcumin enriched (25%) CL and a hydro-ethanolic extract enriched (50%) TC 1 g each divided in two doses comprised the herbal adjuvant. Hemogram, bilirubin and liver enzymes were tested initially and monthly till the end of study to evaluate the result. RESULTS: Incidence and severity of hepatotoxicity was significantly lower in trial group (incidence: 27/192 vs 2/316, P < 0.0001). Mean aspartate transaminase (AST) (195.93 ± 108.74 vs 85 ± 4.24, P < 0.0001), alanine transaminase (ALT) (75.74 ± 26.54 vs 41 ± 1.41, P < 0.0001) and serum bilirubin (5.4 ± 3.38 vs 1.5 ± 0.42, P < 0.0001). A lesser sputum positivity ratio at the end of 4 wk (10/67 vs 4/137, P = 0.0068) and decreased incidence of poorly resolved parenchymal lesion at the end of the treatment (9/152 vs 2/278, P = 0.0037) was observed. Improved patient compliance was indicated by nil drop-out in trial vs 10/192 in control group (P < 0.0001). CONCLUSION: The herbal formulation prevented hepatotoxicity significantly and improved the disease outcome as well as patient compliance without any toxicity or side effects. PMID:18720535

  18. An attenuation integral digital imaging technique for the treatment portal verification of conventional and intensity-modulated radiotherapy

    SciTech Connect

    Guan Huaiqun

    2010-07-15

    Purpose: To propose an attenuation integral digital imaging (AIDI) technique for the treatment portal verification of conventional and intensity-modulated radiotherapy (IMRT). Methods: In AIDI technique, an open in air fluence image I{sub o} and a patient fluence image I were acquired under the same exposure. Then after doing the dark field correction for both the I{sub o} and I, the AIDI image was simply calculated as log(I{sub o}/I), which is the attenuation integral along the ray path from the x-ray source to a detector pixel element. Theoretical analysis for the low contrast detection and the contrast to noise ratio (CNR) of AIDI was presented and compared to those for the fluence imaging. With AIDI, the variation of x-ray fluence and the variation of individual detector pixel's response can be automatically compensated without using the flood field correction. Results: The AIDI image for a contrast detail phantom demonstrated that it can efficiently suppress the background structures such as the couch and generate better visibility for low contrast objects with megavoltage x rays. The AIDI image acquired for a Catphan 500 phantom using a 60 deg. electronic dynamic wedge field also revealed more contrast disks than the fluence imaging did. Finally, AIDI for an IMRT field of a head/neck patient successfully displayed the anatomical structures underneath the treatment portal but not shown in fluence imaging. Conclusions: For IMRT and high degree wedge beams, direct imaging using them is difficult because their photon fluence is highly nonuniform. But AIDI can be used for the treatment portal verification of these beams.

  19. Integrated gasification and plasma cleaning for waste treatment: A life cycle perspective

    SciTech Connect

    Evangelisti, Sara; Tagliaferri, Carla; Clift, Roland; Lettieri, Paola; Taylor, Richard; Chapman, Chris

    2015-09-15

    Highlights: • A life cycle assessment of an advanced two-stage process is undertaken. • A comparison of the impacts of the process when fed with 7 feedstock is presented. • Sensitivity analysis on the system is performed. • The treatment of RDF shows the lowest impact in terms of both GWP and AP. • The plasma shows a small contribution to the overall impact of the plant. - Abstract: In the past, almost all residual municipal waste in the UK was landfilled without treatment. Recent European waste management directives have promoted the uptake of more sustainable treatment technologies, especially for biodegradable waste. Local authorities have started considering other options for dealing with residual waste. In this study, a life cycle assessment of a future 20 MWe plant using an advanced two-stage gasification and plasma technology is undertaken. This plant can thermally treat waste feedstocks with different composition and heating value to produce electricity, steam and a vitrified product. The objective of the study is to analyse the environmental impacts of the process when fed with seven different feedstocks (including municipal solid waste, solid refuse fuel, reuse-derived fuel, wood biomass and commercial & industrial waste) and identify the process steps which contribute more to the environmental burden. A scenario analysis on key processes, such as oxygen production technology, metal recovery and the appropriate choice for the secondary market aggregate material, is performed. The influence of accounting for the biogenic carbon content in the waste from the calculations of the global warming potential is also shown. Results show that the treatment of the refuse-derived fuel has the lowest impact in terms of both global warming potential and acidification potential because of its high heating value. For all the other impact categories analysed, the two-stage gasification and plasma process shows a negative impact for all the waste streams

  20. Treatment Efficacy of Integrative Family and Systems Treatment (I-FAST) With and Without Consultation: The Role of Model Training in the Sustainability of Evidence-Based Family Treatments.

    PubMed

    Lee, Mo Yee; Hsu, Kai-Shyang; Liu, Chang; Greene, Gilbert J; Fraser, J Scott; Grove, David; Solovey, Andy; Edwards, Shivani G; Scott, Pam

    2016-07-01

    This study examined the efficacy of the Integrative Family and Systems Treatment (I-FAST) training model that seeks to support development of model expertise within the agency in the context of facilitating the sustainability of evidence-based family treatment within community mental health settings. A quasi-experimental design was used to examine treatment outcomes of I-FAST among agencies that received ongoing Consultation and agencies that received No Consultation upon completion of I-FAST training. χ (2) analyses and independent samples t test analyses showed that there were no significant differences between the two groups on clients who had achieved reliable change on Problem Severity and Functioning based on parents' assessments. Significance of this study is discussed in the context of the role of evidence-based family therapy (EBFT) training in facilitating its sustainability in community mental health settings. PMID:25813342

  1. CONTROL OF BITTER ROT & BLUE MOLD OF APPLES BY INTEGRATING HEAT AND ANTAGONIST TREATMENTS ON 1-MCP TREATED FRUIT STORED UNDER CONTROLLED ATMOSPHERE CONDITIONS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In order to maximize control of fruit decay by alternatives to synthetic fungicides after harvest, various control strategies can be integrated. Treatment of fruit with antagonists is one of the most promising alternatives. This treatment, however, has little or no eradicative activity, which limi...

  2. Integrating treatment and education for mood disorders: an adolescent case report.

    PubMed

    Navalta, Carryl P; Goldstein, Jessica; Ruegg, Laura; Perna, David A; Frazier, Jean A

    2006-10-01

    This case study illustrates one successful outcome of an intensive, outpatient, treatment project for adolescents with mood disorders. An 18-year-old female with symptoms across several DSM-IV Axis I classifications, including a depressive disorder, and her parents participated in a year-long, multimodal intervention that included mood-focused psychoeducation and coaching designed to impact on her, her family, school, and community systems. Self-report, clinician-driven, and ecologically valid measures were used to assess treatment effects on psychiatric symptoms and psychosocial functioning. Results on the Child and Adolescent Functional Assessment Scale demonstrated considerable gains in the following areas: Home, school/work, social behavior, self-harm, thinking/communication, and substance use. During the intervention, she went from failing several of her classes to graduating from high school. In addition, she made the Honours' List in her first semester at a local community college. A discussion of intervention pluses and pitfalls specific to the case highlight the necessity to influence the various spheres of the young person's life. PMID:17163224

  3. Psychological Treatments for Provoked Vestibulodynia: Integration of Mindfulness-Based and Cognitive Behavioral Therapies.

    PubMed

    Dunkley, Cara R; Brotto, Lori A

    2016-07-01

    Provoked vestibulodynia (PVD) is a chronic and distressing genital pain condition involving sharp pain to the vulvar vestibule with lifetime prevalence as high as 12%. PVD is the most prevalent cause of pain during sexual intercourse (dyspareunia) in premenopausal women, and gives rise to considerable sexual and relational concerns. As intercourse for women with PVD is either painful or impossible, PVD has pronounced negative effects on women's romantic relationship adjustment and sexual intimacy, as well as their emotional well-being and sense of sexual self-efficacy. Given the low efficacy and high side-effect profile of medications for the treatment of PVD, attention has shifted toward psychological interventions over the past decade. Psychological treatments for PVD have the advantage of targeting both the experience of pain and its many psychosexual consequences, such as reduced desire and arousal. Cognitive behavioral therapy (CBT) currently represents one of the most popular first-line psychological interventions for PVD. Mindfulness has been increasingly used alongside, or instead of CBT for a variety of health-related conditions, particularly with respect to chronic pain disorders and more recently in women with PVD. This review provides a detailed overview of CBT and mindfulness-based approaches in treating PVD. PMID:27019368

  4. Cancer treatment as a game: integrating evolutionary game theory into the optimal control of chemotherapy.

    PubMed

    Orlando, Paul A; Gatenby, Robert A; Brown, Joel S

    2012-12-01

    Chemotherapy for metastatic cancer commonly fails due to evolution of drug resistance in tumor cells. Here, we view cancer treatment as a game in which the oncologists choose a therapy and tumors 'choose' an adaptive strategy. We propose the oncologist can gain an upper hand in the game by choosing treatment strategies that anticipate the adaptations of the tumor. In particular, we examine the potential benefit of exploiting evolutionary tradeoffs in tumor adaptations to therapy. We analyze a math model where cancer cells face tradeoffs in allocation of resistance to two drugs. The tumor 'chooses' its strategy by natural selection and the oncologist chooses her strategy by solving a control problem. We find that when tumor cells perform best by investing resources to maximize response to one drug the optimal therapy is a time-invariant delivery of both drugs simultaneously. However, if cancer cells perform better using a generalist strategy allowing resistance to both drugs simultaneously, then the optimal protocol is a time varying solution in which the two drug concentrations negatively covary. However, drug interactions can significantly alter these results. We conclude that knowledge of both evolutionary tradeoffs and drug interactions is crucial in planning optimal chemotherapy schedules for individual patients. PMID:23197192

  5. System-level effects of integrating a promising treatment into juvenile drug courts.

    PubMed

    McCart, Michael R; Henggeler, Scott W; Chapman, Jason E; Cunningham, Phillippe B

    2012-09-01

    This study examined the system-level effects of implementing a promising treatment for adolescent substance abuse in juvenile drug courts (JDCs). Six JDCs were randomized to receive training in the experimental intervention (contingency management-family engagement [CM-FAM]) or to continue their usual services (US). Participants were 104 families served by the courts, 51 therapists, and 74 JDC stakeholders (e.g., judges, prosecutors, defense attorneys). Assessments included repeated measurements of CM-FAM implementation by therapists and therapist and stakeholder perceptions of incentive-based interventions and organizational characteristics. Results revealed greater use of CM and family engagement techniques among CM-FAM relative to US therapists. In addition, therapists and stakeholders in the CM-FAM condition reported more favorable attitudes toward the use of incentives and greater improvement on several domains of organizational functioning relative to US counterparts. Taken together, these findings suggest that JDC professionals are amenable to the adoption and implementation of a treatment model that holds promise for improving youth outcomes. PMID:22154039

  6. Integrating forward osmosis into microbial fuel cells for wastewater treatment, water extraction and bioelectricity generation.

    PubMed

    Zhang, Fei; Brastad, Kristen S; He, Zhen

    2011-08-01

    A novel osmotic microbial fuel cell (OsMFC) was developed by using a forward osmosis (FO) membrane as a separator. The performance of the OsMFC was examined with either NaCl solution or artificial seawater as a catholyte (draw solution). A conventional MFC with a cation exchange membrane was also operated in parallel for comparison. It was found that the OsMFC produced more electricity than the MFC in both batch operation (NaCl solution) and continuous operation (seawater), likely due to better proton transport with water flux through the FO membrane. Water flux from the anode into the cathode was clearly observed with the OsMFC but not in the MFC. The solute concentration of the catholyte affected both electricity generation and water flux. These results provide a proof of concept that an OsMFC can simultaneously accomplish wastewater treatment, water extraction (from the wastewater), and electricity generation. The potential applications of the OsMFC are proposed for either water reuse (linking to reverse osmosis for reconcentration of draw solution) or seawater desalination (connecting with microbial desalination cells for further wastewater treatment and desalination). PMID:21751820

  7. Cancer treatment as a game: integrating evolutionary game theory into the optimal control of chemotherapy

    NASA Astrophysics Data System (ADS)

    Orlando, Paul A.; Gatenby, Robert A.; Brown, Joel S.

    2012-12-01

    Chemotherapy for metastatic cancer commonly fails due to evolution of drug resistance in tumor cells. Here, we view cancer treatment as a game in which the oncologists choose a therapy and tumors ‘choose’ an adaptive strategy. We propose the oncologist can gain an upper hand in the game by choosing treatment strategies that anticipate the adaptations of the tumor. In particular, we examine the potential benefit of exploiting evolutionary tradeoffs in tumor adaptations to therapy. We analyze a math model where cancer cells face tradeoffs in allocation of resistance to two drugs. The tumor ‘chooses’ its strategy by natural selection and the oncologist chooses her strategy by solving a control problem. We find that when tumor cells perform best by investing resources to maximize response to one drug the optimal therapy is a time-invariant delivery of both drugs simultaneously. However, if cancer cells perform better using a generalist strategy allowing resistance to both drugs simultaneously, then the optimal protocol is a time varying solution in which the two drug concentrations negatively covary. However, drug interactions can significantly alter these results. We conclude that knowledge of both evolutionary tradeoffs and drug interactions is crucial in planning optimal chemotherapy schedules for individual patients.

  8. AlgaeSim: a model for integrated algal biofuel production and wastewater treatment.

    PubMed

    Drexler, Ivy L C; Joustra, Caryssa; Prieto, Ana; Bair, Robert; Yeh, Daniel H

    2014-02-01

    AlgaeSim, a dynamic multiple-systems (C, N, P) mass balance model, was developed to explore the potential for algae biomass production from wastewater by coupling two photobioreactors into the main treatment train at a municipal wastewater resource recovery facility (WRRF) in Tampa, Florida. The scoping model examined the synergy between algae cultivation and wastewater treatment through algal growth and substrate removal kinetics, as well as through macroeconomic analyses of biomass conversion to bioproducts. Sensitivity analyses showed that biomass production is strongly dependent on Monod variables and harvesting regime, with sensitivity changing with growth phase. Profitability was sensitive to processing costs and market prices of products. Under scenarios based on current market conditions and typical algae production, AlgaeSim shows that a WRRF can potentially generate significant profit if algae are processed for biodiesel, biogas, or fertilizer. Wastewater resource recovery facilities could similarly save on operating costs resulting from the reduction in aeration (for nitrification) and chemicals (for denitrification). PMID:24645547

  9. Patient Satisfaction with Methadone Maintenance Treatment in Vietnam: A Comparison of Different Integrative-Service Delivery Models

    PubMed Central

    Tran, Bach Xuan; Nguyen, Long Hoang; Phan, Huong Thu Thi; Latkin, Carl A.

    2015-01-01

    Background Patient satisfaction is an important component of quality in healthcare delivery. To inform the expansion of Methadone Maintenance Treatment (MMT) services in Vietnam, we examined the satisfaction of patients with regards to different services delivery models and identified its associated factors. Methods We interviewed 1,016 MMT patients at 5 clinics in Hanoi and Nam Dinh province. The modified SATIS instrument, a 10-item scale, was used to measure three dimensions: “Services quality and convenience”, “Health workers’ capacity and responsiveness” and “Inter-professional care”. Results The average score was high across three SATIS dimensions. However, only one third of patients completely satisfied with general health services and treatment outcomes. Older age, higher education, having any problem in self-care and anxiety/depression were negatively associated with patient’s satisfaction. Meanwhile, patients receiving MMT at clinics, where more comprehensive HIV and general health care services were available, were more likely to report a complete satisfaction. Conclusion Patients were highly satisfied with MMT services in Vietnam. However, treatment for drug users should go beyond methadone maintenance to address complicated health demands of drug users. Integrating MMT with comprehensive HIV and general health services together with improving the capacity of health workers and efficiency of services organisation to provide interconnected health care for drug users are critical for improving the outcomes of the MMT program. PMID:26556036

  10. Prostate cancer: precision of integrating functional MR imaging with radiation therapy treatment by using fiducial gold markers.

    PubMed

    Huisman, Henkjan J; Fütterer, Jurgen J; van Lin, Emile N J T; Welmers, Arjan; Scheenen, Tom W J; van Dalen, Jorn A; Visser, Andries G; Witjes, J A; Barentsz, Jelle O

    2005-07-01

    The use of intensity-modulated radiation therapy for treatment of dominant intraprostatic lesions may require integration of functional magnetic resonance (MR) imaging with treatment-planning computed tomography (CT). The purpose of this study was to compare prospectively the landmark and iterative closest point methods for registration of CT and MR images of the prostate gland after placement of fiducial markers. The study was approved by the institutional ethics review board, and informed consent was obtained. CT and MR images were registered by using fiducial gold markers that were inserted into the prostate. Two image registration methods--a commonly available landmark method and dedicated iterative closest point method--were compared. Precision was assessed for a data set of 21 patients by using five operators. Precision of the iterative closest point method (1.1 mm) was significantly better (P < .01) than that of the landmark method (2.0 mm). Furthermore, a method is described by which multimodal MR imaging data are reduced into a single interpreted volume that, after registration, can be incorporated into treatment planning. PMID:15983070

  11. The use of mindfulness in obsessive compulsive disorder: suggestions for its application and integration in existing treatment.

    PubMed

    Fairfax, Hamilton

    2008-01-01

    Treatment for obsessive-compulsive disorder (OCD) is a standard activity of psychologists, particularly those in Community Mental Health Teams (CMHT). In 2005, NICE published guidelines recommending Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ER-P) as the evidence-based psychological treatments of choice. In recent years there have been significant developments within cognitive behavioural theory, including what has been referred to as the 'Third Wave'. This paper explores the contribution of mindfulness; a practice that has previously been integrated into other CBT models of treatment, to cognitive interventions in OCD, suggesting that in complements both CBT and ER-However it had previously been suggested by Freeston that mindfulness may prevent successful ER-P by becoming a neutralising technique. Examples of the application of a mindfulness-based approach are explored (MOCD), including reference to an OCD group run by the author, and areas of potential overlap are identified, in particular thought-action Fusion. It is concluded that if applied properly, mindfulness not only complements traditional CBT interventions, but could also increase their efficacy and perhaps prevent relapse. PMID:19115428

  12. INTEGRATED OPTICAL TOOLS FOR MINIMALLY INVASIVE DIAGNOSIS AND TREATMENT AT GASTROINTESTINAL ENDOSCOPY

    PubMed Central

    Rodriguez-Diaz, Eladio; Bigio, Irving J.; Singh, Satish K.

    2010-01-01

    Over the past two decades, the bulk of gastrointestinal (GI) endoscopic procedures has shifted away from diagnostic and therapeutic interventions for symptomatic disease toward cancer prevention in asymptomatic patients. This shift has resulted largely from a decrease in the incidence of peptic ulcer disease in the era of antisecretory medications coupled with emerging evidence for the efficacy of endoscopic detection and eradication of dysplasia, a histopathological biomarker widely accepted as a precursor to cancer. This shift has been accompanied by a drive toward minimally-invasive, in situ optical diagnostic technologies that help assess the mucosa for cellular changes that relate to dysplasia. Two competing but complementary approaches have been pursued. The first approach is based on broad-view targeting of “areas of interest” or “red flags.” These broad-view technologies include standard white light endoscopy (WLE), high-definition endoscopy (HD), and “electronic” chromoendoscopy (narrow-band-type imaging). The second approach is based on multiple small area or point-source (meso/micro) measurements, which can be either machine (spectroscopy) or human-interpreted (endomicroscopy, magnification endoscopy), much as histopatholgy slides are. In this paper we present our experience with the development and testing of a set of familiar but “smarter” standard tissue-sampling tools that can be routinely employed during screening/surveillance endoscopy. These tools have been designed to incorporate fiberoptic probes that can mediate spectroscopy or endomicroscopy. We demonstrate the value of such tools by assessing their preliminary performance from several ongoing clinical studies. Our results have shown promise for a new generation of integrated optical tools for a variety of screening/surveillance applications during GI endoscopy. Integrated devices should prove invaluable for dysplasia surveillance strategies that currently result in large

  13. Integrated gasification and plasma cleaning for waste treatment: A life cycle perspective.

    PubMed

    Evangelisti, Sara; Tagliaferri, Carla; Clift, Roland; Lettieri, Paola; Taylor, Richard; Chapman, Chris

    2015-09-01

    In the past, almost all residual municipal waste in the UK was landfilled without treatment. Recent European waste management directives have promoted the uptake of more sustainable treatment technologies, especially for biodegradable waste. Local authorities have started considering other options for dealing with residual waste. In this study, a life cycle assessment of a future 20MWe plant using an advanced two-stage gasification and plasma technology is undertaken. This plant can thermally treat waste feedstocks with different composition and heating value to produce electricity, steam and a vitrified product. The objective of the study is to analyse the environmental impacts of the process when fed with seven different feedstocks (including municipal solid waste, solid refuse fuel, reuse-derived fuel, wood biomass and commercial & industrial waste) and identify the process steps which contribute more to the environmental burden. A scenario analysis on key processes, such as oxygen production technology, metal recovery and the appropriate choice for the secondary market aggregate material, is performed. The influence of accounting for the biogenic carbon content in the waste from the calculations of the global warming potential is also shown. Results show that the treatment of the refuse-derived fuel has the lowest impact in terms of both global warming potential and acidification potential because of its high heating value. For all the other impact categories analysed, the two-stage gasification and plasma process shows a negative impact for all the waste streams considered, mainly due to the avoided burdens associated with the production of electricity from the plant. The plasma convertor, key characteristic of the thermal process investigated, although utilising electricity shows a relatively small contribution to the overall environmental impact of the plant. The results do not significantly vary in the scenario analysis. Accounting for biogenic carbon

  14. [Acamprosate and psychosocial intervention. An integrative treatment approach for prevention of alcohol dependent patients in Switzerland].

    PubMed

    Fuchs, W J; Riebenfeld, D

    2002-04-24

    105 patients with severe alcohol dependence, who were treated in 13 centers in Switzerland, took part in this open study. The abstinence rate achieved under treatment with Acamprosat, which was used within the framework of established psychotherapeutic intervention programmes in which the doctors could choose between five different procedures, was determined over a period of 24 weeks. In addition, a sociodemographic profile was drawn up, a physical examination was carried out and data were collected on the safety aspect of Acamprosat. It was also of interest to ascertain whether, and if so how, the patients' quality of life changed under the treatment, and in what form they received psychosocial support. As supportive therapy almost two-thirds of the patients (63%) received individual psychotherapy, in 28% the doctor decided on cognitive behavioural therapy, in 4% a short intervention was carried out, in 4% group therapy and in 2% family therapy. In 85.7% of the patients the doctor continued with the initial form of psychotherapy, while in the remaining patients it was changed once. Due to the very uneven distribution a comparison of the outcome in regard to the concomitant therapy was rather problematical. Psychiatric problems (21%), polyneuritis (12%) and liver damage (10.6%)--all known complications of chronic alcohol abuse--were the most frequent concomitant diagnoses. Of the 91 patients who had remained abstinent for the first two weeks after the start of the study, 12.9% had a recurrence at the end of the study, 56% did not have a recurrence (they were abstinent, but did have a binge or a lapse) and 31.8% did not return for the control visits. When a recurrence did occur, however, significantly less alcohol was consumed than before the treatment. As a result of the combined intervention all the parameters relating to the quality of life that were documented in connection with the SF 36 showed improvement. With this study carried out in Switzerland, which is

  15. Integrated biological (anaerobic-aerobic) and physico-chemical treatment of baker's yeast wastewater.

    PubMed

    Kalyuzhnyi, S; Gladchenko, M; Starostina, E; Shcherbakov, S; Versprille, B

    2005-01-01

    The UASB reactor (35 degrees C) was quite efficient for removal of bulk COD (52-74%) from simulated (on the basis of cultivation medium from the first separation process) general effluent of baker's yeast production (the average organic loading rates varied from 8.1 to 16 g COD/l/d). The aerobic-anoxic biofilter (19-23 degrees C) can be used for removal of remaining BOD and ammonia from anaerobic effluents; however, it suffered from COD-deficiency to fulfil denitrification requirements. To balance COD/N ratio, some bypass (approximately 10%) of anaerobically untreated general effluent should be added to the biofilter feed. The application of iron (III)-, aluminium- or calcium-induced coagulation for post-treatment of aerobic-anoxic effluents can fulfil the limits for discharge to sewerage (even for colour mainly exerted by hardly biodegradable melanoidins), however, the required amounts of coagulants were relatively high. PMID:16459801

  16. Integrated treatment of municipal sewage sludge by deep dewatering and anaerobic fermentation for biohydrogen production.

    PubMed

    Yu, Li; Yu, Yang; Jiang, Wentian; Wei, Huangzhao; Sun, Chenglin

    2015-02-01

    The increasing sludge generated in wastewater treatment plants poses a threat to the environment. Based on the traditional processes, sludge dewatered by usual methods was further dewatered by hydraulic compression and the filtrate released was treated by anaerobic fermentation. The difficulties in sludge dewatering were associated with the existence of sludge flocs or colloidal materials. A suitable CaO dosage of 125 mg/g dry sludge (DS) could further decrease the moisture content of sludge from 82.4 to 50.9 %. The filtrate from the dewatering procedure was a potential substrate for biohydrogen production. Adding zero-valent iron (ZVI) into the anaerobic system improved the biohydrogen yield by 20 %, and the COD removal rate was lifted by 10 % as well. Meanwhile, the sludge morphology and microbial community were altered. The novel method could greatly reduce the sludge volume and successfully treated filtrate along with the conversion of organics into biohydrogen. PMID:25192669

  17. Integrating genomics in head and neck cancer treatment: Promises and pitfalls.

    PubMed

    Thariat, Juliette; Vignot, Stéphane; Lapierre, Ariane; Falk, Alexander T; Guigay, Joel; Van Obberghen-Schilling, Ellen; Milano, Gerard

    2015-09-01

    Head and neck squamous cell carcinomas (HNSCC) represent a multifactorial disease of poor prognosis. They have lagged behind other cancers in terms of personalized therapy. With expansion and high throughput sequencing methods, recent landmark exonic studies and Cancer Genome Atlas data have identified genes relevant to carcinogenesis and cancer progression. Mutational profiles and rates vary widely depending on exposure to carcinogens, anatomic subsites and human papilloma virus (HPV) infection. Tumors may exhibit specific, tissue-specific, not exclusively HPV-related, gene alterations, such those observed in oral cavity cancers in Asia or Occident. Except for the PI3K pathway, the rate of mutations in HPV+ cancers is much lower than in tobacco/alcohol-related cancers. Somatic driver mutation analyses show that relatively few driver genes are druggable in HNSCC and that tumor suppressor gene alterations prevail. More mature for therapeutic applications is the oncogenic PI3K pathway, with preclinical human xenograft models suggesting that PI3KCA pathway mutations may be used as predictive biomarkers and clinical data showing efficacy of mTOR/Akt inhibitors. Therapeutic guidance, to date, relies on classical histoprognostic factors, anatomic subsite and HPV status, with integration of hierarchized supervised mutational profiling to provide additional therapeutic options in advanced HNSCC in a near future. Unsupervised controlled genomic analyses remain necessary to unravel potentially relevant genes. PMID:25979769

  18. Integrated anaerobic-aerobic fixed-film reactor for slaughterhouse wastewater treatment.

    PubMed

    Del Pozo, R; Diez, V

    2005-03-01

    An integrated anaerobic-aerobic fixed-film pilot-scale reactor with arranged media was fed during 166 days with slaughterhouse wastewater. Operation temperature was 25 degrees C and the anaerobic-aerobic volume ratio was decreased from 4:1 to 3:2 and finally to 2:3. Overall organic matter removal efficiencies of 93% were achieved for an average organic loading rate of 0.77 kg COD/m3 d, and nitrogen removal efficiencies of 67% were achieved for nitrogen loading rates of 0.084 kg N/m3 d. The high internal recirculation associated to the air-lift effect linked to the aeration of a part of the reactor section caused high mixing between the anaerobic and aerobic zones, so that most organic matter was removed aerobically. The nitrification process achieved an efficiency of 91% for nitrogen loads of 0.15 kg N/m3 d when the anaerobic-aerobic volume ratio was 2:3 and was limited by dissolved oxygen concentration below 3 mg/l. The influence of the heterotrophic biomass growing in the outer biofilm was checked. Denitrification only implied the 12-34% of the total nitrogen removal and was limited by dissolved oxygen concentration in the anaerobic zone above 0.5 mg/l caused by the mixing regime. Most removed nitrogen was employed in synthesis of heterotrophic bacteria. PMID:15766966

  19. An integrative analysis of treatment, outcomes and prognostic factors for primary spinal anaplastic ependymomas.

    PubMed

    Chen, Peiqin; Sui, Mingxing; Ye, Jingliang; Wan, Zhiping; Chen, Feng; Luo, Chun

    2015-06-01

    The aim of this study was to elucidate the role of treatment modalities in primary spinal anaplastic ependymomas (PSAE) and identify promising prognostic factors. PSAE are rare tumors of the central nervous system with poorly understood clinical characteristics and treatment outcomes. We reviewed the literature in PubMed, Web of Science and Scopus databases to identify patients with PSAE. Multivariate Cox proportional hazards analysis and univariate Kaplan-Meier analysis were performed on the PSAE patients and overall survival (OS) and progression-free survival (PFS) were assessed to evaluate the clinical outcomes. Of the 40 patients with PSAE, the tumors were mostly intramedullary (n=19; 47.5%) and frequently involved the thoracic cord (n=25; 62.5%). Eighteen patients suffered recurrence during the follow-up with a median PFS of 24 months. The 1, 2, and 5year OS rates of the PSAE patients were 91.5%, 82.1%, and 63.1%, respectively. Gross total resection (GTR) was independently associated with prolonged PFS (hazard ratio [HR] 0.11; p=0.004) and OS (HR 0.11; p=0.003) in the multivariate analysis. Adjuvant radiotherapy also conferred improved PFS (HR 0.15; p=0.008) and OS (HR 0.16; p=0.022). Age, sex, tumor location and chemotherapy did not influence the outcomes in this group. The results of our study suggest that GTR and adjuvant radiotherapy are strong prognostic indicators in patients with PSAE and the role of chemotherapy is yet to be defined. PMID:25769252

  20. INtegration of DEPression Treatment into HIV Care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Despite 10 to% of persons living with HIV in sub-Saharan Africa having clinical depression, and the consequences of depression for key public health outcomes (HIV treatment adherence and condom use), depression treatment is rarely integrated into HIV care programs. Task-shifting, protocolized approaches to depression care have been used to overcome severe shortages of mental health specialists in developing countries, but not in sub-Saharan Africa and not with HIV clients. The aims of this trial are to evaluate the implementation outcomes and cost-effectiveness of a task-shifting, protocolized model of antidepressant care for HIV clinics in Uganda. Methods/Design INDEPTH-Uganda is a cluster randomized controlled trial that compares two task-shifting models of depression care - a protocolized model versus a model that relies on the clinical acumen of trained providers to provide depression care in ten public health HIV clinics in Uganda. In addition to data abstracted from routine data collection mechanisms and supervision logs, survey data will be collected from patient and provider longitudinal cohorts; at each site, a random sample of 150 medically stable patients who are depressed according to the PHQ-2 screening will be followed for 12 months, and providers involved in depression care implementation will be followed over 24 months. These data will be used to assess whether the two models differ on implementation outcomes (proportion screened, diagnosed, treated; provider fidelity to model of care), provider adoption of treatment care knowledge and practices, and depression alleviation. A cost-effectiveness analysis will be conducted to compare the relative use of resources by each model. Discussion If effective and resource-efficient, the task-shifting, protocolized model will provide an approach to building the capacity for sustainable integration of depression treatment in HIV care settings across sub-Saharan Africa and improving key public

  1. Integrative approach for the treatment of posttraumatic stress disorder in 9/11 first responders: three core techniques.

    PubMed

    Haugen, Peter T; Splaun, Allison Keisler; Evces, Mark R; Weiss, Daniel S

    2013-09-01

    We describe an integrative psychotherapy for first responders to the September 11, 2001 terrorist attack, including those who continue to be psychologically impacted by these events, most of whom meet criteria for a diagnosis of posttraumatic stress disorder. Three core techniques used in this treatment are described: (a) an emphasis on meaning making, particularly regarding the traumatic event; (b) focus on the most affect-laden components of the traumatic exposure; and (c) identifying and challenging the implicit strategies used by individuals to avoid discussion of components of their traumatic memories and the attendant negative affect. For each intervention, a theoretical rationale and the presumed mechanism of operation are presented. We discuss the clinical and research implications of this intervention. PMID:24000847

  2. Development of Site-Specific Soil Design Basis Earthquake (DBE) Parameters for the Integrated Waste Treatment Unit (IWTU)

    SciTech Connect

    Payne, Suzette

    2008-08-01

    Horizontal and vertical PC 3 (2,500 yr) Soil Design Basis Earthquake (DBE) 5% damped spectra, corresponding time histories, and strain-compatible soil properties were developed for the Integrated Waste Treatment Unit (IWTU). The IWTU is located at the Idaho Nuclear Technology and Engineering Center (INTEC) at the Idaho National Laboratory (INL). Mean and 84th percentile horizontal DBE spectra derived from site-specific site response analyses were evaluated for the IWTU. The horizontal and vertical PC 3 (2,500 yr) Soil DBE 5% damped spectra at the 84th percentile were selected for Soil Structure Interaction (SSI) analyses at IWTU. The site response analyses were performed consistent with applicable Department of Energy (DOE) Standards, recommended guidance of the Nuclear Regulatory Commission (NRC), American Society of Civil Engineers (ASCE) Standards, and recommendations of the Blue Ribbon Panel (BRP) and Defense Nuclear Facilities Safety Board (DNFSB).

  3. Integrating the selection of PHA storing biomass and nitrogen removal via nitrite in the main wastewater treatment line.

    PubMed

    Basset, N; Katsou, E; Frison, N; Malamis, S; Dosta, J; Fatone, F

    2016-01-01

    A novel scheme was developed for the treatment of municipal wastewater integrating nitritation/denitritation with the selection of polyhydroxyalkanoates (PHA) storing biomass under an aerobic/anoxic, feast/famine regime. The process took place in a sequencing batch reactor (SBR) and the subsequent PHA accumulation in a batch reactor. The carbon source added during the selection and accumulation steps consisted of fermentation liquid from the organic fraction of municipal solids waste (OFMSW FL) (Period I) and OFMSW and primary sludge fermentation liquid (Period II). Selection of PHA storing biomass was successful and denitritation was driven by internally stored PHA during the famine phase. Under optimum conditions of SBR operation ammonia removal was 93%, reaching a maximum nitrite removal of 98%. The treated effluent met the nitrogen limits, while PHA-storing biomass was successfully selected. The maximum accumulation of PHA was 10.6% (wt.) since the nutrients present in the carbon source promoted bacterial growth. PMID:26587791

  4. Development of an integral damping treatment for NASA's next-generation hollow fan blades

    NASA Astrophysics Data System (ADS)

    Kosmatka, John B.; Mehmed, Oral

    2002-06-01

    A NASA research program is underway to develop fan blades that have significantly greater propulsive efficiency, lower acoustic noise, and lower weight. These blades have a large internal manifold and open trailing edge that is used to blow air in the downwash. The blades are composed of a titanium root and composite internal manifold with an outer graphite/epoxy shell. Due to the complex internal structure and open-cell design, these blades have low natural frequencies and bending-torsion coupled mode shapes that could potentially lead to aeroelastic instabilities. Increasing the damping levels in these blades will improve the fatigue life and reduce aeroelastic instability concerns. The vibratory modes of interest include the first and second bending modes as well as first torsion mode. Due to the geometric constraints of the outer blade shape and large internal manifold very little room is available for damping treatment placement. Results from the analysis study reveal that (1) significantly more damping can be obtained by embedding the material in the outer shells than within the manifold vanes, (2) carefully designing a patch that fills approximately 29% of the surface area and is only 0.005' thick will produce a loss factor of at least 0.01 for the first three structural modes, and (3) a patch that fills approximately 45% of the surface area will produce a loss factor of at least 0.02 for the first three structural modes.

  5. Effects of remifemin treatment on bone integrity and remodeling in rats with ovariectomy-induced osteoporosis.

    PubMed

    Cui, Guangxia; Leng, Huijie; Wang, Ke; Wang, Jianwei; Zhu, Sainan; Jia, Jing; Chen, Xing; Zhang, Weiguang; Qin, Lihua; Bai, Wenpei

    2013-01-01

    This study aims to evaluate the effects of Remifemin (isopropanolic extract of Cimicifuga Racemosa) on postmenopausal osteoporosis. 120 female Sprague-Dawley rats were randomly assigned to four groups: sham surgery with vehicle, ovariectomy with vehicle, ovariectomy with estradiol valerate, or ovariectomy with Remifemin. Daily oral administrations of the vehicle, estradiol valerate, or Remifemin began 2 weeks after surgery and lasted to 4, 8, or 12 weeks. Ten rats in each group were sacrificed at each timestep with assessment of bone mineral density, trabecular bone structure, and biomechanical parameters of the femur and lumbar vertebra. Bone turnover markers were evaluated 12 weeks after surgery. Both drugs prevented bone density loss in the distal end of the femur and preserved the trabecular bone structure in both the lumbar vertebra and distal end of the femur following ovariectomy. Both drugs protected bone stiffness at the tested regions and reduced bone reabsorption in ovariectomized rats. The preventive effects of Remifemin against bone-loss can rival those of estradiol valerate if treatment duration is adequately extended. In conclusion, Remifemin may demonstrate equivalent effects to estradiol valerate in terms of preventing postmenopausal osteoporosis. PMID:24349369

  6. Integration of chemotherapy into a combined modality treatment plan for head and neck cancer: a review

    SciTech Connect

    Glick, J.H.; Taylor, S.G.

    1981-02-01

    This review highlights the most important recent advances in the chemotherapeutic management of patients with squamous cell carcinoma of the head and neck. In patients who have recurrent or metastatic disease, methotrexate, platinum, and bleomyc are three active drugs when used as single agents. There is no evidence that high-dose methotrexate therapy is superior to more conventional weekly intravenous methotrexate in the treatment of recurrent disease. Platinum is a new agent that has demonstrated activity against hematogenous as well as regional disease. In the absence of evidence of a dose-response curve for platinum, the lower dosage schedules sould be used that can be given with acceptable toxicity on an outpatient basis. Combination chemotherapy has resulted in a high proportion of objective responders and approximately 20% complete remissions to any of several platinum-containing regimens. However, the median duration of response remains short and none of the combination drug programs has been established as yet as superior to single agent chemotherapy in a randomized trial.

  7. Effects of Remifemin Treatment on Bone Integrity and Remodeling in Rats with Ovariectomy-Induced Osteoporosis

    PubMed Central

    Wang, Ke; Wang, Jianwei; Zhu, Sainan; Jia, Jing; Chen, Xing; Zhang, Weiguang; Qin, Lihua; Bai, Wenpei

    2013-01-01

    This study aims to evaluate the effects of Remifemin (isopropanolic extract of Cimicifuga Racemosa) on postmenopausal osteoporosis. 120 female Sprague-Dawley rats were randomly assigned to four groups: sham surgery with vehicle, ovariectomy with vehicle, ovariectomy with estradiol valerate, or ovariectomy with Remifemin. Daily oral administrations of the vehicle, estradiol valerate, or Remifemin began 2 weeks after surgery and lasted to 4, 8, or 12 weeks. Ten rats in each group were sacrificed at each timestep with assessment of bone mineral density, trabecular bone structure, and biomechanical parameters of the femur and lumbar vertebra. Bone turnover markers were evaluated 12 weeks after surgery. Both drugs prevented bone density loss in the distal end of the femur and preserved the trabecular bone structure in both the lumbar vertebra and distal end of the femur following ovariectomy. Both drugs protected bone stiffness at the tested regions and reduced bone reabsorption in ovariectomized rats. The preventive effects of Remifemin against bone-loss can rival those of estradiol valerate if treatment duration is adequately extended. In conclusion, Remifemin may demonstrate equivalent effects to estradiol valerate in terms of preventing postmenopausal osteoporosis. PMID:24349369

  8. Enhanced Cell Integration to Titanium Alloy by Surface Treatment with Microarc Oxidation: A Pilot Study

    PubMed Central

    Lim, Young Wook; Kwon, Soon Yong; Sun, Doo Hoon; Kim, Hyoun Ee

    2009-01-01

    Microarc oxidation (MAO) is a surface treatment that provides nanoporous pits, and thick oxide layers, and incorporates calcium and phosphorus into the coating layer of titanium alloy. We presumed such modification on the surface of titanium alloy by MAO would improve the ability of cementless stems to osseointegrate. We therefore compared the in vitro ability of cells to adhere to MAOed titanium alloy to that of two different types of surface modifications: machined and grit-blasted. We performed energy-dispersive x-ray spectroscopy and scanned electron microscopy investigations to assess the structure and morphology of the surfaces. Biologic and morphologic responses to osteoblast cell lines (SaOS-2) were then examined by measuring cell proliferation, cell differentiation (alkaline phosphatase activity), and αvβ3 integrin. The cell proliferation rate, alkaline phosphatase activity, and cell adhesion in the MAO group increased in comparison to those in the machined and grit-blasted groups. The osteoblast cell lines of the MAO group were also homogeneously spread on the surface, strongly adhered, and well differentiated when compared to the other groups. This method could be a reasonable option for treating the surfaces of titanium alloy for better osseointegration. PMID:19434468

  9. Integrating biological treatment of crop residue into a hydroponic sweetpotato culture.

    PubMed

    Trotman, A A; David, P P; Bonsi, C K; Hill, W A; Mortley, D G; Loretan, P A

    1997-01-01

    Residual biomass from hydroponic culture of sweetpotato [Ipomoea batatas (L.) Lam.] was degraded using natural bacterial soil isolates. Sweetpotato was grown for 120 days in hydroponic culture with a nutrient solution comprised of a ratio of 80% modified half Hoagland solution to 20% filtered effluent from an aerobic starch hydrolysis bioreactor. The phytotoxicity of the effluent was assayed with Waldmann's Green' lettuce (Lactuca sativa L.) and the ratio selected after a 60-day bioassay using sweetpotato plants propagated vegetatively from cuttings. Controlled environment chamber experiments were conducted to investigate the impact of filtrate from biological treatment of crop residue on growth and storage root production with plants grown in a modified half Hoagland solution. Incorporation of bioreactor effluent, reduced storage root yield of 'Georgia Jet' sweetpotato but the decrease was not statistically significant when compared with yield for plants cultured in a modified half Hoagland solution without filtrate. However, yield of 'TU-82-155' sweetpotato was significantly reduced when grown in a modified half Hoagland solution into which filtered effluent had been incorporated. Total biomass was significantly reduced for both sweetpotato cultivars when grown in bioreactor effluent. The leaf area and dry matter accumulation were significantly (P < 0.05) reduced for both cultivars when grown in solution culture containing 20% filtered effluent. PMID:11542554

  10. A novel, integrated treatment system for coal wastewaters. Quarterly report, September 2, 1992--December 1, 1992

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-12-31

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and the heavy metals present in coal conversion wastewaters. Hec-CBDA-DT, (HCDT), a modified hectorite containing a mixed bilayer of a cationic (CBDA) and a dismine (DT) type surfactants, has been shown to adsorb Cr (VI) strongly at PH below 5.0. A second kind of a modified clay, montmorillonite-DT, (MONT-DT), in which the protonated form of the diamine is directly attached to the negative sites of clay surface, has also been found to adsorb CR(VI) as strongly as Hec-CBDA-DT at a pH of 4.5. The adsorption of Cr (VI) onto these two modified-clays is strongly inhibited by an increase in the ionic strength of the medium. It is inferred that the main mechanism of adsorption of CR(VI) onto these two clay complexes is of the counterion. Preliminary data on the partitioning of phenanthrene, a three-ringed polyaromatic hydrocarbon (PAH), reveal that organic carbon located on the external surfaces of clay complexes is more effective in partitioning nonionic, toxic organic compounds.

  11. A novel, integrated treatment systems for coal wastewaters. Quarterly Report, June 2, 1992--September 1, 1992

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-12-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and heavy metals present in coal conversion wastewaters. Hec-CBDA-DT, a modified hectorite containing a mixed bilayer of a cationic (CBDA) and a diamine (DT) type surfactants, was shown to adsorb simultaneously heavy metals such as Cu{sup 2+} and Cd{sup 2+} and toxic organics such as chlorophenols. The pH dependence of the adsorption of chlorophenols on Hec-CBDA-DT suggested hydrophobic partitioning, counterion adsorption and hydrogen-bond interaction of the phenolate ions with the surface diamine groups as the possible mechanisms of sorption. Adsorption of Cu{sup 2+} by Hec-CBDA-DT was shown to be only slightly affected by a large excess of counterions, thus indicating that Cu{sup 2+} adsorbed specifically to the surface. A second type of modified clay, Hec-CBDA-Palmitic Acid (Hec-CBDA-PA) adsorbed both Cu{sup 2+} and Cd{sup 2+} strongly. However, the pH optima for adsorption were 6.0 and 8.0 respectively in the case of Cu{sup 2+} and Cd{sup 2+}. It is inferred that the mechanisms of adsorption of these two metal ions to Hec-CBDA-PA are different, specific and counterion binding respectively in the case of Cu and Cd ions.

  12. A novel integrated treatment system for coal wastewaters. Quarterly report, March 2, 1992--June 1, 1992

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-08-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and heavy metals present in coal conversion wastewaters. To remove and recover heavy metals from wastewaters, four different types of surfactant-clay complexes have been prepared using hectored or montmorillonite as the base clays. The adsorbent is prepared by first coating the clay surface, upto a monolayer, with a cationic surfactant, CBDA, to which an amine, (DT), or a carboxylic acid (Palmitic acid, PA) is anchored using hydrophobic effect to form a mixed bilayer. Such an arrangement is expected to locate the functional groups in metal adsorption at the solid-solution interface. Complexes based on hectored are shown to adsorb Cu{sup 2+} ions more strongly than the ones based on montmorillonite. The rate of adsorption of Cu{sup 2+} ions is quite rapid and the adsorbed amount levels off in less than 2 hrs. The optimum pH for metal adsorption is around 6.5 and the amount of metal adsorbed declines sharply on the lower pH side of the pH optimum, suggesting that removal and recovery of adsorbed metal ions can be effected by a slight pH shift.

  13. Combining urban wastewater treatment with biohydrogen production--an integrated microalgae-based approach.

    PubMed

    Batista, Ana Paula; Ambrosano, Lucas; Graça, Sofia; Sousa, Catarina; Marques, Paula A S S; Ribeiro, Belina; Botrel, Elberis P; Castro Neto, Pedro; Gouveia, Luisa

    2015-05-01

    The aim of the present work was the simultaneous treatment of urban wastewater using microalgae and the energetic valorization of the obtained biomass. Chlorella vulgaris (Cv), Scenedesmus obliquus (Sc) and a naturally occurring algal Consortium C (ConsC) were grown in an urban wastewater. The nutrient removals were quite high and the treated water fits the legislation (PT Dec-Lei 236/98) in what concerns the parameters analysed (N, P, COD). After nutrient depletion the microalgae remained two more weeks in the photobioreactor (PBR) under nutritional stress conditions, to induce sugar accumulation (22-43%). The stressed biomass was converted into biohydrogen (bioH2), a clean energy carrier, through dark fermentation by a strain of the bacteria Enterobacter aerogenes. The fermentation kinetics were monitored and fitted to a modified Gompertz model. The highest bioH2 production yield was obtained for S. obliquus (56.8 mL H2/gVS) which was very similar when using the same algae grown in synthetic media. PMID:25453433

  14. Integrating biological treatment of crop residue into a hydroponic sweetpotato culture

    NASA Astrophysics Data System (ADS)

    Trotman, A. A.; David, P. P.; Bonsi, C. K.; Hill, W. A.; Mortley, D. G.; Loretan, P. A.

    1997-01-01

    Residual biomass from hydroponic culture of sweetpotato [Ipomoea batatas (L.) Lam.] was degraded using natural bacterial soil isolates. Sweetpotato was grown for 120 days in hydroponic culture with a nutrient solution comprised of a ratio of 80% modified half Hoagland solution to 20% filtered effluent from an aerobic starch hydrolysis bioreactor. The phytotoxicity of the effluent was assayed with `Waldmann's Green' lettuce (Lactuca sativa L.) and the ratio selected after a 60-day bioassay using sweetpotato plants propagated vegetatively from cuttings. Controlled environment chamber experiments were conducted to investigate the impact of filtrate from biological treatment of crop residue on growth and storage root production with plants grown in a modified half Hoagland solution. Incorporation of bioreactor effluent, reduced storage root yield of `Georgia Jet' sweetpotato but the decrease was not statistically significant when compared with yield for plants cultured in a modified half Hoagland solution without filtrate. However, yield of `TU-82-155' sweetpotato was significantly reduced when grown in a modified half Hoagland solution into which filtered effluent had been incorporated. Total biomass was significantly reduced for both sweetpotato cultivars when grown in bioreactor effluent. The leaf area and dry matter accumulation were significantly (P < 0.05) reduced for both cultivars when grown in solution culture containing 20% filtered effluent.

  15. Treatment

    MedlinePlus

    ... Prevention Treatment 2003 U.S. Outbreak African Rodent Importation Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox ... Examining Animals with Suspected Monkeypox African Rodent Importation Ban Resources Related Links Poxvirus Molluscum Contagiosum Orf Virus ( ...

  16. Enhanced ethanol production from pomelo peel waste by integrated hydrothermal treatment, multienzyme formulation, and fed-batch operation.

    PubMed

    Huang, Renliang; Cao, Ming; Guo, Hong; Qi, Wei; Su, Rongxin; He, Zhimin

    2014-05-21

    Pomelo peel is an abundant pectin-rich biomass waste in China and has the potential to serve as a source of fuels and chemicals. This study reports a promising way to deal with pomelo peel waste and to utilize it as raw material for ethanol production via simultaneous saccharification and fermentation (SSF). An integrated strategy, incorporating hydrothermal treatment, multienzyme formulation, and fed-batch operation, was further developed to enhance the ethanol production. The results show that hydrothermal treatment (120 °C, 15 min) could significantly reduce the use of cellulase (from 7 to 3.8 FPU g(-1)) and pectinase (from 20 to 10 U g(-1)). A multienzyme complex, which consists of cellulase, pectinase, β-glucosidase, and xylanase, was also proven to be effective to improve the hydrolysis of pretreated pomelo peel, leading to higher concentrations of fermentative sugars (36 vs 14 g L(-1)) and galacturonic acid (23 vs 9 g L(-1)) than those with the use of a single enzyme. Furthermore, to increase the final ethanol concentration, fed-batch operation by adding fresh substrate was employed in the SSF process. A final solid loading of 25% (w/v), which is achieved by adding 15% fresh substrate to the SSF system at an initial solid loading of 10%, produced 36 g L(-1) ethanol product in good yield (73.5%). The ethanol concentration is about 1.73-fold that at the maximum solid loading of 14% for batch operation, whereas both of them have a closed ethanol yield. The results indicate that the use of the fed-batch mode could alleviate the decrease in ethanol yield at high solid loading, which is caused by significant mass transfer limitation and increased inhibition of toxic compounds in the SSF process. The integrated strategy demonstrated in this work could open a new avenue for dealing with pectin-rich biomass wastes and utilization of the wastes to produce ethanol. PMID:24802243

  17. Integrative analysis of diffusion-weighted MRI and genomic data to inform treatment of glioblastoma.

    PubMed

    Jajamovich, Guido H; Valiathan, Chandni R; Cristescu, Razvan; Somayajula, Sangeetha

    2016-09-01

    Gene expression profiling from glioblastoma (GBM) patients enables characterization of cancer into subtypes that can be predictive of response to therapy. An integrative analysis of imaging and gene expression data can potentially be used to obtain novel biomarkers that are closely associated with the genetic subtype and gene signatures and thus provide a noninvasive approach to stratify GBM patients. In this retrospective study, we analyzed the expression of 12,042 genes for 558 patients from The Cancer Genome Atlas (TCGA). Among these patients, 50 patients had magnetic resonance imaging (MRI) studies including diffusion weighted (DW) MRI in The Cancer Imaging Archive (TCIA). We identified the contrast enhancing region of the tumors using the pre- and post-contrast T1-weighted MRI images and computed the apparent diffusion coefficient (ADC) histograms from the DW-MRI images. Using the gene expression data, we classified patients into four molecular subtypes, determined the number and composition of genes modules using the gap statistic, and computed gene signature scores. We used logistic regression to find significant predictors of GBM subtypes. We compared the predictors for different subtypes using Mann-Whitney U tests. We assessed detection power using area under the receiver operating characteristic (ROC) analysis. We computed Spearman correlations to determine the associations between ADC and each of the gene signatures. We performed gene enrichment analysis using Ingenuity Pathway Analysis (IPA). We adjusted all p values using the Benjamini and Hochberg method. The mean ADC was a significant predictor for the neural subtype. Neural tumors had a significantly lower mean ADC compared to non-neural tumors ([Formula: see text]), with mean ADC of [Formula: see text] and [Formula: see text] for neural and non-neural tumors, respectively. Mean ADC showed an area under the ROC of 0.75 for detecting neural tumors. We found eight gene modules in the GBM cohort. The

  18. Biotic integrity of the Boise River upstream and downstream from two municipal wastewater treatment facilities, Boise, Idaho, 1995-96

    USGS Publications Warehouse

    Mullins, William H.

    1999-01-01

    Aquatic biological communities were used to assess the biotic integrity of the Boise River upstream and downstream from the Lander Street and West Boise municipal wastewater treatment facilities (WTFs) in Boise, Idaho. Samples of epilithic periphyton, benthic macroinvertebrates, and fish were collected in late February and early March 1995, in late October 1996, and in early December 1996. Epilithic periphyton biomass, expressed as chlorophyll-a and ash-free dry weight, declined substantially between 1995 and 1996. Chlorophyll-a concentrations were higher at sites downstream from WTFs in both years, but differences in concentrations between sites upstream and downstream from WTFs were not statistically significant. High withinsite variance suggests that greater sampling intensity would improve statistical comparison. Index of Biotic Integrity (IBI) scores calculated for benthic macroinvertebrates were higher for the sites upstream from WTFs in 1995 and were the same for all sites in 1996. Similarly, IBI scores calculated for fish were higher for the sites upstream from WTFs in 1995, were higher for the site upstream from the Lander Street WTF in 1996, and were the same for sites upstream and downstream from the West Boise WTF in 1996. Two species of sculpin (Cottus) were abundant at the site upstream from both WTFs but were absent at all other sites downstream from WTFs in 1995 and composed only 2 percent of the total number of fish collected downstream from the Lander Street WTF in 1996.

  19. An integrated 45L pilot microbial fuel cell system at a full-scale wastewater treatment plant.

    PubMed

    Hiegemann, Heinz; Herzer, Daniel; Nettmann, Edith; Lübken, Manfred; Schulte, Patrick; Schmelz, Karl-Georg; Gredigk-Hoffmann, Sylvia; Wichern, Marc

    2016-10-01

    A 45-L pilot MFC system, consisting of four single-chamber membraneless MFCs, was integrated into a full-scale wastewater treatment plant (WWTP) and operated under practical conditions with the effluent of the primary clarifier for nine months to identify an optimal operational strategy for stable power output and maximum substrate based energy recovery (Normalized Energy Recovery, NER). Best results with the MFC were obtained at a hydraulic retention time of 22h with COD, TSS and nitrogen removal of 24%, 40% and 28%, respectively. Mean NER of 0.36kWhel/kgCOD,deg and coulombic efficiency of 24.8% were reached. Experimental results were used to set up the first described energy balance for a whole WWTP with an integrated MFC system. Energetic calculations of the model WWTP showed that energy savings due to reduced excess sludge production and energy gain of the MFC are significantly higher than the loss of energy due to reduced biogas production. PMID:27351707

  20. Integrated environmental assessment of tertiary and residuals treatment--LCA in the wastewater industry.

    PubMed

    Beavis, P; Lundie, S

    2003-01-01

    In the wastewater industry, decision-makers lack access to an environmental tool that can assist in further informing the non-financial analysis of a system. Such a tool should incorporate impacts beyond the effluent quality and look at the supporting processes of a plant as well as plant specific operations. Life Cycle Assessment can provide the means to fill a gap in pertinent information towards more sustainable decision-making. The project "Best Practice LCA in the Wastewater Industry" is commissioned by the CRC for Waste Management and Pollution Control at UNSW with representatives from Sydney Water Corporation (SWC), NSW Department of Land and Water Conservation and the NSW Department of Public Works. Two case studies were researched to provide a post-implementation review of changes in wastewater. Case study 1: The conversion from chlorine gas to hypochlorite and UV disinfection has been completed for several inland wastewater plants at SWC. A review of operational data for each of the options has been incorporated into an LCA of each technology. Under efficient dosing conditions, disinfection with the hypochlorite system has the minimum environmental impact. Case study 2 deals with the conversion from anaerobic to aerobic digestion. Aerobic digestion minimises release of nutrients into a sidestream to be further treated in the plant. However conversion results in more biosolids production and higher electricity requirements. This study includes a consideration of the environmental impacts of biosolids production and application. On the basis of the extended boundary including consideration of reflux composition, energy requirements and biosolids quality to potentially offset fertiliser production, anaerobic digestion performs best in 6 out of 9 impact categories. These results suggest that environmental LCA has a role in informing decision-making on unit process and treatment train selection by quantifying aspects on non-financial criteria. Also

  1. Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study

    PubMed Central

    Middlemass, Jo; Davy, Zowie; Cavanagh, Kate; Linehan, Conor; Morgan, Kevin; Lawson, Shaun; Siriwardena, A Niroshan

    2012-01-01

    Background Insomnia is a common psychological complaint. Cognitive behavioural therapy for insomnia (CBT-I), although effective, is little used because of lack of trained providers. Computerised CBT-I (CCBT-I) may be a solution to this shortfall in access. Aim To explore patient and health professional perspectives and the role of social networking, to develop a novel CCBT-I programme to increase access to this form of intervention. Design and setting Qualitative methods underpinned by the theory of planned behaviour in primary care in Lincolnshire and Nottinghamshire. Method Semi-structured interviews and focus groups with a purposive sample of health professionals and adults with insomnia. Results A total of 23 health professionals and 28 patients were interviewed. Features designed to engender trust and improve functionality were perceived to improve uptake and adherence to CCBT-I. Trust lay in programme accreditation; for professionals, trust derived from evidence of effectiveness; for patients, trust depended on the doctor–patient relationship, professional support, the quality of online peer support, and perceptions of risk. Patients wanted mobile applications; access in short periods; self-assessment; interactive, personalised information on sleep; and moderated contact with other users. Patients and practitioners differed over whether useful information could be distinguished from less useful or potentially incorrect information. Conclusion Improving uptake and adherence to online programmes for insomnia requires design features focusing on trust and functionality. Enabling greater patient control and interaction with other users and professionals may stimulate positive experiences of online therapy. CCBT-I would enable greater access to treatment but is limited by lack of online access or poor computer literacy. PMID:23211265

  2. Improving Depression Treatment for Women: Integrating a Collaborative Care Depression Intervention into OB-GYN Care

    PubMed Central

    LaRocco-Cockburn, Anna; Reed, Susan D.; Melville, Jennifer; Croicu, Carmen; Russo, Joan; Inspektor, Michal; Edmondson, Eddie; Katon, Wayne

    2013-01-01

    Background Women have higher rates of depression and often experience depression symptoms during critical reproductive periods, including adolescence, pregnancy, postpartum, and menopause. Collaborative care intervention models for mood disorders in patients receiving care in an OB-GYN clinic setting have not been evaluated. Study design and methodology for a randomized, controlled trial of collaborative care depression management versus usual care in OB-GYN clinics and the details of the adapted collaborative care intervention and model implementation are described in this paper. Methods Women over age 18 years with clinically significant symptoms of depression, as measured by a Patient Health Questionnaire-9 (PHQ-9) score ≥10 and a clinical diagnosis of major depression or dysthymia, were randomized to the study intervention or to usual care and were followed for 18 months. The primary outcome assessed was change over time in the SCL-20 depression scale between baseline and 12 months. Baseline Results 205 women were randomized: 57% white, 20% African American, 9% Asian or Pacific Islander, 7% Hispanic, and 6% Native American. Mean age was 39 years. 4.6% were pregnant and 7.5% were within 12 months postpartum. The majority were single, (52%), and 95% had at least the equivalent of a high school diploma. Almost all patients met DSM IV criteria for major depression (99%) and approximately 33% met criteria for dysthymia. Conclusions An OB-GYN collaborative care team including a social worker, psychiatrist and OB-GYN physician who met weekly and used an electronic tracking system for patients were essential elements of the proposed depression care treatment model described here. Further study of models that improve quality of depression care that are adapted to the unique OB-GYN setting are needed. PMID:23939510

  3. Designing a broad-spectrum integrative approach for cancer prevention and treatment.

    PubMed

    Block, Keith I; Gyllenhaal, Charlotte; Lowe, Leroy; Amedei, Amedeo; Amin, A R M Ruhul; Amin, Amr; Aquilano, Katia; Arbiser, Jack; Arreola, Alexandra; Arzumanyan, Alla; Ashraf, S Salman; Azmi, Asfar S; Benencia, Fabian; Bhakta, Dipita; Bilsland, Alan; Bishayee, Anupam; Blain, Stacy W; Block, Penny B; Boosani, Chandra S; Carey, Thomas E; Carnero, Amancio; Carotenuto, Marianeve; Casey, Stephanie C; Chakrabarti, Mrinmay; Chaturvedi, Rupesh; Chen, Georgia Zhuo; Chen, Helen; Chen, Sophie; Chen, Yi Charlie; Choi, Beom K; Ciriolo, Maria Rosa; Coley, Helen M; Collins, Andrew R; Connell, Marisa; Crawford, Sarah; Curran, Colleen S; Dabrosin, Charlotta; Damia, Giovanna; Dasgupta, Santanu; DeBerardinis, Ralph J; Decker, William K; Dhawan, Punita; Diehl, Anna Mae E; Dong, Jin-Tang; Dou, Q Ping; Drew, Janice E; Elkord, Eyad; El-Rayes, Bassel; Feitelson, Mark A; Felsher, Dean W; Ferguson, Lynnette R; Fimognari, Carmela; Firestone, Gary L; Frezza, Christian; Fujii, Hiromasa; Fuster, Mark M; Generali, Daniele; Georgakilas, Alexandros G; Gieseler, Frank; Gilbertson, Michael; Green, Michelle F; Grue, Brendan; Guha, Gunjan; Halicka, Dorota; Helferich, William G; Heneberg, Petr; Hentosh, Patricia; Hirschey, Matthew D; Hofseth, Lorne J; Holcombe, Randall F; Honoki, Kanya; Hsu, Hsue-Yin; Huang, Gloria S; Jensen, Lasse D; Jiang, Wen G; Jones, Lee W; Karpowicz, Phillip A; Keith, W Nicol; Kerkar, Sid P; Khan, Gazala N; Khatami, Mahin; Ko, Young H; Kucuk, Omer; Kulathinal, Rob J; Kumar, Nagi B; Kwon, Byoung S; Le, Anne; Lea, Michael A; Lee, Ho-Young; Lichtor, Terry; Lin, Liang-Tzung; Locasale, Jason W; Lokeshwar, Bal L; Longo, Valter D; Lyssiotis, Costas A; MacKenzie, Karen L; Malhotra, Meenakshi; Marino, Maria; Martinez-Chantar, Maria L; Matheu, Ander; Maxwell, Christopher; McDonnell, Eoin; Meeker, Alan K; Mehrmohamadi, Mahya; Mehta, Kapil; Michelotti, Gregory A; Mohammad, Ramzi M; Mohammed, Sulma I; Morre, D James; Muralidhar, Vinayak; Muqbil, Irfana; Murphy, Michael P; Nagaraju, Ganji Purnachandra; Nahta, Rita; Niccolai, Elena; Nowsheen, Somaira; Panis, Carolina; Pantano, Francesco; Parslow, Virginia R; Pawelec, Graham; Pedersen, Peter L; Poore, Brad; Poudyal, Deepak; Prakash, Satya; Prince, Mark; Raffaghello, Lizzia; Rathmell, Jeffrey C; Rathmell, W Kimryn; Ray, Swapan K; Reichrath, Jörg; Rezazadeh, Sarallah; Ribatti, Domenico; Ricciardiello, Luigi; Robey, R Brooks; Rodier, Francis; Rupasinghe, H P Vasantha; Russo, Gian Luigi; Ryan, Elizabeth P; Samadi, Abbas K; Sanchez-Garcia, Isidro; Sanders, Andrew J; Santini, Daniele; Sarkar, Malancha; Sasada, Tetsuro; Saxena, Neeraj K; Shackelford, Rodney E; Shantha Kumara, H M C; Sharma, Dipali; Shin, Dong M; Sidransky, David; Siegelin, Markus David; Signori, Emanuela; Singh, Neetu; Sivanand, Sharanya; Sliva, Daniel; Smythe, Carl; Spagnuolo, Carmela; Stafforini, Diana M; Stagg, John; Subbarayan, Pochi R; Sundin, Tabetha; Talib, Wamidh H; Thompson, Sarah K; Tran, Phuoc T; Ungefroren, Hendrik; Vander Heiden, Matthew G; Venkateswaran, Vasundara; Vinay, Dass S; Vlachostergios, Panagiotis J; Wang, Zongwei; Wellen, Kathryn E; Whelan, Richard L; Yang, Eddy S; Yang, Huanjie; Yang, Xujuan; Yaswen, Paul; Yedjou, Clement; Yin, Xin; Zhu, Jiyue; Zollo, Massimo

    2015-12-01

    address stages and types of cancer that lack conventional treatment, and it may reduce relapse risks. A proposed agenda for future research is offered. PMID:26590477

  4. What is the place of peritoneal dialysis in the integrated treatment of renal failure?

    PubMed

    Coles, G A; Williams, J D

    1998-12-01

    The role of peritoneal dialysis (PD) in renal replacement therapy (RRT) remains unclear. There are no controlled trials to provide hard evidence of its efficacy. Comparative studies with haemodialysis from different centres and countries have given conflicting results even when allowing for case mix. Data from the United States on patients starting or receiving treatment in the late 1980s suggested a worse prognosis for older patients, particularly diabetics receiving PD as compared to HD. Analysis of the USRDS data base for patients starting in the early 1990s shows an improvement in outcome but with no difference in overall mortality. The Canadian registry has recently published data showing a better survival with PD than with HD in the first two years of RRT. Morbidity is similar with both therapies, although hospitalization is increased with PD. Unfortunately long-term technique survival is not as good with PD. However, PD has certain medical advantages, particularly the maintenance of residual renal function that contributes to solute and fluid removal. It may also postpone the onset of amyloidosis. Patients transplanted after previous PD have a decreased risk of early acute renal failure and equally good long-term results when compared to those patients who were on HD before transplantation. The quality of life is as good with PD as with center HD, and there are social advantages to PD including an increased chance of employment, more flexible holidays and avoidance of thrice weekly travel to a dialysis center. PD also has logistical advantages and can be utilized by the majority of new patients. We therefore conclude that PD has potential advantages early in the course of RRT, and should therefore be offered as a first option to all suitable new patients. Whether PD has a major or minor role in later years (> 5) remains unclear. PMID:9853290

  5. A novel, integrated treatment system for coal wastewaters. Quarterly report, December 2, 1992--March 1, 1993

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1993-07-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and the heavy metals present in coal conversion wastewaters. In this report, the following findings have been reported and discussed. Hec-CBDA-PA, (HCPA), a modified hectorite containing a mixed bilayer of a cationic (CBDA) and a long chain carboxylic acid (palmitic acid, PA) type surfactants, has been shown to adsorb Cu (II) strongly at pH 6.0. Increasing concentrations of NaCl reduce the affinity of CU(II) adsorption onto HCPA. For example, the binding constants for CU(II) adsorption onto HCPA at pH 6.0 are 88 and 35 mM{sup {minus}1} at 20 and 200 mM NaCl respectively. The saturation binding capacity is also observed to decrease from 0.25 to 0.12 mmoles Cu(II)/g adsorbent in the same ionic strength range. Spectral properties of Cu(II)-DT complex have been examined. Our previous results had shown that DT, an alkyl diamine, binds Cu(II) strongly at pH 7.4, but very weakly at pH 3.0. The formation of Cu(II)-DT complex at pH 7.4 produces an intense blue color and spectral measurements at 626 mn reveal a stoichiometric ratio of 3:1 for the DT-Cu(II) complex. {beta}-naphthoic acid, a organic acid (pKa = 4.17), has been used to probe the pH dependent surface charge of montmorillonite-DT (MONT-DT) complex. Our results indicate that bulk of the surface diamines are de-protonated above pH 9.0.

  6. Machinability of Austempered Ductile Iron (ADI) Produced by Integrated Green Technology of Continuous Casting-Heat Treatment Processes

    SciTech Connect

    Meena, A.; El Mansori, M.; Ghidossi, P.

    2011-01-17

    This study presents the novel processing technique known as continuous casting-heat treatment processes to produce Austempered Ductile Iron (ADI) which is a new class of ductile iron. ADI is characterized by improved mechanical properties but has low machinability as compared to other cast irons and steel of similar strength. The novel technique is developed by the integration of casting (in die casting) and heat treatment processes in foundry to save cost energy and time. Specimens just after casting were austenitized at 930 deg. C for 90 min and then austempered in fluidized bed at 380 deg. C for 90 and 120 min. Hence, the effect of austempering time on the morphology of retained austenite and mechanical properties of the material were examined and compared with conventionally produced ADI. Drilling tests were then carried out to evaluate the machinability of ADI in terms of cutting forces, chip micro-hardness, chip morphology and surface roughness. The mechanical properties of ADI austempered for 120 min have found to be better as compare to the ADI austempered for 90 min.

  7. Studies on the integration of nanofiltration and soil treatment for municipal effluent reclamation as a groundwater supplement.

    PubMed

    Linlin, Wu; Xuan, Zhao; Meng, Zhang

    2010-01-01

    Water shortage leads to increasing attention to artificial groundwater recharge by reclaimed water. An injection well is the most common recharge approach. In this paper, a new kind of integrated technology-short-term vadose soil treatment followed by nanofiltration-is recommended as pretreatment for artificial groundwater recharge by an injection well. Laboratory-scale experiments demonstrate that the short-term vadose soil can remove approximately 30% of the total dissolved organic carbon (DOC) content and 40% of dissolved organic matter with a molecular weight less than 1 kDa. As a compensatory process of soil treatment, nanofiltration offers a favorable desalination and additional organics removal. The removal efficiencies for total dissolved solids and conductivity amount to 45 and 48%, respectively. The residual DOC in the final effluent is below 1.0 mg/L. In addition, short-term vadose soil offers effective elimination of aromatic protein-like and polysaccharide-like substances, which are detected as components of the membrane foulant. PMID:20112534

  8. Machinability of Austempered Ductile Iron (ADI) Produced by Integrated Green Technology of Continuous Casting-Heat Treatment Processes

    NASA Astrophysics Data System (ADS)

    Meena, A.; El Mansori, M.; Ghidossi, P.

    2011-01-01

    This study presents the novel processing technique known as continuous casting-heat treatment processes to produce Austempered Ductile Iron (ADI) which is a new class of ductile iron. ADI is characterized by improved mechanical properties but has low machinability as compared to other cast irons and steel of similar strength. The novel technique is developed by the integration of casting (in die casting) and heat treatment processes in foundry to save cost energy and time. Specimens just after casting were austenitized at 930° C for 90 min and then austempered in fluidized bed at 380° C for 90 and 120 min. Hence, the effect of austempering time on the morphology of retained austenite and mechanical properties of the material were examined and compared with conventionally produced ADI. Drilling tests were then carried out to evaluate the machinability of ADI in terms of cutting forces, chip micro-hardness, chip morphology and surface roughness. The mechanical properties of ADI austempered for 120 min have found to be better as compare to the ADI austempered for 90 min.

  9. An overview of child physical abuse: developing an integrated parent-child cognitive-behavioral treatment approach.

    PubMed

    Runyon, Melissa K; Deblinger, Esther; Ryan, Erika E; Thakkar-Kolar, Reena

    2004-01-01

    This article reviews and summarizes the extant literature regarding child physical abuse (CPA). Literature is summarized that describes the wide range of short- and long-term effects of CPA on children as well as the documented characteristics of parents/caregivers who engage in physically abusive parenting practices. Although the reviewed research documents that interventions geared only toward the parent have been found to produce significant improvements with respect to parenting abilities, parent-child interactions, and children's behavior problems, there is a paucity of research examining the efficacy of interventions developed specifically to target the child's emotional and behavioral difficulties. Based on the few studies that have shown emotional and behavioral gains for children who have participated in treatment, an integrated parent-child cognitive-behavioral therapy (CBT) approach is proposed here to address the complex issues presented by both parent and child in CPA cases. The direct participation of the child in treatment also may improve our ability to target posttraumatic stress disorder (PTSD), depressive symptoms as well as anger control and dysfunctional abuse attributions in the children themselves. Implications for practice, public policy, and research are also addressed. PMID:15006297

  10. Dynamic changes of integrated backscatter, attenuation coefficient and bubble activities during high-intensity focused ultrasound (HIFU) treatment.

    PubMed

    Zhang, Siyuan; Wan, Mingxi; Zhong, Hui; Xu, Cheng; Liao, Zhenzhong; Liu, Huanqing; Wang, Supin

    2009-11-01

    This paper simultaneously investigated the transient characteristics of integrated backscatter (IBS), attenuation coefficient and bubble activities as time traces before, during and after HIFU treatment, with different HIFU parameters (acoustic power and duty cycle) in both transparent tissue-mimicking phantoms and freshly excised bovine livers. These dynamic changes of acoustic parameters and bubble activities were correlated with the visualization of lesion development selected from photos, conventional B-mode ultrasound images and differential IBS images over the whole procedure of HIFU treatment. Two-dimensional radiofrequency (RF) data were acquired by a modified diagnostic ultrasound scanner to estimate the changes of mean IBS and attenuation coefficient averaged in the lesion region, and to construct the differential IBS images and B-mode ultrasound images simultaneously. Bubble activities over the whole procedure of HIFU treatment were investigated by the passive cavitation detection (PCD) method and the changes in subharmonic and broadband noise were correlated with the transient characteristics of IBS and attenuation coefficient. When HIFU was switched on, IBS and attenuation coefficient increased with the appearance of bubble clouds in the B-mode and differential IBS image. At the same time, the level of subharmonic and broadband noise rose abruptly. Then, there was an initial decrease in the attenuation coefficient, followed by an increase when at lower HIFU power. As the lesion appeared, IBS and attenuation coefficient both increased rapidly to a value twice that of normal. Then the changes in IBS and attenuation coefficient showed more complex patterns, but still showed a slower trend of increases with lesion development. Violent bubble activities were visible in the gel and were evident as strongly echogenic regions in the differential IBS images and B-mode images simultaneously. This was detected by a dramatic high level of subharmonic and broadband

  11. Ozonation and ultrafiltration for the treatment of olive mill wastewaters: effect of key operating conditions and integration schemes.

    PubMed

    Martins, Rui C; Ferreira, Ana M; Gando-Ferreira, Licínio M; Quinta-Ferreira, Rosa M

    2015-10-01

    With the objective of reaching suitable techniques for olive mill wastewater treatment, ozonation and ultrafiltration were studied individually and combined. A continuous reactor was run for the treatment of a phenolic mixture mimicking an actual olive mill wastewater (OMW) by ozonation. The effect of the main operating parameters was analysed (pH, liquid flow rate and ozone inlet concentration). The increase of pH and ozone dose improved ozonation efficiency. As expected, the highest residence time led to higher steady-state degradation (35 % of chemical oxygen demand (COD) abatement). Even if the rise on ozone inlet gas concentration was able to remove COD in a higher extent, it should be taken into consideration that with the lowest oxidant load (15 g O3/m(3)), the maximum steady-state biochemical oxygen demand (BOD5)/COD ratio was reached which would reduce the process costs. These operating conditions (pH 9, 1 mL/min of liquid flow rate and 15 g O3/m(3)) were applied to an actual OMW leading to 80 % of phenolic content abatement and 12 % of COD removal at the steady state. Regarding ultrafiltration, it was concluded that the best total phenolic content (TPh) and COD abatement results (55 and 15 %) are attained for pH 9 and using a transmembrane pressure drop of 1 bar. Among the integration schemes that were tested, ultrafiltration followed by ozonation was able to reach 93 and 20 % of TPh and COD depletion, respectively. Moreover, this sequence led to an effluent with a BOD5/COD ratio of about 0.55 which means that it likely can be posteriorly refined in a municipal wastewater treatment plant. PMID:26013744

  12. Integrated treatment process using a natural Wyoming clinoptilolite for remediating produced waters from coalbed natural gas operations

    USGS Publications Warehouse

    Zhao, H.; Vance, G.F.; Urynowicz, M.A.; Gregory, R.W.

    2009-01-01

    Coalbed natural gas (CBNG) development in western U.S. states has resulted in an increase in an essential energy resource, but has also resulted in environmental impacts and additional regulatory needs. A concern associated with CBNG development relates to the production of the copious quantities of potentially saline-sodic groundwater required to recover the natural gas, hereafter referred to as CBNG water. Management of CBNG water is a major environmental challenge because of its quantity and quality. In this study, a locally available Na-rich natural zeolite (clinoptilolite) from Wyoming (WY) was examined for its potential to treat CBNG water to remove Na+ and lower the sodium adsorption ratio (SAR, mmol1/2 L- 1/2). The zeolite material was Ca-modified before being used in column experiments. Column breakthrough studies indicated that a metric tonne (1000??kg) of Ca-WY-zeolite could be used to treat 60,000??L of CBNG water in order to lower SAR of the CBNG water from 30 to an acceptable level of 10??mmol1/2 L- 1/2. An integrated treatment process using Na-WY-zeolite for alternately treating hard water and CBNG water was also examined for its potential to treat problematic waters in the region. Based on the results of this study, use of WY-zeolite appears to be a cost-effective water treatment technology for maximizing the beneficial use of poor-quality CBNG water. Ongoing studies are evaluating water treatment techniques involving infiltration ponds lined with zeolite. ?? 2008 Elsevier B.V. All rights reserved.

  13. Behavioral health referrals and treatment initiation rates in integrated primary care: a Collaborative Care Research Network study.

    PubMed

    Auxier, Andrea; Runyan, Christine; Mullin, Daniel; Mendenhall, Tai; Young, Jessica; Kessler, Rodger

    2012-09-01

    Although the benefits of integrating behavioral health (BH) services into primary care are well established (World Health Organization and World Organization of Family Doctors, 2012; Chiles et al. in Clin Psychol-Sci Pr 6:204-220, 1999; Cummings 1997; O'Donohue et al. 2003; Olfson et al. in Health Aff 18:79-93, 1999; Katon et al. in Ann Intern Med 124:917-925, 2001; Simon et al. in Arch Gen Psychiatry 52:850-856, 1995; Anderson et al. in Diabetes Care 24:1069-1078, 2001; Ciechanowski et al. in Arch Intern Med 160:3278-3285, 2000; Egede et al. in Diabetes Care 25:464-470, 2002), research has focused primarily on describing the types of interventions behavioral health providers (BHPs) employ rather than on reasons for referral, treatment initiation rates, or the patient characteristics that may impact them. This study presents the results of a multisite card study organized by The Collaborative Care Research Network, a subnetwork of the American Academy of Family Physicians' National Research Network devoted to conducting practice-based research focused on the provision of BH and health behavior services within primary care practices. The goals of the study included: (1) identifying the characteristics of patients referred for BH services; (2) codifying reasons for referral and whether patients were treated for the referral; (3) exploring any differences between patients who initiated BH contact and those who did not; and (4) assessing the types and frequency of BH services provided to patients who attended at least one appointment. Of the 200 patients referred to a BHP, 81 % had an initial contact, 71 % of which occurred on the same day. Men and women were equally likely to engage with a BHP although the time between appointments varied by gender. Depression and anxiety were the primary reasons for referral. Practice-based research is a viable strategy for advancing the knowledge about integrated primary care. PMID:24073133

  14. Integrated Bacillus sp. immobilized cell reactor and Synechocystis sp. algal reactor for the treatment of tannery wastewater.

    PubMed

    Sekaran, G; Karthikeyan, S; Nagalakshmi, C; Mandal, A B

    2013-01-01

    The wastewater discharged from leather industries lack biodegradability due to the presence of xenobiotic compounds. The primary clarification and aerobic treatment in Bacillus sp. immobilized Chemo Autotrophic Activated Carbon Oxidation (CAACO) reactor removed considerable amount of pollution parameters. The residual untreated organics in the wastewater was further treated in algal batch reactor inoculated with Synechocystis sp. Sodium nitrate, K(2)HPO(4), MgSO(4).7H(2)O, NH(4)Cl, CaCl(2)·2H(2)O, FeCl(3) (anhydrous), and thiamine hydrochloride, rice husk based activated carbon (RHAC), immobilization of Bacillus sp. in mesoporous activated carbon, sand filter of dimensions diameter, 6 cm and height, 30 cm; and the CAACO reactor of dimensions diameter, 5.5 cm and height, 30 cm with total volume 720 ml, and working volume of 356 ml. In the present investigation, the CAACO treated tannery wastewater was applied to Synechocystis sp. inoculated algal batch reactor of hydraulic residence time 24 h. The BOD(5), COD, and TOC of treated wastewater from algal batch reactor were 20 ± 7, 167 ± 29, and 78 ± 16 mg/l respectively. The integrated CAACO system and Algal batch reactor was operated for 30 days and they accomplished a cumulative removal of BOD(5),COD, TOC, VFA and sulphide as 98 %, 95 %, 93 %, 86 %, and 100 %, respectively. The biokinetic constants for the growth of algae in the batch reactor were specific growth rate, 0.095(day(-1)) and yield coefficient, 3.15 mg of algal biomass/mg of COD destructed. The degradation of xenobiotic compounds in the algal batch reactor was confirmed through HPLC and FT-IR techniques. The integrated CAACO-Algal reactor system established a credible reduction in pollution parameters in the tannery wastewater. The removal mechanism is mainly due to co-metabolism between algae and bacterial species and the organics were completely metabolized rather than by adsorption. PMID:22528997

  15. Whole-body hybrid imaging concept for the integration of PET/MR into radiation therapy treatment planning.

    PubMed

    Paulus, Daniel H; Oehmigen, Mark; Grüneisen, Johannes; Umutlu, Lale; Quick, Harald H

    2016-05-01

    Modern radiation therapy (RT) treatment planning is based on multimodality imaging. With the recent availability of whole-body PET/MR hybrid imaging new opportunities arise to improve target volume delineation in RT treatment planning. This, however, requires dedicated RT equipment for reproducible patient positioning on the PET/MR system, which has to be compatible with MR and PET imaging. A prototype flat RT table overlay, radiofrequency (RF) coil holders for head imaging, and RF body bridges for body imaging were developed and tested towards PET/MR system integration. Attenuation correction (AC) of all individual RT components was performed by generating 3D CT-based template models. A custom-built program for μ-map generation assembles all AC templates depending on the presence and position of each RT component. All RT devices were evaluated in phantom experiments with regards to MR and PET imaging compatibility, attenuation correction, PET quantification, and position accuracy. The entire RT setup was then evaluated in a first PET/MR patient study on five patients at different body regions. All tested devices are PET/MR compatible and do not produce visible artifacts or disturb image quality. The RT components showed a repositioning accuracy of better than 2 mm. Photon attenuation of  -11.8% in the top part of the phantom was observable, which was reduced to  -1.7% with AC using the μ-map generator. Active lesions of 3 subjects were evaluated in terms of SUVmean and an underestimation of  -10.0% and  -2.4% was calculated without and with AC of the RF body bridges, respectively. The new dedicated RT equipment for hybrid PET/MR imaging enables acquisitions in all body regions. It is compatible with PET/MR imaging and all hardware components can be corrected in hardware AC by using the suggested μ-map generator. These developments provide the technical and methodological basis for integration of PET/MR hybrid imaging into RT planning. PMID

  16. Whole-body hybrid imaging concept for the integration of PET/MR into radiation therapy treatment planning

    NASA Astrophysics Data System (ADS)

    Paulus, Daniel H.; Oehmigen, Mark; Grueneisen, Johannes; Umutlu, Lale; Quick, Harald H.

    2016-05-01

    Modern radiation therapy (RT) treatment planning is based on multimodality imaging. With the recent availability of whole-body PET/MR hybrid imaging new opportunities arise to improve target volume delineation in RT treatment planning. This, however, requires dedicated RT equipment for reproducible patient positioning on the PET/MR system, which has to be compatible with MR and PET imaging. A prototype flat RT table overlay, radiofrequency (RF) coil holders for head imaging, and RF body bridges for body imaging were developed and tested towards PET/MR system integration. Attenuation correction (AC) of all individual RT components was performed by generating 3D CT-based template models. A custom-built program for μ-map generation assembles all AC templates depending on the presence and position of each RT component. All RT devices were evaluated in phantom experiments with regards to MR and PET imaging compatibility, attenuation correction, PET quantification, and position accuracy. The entire RT setup was then evaluated in a first PET/MR patient study on five patients at different body regions. All tested devices are PET/MR compatible and do not produce visible artifacts or disturb image quality. The RT components showed a repositioning accuracy of better than 2 mm. Photon attenuation of  ‑11.8% in the top part of the phantom was observable, which was reduced to  ‑1.7% with AC using the μ-map generator. Active lesions of 3 subjects were evaluated in terms of SUVmean and an underestimation of  ‑10.0% and  ‑2.4% was calculated without and with AC of the RF body bridges, respectively. The new dedicated RT equipment for hybrid PET/MR imaging enables acquisitions in all body regions. It is compatible with PET/MR imaging and all hardware components can be corrected in hardware AC by using the suggested μ-map generator. These developments provide the technical and methodological basis for integration of PET/MR hybrid imaging into RT planning.

  17. Helical tomotherapy with simultaneous integrated boost dose painting for the treatment of synchronous primary cancers involving the head and neck

    PubMed Central

    Daly, M E; Cui, J; Wooten, H O; Farwell, D G; Purdy, J A

    2014-01-01

    Objective: To demonstrate the feasibility of helical tomotherapy (HT)-based intensity-modulated radiotherapy (IMRT) for the treatment of synchronous primary cancers arising from the head and neck. Methods: 14 consecutive patients with histologically proven squamous cell carcinoma of the head and neck were determined to have a second primary cancer in the upper aerodigestive tract on further evaluation and were treated with HT using simultaneous integrated boost IMRT. Megavoltage CT scans were acquired daily as part of an image-guided registration protocol. Concurrent platinum-based systemic therapy was given to nine patients (64%). Results: HT resulted in durable local control in 21 of the 28 primary disease sites irradiated, including a complete clinical and radiographic response initially observed at 17 of the 20 sites with gross tumour. The mean displacements to account for interfraction motion were 2.44 ± 1.25, 2.92 ± 1.09 and 2.31 ± 1.70 mm for the medial–lateral (ML), superior–inferior (SI) and anteroposterior (AP) directions, respectively. Table shifts of >3 mm occurred in 19%, 20% and 22% of the ML, SI and AP directions, respectively. The 2-year estimates of overall survival, local-regional control and progression-free survival were 58%, 73% and 60%, respectively. Conclusion: The effectiveness of HT for the treatment of synchronous primary cancers of the head and neck was demonstrated. Advances in knowledge: HT is a feasible option for synchronous primary cancers of the head and neck and can result in long-term disease control with acceptable toxicity in appropriately selected patients. PMID:24884726

  18. The Adolescent Mentalization-based Integrative Treatment (AMBIT) approach to outcome evaluation and manualization: adopting a learning organization approach.

    PubMed

    Fuggle, Peter; Bevington, Dickon; Cracknell, Liz; Hanley, James; Hare, Suzanne; Lincoln, John; Richardson, Garry; Stevens, Nina; Tovey, Heather; Zlotowitz, Sally

    2015-07-01

    AMBIT (Adolescent Mentalization-Based Integrative Treatment) is a developing team approach to working with hard-to-reach adolescents. The approach applies the principle of mentalization to relationships with clients, team relationships and working across agencies. It places a high priority on the need for locally developed evidence-based practice, and proposes that outcome evaluation needs to be explicitly linked with processes of team learning using a learning organization framework. A number of innovative methods of team learning are incorporated into the AMBIT approach, particularly a system of web-based wiki-formatted AMBIT manuals individualized for each participating team. The paper describes early development work of the model and illustrates ways of establishing explicit links between outcome evaluation, team learning and manualization by describing these methods as applied to two AMBIT-trained teams; one team working with young people on the edge of care (AMASS - the Adolescent Multi-Agency Support Service) and another working with substance use (CASUS - Child and Adolescent Substance Use Service in Cambridgeshire). Measurement of the primary outcomes for each team (which were generally very positive) facilitated team learning and adaptations of methods of practice that were consolidated through manualization. PMID:24595808

  19. Integrated experimental investigation and mathematical modeling of brackish water desalination and wastewater treatment in microbial desalination cells.

    PubMed

    Ping, Qingyun; Huang, Zuyi; Dosoretz, Carlos; He, Zhen

    2015-06-15

    Desalination of brackish water can provide freshwater for potable use or non potable applications such as agricultural irrigation. Brackish water desalination is especially attractive to microbial desalination cells (MDCs) because of its low salinity, but this has not been well studied before. Herein, three brackish waters prepared according to the compositions of actual brackish water in three locations in Israel were examined with domestic wastewater as an electron source in a bench-scale MDC. All three brackish waters could be effectively desalinated with simultaneous wastewater treatment. The MDC achieved the highest salt removal rate of 1.2 g L(-1) d(-1) with an initial salinity of 5.9 g L(-1) and a hydraulic retention time (HRT) of 0.8 d. The desalinated brackish water could meet the irrigation standard of both salinity (450 mg L(-1) TDS) and the concentrations of major ionic species, given a sufficient HRT. The MDC also accomplished nearly 70% removal of organic compounds in wastewater with Coulombic efficiency varied between 5 and 10%. A previously developed MDC model was improved for brackish water desalination, and could well predict salinity variation and the concentrations of individual ions. The model also simulated a staged operation mode with improved desalination performance. This integrated experiment and mathematical modeling approach provides an effective method to understand the key factors in brackish water desalination by MDCs towards further system development. PMID:25839832

  20. Benefits and risks of emerging technologies: integrating life cycle assessment and decision analysis to assess lumber treatment alternatives.

    PubMed

    Tsang, Michael P; Bates, Matthew E; Madison, Marcus; Linkov, Igor

    2014-10-01

    Assessing the best options among emerging technologies (e.g., new chemicals, nanotechnologies) is complicated because of trade-offs across benefits and risks that are difficult to quantify given limited and fragmented availability of information. This study demonstrates the integration of multicriteria decision analysis (MCDA) and life cycle assessment (LCA) to address technology alternative selection decisions. As a case study, prioritization of six lumber treatment alternatives [micronized copper quaternary (MCQ); alkaline copper quaternary (ACQ); water-borne copper naphthenate (CN); oil-borne copper naphthenate (CNo); water-borne copper quinolate (CQ); and water-borne zinc naphthenate (ZN)] for military use are considered. Multiattribute value theory (MAVT) is used to derive risk and benefit scores. Risk scores are calculated using a cradle-to-gate LCA. Benefit scores are calculated by scoring of cost, durability, and corrosiveness criteria. Three weighting schemes are used, representing Environmental, Military and Balanced stakeholder perspectives. Aggregated scores from all three perspectives show CQ to be the least favorable alterative. MCQ is identified as the most favorable alternative from the Environmental stakeholder perspective. From the Military stakeholder perspective, ZN is determined to be the most favorable alternative, followed closely by MCQ. This type of scoring and ranking of multiple heterogeneous criteria in a systematic and transparent way facilitates better justification of technology selection and regulation. PMID:25209330

  1. Integration of traditional systems and advanced oxidation process technologies for the industrial treatment of olive mill wastewaters.

    PubMed

    Amaral-Silva, Nuno; Martins, Rui C; Castro-Silva, Sérgio; Quinta-Ferreira, Rosa M

    2016-10-01

    A complete industrial treatment system (involving the integration of coagulation/flocculation and Fenton processes) to depurate real wastewaters coming from two-phase olive oil production mills has been studied. The experimental results indicated that at the end of this combined strategy, involving a primary physical separation stage followed by Fenton's chemical oxidation, chemical oxygen demand (COD) is reduced up to 90% and total polyphenols' concentration is decreased up to 92%. The treated stream biodegradability (BOD5/COD) reached 0.52 and the Total Suspended Solids (TSSs) and Total Dissolved Solids (TDSs) decreased up to 95% and 69%, respectively. Fenton's procedure was optimized bearing in mind the pH adjustment step, different procedures for hydrogen peroxide addition and the use of coagulants instead of the chemical precipitation (by raising pH) to promote iron sludge settling. Our results demonstrated that pH (3.0 ± 0.1) control during the oxidation reaction improves the oxidation efficiency. Moreover, the final NaOH addition is essential to a better sludge formation and consequent precipitation of the residual iron removing also some organic matter. PMID:26878594

  2. Efficiency assessment of wastewater treatment plants: A data envelopment analysis approach integrating technical, economic, and environmental issues.

    PubMed

    Castellet, Lledó; Molinos-Senante, María

    2016-02-01

    The assessment of the efficiency of wastewater treatment plants (WWTPs) is essential to compare their performance and consequently to identify the best operational practices that can contribute to the reduction of operational costs. Previous studies have evaluated the efficiency of WWTPs using conventional data envelopment analysis (DEA) models. Most of these studies have considered the operational costs of the WWTPs as inputs, while the pollutants removed from wastewater are treated as outputs. However, they have ignored the fact that each pollutant removed by a WWTP involves a different environmental impact. To overcome this limitation, this paper evaluates for the first time the efficiency of a sample of WWTPs by applying the weighted slacks-based measure model. It is a non-radial DEA model which allows assigning weights to the inputs and outputs according their importance. Thus, the assessment carried out integrates environmental issues with the traditional "techno-economic" efficiency assessment of WWTPs. Moreover, the potential economic savings for each cost item have been quantified at a plant level. It is illustrated that the WWTPs analyzed have significant room to save staff and energy costs. Several managerial implications to help WWTPs' operators make informed decisions were drawn from the methodology and empirical application carried out. PMID:26686068

  3. Hypofractionated high-dose irradiation for the treatment of malignant astrocytomas using simultaneous integrated boost technique by IMRT

    SciTech Connect

    Iuchi, Toshihiko; Hatano, Kazuo; Narita, Yuichiro; Kodama, Takashi; Yamaki, Tomohiro; Osato, Katsunobu

    2006-04-01

    Purpose: We evaluated the clinical significance of hypofractionated high-dose irradiation using simultaneous integrated boost technique with intensity-modulated radiation therapy (IMRT) for the treatment of malignant astrocytomas (MAs). Methods and Materials: Twenty-five patients with MAs were treated by IMRT. Three layered planning target volumes (PTVs) were contoured. PTV-1 was the area of enhanced lesion with 5-mm margin; PTV-2 was the area with 15-mm margin surrounding the PTV-1; PTV-3 was the area of perifocal edema. Irradiation was performed in 8 fractions, and only the dose for PTV-1 was escalated from 48 Gy to 68 Gy while maintaining the dose for PTV-2 (40 Gy) and PTV-3 (32 Gy). The clinical outcome of IMRT was compared with 60 MA patients treated by conventional external beam irradiation (EBI). Results: The progression-free survival of patients in the IMRT group was significantly longer than that in the EBI group (p < 0.0001). No distant failure was observed in both groups. In the IMRT group, dissemination was the most frequent cause of death (70%). The overall survival of patients in the IMRT group was better than that in the EBI group (p = 0.043). Conclusions: Our regimen of IMRT contributed to the control of both the regional and infiltrating tumors, resulting in better survival of patients.

  4. Risk assessment, disease prevention and personalised treatments in breast cancer: is clinically qualified integrative approach in the horizon?

    PubMed Central

    2013-01-01

    Breast cancer is a multifactorial disease. A spectrum of internal and external factors contributes to the disease promotion such as a genetic predisposition, chronic inflammatory processes, exposure to toxic compounds, abundant stress factors, a shift-worker job, etc. The cumulative effects lead to high incidence of breast cancer in populations worldwide. Breast cancer in the USA is currently registered with the highest incidence rates amongst all cancer related patient cohorts. Currently applied diagnostic approaches are frequently unable to recognise early stages in tumour development that impairs individual outcomes. Early diagnosis has been demonstrated to be highly beneficial for significantly enhanced therapy efficacy and possibly full recovery. Actual paper shows that the elaboration of an integrative diagnostic approach combining several levels of examinations creates a robust platform for the reliable risk assessment, targeted preventive measures and more effective treatments tailored to the person in the overall task of breast cancer management. The levels of examinations are proposed, and innovative technological approaches are described in the paper. The absolute necessity to create individual patient profiles and extended medical records is justified for the utilising by routine medical services. Expert recommendations are provided to promote further developments in the field. PMID:23418957

  5. Development of a Novel Process Integrating the Treatment of Sludge Reject Water and the Production of Polyhydroxyalkanoates (PHAs).

    PubMed

    Frison, Nicola; Katsou, Evina; Malamis, Simos; Oehmen, Adrian; Fatone, Francesco

    2015-09-15

    Polyhydroxyalkanoates (PHAs) from activated sludge and renewable organic material can become an alternative product to traditional plastics since they are biodegradable and are produced from renewable sources. In this work, the selection of PHA storing bacteria was integrated with the side stream treatment of nitrogen removal via nitrite from sewage sludge reject water. A novel process was developed and applied where the alternation of aerobic-feast and anoxic-famine conditions accomplished the selection of PHA storing biomass and nitrogen removal via nitrite. Two configurations were examined: in configuration 1 the ammonium conversion to nitrite occurred in the same reactor in which the PHA selection process occurred, while in configuration 2 two separate reactors were used. The results showed that the selection of PHA storing biomass was successful in both configurations, while the nitrogen removal efficiency was much higher (almost 90%) in configuration 2. The PHA selection degree was evaluated by the volatile fatty acid (VFA) uptake rate (-qVFAs) and the PHA production rate (qPHA), which were 239 ± 74 and 89 ± 7 mg of COD per gram of active biomass (Xa) per hour, respectively. The characterization of the biopolymer recovered after the accumulation step, showed that it was composed of 3-hydroxybutyrate (3HB) (60%) and 3-hydroxyvalerate (3HV) (40%). The properties associated with the produced PHA suggest that they are suitable for thermoplastic processing. PMID:26270064

  6. Enhanced treatment of tannery wastewater in an integrated multistage bioreactor (IMBR) by the predominant bacterial strains enriched from marine sediments.

    PubMed

    Huang, Guangdao; Fan, Guofeng; Liu, Guoguang

    2016-01-01

    An innovative integrated multistage bioreactor (IMBR) system, which was augmented with three predominant bacterial strains (Lactobacillus paracasei CL1107, Pichia jadinii CL1705, and Serratia marcescens CL1502) isolated from marine sediments, was developed to treat real tannery wastewater without performing physicochemical pretreatment, with the potential to reduce the generation of waste sludge and odors. The performance of the IMBR treatment system, with and without the inclusion of the predominant bacterial strains, was compared. The results indicated that the performance of the IMBR system without bioaugmentation by the predominant bacterial strains was poor. However, when in the presence of the predominant bacterial strains, the IMBR system exhibited high removal efficiencies of chemical oxygen demand (COD) (97%), NH4(+)-N (97.7%), and total nitrogen (TN) (90%). In addition, the system had the capacity for the simultaneous removal of organics and nitrogen, heterotrophic nitrification and denitrification being carried out concurrently, thereby avoiding the strong inhibition of high concentrations of COD on nitrification. The system possessed excellent adaptability and ability to resist influent loading fluctuations, and had a good alkalinity balance such that it could achieve a high NH4(+)-N, and TN removal efficiency without a supplement of external alkalinity. In addition, an empirical performance modeling of the IMBR system was analyzed. PMID:26901723

  7. [Implementation of the multi-site Integrated Psychological Treatment (IPT) program for people with schizophrenia. Elaboration of renewed version].

    PubMed

    Briand, Catherine; Bélanger, René; Hamel, Virginie; Nicole, Luc; Stip, Emmanuel; Reinharz, Daniel; Lalonde, Pierre; Lesage, Alain

    2005-01-01

    Brenner's Integrated Psychological Treatment (IPT) program (Brenner et al., 1992 ; Pomini et al., 1998), a cognitive-behavioural approach, was implemented in nine of Quebec's clinical settings that treat people with schizophrenia. A study allowed an evaluation of the IPT program in each location, with emphasis on the level of satisfaction of both participants and professionals, the program's strong points, and areas where improvements were needed. The results have shown that the implementation of the program has been successful in all nine clinical settings. Professionals and participants appreciated the IPT program not only for its hierarchic structure that considers the rehabilitation needs of people affected by schizophrenia, but also for its customised application framework, which allows a regular follow-up of a similar group of patients over the course of a one year period. As a result of this study, the modifications proposed and additions have enabled the creation of a Quebec version of the IPT program, which better achieves its objectives, particularly those relating to the maintenance and generalisation of social learning in the context of a participant's real-life situation. PMID:16170424

  8. The effects of integrated treatment of UV light and low dose gamma radiation on Escherichia coli O157:H7 and Salmonella enterica on grape tomatoes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In recent years considerable numbers of foodborne disease outbreaks associated with produce were reported and specifically Tomatoes have been involved with a number of multi state outbreaks. The purpose of this study was to evaluate efficacy of integrated treatment of UVC and low dose Gamma radiatio...

  9. Functional Analytic Psychotherapy Is a Framework for Implementing Evidence-Based Practices: The Example of Integrated Smoking Cessation and Depression Treatment

    ERIC Educational Resources Information Center

    Holman, Gareth; Kohlenberg, Robert J.; Tsai, Mavis; Haworth, Kevin; Jacobson, Emily; Liu, Sarah

    2012-01-01

    Depression and cigarette smoking are recurrent, interacting problems that co-occur at high rates and--especially when depression is chronic--are difficult to treat and associated with costly health consequences. In this paper we present an integrative therapeutic framework for concurrent treatment of these problems based on evidence-based…

  10. Efficacy of integrated treatment of UV light and low dose gamma irradiation on Escherichia coli O157:H7 and Salmonella enterica on grape tomatoes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Efficacy of integrated treatment of UVC and low dose Gamma irradiation to inactivate mixed Strains of Escherichia coli O157:H7 and Salmonella enterica inoculated on whole Grape tomatoes was evaluated. A mixed bacterial cocktail composed of a three strain mixture of E. coli O157:H7 (C9490, E02128 an...

  11. Development of an integrated, in-situ remediation technology: Task 1 -- Evaluation of treatment zone formation options. Topical report, September 26, 1994--May 25, 1996

    SciTech Connect

    Shoemaker, S.H.; Landis, R.C.; Griffith, R.J.; Schultz, D.S.; Quinton, G.E.

    1997-05-01

    Contamination in low permeability soils poses a significant technical challenge to in-situ remediation efforts. Poor accessibility to the contaminants and difficulty in delivery of treatment reagents have rendered existing in-situ treatments such as bioremediation, vapor extraction, pump and treat rather ineffective when applied to low permeability soils present at many contaminated sites. The technology is an integrated in-situ treatment in which established geotechnical methods are used to install degradation zones directly in the contaminated soil and electro-osmosis is utilized to move the contaminants back and forth through those zones until the treatment is completed. This topical report presents the results of evaluations by E.I. duPont de Nemours and Co., Inc. of treatment zone and electrode emplacement alternatives for use in the integrated treatment process. Specifically, the scope of this study was limited to vertical configuration emplacements. Several promising alternatives were identified ranging from approaches involving standard excavation techniques to relatively specialized geotechnical construction methods which could be modified for the treatment zone emplacement purpose. Information developed in this report is designed to help the user select the most promising emplacement method(s) for a given site on the basis of (1) depth of emplacement, and (2) restrictions on handling excavated soils. Advantages, disadvantages, and estimated costs are identified for each alternative, and possible bases for improvement and cost reduction through further development are described.

  12. Large-scale demonstration of the sulfate reduction autotrophic denitrification nitrification integrated (SANI(®)) process in saline sewage treatment.

    PubMed

    Wu, Di; Ekama, George A; Chui, Ho-Kwong; Wang, Bo; Cui, Yan-Xiang; Hao, Tian-Wei; van Loosdrecht, Mark C M; Chen, Guang-Hao

    2016-09-01

    Recently, the Sulfate reduction Autotrophic denitrification Nitrification Integrated (SANI(®)) process was developed for the removal of organics and nitrogen with sludge minimization in the treatment of saline sewage (with a Sulfate-to-COD ratio > 0.5 mg SO4(2-)-S/mg COD) generated from seawater used for toilet flushing or salt water intrusion. Previously investigated in lab- and pilot-scale, this process has now been scaled up to a 800-1000 m(3)/d full-scale demonstration plant. In this paper, the design and operating parameters of the SANI demo plant built in Hong Kong are analyzed. After a 4-month start-up period, a stable sulfur cycle-based biological nitrogen removal system having a hydraulic retention time (HRT) of 12.5 h was developed, thereby reducing the amount of space needed by 30-40% compared with conventional activated sludge (CAS) plants in Hong Kong. The demo plant satisfactorily met the local effluent discharge limits during both the summer and winter periods. In winter (sewage temperature of 21 ± 1 °C), the maximum volumetric loading rates for organic conversion, nitrification, and denitrification were 2 kg COD/(m(3)·d), 0.39 kg N/(m(3)·d), and 0.35 kg N/(m(3)·d), respectively. The biological sludge production rate of SANI process was 0.35 ± 0.08 g TSSproduced/g BOD5 (or 0.19 ± 0.05 g TSS/g COD), which is 60-70% lower than that of the CAS process in Hong Kong. While further process optimization is possible, this study demonstrates the SANI process can be potentially implemented for the treatment of saline sewage. PMID:27232994

  13. Comparison of whole-field simultaneous integrated boost VMAT and IMRT in the treatment of nasopharyngeal cancer

    SciTech Connect

    Jin, Xiance; Yi, Jinling; Zhou, Yongqiang; Yan, Huawei; Han, Ce; Xie, Congying

    2013-01-01

    To study the feasibility of using volumetric-modulated arc therapy (VMAT) to deliver whole-field simultaneous integrated boost (WF-SIB) to treat patients with nasopharyngeal cancer (NPC). WF-SIB intensity-modulated radiotherapy (IMRT) plans, one-arc WF-SIB VMAT plans, and two-arc WF-SIB VMAT plans were generated with identical objective functions for 8 patients with NPC of various stages. Isodose distributions and dose-volume histograms were evaluated. Dosimetric and biological quality indices of clinical target volume (CTV) and organs at risk (OARs) were calculated to study the optimization capability of these 3 modalities in the treatment of patients with NPC. The optimization time, delivery time, required monitor units (MUs), and delivery accuracy were also compared to investigate the feasibility of these 3 modalities. There was no significant difference (p = 0.92) in target coverage (TC) between WF-SIB IMRT (99.00 ± 0.79) and two-arc WF-SIB VMAT (97.98 ± 1.29). However, both had higher TC than one-arc VMAT plans (89.92 ± 6.32, p < 0.01). IMRT demonstrated the best protection of the spinal cord, whereas two-arc VMAT showed the minimum D{sub max} to OARs. No other significant differences were observed among these 3 modalities on CTV coverage and OAR sparing. The delivery and MU efficiency of one-arc and two-arc WF-SIB VMAT were greatly improved compared with WF-SIB IMRT. The optimization time of one-arc and two-arc WF-SIB VMAT plans were 5 and 10 times greater than that of WF-SIB IMRT, respectively. The delivery accuracy of WF-SIB VMAT was not affected by the increased freedom. For patients with NPC, one-arc WF-SIB VMAT might not be able to achieve sufficient TC, whereas two-arc WF-SIB VMAT was able to achieve reasonable TC. No significant advantage on OAR protection was demonstrated by VMAT compared with IMRT. WF-SIB VMAT has significantly shorter delivery times, but WF-SIB IMRT may still be the first treatment choice for patients with NPC.

  14. Radioactive Air Emissions Notice of Construction for the 105-KW Basin integrated water treatment system filter vessel sparging vent

    SciTech Connect

    Kamberg, L.D.

    1998-02-23

    This document serves as a notice of construction (NOC), pursuant to the requirements of Washington Administrative Code (WAC) 246-247-060, and as a request for approval to construct, pursuant to 40 Code of Federal Regulations (CFR) 61.07, for the Integrated Water Treatment System (IWTS) Filter Vessel Sparging Vent at 105-KW Basin. Additionally, the following description, and references are provided as the notices of startup, pursuant to 40 CFR 61.09(a)(1) and (2) in accordance with Title 40 Code of Federal Regulations, Part 61, National Emission Standards for Hazardous Air Pollutants. The 105-K West Reactor and its associated spent nuclear fuel (SNF) storage basin were constructed in the early 1950s and are located on the Hanford Site in the 100-K Area about 1,400 feet from the Columbia River. The 105-KW Basin contains 964 Metric Tons of SNF stored under water in approximately 3,800 closed canisters. This SNF has been stored for varying periods of time ranging from 8 to 17 years. The 105-KW Basin is constructed of concrete with an epoxy coating and contains approximately 1.3 million gallons of water with an asphaltic membrane beneath the pool. The IWTS, which has been described in the Radioactive Air Emissions NOC for Fuel Removal for 105-KW Basin (DOE/RL-97-28 and page changes per US Department of Energy, Richland Operations Office letter 97-EAP-814) will be used to remove radionuclides from the basin water during fuel removal operations. The purpose of the modification described herein is to provide operational flexibility for the IWTS at the 105-KW basin. The proposed modification is scheduled to begin in calendar year 1998.

  15. Analytical treatment of two-center overlap integral with respect to same screening constants over Slater type orbitals

    NASA Astrophysics Data System (ADS)

    Ćopuroǧlu, Ebru; Mamedov, Bahtiyar A.

    2016-08-01

    By the use of Löwdin- α radial function, an alternative method is introduced for two-center overlap integral over Slater type orbitals (STOs) at same screening constants (SSC). Notice that the overlap integrals with SSC have an important role in accurate evaluation of multicenter multielectron molecular integrals arising in combined Hartree-Fock-Roothaan (CHFR) theory. This approximation provides us simple and efficient expression for the two-center overlap integrals. To show the effectiveness of established formula we have compared our results with available literature data. The method ensures high performance with a very short CPU time.

  16. Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma

    SciTech Connect

    Wootton, Jeffery H.; Hsu, I-Chow Joe; Diederich, Chris J.

    2011-02-15

    Purpose: The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Methods: Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6-7.4 MHz that are unsectored (360 deg.), bisectored (2x180 deg.), or trisectored (3x120 deg.) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. Results: The CTV in HDR brachytherapy plans extends 20.5{+-}5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4{+-}7.3 mm from the tandem. Simulations indicate that for 60

  17. Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma

    PubMed Central

    Wootton, Jeffery H.; Hsu, I-Chow Joe; Diederich, Chris J.

    2011-01-01

    Purpose: The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Methods: Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6–7.4 MHz that are unsectored (360°), bisectored (2×180°), or trisectored (3×120°) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. Results: The CTV in HDR brachytherapy plans extends 20.5±5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4±7.3 mm from the tandem. Simulations indicate that for 60 min

  18. Integration of a kraft pulping mill into a forest biorefinery: pre-extraction of hemicellulose by steam explosion versus steam treatment.

    PubMed

    Martin-Sampedro, Raquel; Eugenio, Maria E; Moreno, Jassir A; Revilla, Esteban; Villar, Juan C

    2014-02-01

    Growing interest in alternative and renewable energy sources has brought increasing attention to the integration of a pulp mill into a forest biorefinery, where other products could be produced in addition to pulp. To achieve this goal, hemicelluloses were extracted, either by steam explosion or by steam treatment, from Eucalyptus globulus wood prior to pulping. The effects of both pre-treatments in the subsequent kraft pulping and paper strength were evaluated. Results showed a similar degree of hemicelluloses extraction with both options (32-67% of pentosans), which increased with the severity of the conditions applied. Although both pre-treatments increased delignification during pulping, steam explosion was significantly better: 12.9 kappa number vs 22.6 for similar steam unexploded pulps and 40.7 for control pulp. Finally, similar reductions in paper strength were found regardless of the type of treatment and conditions assayed, which is attributed to the increase of curled and kinked fibers. PMID:24368272

  19. Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections: A 33 months follow up study

    PubMed Central

    2011-01-01

    Background The geographical congruency in distribution of helminths and Plasmodium falciparum makes polyparasitism a common phenomenon in Sub Saharan Africa. The devastating effects of helminths-Plasmodium co-infections on primary school health have raised global interest for integrated control. However little is known on the feasibility, timing and efficacy of integrated helminths-Plasmodium control strategies. A study was conducted in Zimbabwe to evaluate the efficacy of repeated combined school based antihelminthic and prompt malaria treatment. Methods A cohort of primary schoolchildren (5-17 years) received combined Praziquantel, albendazole treatment at baseline, and again during 6, 12 and 33 months follow up surveys and sustained prompt malaria treatment. Sustained prompt malaria treatment was carried out throughout the study period. Children's infection status with helminths, Plasmodium and helminths-Plasmodium co-infections was determined by parasitological examinations at baseline and at each treatment point. The prevalence of S. haematobium, S. mansoni, STH, malaria, helminths-Plasmodium co-infections and helminths infection intensities before and after treatment were analysed. Results Longitudinal data showed that two rounds of combined Praziquantel and albendazole treatment for schistosomiasis and STHs at 6 monthly intervals and sustained prompt malaria treatment significantly reduced the overall prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum infection in primary schoolchildren by 73.5%, 70.8%, 67.3% and 58.8% respectively (p < 0.001, p < 0.001, p < 0.001, p < 0.001 respectively). More importantly, the prevalence of STH + schistosomes, P. f + schistosomes, and P. f + STHs + schistosomes co-infections were reduced by 68.0%, 84.2%, and 90.7%, respectively. The absence of anti-helminthic treatment between the 12 mth and 33 mth follow-up surveys resulted in the sharp increase in STHs + schistosomes co-infection from 3.3% at 12 months

  20. Colour and toxic characteristics of metakaolinite-hematite pigment for integrally coloured concrete, prepared from iron oxide recovered from a water treatment plant of an abandoned coal mine

    NASA Astrophysics Data System (ADS)

    Sadasivam, Sivachidambaram; Thomas, Hywel Rhys

    2016-07-01

    A metakaolinite-hematite (KH) red pigment was prepared using an ocherous iron oxide sludge recovered from a water treatment plant of an abandoned coal mine. The KH pigment was prepared by heating the kaolinite and the iron oxide sludge at kaolinite's dehydroxylation temperature. Both the raw sludge and the KH specimen were characterised for their colour properties and toxic characteristics. The KH specimen could serve as a pigment for integrally coloured concrete and offers a potential use for the large volumes of the iron oxide sludge collected from mine water treatment plants.